Chapter 2, 3, 4, 5, 6, 7: Critical thinking and nursing process - Davis

Which of the nurse's questions demonstrates critical thinking? "Have I gathered enough data to make a decision?" "Where do I document my findings?" "When does the nursing intervention need to be performed?" "What assessments must be done?"

"Have I gathered enough data to make a decision?" evaluating the nurse's own performance to make sure enough data has been collected demonstrates critical thinking

Which statement best reflects a critical-thinking philosophy being taught to a nursing student? "Think about different interventions that can be used with this client." "Dig deeper until you reach a single solution." "Don't rely on subjective information; use objective analysis to determine the best protocol." "Trust your gut and go with what you know to be correct."

"Think about different interventions that can be used with this client." critical thinkers about the multiple scenarios quickly and develop a plan for all anticipated problems and outcomes

Which is the best example of intellectual courage? A nurse fairly examines his or her own values and beliefs even when uncomfortable. A nurse does not jump to conclusions right away but thinks through all the options before acting. A nurse admits he or she does not have all of the answers and is willing to ask for assistance from others. A nurse tries to understand the feelings of other people and visualize a situation from their vantage points. 8551

A nurse fairly examines his or her own values and beliefs even when uncomfortable. Intellectual courage is a critical thinking attitudes in which the nurse looks at his or her own values and puts those aside to determine the best options

The registered nurse is educating a student nurse about critical thinking when caring for clients. Which action made by the graduate nurse indicates the use of critical thinking? Analyzing a client's temperature changes and assessing for signs of infection Filling out food selections on the menu with the client to determine food preferences Ensuring the bed is in a low and locked position and the call light is in reach prior to leaving the client's room Asking the client to verify his or her name and date of birth prior to medication administration

Analyzing a client's temperature changes and assessing for signs of infection (when the graduate study analyzes the temperature changes and then performs further assessments looking for signs of infection, this indicates the use of critical thinking)

The nurse enters a client's room to obtain a fasting blood glucose reading and notices the breakfast tray is in front of the client. Which action best indicates the nurse using critical thinking? Obtaining the blood glucose reading and documenting the client is halfway through breakfast Asking the client if he or she has eaten any food yet Deferring the blood glucose reading until the next time it is scheduled Notifying the health-care provider that the client has eaten prior to the blood glucose reading

Asking the client if he or she has eaten any food yet (nurse understands the need to obtain more information before making a decision, demonstrating critical thinking)

A client tells the nurse that the hospital food is "terrible." The nurse asks what foods the client would prefer based on his cultural customs. She then contacts the dietary department to determine whether adjustments can be made. After the next meal, the nurse asks the client whether the food has improved. CRITICAL THINKING NOT CRITICAL THINKING

CRITICAL THINKING The nurse has identified a problem, assessed the client's individual needs, made adjustments to care, and evaluated whether the changes were effective.

The nurse recognizes that the client has crackles in the lower lung fields from an accumulation of fluid. He further explores the patient's weight, intake and output, and medication list before documenting the findings. CRITICAL THINKING NOT CRITICAL THINKING

CRITICAL THINKING Further inquiry allows the nurse to determine the severity of the findings and whether additional intervention is necessary.

A nurse decides to place the intravenous catheter into the client's left arm because he is right handed. CRITICAL THINKING NOT CRITICAL THINKING

CRITICAL THINKING Taking patient considerations into account when inserting an intravenous catheter demonstrates critical thinking.

The nurse discovers abnormal findings when performing a physical assessment. She reviews the electronic health record, comparing the findings, and calls the healthcare provider with the contrasting information. The nurse practitioner then gives new medication orders. CRITICAL THINKING NOT CRITICAL THINKING

CRITICAL THINKING The nurse performed further investigation to determine whether the findings were new or had been previously reported. Further reporting identified that additional follow-up was required.

The nurse delivers the first dose of a new blood pressure medicine that the client has not taken previously. She assesses the blood pressure before delivery of the medication and 1 hour afterward. Prior to the second dosage, the patient's blood pressure is very low and the nurse decides to hold the medication. CRITICAL THINKING NOT CRITICAL THINKING

CRITICAL THINKING With the patient's best interest in mind, the nurse has gathered data, evaluated the data, and made decisions based on the information.

Which of the following exemplify critical thinking? Select all that apply. Decision making following data evaluation Always delivering medications as ordered Following a step-by-step procedure Collecting data and recording findings Accounting for patient considerations

Decision making following data evaluation Accounting for patient considerations

A client is processing information regarding a new diagnosis and the treatment the physician has recommended. The client's family has provided excessive input and are attempting to have the nurse "convince" the client to see things their way. Which critical thinking attitude should the nurse present? Independent thinking Fair-mindedness Intellectual empathy Intellectual courage

Fair-mindedness (critical thinkers try to make impartial judgements, treating all viewpoints fairly, realizing that personal biases, customs, and social pressures can influence their thinking)

A nurse is working in a health-care facility with a protocol of having clients who have pneumonia turn, cough, and deep breathe. This nurse is assigned to care for a client admitted with pneumonia but does not encourage the client to cough because the client also has esophageal varices from cirrhosis. Which aspect of critical thinking is this nurse using to guide client care? Client's roles Client's culture Individual differences Multiple and varying concerns

Individual differences (clients may have comorbidities that prevent the nurse from following evidence-based practice. Esophageal varices from cirrhosis contraindicated coughing to clear secretions because this could cause a massive upper gastrointestinal bleed. The nurse is using critical thinking and taking into the account the individual differences of this client )

A nurse with several years of experience in the intensive care unit obtains a new job in the newborn nursery at the health-care facility. Which critical thinking attitude would be best for the nurse to employ in this new setting when asking for guidance? Intellectual humility Intellectual empathy Fair-mindedness Intellectual courage

Intellectual humility (a nurse in a new care setting may use intellectual humility when asking for help during orientation or work)

For each scenario, decide whether the nurse is using critical thinking or not.The unlicensed assistive personnel reports to the nurse that the blood pressure for a client is very low. The nurse reports the information to the next shift. CRITICAL THINKING NOT CRITICAL THINKING

NOT CRITICAL THINKING A critical-thinking nurse would question the results, reevaluate the findings, and confirm that the information is correct. If the findings are correct, the critical-thinking nurse would then determine next steps.

Without assistance, a student ambulates a client in the hallway who recently returned from surgery. CRITICAL THINKING NOT CRITICAL THINKING

NOT CRITICAL THINKING Clients can be unstable after surgery and there are several reasons for concern, including dizziness, incisional damage, bleeding, and changes in vital signs. The nurse must be aware of the individual client's needs when determining when and how to ambulate the client for the first time after surgery.

This or That? For each scenario, decide whether the nurse is using critical thinking or not. The nurse gathers equipment for the insertion of a Foley catheter, obtains a verbal consent from the client, and follows the agency's procedure to complete the task. CRITICAL THINKING NOT CRITICAL THINKING

NOT CRITICAL THINKING The nurse is completing a task that follows a specific step-by-step procedure and thus does not require critical thinking.

The student explores the client's health record, reads the history and physical examination, and records the information on the nursing care plan. CRITICAL THINKING NOT CRITICAL THINKING

NOT CRITICAL THINKING The process of data collection and recording do not require critical-thinking skills.

A registered nurse is instructing nursing students about incorporating critical thinking into client care. Which attributes will the registered nurse include during this lesson? Select all that apply. Need to find the truth Openness to other options Use of reasoned thinking Capacity to reflect on situations Ability to delegate tasks to others Ability to convey important information

Need to find the truth Openness to other options Use of reasoned thinking Capacity to reflect on situations

Which nursing action is part of the evaluation phase when performing wound care for a client? Obtaining wound measurements once a week Irrigating the wound with normal saline Observing the drainage of the fresh wound Discussing goals for wound management with the client

Obtaining wound measurements once a week (obtaining wound measurements weekly is part of evaluating the progress of the wound healing)

How can a student develop critical-thinking skills? Select all that apply. Study with a peer to compare class notes. Play "what if?" multiple times a day. Come to class daily. Question each test item, asking why it was incorrect. Complete all of the questions at the end of the book chapter.

Play "what if?" multiple times a day. Question each test item, asking why it was incorrect.

Which nursing action reflects the nurse assisting the client in maintaining belief? Bathing and dressing the client Making eye contact with the client Providing encouragement to a client with a new amputation Listening to the client's feelings about the amputation

Providing encouragement to a client with a new amputation (this allows the client to maintain beliefs)

The nurse completes the critical-thinking process but the client's care outcome has been only partially met. What should be the nurse's next action? Share the process with a peer so he or she can make decisions the same way. Reevaluate the plan to determine whether it was realistic. Consider the process complete. Repeat the same thinking process for the next client.

Reevaluate the plan to determine whether it was realistic.

Which critical thinking skills will a nurse utilize when reviewing the health record of a new client to prepare a nursing diagnosis? Select all that apply. Visualizing potential solutions to a problem Prioritizing or ranking data as needed Thinking independently with curiosity and perseverance Separating relevant from irrelevant data Documenting assessment findings in the health record

Visualizing potential solutions to a problem Prioritizing or ranking data as needed (data such as orders written from physician and diagnostic testings, are skills of a critical thinker) Separating relevant from irrelevant data (able to separate relevant from irrelevant information, allowing for an accurate nursing diagnosis and process)

The steps of critical thinking include which of the following? Select all that apply. Perform Analyze Assume Identify Explore

analyze identify explore

Which of the following describe the decision-making process of a nurse? Simplistic list of options Innate process of thinking Methodical linear process Complex maze of alternatives

complex maze of alternatives