Deck 11: Critical Thinking and the Nursing Process

Question 1

A nurse who just moved from an urban area to a sparsely populated rural area understands that certain customs and practices the nurse is familiar with may be quite foreign to the people in the new area. This nurse is practicing which of the attitudes of critical thinking?

A) Intellectual humility.
B) Fair-mindedness.
C) Intellectual courage to challenge the status quo and rituals.
D) Insight into egocentricity.

Answer 1

Insight into egocentricity.

Question 2

A nurse uses an example of divergent thinking, when a client states, "I think I have a tumour", by saying:

A) "I am sure the doctor can fix that."
B) "Have you updated your will and financial interests?"
C) "Do you have much pain with it?"
D) "What do you mean by 'tumour'?"

Answer 2

"What do you mean by 'tumour'?"

Question 3

A client comes into the clinic with complaints of "extreme" low back pain after helping to move a heavy object. The client is pale and diaphoretic and walks bent at the waist. Before taking vital signs, the nurse projects that the blood pressure as well as heart rate will be elevated. This is an example of which of the following?

A) Inference.
B) Opinion.
C) Fact.
D) Judgment.

Answer 3

Inference.

Question 4

A rehab client has a treatment plan for active range of motion exercises to her shoulder following a stroke. The client doesn't like to do these because they are uncomfortable and she has little insight into the treatment. Which of the following demonstrates the critical-thinking component of creativity?

A) The ability to develop and implement new and better solutions.
B) The explanation to the client that the treatment plan will help.
C) The need to have some knowledge of the presenting problem.
D) Implementing previously tried solutions.

Question 5

A new graduate nurse learns a quicker way to set up and initiate an IV. This graduate nurse still follows safe practice, but implements changes that help with time management. This nurse is practicing which of the attitudes of critical thinking?

A) Independence.
B) Intellectual courage to challenge the status quo or rituals.
C) Confidence.
D) Integrity.

Question 6

Nurses must use critical thinking in their day-to-day practice, especially in circumstances surrounding client care and wise use of resources. In which of the following situations would critical thinking be most beneficial?

A) Teaching new parents car seat safety.
B) Administering IV push medications to critically ill clients.
C) When unexpected situations arise.
D) Assisting an orthopaedic client with the proper use of crutches.

Question 7

A nurse continues to question the practice of administering rectal suppositories to residents in a long-term care facility at bedtime, rather than earlier in the day. She is told that this is the best time for staff and that's the routine that has been practiced for a long time. The nurse continues to research whether there would be a better time, especially in the best interest of the residents. This nurse is practicing which of the critical-thinking attitudes?

A) Integrity.
B) Perseverance.
C) Curiosity.
D) Confidence.

Question 8

A nurse educator has always believed that lectures with focused outlines are the best way to present theory content in class. A colleague, who teaches the same group of students, but a different subject, utilises group work and in-class activities to teach difficult content and finds that students perform as well, or better, on their tests. The first educator in this situation is starting to rethink her position. This is an example of which of the following?

A) Perseverance.
B) Humility.
C) Integrity.
D) Fair-mindedness.

Question 9

A client has just been admitted, is complaining of shortness of breath, has no pallor, no cyanosis and no accessory muscle use with respirations. The client's respiratory rate is 16 breaths per minute. The nurse is performing the assessment and continues to ask herself how the client's report and the physical findings conflict. This nurse is using which universal standard of critical thinking?

A) Logicalness.
B) Significance.
C) Accuracy.
D) Clarity.

Question 10

A nurse is checking over the past charting of the previous shift, paying special attention to how a particular client responded to nursing interventions throughout the day. The nurse is caring for this client and wants to see what has been effective, as well as what didn't work. This nurse is utilising which of the steps of the decision-making process?

A) Implement.
B) Examine alternatives.
C) Set the criteria.
D) Evaluate the outcome.

Question 11

A client comes into the emergency department (ED) with a productive cough, audible coarse crackles, elevated temperature of 40.2 °C, high respiratory rate, chills and body aches. The nurse identifies the problem as respiratory compromise. The nurse is using which of the following?

A) Deductive reasoning.
B) Socratic questioning.
C) Critical analysis.
D) Inductive reasoning.

Question 12

A seasoned nurse works in a busy ICU unit. When a particularly complex client is admitted, the nurse uses past experiences and knowledge gained from those situations to help care for this client. This nurse is practicing which of the attributes of critical thinking?

A) Time.
B) Dialogue.
C) Planned care.
D) Reflection.

Question 13

A nurse is interviewing a client who claims that she refuses to have immunisations because they are harmful. Using Socratic questioning about this assumption, the nurse would state:

A) "All immunisations are safe."
B) "Have you ever had any communicable diseases?"
C) "What makes you assume that vaccines are unsafe?"
D) "How are immunisations harmful?"

Question 14

A nurse is caring for a client who has unstable cardiac dysrhythmias. The client has orders for medications, one of which is by oral route, the other by IV delivery. The nurse realises that the IV route would be fastest, but is also concerned about the side effects that this drug may produce and the fact that the client has never taken the drug, so any adverse effect is unknown. The nurse is implementing which step of the decision-making process?

A) Implement.
B) Identify the purpose.
C) Project.
D) Seek alternatives.

Question 15

An experienced nurse educator senses that a student has been struggling with clinical skills learned in lab. In the clinical area, this student is usually lagging behind and seems to be minimally involved when the other students have opportunities to perform some of the tasks. The educator pairs the student with a particularly outgoing staff nurse who has a number of unique clients with a variety of treatments and cares. The educator is utilising which step in the decision-making process?

A) Trial and error.
B) Seeking alternatives.
C) Weighting.
D) Research project.

Question 16

A nurse is completing a plan of care for a client. The statement, "Client will be able to walk three metres, twice a day without shortness of breath", is which part of the nursing process (in comparison to the decision-making process)?

A) Assess.
B) Plan.
C) Evaluate.
D) Diagnose.

Question 17

A nurse is taking an admission history from a client who is easily distracted and offers much information about his health and social history. Although careful to document what the client relates, the nurse sorts out the relevant data to determine the best nursing care for this client. This nurse is practicing which attribute of critical thinking?

A) Reflection.
B) Time.
C) Context.
D) Dialogue.

Question 18

Nursing in a complex environment requires nurses to be able to think critically. The key to critical thinking is:

A) arguing a point and standing your ground.
B) focus on your thoughts to make decisions.
C) analysing how best to criticise orders.
D) None of the above.

Question 19

Which one of the following is not a trait that nurses must develop for critical thinking?

A) Perseverance.
B) Independence.
C) Egocentricity.
D) Confidence.

Question 20

A student nurse is being taught about how to promote wound healing. As part of critical thinking, this student is being taught about previously learned information as well as new information. Critical-thinking skills are used in various ways, for example:

A) nurses use knowledge from other subjects and fields.
B) nurses collect and interpret all information to arrive at a decision.
C) knowledge is mainly going to be from the textbook.
D) lectures and tutorials lead the way in critical thinking.

Question 21

Before beginning a particularly stressful shift in a critical care nursery, a nurse is in the practice of reviewing his attitudes and feelings about death and dying, dignity of people, and the parental role in understanding and questioning cares and treatments. This nurse is cultivating which of the following?

A) Critical-thinking attitudes.
B) Ambiguity.
C) Dissonance.
D) Self-assessment.

Question 22

A nurse is caring for a client of a different culture. The nurse is not familiar with the customs of this particular client and becomes disturbed when the client's spouse makes all the decisions about care and treatments. The nurse's reaction is an example of which of the following?

A) Inference.
B) Opinion.
C) Judgment.
D) Evaluation.

Question 23

A nurse is trying to encourage a 2-year-old child to eat their meal. She makes the food into the shape of a train and tells the child that it has to go into a big tunnel and can only get there if she opens her mouth. The nurse makes train noises as she feeds the child. This shows the nurse using a strategy called:

A) deductive reasoning.
B) inductive reasoning.
C) creativity.
D) reflection.

Question 24

A nurse who utilises principles of critical thinking is also aware that the client may hold diverse views of health and illness, therapy and preventive measures. Which phase of the nursing process is this related to?

A) Goal setting.
B) Evaluation.
C) Assessment.
D) Diagnosing.

Question 25

Students usually lack the knowledge base and clinical experience on which to make a valid judgment. It is therefore important for them not to act on which of the following?

A) Intuition.
B) Trial and error.
C) Knowledge only gained from textbooks.
D) Inference.

Question 26

A nurse enters the room of a critically ill child and has a sense that "something" isn't right. After performing an initial physical assessment and finding that the child is stable, the nurse continues to perform a check of all the lines and equipment in the room and finds that the last IV solution hung by the previous nurse was not the correct solution. This nurse was utilising which method of problem solving?

A) Intuition.
B) Judgment.
C) Scientific method.
D) Trial and error.

Question 27

When a nurse is planning care for a client for a routine admission for theatre, she is showing critical thinking when:

A) she gives the client education on the procedure.
B) she asks the client if she has signed a consent form.
C) she tells the client that the doctor will explain everything.
D) she explores actual and potential problems for the client.

Question 28

A client has had a non-healing wound for a period of time. The home health nurse decides to implement a variety of wound care products to see if any of them work. Each day, the nurse switches to a different brand or product. In this situation, the nurse is utilising which method of problem solving?

A) Scientific method.
B) Intuition.
C) Research process.
D) Trial and error.

Question 29

A nurse is learning how to operate a new ventilator that the hospital is considering for purchase. She notes that many of the functions available on the new model were not available on the old, and the set-up is not similar between the two machines. Which order of critical-thinking skill is this nurse utilising?

A) Intuition.
B) Lower.
C) Minimal thinking.
D) Higher.