Deck 4: Critical Thinking in Nursing

Question 1

The nurse is administering medications to a patient with high blood pressure. The patient states, "This pill made me so sick yesterday. Are you sure I have to take it now?" The nurse should:

A) give the medication because no one gets sick on this pill.
B) hold the medication and check the order since there may be a lack of information.
C) give the medication since he/she is the nurse and knows what should be done.
D) give the medication since the nurse did not see the doctor come so the order is valid.

Answer 1

hold the medication and check the order since there may be a lack of information.

Question 2

The nurse is preparing to restart a patient's intravenous line and discovers that the patient has no usable veins in either arm. To solve this problem, the nurse should:

A) discuss the problem with the nurse in charge.
B) not start the intravenous line.
C) conduct an internet search for infusion journal articles.
D) contact the physician and report the concern.

Answer 2

discuss the problem with the nurse in charge.

Question 3

The nurse is caring for a patient who is suspected of having early stages of dementia. The nurse observes mild confusion, short-term memory loss, and restlessness. The nurse conducts a mini-mental status exam. The nurse is using which of the following components of critical thinking?

A) Validation
B) Interpretation
C) Intuition
D) Reasoning

Answer 3

Validation

Question 4

The nurse is taking an advanced cardiac life support (ACLS) recertification class. As part of that class, the nurse, and other nurses in the group, rotates responsibilities during multiple mock code exercises simulating cardiac arrest scenarios. The process of assigning nurses to different responsibilities is known as:

A) concept mapping.
B) simulation.
C) role playing.
D) literature review.

Question 5

The nursing student is observing a staff nurse demonstrating a subcutaneous injection during a skills competency fair. The student tells the nurse that nursing textbooks indicate that aspirating for blood is not necessary. The nurse replies, "I prefer to check for blood, just in case. This is the way I learned to give shots and it works for me." The nurse's response is most likely related to:

A) illogical thinking.
B) a bias.
C) closed-mindedness.
D) an erroneous assumption.

Question 6

The patient is complaining of severe incisional pain 2 days after surgery. The patient has Morphine ordered intravenously or by mouth. The nurse chooses to give the medication orally. This is an example of:

A) decision making.
B) reasoning.
C) problem solving.
D) judgment.

Question 7

The nurse has received advanced orders for a patient that she is expecting to be admitted from the emergency room (ER). The patient's name is Mr. Herman Goldstein. Trying to get ahead on her task, the nurse changes the patient's diet from "Regular" to "Kosher." When the patient reaches the unit, the nurse discovers that the patient is Catholic even though his father is Jewish. The nurse is guilty of giving in to:

A) illogical thinking.
B) a bias.
C) closed-mindedness.
D) an erroneous assumption.

Question 8

A patient has been instructed in self-administration of insulin injections. The nurse observes the patient attempting to recap the needle and realizes that further teaching is needed. The nurse is applying which critical-thinking skill of the nursing process?

A) Interpretation
B) Analysis
C) Inference
D) Evaluation

Question 9

The nurse has been hired for her first job and is nervous about making errors in clinical judgment. It is important for the nurse to realize that clinical reasoning and the ability to make decisions in a clinical setting:

A) has been instilled in the content covered in nursing school.
B) is solely based in clinical experience.
C) develops over time with increased knowledge and expertise.
D) is an expectation of all nurses regardless of experience.

Question 10

The nurse is planning care for a group of patients. Which of the following activities may be delegated to unlicensed assistive personnel?

A) Analysis of the patient's physical condition
B) Morning vital signs, height, and weight.
C) Evaluation of whether colostomy drainage is normal
D) Determining patient readiness for postsurgical learning

Question 11

The nurse is preparing to administer an anticoagulant when the patient says, "Why do I have these bruises on my arms?" The nurse reviews the patient's blood tests and notes an abnormal bleeding time. Based on the findings, the nurse decides to hold the medication and notifies the health care provider. This action, by the nurse, is an example of:

A) thinking aloud.
B) reviewing the literature.
C) applying knowledge .
D) role playing.

Question 12

The nurse is caring for a patient scheduled for a heart catheterization. During shift report, the nurse describes an overheard telephone conversation regarding the patient's HIV-positive son-in-law. This information should be evaluated for:

A) accuracy.
B) depth.
C) breadth.
D) relevance.

Question 13

The nurse is reviewing the last 3 days of a patient's pain history and notes that the pain level has remained constant. The nurse validates the pain level with the patient and decides to contact the physician for further orders. In this scenario the nurse is using the process of:

A) decision making.
B) reasoning.
C) problem solving.
D) judgment.

Question 14

The nurse is preparing to teach Foley insertion techniques to a group of graduate nurses. Which of the following teaching-learning strategies would the nurse find most useful in teaching this skill?

A) Concept mapping
B) Simulation
C) Role playing
D) Literature review

Question 15

The nursing student is admitting a patient with abdominal distention and severe nausea. The physician orders the insertion of a nasogastric tube. The student reviews the procedure, gathers the supplies, and tells the instructor, "I'm ready to begin." Which of the following critical thinking traits suggest that the student is prepared for the task?

A) Risk taking
B) Curiosity
C) Confidence
D) Perseverance

Question 16

To develop critical thinking, the nurse needs to develop a critical-thinking character that includes:

A) developing honesty and confidence.
B) learning from experiences.
C) enhancing self-reliance.
D) growing a "thick skin" to withstand criticism.

Question 17

The nurse completes the health interview and physical exam on a patient admitted with an infection of the gallbladder. The nurse reviews the medical record and compares the abnormal lab results to the normal standards. Which critical thinking skill is the nurse using in this part of the nursing process?

A) Interpretation
B) Analysis
C) Evaluation
D) Inference

Question 18

A patient arrives at the urgent care clinic and complains of vague pains in the legs. The nurse asks the patient to describe this pain. This type of question meets the intellectual standard of precision. As with any skill, critical thinking questions:

A) are used to avoid repetition in providing care.
B) can be enhanced through practice.
C) should be based in thought and not spontaneity.
D) become dull when used routinely.

Question 19

A patient, frequently admitted to the hospital for chronic back pain, asks the medication nurse for additional pain medication. The nurse has seen patients like this before, and "knows" that the only reason that these people come to the hospital is to get their pain medication. The nurse is demonstrating:

A) illogical thinking.
B) a bias.
C) closed-mindedness.
D) an erroneous assumption.

Question 20

The nurse has finished her shift and is on her way home. During the shift, one of the patients attempted to climb out of bed and fell. On her way home the nurse is thinking about what she could have done differently to prevent the fall. This is an example of using:

A) evidence
B) standards
C) attributes or traits.
D) reflection

Question 21

When a patient is initially interviewed and assessed, the nurse must: (Select all that apply.)

A) analyze the patient's psychomotor status.
B) take the patient's vital signs.
C) weigh the patient using a bed scale.
D) evaluate the patient's emotional and spiritual needs.
E) ensure the coordination of the patient's care.

Question 22

Professional nursing requires a commitment to lifelong learning because: (Select all that apply.)

A) treatment modalities and technology continue to advance.
B) there are always new things to memorize and store in memory.
C) nurses are expected to update and maintain competency.
D) critical thinking is essential in nursing.
E) nursing school gives the nurse all he/she needs to be competent.

Question 23

The nurse has been practicing for several years and has become the unofficial leader, with newer nurses going to her for advice about patient care. They are amazed at how much the older nurse "thinks like a nurse." In order to "think like a nurse," the nurse must: (Select all that apply.)

A) be a nurse for several years.
B) be able to apply knowledge in making clinical decisions.
C) actively participate in the process.
D) accept procedures that have been in place for years as right.
E) develop a questioning attitude.

Question 24

The nurse observes that a patient who recently had an indwelling urinary catheter removed complains of burning on urination and that the urine is cloudy and foul smelling. On the basis of this assessment, the nurse may reason that the patient has a urinary tract infection (UTI). The nurse comes to this conclusion using:

A) inductive reasoning.
B) deductive reasoning.
C) intellectual thought processes (thinking).
D) intuition.

Question 25

A patient is admitted to a skilled nursing facility with a closed head injury. The nurse believes that the patient has been pocketing food in his cheeks during the noon meal although she has not found any food pocketed. The nurse refers the patient to the speech therapist for a swallowing evaluation. The nurse is using which critical thinking component in making this decision?

A) Inference
B) Deductive reasoning
C) Intuition
D) Inductive reasoning