Deck 4: Critical Thinking and Decision-Making Skills

Question 1

How is leadership at the staff nurse level exemplified?

A) The staff nurse adapts to a challenging patient assignment.
B) The staff nurse refers issues to the performance improvement committee.
C) The staff nurse accepts the status quo.
D) The staff nurse questions current practice and refers to unit leadership for change.

Answer 1

The staff nurse adapts to a challenging patient assignment.

Question 2

A family member of a patient files a complaint that her mother's dentures were lost when the patient was transferred from one unit to another. The risk management department interviews the patient and the staff nurses who cared for the patient. Which of the following problem-solving techniques was used?

A) Delegation
B) Direct intervention
C) Indirect intervention
D) Purposeful inaction

Answer 2

Direct intervention

Question 3

Which of the following problem definitions is matched with an accurate example?

A) Problem solving: A nurse ignores a client's requests to stop his dialysis.
B) Dilemma: A nurse is scheduled to work over the weekend, and she has a family outing to attend.
C) Critical thinking: A nurse is counseling a woman with breast cancer about terminating her pregnancy and receiving chemotherapy or completing the pregnancy and possibly not surviving.
D) Purposeful action: A nurse has been offered an exciting new position with a dramatic increase in salary, but she would have to move out of state, away from her ailing parents.

Answer 3

Critical thinking: A nurse is counseling a woman with breast cancer about terminating her pregnancy and receiving chemotherapy or completing the pregnancy and possibly not surviving.

Question 4

A disaster team is planning strategies to use in the event of multiple catastrophes. Various questions are posed such as, "If we lost all electricity in Kent County, what challenges would we face in providing care? If the Grand River flooded, which institutions would not be available for health care? What other facilities could be used as a backup system? Which roadways would be available in the event of a flood?" This is an example of which of the following decision-making strategies?

A) Creativity techniques
B) Decision trees
C) Simulated trial and error
D) Worst case scenarios

Question 5

A nationwide community health care nursing organization has formed a team to assist with disaster victim relocation and to plan for psychological, physical, and emotional needs that the victims may encounter. In which stage of decision making is this group?

A) Deliberation
B) Evaluation
C) Judgment
D) Selection

Question 6

A team consisting of preoperative, operative, and postoperative health care professionals and ancillary staff is examining the turnaround time from the preoperative area to discharge for patients having tonsillectomies. The goal is to decrease waiting times for clients. Which of the following techniques would delineate processes that are delaying time for patients having tonsillectomies?

A) Cost-benefit analysis
B) Trial and error
C) Shared decision making
D) Scenario planning

Question 7

A nurse manager has ordered equipment for a new unit. The company has sent two notices that the equipment is on back order. The nurse manager is debating whether to wait for the equipment on back order or to cancel the order and go with another company. She discusses this issue with another nurse manager. This is an example of:

A) incrementalism.
B) optimizing.
C) mixed scanning.
D) strategic planning.

Question 8

A multidisciplinary team makes a decision to develop a plan for the use of thrombolytics in the emergency medical service system. Questions are asked such as, "Is the client a candidate for thrombolytic therapy? Does the client have a history of gastrointestinal bleeding? Has the client ever had a stroke? Does the client have any bleeding disorders?" Which of the following decision-making strategies would work best in this situation?

A) Cost-benefit analysis
B) Decision tree
C) Problem critique
D) Trial and error

Question 9

A patient has arrived at the critical care unit with a head injury. On admission, the patient is talking and is a little drowsy but oriented. Two hours later, the nurse discovers that the patient is talking at a rapid pace and keeps repeating his words. Which of the following examples best depicts Benner's stages and appropriate critical-thinking processes in this situation?

A) Advanced beginner-thinks that the patient is trying to be funny
B) Competent-thinks that the patient is experiencing effects from cerebral edema
C) Novice-thinks that the patient is stressed and has had a surge of adrenaline
D) Proficient-thinks that the patient is waking up from a coma

Question 10

The nursing education department is revising its orientation curriculum for nurse externs. A consultant has been hired to revise the program completely. When the curriculum is completed, most of the prior curriculum and activities are found to be the same. This is an example of which of the following decision-making distortions?

A) Anchoring trap
B) Confirming evidence trap
C) Framing trap
D) Status quo trap

Question 11

What is the definition of the process of making choices that will provide maximum benefit?

A) Critical thinking
B) Problem solving
C) Decision making
D) Leading

Question 12

A long-term care facility has been busy for several months with patients who have a very high acuity. Nurses have been working double shifts. The nurses have been given the task of determining whether they would like to implement an on-call program and determine guidelines for implementation, if most nurses believe that it is the best solution. This example depicts which type of decision-making style?

A) Autocratic
B) Consultative
C) Delegative
D) Facilitative

Question 13

The marketing department of a major children's hospital is hosting a fund-raiser for the local Ronald McDonald House. In the past, fund-raisers were successful when scheduled in the spring. This year, the fund-raiser is scheduled in the fall, when the city and several local organizations have community festivals. The first fund-raiser was scheduled 10 years ago in the fall and raised $50,000, only one eighth of the goal. This depicts an example of which of the following decision-making distortions?

A) Confirming evidence trap
B) Estimating and forecasting trap
C) Status quo trap
D) Sunk cost trap

Question 14

Nursing students are working on a long-term care unit at a new clinical site. The instructor is concerned because the clinical site is missing some needed components. In a discussion with the director of nursing, it is determined that the instructor should document the expected and actual outcomes of the experience and compare them. This type of decision making is made utilizing (the):

A) rational model.
B) process model.
C) political model.
D) outcome evaluation.

Question 15

Family members of a dying patient are arguing about terminating life support. The nurse educates the two opposing groups individually about terminating life support and discusses the dying process. This is an example of:

A) delegation.
B) negotiation.
C) clinical judgment.
D) purposeful inaction.

Question 16

A staff registered nurse (RN) has been struggling with the delivery system from central supply. He documents a delay of 1 to 3 hours from the time that the order is sent to central supply to the time that the requested equipment is sent to the floor. The RN asks, "Why does a central supply unit need to service the entire hospital? Why not consider a decentralized central supply established for each floor?" This is an example of what type of thinking?

A) Amiable thinker
B) Critical thinker
C) Traditional thinker
D) Unrealistic thinker

Question 17

A continuous quality improvement team has considered all aspects of a decision to purchase two new computed tomography scanners to meet the needs of the community. The team decides to go with the less expensive, larger machines with few additional capabilities because of current budget restraints, even though it will mean purchasing newer smaller models with more capabilities in the future when moving to a new hospital in 3 years. This decision is known as a(n) _____ decision.

A) cost-conscious
B) group
C) optimizing
D) satisficing

Question 18

An intravenous infusion center is considering switching intravenous pumps to another vendor. A team of nurses is gathered to examine the benefits and uses and to conduct a cost analysis of various intravenous pumps. After thoroughly reviewing the data and piloting several intravenous pumps, the team and the nurse leader vote to determine which pumps to use. This example depicts which of the following decision styles?

A) Autocratic
B) Consultative
C) Delegative
D) Facilitative

Question 19

Nurses working on the intermediate care unit have had many hours of overtime in the last 6 months. Before forming a team, the nurse manager gathers data about patient condition severity, staffing ratios, educational levels of staff, and personality mixes on each shift. What level of decision making is this process?

A) Establishment of solution evaluation criteria
B) Evaluation of the alternative solutions
C) Identification of a problem, issue, or situation
D) Search for alternative solutions or actions

Question 20

A staff RN is leading a quality improvement team on the care of the total hip replacement patient. The issue is an increased length of stay from 1 year ago. The nurse asks team members to reframe the problem statement from their perspective. Twenty different problem statements were developed. The team is focusing on four of the problem statements. This is an example of which of the following techniques?

A) Problem solving
B) Evaluating the consequences
C) Inclusive judgment
D) Problem processing

Question 21

Two cognitive processes that nurses use in clinical judgments include (select two answers):

A) analysis.
B) brainstorming.
C) fish boning.
D) intuition.

Question 22

Effective managers utilize group problem solving to discuss and participate in solving a problem. Which are examples of decision-making strategies that are useful in groups (select all that apply)?

A) Incrementalism
B) Scenario planning
C) Worst-case scenario
D) Six Sigma
E) Budgetary model

Question 23

Which of the following are examples of formal decision-making strategies (select all that apply)?

A) Trial and error
B) Anchoring
C) Pilot project
D) Creativity technique
E) Decision tree

Question 24

A client becomes confused after surgery. He is in a room farthest away from the nurses' station. The client tries to get out of bed several times during the shift. The nurse informs the physician and obtains an order for soft restraints. In addition she moves the client close to the station and assigns a sitter to watch him. Which of the following did the nurse utilize (select all that apply)?

A) Critical thinking
B) Problem solving
C) Autocratic decision
D) Financial decision

Question 25

Nurses in clinical practice need to be able to make decisions based on the needs of the client, situations, or practice problems. Which of the following statements are true regarding critical thinking in nursing (select all that apply)?

A) Critical thinkers challenge the norm.
B) Critical thinkers consider unintended consequences when making decisions.
C) Critical thinkers utilize the step-by-step nursing process in order.
D) Critical thinkers are creative in their thinking.
E) Critical thinking should be left to the discretion of the nurse leader.

Question 26

Utilizing the DECIDE acronym for the process of decision making, what are the first and final steps in the process (select two that apply)?

A) Develop and implement an action plan for problem solution.
B) Establish criteria for what you want to accomplish.
C) Define the problem and determine why anything should be done about it.
D) Evaluate the decision through monitoring, troubleshooting, and feedback.
E) Determine the best choice or alternative.