Chapter 14: Critical Thinking in Nursing Practice Nursing School Test Banks

Potter & Perry: Fundamentals of Nursing, 6th Edition

MULTIPLE CHOICE

1. Which of the following best reflects the philosophy of critical thinking as taught by a nurse educator to a nursing student?

a.

Dont draw subjective inferences about your clientbe more objective.

b.

Please think harderI am looking for a single solution.

c.

Trust your feelingsdont be concerned about trying to find a rationale to support your decision.

d.

Think about several interventions that you could use with this client.

ANS: d

d. The nurse educator is asking the student to synthesize critical thinking skills by encouraging the student to examine alternatives to meet the clients unique needs within the context of the nursing process.

a. Drawing inferences is a specific critical thinking competency used in diagnostic reasoning. The educator who tells the student not to draw inferences is not allowing the student to practice competencies necessary for specific critical thinking in clinical situations.

b. The critical thinker will look beyond a single solution to a problem.

c. Intuition develops as ones clinical experience increases. The nursing student should examine rationales to make good decisions.

REF: Text Reference: p. 265, Text Reference: p. 273

2. The second component of critical thinking in the critical thinking model is:

a.

Competencies

b.

Experience

c.

Specific knowledge

d.

Diagnostic reasoning

ANS: b

b. Experience is the second component of critical thinking in the critical thinking model.

a. The third component of the critical thinking model is competencies.

c. Specific knowledge base is the first component of the critical thinking model.

d. Diagnostic reasoning is a specific critical thinking competency in clinical situations.

REF: Text Reference: p. 270

3. The nurse enters the room of a client who has a history of heart disease. On looking at the client, the nurse feels that something is not right with the client and proceeds to take the vital signs. This is the nurse acting on:

a.

Intuition

b.

Reflection

c.

Knowledge

d.

Scientific method

ANS: a

a. Intuition is an inner sensing that something is so, as in this example.

b. Reflection is the process of purposefully thinking back or recalling a situation to discover its purpose or meaning.

c. Knowledge of the nurse includes information and theory from the basic sciences, humanities, behavioral sciences, and nursing.

d. Scientific method is an approach to seeking the truth or verifying that a set of facts agrees with reality.

REF: Text Reference: p. 264

4. The nurse manager has developed a staff protocol for peer evaluation. The nurses on her surgical unit are nervous about using her instrument. If the nurse manager continues to implement the new strategy, which of the following critical thinking attitudes is she portraying?

a.

Accountability

b.

Thinking independently

c.

Risk taking

d.

Humility

ANS: c

c. This is an example of the critical thinking attitude of risk taking. A critical thinker is willing to take risks in trying different approaches to solving problems.

a. To be accountable means to be answerable for the outcomes of your actions.

b. To think independently, one questions others ways of interpreting knowledge and looks for rational and logical answers to problems.

d. Humility is a critical thinking attitude with which a person admits what he or she does not know and tries to acquire the knowledge needed to make proper decisions.

REF: Text Reference: p. 270, Text Reference: p. 271

5. The nurse is working with a client who has recently had a colostomy. The client is having difficulty using the supplies that are provided for the ostomy care. The nurse investigates the other types of available supplies and works with the client to see which ones are the best. This is an example of the critical thinking strategy of:

a.

Inference

b.

Problem solving

c.

Management

d.

Diagnostic reasoning

ANS: b

b. This is an example of the critical thinking strategy of problem solving. The nurse gathers information from the client and combines that information with what the nurse already knows about ostomy care to find a solution. Effective problem solving involves the examination of alternatives.

a. Inference is the process of drawing conclusions.

c. Management is not a critical thinking strategy.

d. Diagnostic reasoning is a process of determining a clients health status after the nurse assigns meaning to the behaviors, physical signs, and symptoms presented by the client.

REF: Text Reference: p. 266

6. Which of the following is an example of a nurses statement that reflects using the scientific method in the nursing process?

a.

My instincts tell me that the client is getting depressed.

b.

The client doesnt look the same today. I think something is wrong.

c.

The clients husband told me that she is feeling uncomfortable.

d.

The client seems to be having more pain today than yesterday and her blood pressure is elevated

ANS: b

d. This statement reflects using the scientific method in the nursing process. The nurse identified a problem of pain, hypothesized that it was greater than that the day before, and collected data to evaluate its reality.

a. This statement reflects intuition.

b. This statement reflects intuition.

c. This statement reflects information gathering, which may be used in diagnostic reasoning.

REF: Text Reference: p. 266

7. The nurse decides to administer tablets of acetaminophen (Tylenol) instead of the intramuscular meperidine (Demerol) she has been giving one of her orthopedic clients, in accordance with the prescribers order. Which step of the nursing process does this address?

a.

Assessment

b.

Nursing diagnosis

c.

Planning

d.

Implementation

ANS: d

d. Taking appropriate action demonstrates the implementation step of the nursing process.

a. Assessment involves the gathering of data.

b. When formulating a nursing diagnosis, the nurse critically examines and analyzes the data and identifies the clients response to a problem. The nurse may then determine priorities.

c. Planning involves establishing goals and expected outcomes of care.

REF: Text Reference: p. 268

8. The nurse has a multiple client assignment on the surgical unit. When beginning the shift, the nurse needs to determine which postoperative client should be seen first. Of the following, the nurse should go to see the client who:

a.

Is reported as having a BP of 90/50

b.

Received medication for pain 10 minutes ago

c.

Needs to be out of bed and ambulating

d.

Requires instructions for wound care

ANS: a

a. The nurse who assigns priorities to action and determines to see this client first because of a lower than normal blood pressure for a postoperative patient is using scientifically and practice-based criteria for making clinical judgment. This is an example of following standards. The nurse uses criteria such as the clinical condition of the client, Maslows hierarchy of needs, and risks involved in treatment delays to determine which clients have the greatest priority for care.

b. This client is not reported to be having any problems and therefore is not the priority.

c. This client is not the priority.

d. This client is not the priority.

REF: Text Reference: p. 268, Text Reference: p. 272

9. Of the variety of levels of critical thinking, an example of critical thinking at the complex level is:

a.

Following a procedure for catheterization step-by-step

b.

Giving medication at the time ordered

c.

Discussing alternative pain management techniques

d.

Reviewing the clients medical records thoroughly

ANS: c

c. Discussing alternative pain-management techniques is an example of critical thinking at the complex level. The nurse analyzes and examines alternatives more independently.

a. Following a procedure step-by-step is an example of the basic level of critical thinking.

b. Giving medication at the time ordered is an example of the basic level of critical thinking.

d. Reviewing the clients medical records thoroughly is an example of gathering data and may be used in evaluation of a clients care.

REF: Text Reference: p. 265

10. The nurse is deciding on the type of dressing to use for a client. Which step of the decision making process is being used when the nurse observes the absorbency of different dressing brands?

a.

Defining the problem

b.

Considering consequences

c.

Testing possible options

d.

Making final decisions

ANS: c

c. The nurse who observes the absorbency of different brands of dressing is demonstrating testing of possible options.

a. This is not an example of defining the problem.

b. The nurse is not examining pros and cons, and therefore is not considering consequences.

d. The nurse has not yet made a final decision.

REF: Text Reference: p. 266

11. Which one of the following examples demonstrates the critical thinking attitude of responsibility and authority?

a.

Offering an alternative approach

b.

Looking for a different treatment option

c.

Sharing ideas about nursing interventions

d.

Reporting client difficulties

ANS: d

d. Reporting client difficulties demonstrates the critical thinking attitude of responsibility and authority. Asking for help if uncertain and following standards of practice also demonstrate the critical thinking attitudes of responsibility and authority.

a. Offering an alternative approach would demonstrate the critical thinking attitude of risk taking.

b. Looking for a different treatment option demonstrates the critical thinking attitude of creativity.

c. Sharing ideas about nursing interventions demonstrates the critical thinking attitude of thinking independently.

REF: Text Reference: p. 271

12. Use of the intellectual standard of critical thinking implies that the nurse:

a.

Questions the physicians order

b.

Recognizes conflicts of interest

c.

Listens to both sides of the story

d.

Approaches assessment logically and consistently

ANS: d

d. Use of the intellectual standard of critical thinking implies that the nurse approaches assessment logically and consistently.

a. Questioning the physicians order is an example of the critical thinking attitude of risk taking.

b. Recognizing conflicts of interest demonstrates the critical thinking attitude of integrity.

c. Listening to both sides of the story demonstrates the critical thinking attitude of fairness.

REF: Text Reference: p. 269

13. A client requires urinary catheterization but has difficulty keeping her legs in the usual position. The nurse has worked for many years and adapts the procedure to allow the client to lie on her side. This action is based on the critical thinking element of:

a.

Curiosity

b.

Experience

c.

Perseverance

d.

Scientific knowledge

ANS: b

b. Having worked for many years and being able to adapt a procedure to meet the clients needs is an example of the second component of the critical thinking model, experience.

a. Curiosity is a critical thinking attitude in which the nurse asks why, and continues to learn more about the client to make appropriate clinical judgments.

c. Perseverance is a critical thinking attitude in which the nurse does not readily accept the easy answer but does look further to find necessary information and appropriate solutions.

d. Scientific knowledge is knowledge acquired from the study of science. It may be acquired through education such as course work, or in reading nursing literature to remain current in nursing science.

REF: Text Reference: p. 270

Copyright 2005 by Mosby, Inc. All rights reserved.

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