Ch 15 Nclex -Critical Thinking

Question 1

1. Two patient deaths have occurred on a medical unit in the last month. The staff notices that everyone feels pressured and team members are getting into more arguments. As a nurse on the unit, what will best help you manage this stress?
2. Keep a journal
3. Participate in a unit meeting to discuss feelings about the patient deaths
4. Ask the nurse manager to assign you to less difficult patients
5. Review the policy and procedure manual on proper care of patients after death

Answer 1

2. Participate in a unit meeting to discuss feelings about the patient deaths

Question 2

2. A nurse has seen many cancer patients struggle with pain management because they are afraid of becoming addicted to the medicine. Pain control is a priority for cancer care. By helping patients focus on their values and beliefs about pain control, a nurse can best make clinical decisions. This is an example of:
3. Creativity.
4. Fairness.
5. Clinical reasoning.
6. Applying ethical criteria.

Answer 2

4. Applying ethical criteria.

Question 3

3. A nurse prepares to insert a Foley catheter. The procedure manual calls for the patient to lie in the dorsal recumbent position. The patient complains of having back pain when lying on her back. Despite this, the nurse positions the patient supine with knees flexed as the manual recommends and begins to insert the catheter. This is an example of:
4. Accuracy.
5. Reflection.
6. Risk taking.
7. Basic critical thinking.

Answer 3

3. Risk taking.

Question 4

4. A nurse is preparing medications for a patient. The nurse checks the name of the medication on the label with the name of the medication on the doctor’s order. At the bedside the nurse checks the patient’s name against the medication order as well. The nurse is following which critical thinking attitude:
5. Responsible
6. Complete
7. Accurate
8. Broad

Answer 4

1. Responsible

Question 5

5. A nurse on a busy medicine unit is assigned to four patients. It is 10 AM. Two patients have medications due and one of those has a specimen of urine to be collected. One patient is having complications from surgery and is being prepared to return to the operating room. The fourth patient requires instructions about activity restrictions before going home this afternoon. Which of the following should the nurse use in making clinical decisions appropriate for the patient group? (Select all that apply.)
6. Consider availability of assistive personnel to obtain the specimen
7. Combine activities to resolve more than one patient problem
8. Analyze the diagnoses/problems and decide which are most urgent based on patients’ needs
9. Plan a family conference for tomorrow to make decisions about resources the patient will need to go home
10. Identify the nursing diagnoses for the patient going home

Answer 5

1. Consider availability of assistive personnel to obtain the specimen
2. Combine activities to resolve more than one patient problem
3. Analyze the diagnoses/problems and decide which are most urgent based on patients’ needs

Question 6

6. By using known criteria in conducting an assessment such as reviewing with a patient the typical characteristics of pain, a nurse is demonstrating which critical thinking attitude?
7. Curiosity
8. Adequacy
9. Discipline
10. Thinking independently

Answer 6

3. Discipline

Question 7

7. A nurse just started working at a well-baby clinic. One of her recent experiences was to help a mother learn the steps of breastfeeding. During the first clinic visit the mother had difficulty positioning the baby during feeding. After the visit the nurse considers what affected the inability of the mother to breastfeed, including the mother’s obesity and inexperience. The nurse’s review of the situation is called:
8. Reflection.
9. Perseverance.
10. Intuition.
11. Problem solving.

Answer 7

1. Reflection

Question 8

8. Place the steps of the scientific method in their correct order with number 1 being the first step of the process.
9. Formulate a question or hypothesis.
10. Evaluate results of the study.
11. Collect data.
12. Identify the problem.
13. Test the question or hypothesis.

Answer 8

E

Question 9

9. A nurse changed a patient’s surgical wound dressing the day before and now prepares for another dressing change. The nurse had difficulty removing the gauze from the wound bed yesterday, causing the patient discomfort. Today he gives the patient an analgesic 30 minutes before the dressing change. Then he adds some sterile saline to loosen the gauze for a few minutes before removing it. The patient reports that the procedure was much more comfortable. Which of the following describes the nurse’s approach to the dressing change? (Select all that apply.)
10. Clinical inference
11. Basic critical thinking
12. Complex critical thinking
13. Experience
14. Reflection

Answer 9

G

Question 10

10. Which of the following describes a nurse’s application of a specific knowledge base during critical thinking? (Select all that apply.)
11. Initiative in reading current evidence from the literature
12. Application of nursing theory
13. Reviewing policy and procedure manual
14. Considering holistic view of patient needs
15. Previous time caring for a specific group of patients

Answer 10

H

Question 11

11. Fill in the Blank. When a nurse tries to understand a patient’s and family caregiver’s perspective of why a patient is falling at home, the nurse applies the intellectual standard of _________________________ to understand all viewpoints

Answer 11

H

Question 12

12. An aspect of clinical decision making is knowing the patient. Which of the following is the most critical aspect of developing the ability to know the patient?
13. Working in multiple health care settings
14. Learning good communication skills
15. Spending time establishing relationships with patients
16. Relying on evidence in practice

Answer 12

B

Question 13

13. In which of the following examples is a nurse applying critical thinking skills in practice? (Select all that apply.)
14. The nurse thinks back about a personal experience before administering a medication subcutaneously.
15. The nurse uses a pain-rating scale to measure a patient’s pain.
16. The nurse explains a procedure step by step for giving an enema to a patient care technician.
17. The nurse gathers data on a patient with a mobility limitation to identify a nursing diagnosis.
18. A nurse offers support to a colleague who has witnessed a stressful event.

Answer 13

H

Question 14

14. A nurse enters a 72-year-old patient’s home and begins to observe her behaviors and examine her physical condition. The nurse learns that the patient lives alone and notices bruising on the patient’s leg. When watching the patient walk, the nurse notes that she has an unsteady gait and leans to one side. The patient admits to having fallen in the past. The nurse identifies the patient as having the nursing diagnosis of Risk for Falls. This scenario is an example of:
15. Inference.
16. Basic critical thinking.
17. Evaluation.
18. Diagnostic reasoning.

Answer 14

G