Chapter 8-Critical Thinking & Clinical Judgement

Question 1

Critical thinking includes:

Answer 1

Language: using precise clear language.

Intuition: inner sensing that facts do not support something.

Question 2

Three levels of critical thinking

Answer 2

Basic critical thinking: results from limited nursing knowledge and experience, as well as inadequate critical thinking experience.

Complex critical thinking: nurse expresses autonomy. Results from an increase in nursing knowledge, experience, intuition, and more flexible attitudes.

Commitment: nurse makes choices without help from others and fully assumes responsibility for those choices. Expert level of knowledge, experience, developed intuition, and reflective flexible attitudes.

Question 3

Example of basic critical thinking

Answer 3

A client reports pain one hour after receiving a pain medication. Instead of reassessing the clients pain, the nurse tells the client he must wait two more hours before he can receive another dose.

Question 4

Example of complex critical thinking

Answer 4

A nurse realizes that a client is not ambulating as often as prescribed because of fear of missing her daughters phone call. The nurse assures the client that the staff will listen for and answer her phone when she’s out of the room.

Question 5

Example of commitment critical thinking

Answer 5

A nurse increases the rate of an IV fluid infusion when a clients blood pressure indicates hypovolemic shock 24 hours after surgery.

Question 6

Components of critical thinking

Answer 6

Knowledge
Experience
Competence
Attitude
Standards

Question 7

Knowledge of critical thinking

Answer 7

Information specific to nursing can come from: nursing education, evidence-based practice, continuing education, advanced degrees and certifications

Question 8

Experience of critical thinking

Answer 8

Decision making ability: demonstrates understanding of clinical situations, recognizes/analyzes cues for relevance, incorporates experience into intuition.

Question 9

Competence of critical thinking

Answer 9

Using certain cognitive processes to make nursing judgments:

general critical thinking such as scientific method, problem-solving, decision-making, diagnostic reasoning and inference, clinical decision-making, and collaboration.

Also using the nursing process

Question 10

Attitudes of critical thinking

Answer 10

Confidence: feeling sure of abilities

Independence: analyzing ideas for logical reasoning

Fairness: objective nonjudgmental

Responsibility: adhering to standards of practice

Risk-taking: taking calculated chances to find better solutions to problems

Discipline: developing systematic approach to thinking

Perseverance: working at a problem until there’s a solution

Creativity: using imagination to find solutions to unique problems

Curiosity: requiring more info about problems

Integrity: practicing truthfully and ethically

Humility: acknowledging weaknesses

Question 11

Standards of critical thinking

Answer 11

Intellectual standards, professional standards.

Improve critical thinking and clinical reasoning ability through mentoring, journaling, peer relationships.