Critical Thinking Competencies - Critical Thinking in Nursing Practice

Question 1

Cognitive processes that a nurse uses to make judgements about the clinical care of patients.

Answer 1

Critical thinking competencies

Question 2

Not unique to nursing, they include the scientific method, problem-solving, and decision-making.

Answer 2

General critical thinking competencies

Question 3

They include general critical thinking, specific critical thinking in clinical situations, and specific critical thinking in nursing.

Answer 3

Critical thinking competencies

Question 4

Systematic, ordered approach to gathering data and solving problems that is used in nursing, medicine, and various other disciplines.

Answer 4

Scientific method

Question 5

Nurse researchers use this to verify that a set of facts is true when testing research questions in nursing practice.

Answer 5

Scientific method

Question 6

Research incorporating this contributes to evidence-informed nursing practice and the development of Best Practice Guidelines.

Answer 6

Scientific method

Question 7

The scientific method has ___ steps.

Answer 7

5

Question 8

The scientific method has five steps:

1. Identification of the problem
2. Collection of ___
3. Formulation of a research question or h___
4. Testing of the question or hypothesis
5. ___ of the results of the test or study

Answer 8

data

h-ypothesis

Evaluation

Question 9

Consider the following example of the scientific method in nursing practice:

A nurse caring for patients who receive large doses of chemotherapy for ovarian cancer detects a pattern whereby these patients develop severe inflammation of the mouth (mucositis) (___ the problem). The nurse reads research articles (collects ___) about mucositis and learns about evidence that cryotherapy, in which patients keep ice in their mouths during the chemotherapy infusion, reduces the severity of the mucositis after treatment. The nurse asks (forms research ___), “can patients with ovarian cancer who receive chemotherapy have less severe mucositis when given cryotherapy instead of standard mouth rinse in the oral cavity?” The nurse then designs a study that compares the incidence and severity of mucositis in a group of patients who use cryotherapy with those in patients who use traditional mouth rinse (___ the question). The nurse hopes that the results from the study will give oncology nurses a better approach for reducing the frequency and severity of mucositis in cancer patients. A nurse in another oncology setting critically analyzes the study before implementing its recommendations for patient care (___ the results of the study).

Answer 9

identifies

data

question

tests

evaluates

Question 10

Involves evaluating the solution over time to be sure that it is still effective. It becomes necessary to try different options if a problem recurs.

Answer 10

Problem solving

Question 11

Adds to the nurse’s experience in practice and enables the nurse to apply that knowledge in future situations with patients.

Answer 11

Problem solving

Question 12

Facing a problem or situation and needing to choose a course of action from several options.

Answer 12

Decision-making

Question 13

Product of critical thinking that focuses on problem resolution.

Answer 13

Decision-making

Question 14

Involves moving back and forth between steps when all criteria are considered.

Answer 14

Decision-making

Question 15

Leads to informed conclusions that are supported by evidence and reason.

Answer 15

Decision-making

Question 16

Include diagnostic reasoning, clinical inference, and clinical decision-making.

Answer 16

Specific critical thinking competencies

Question 17

Starts as soon as information about a patient in a clinical situation is received.

Answer 17

Diagnostic reasoning

Question 18

A process of determining a patient’s health status after you make physical and behavioural observations and after you assign meaning to the behaviours, physical signs, and symptoms exhibited by the patient.

Answer 18

Diagnostic reasoning

Question 19

Using this thinking process, information collected and analyzed leads to a diagnosis of the patient’s condition.

Answer 19

Diagnostic reasoning

Question 20

Considering this part of the situation enhances the nurse’s analytical skills and results in a more accurate diagnosis.

Answer 20

Context

Question 21

Part of diagnostic reasoning.

Answer 21

Clinical inference

Question 22

Process of drawing conclusions from related pieces of evidence.

Answer 22

Clinical inference

Question 23

Involves forming patterns of information from data before making a diagnosis.

Answer 23

Inference

Question 24

Seeing that a patient has lost his appetite and experienced a loss of weight over the past month and connecting this to a nutritional problem is an example of an ___.

Forming a nursing diagnosis such as imbalanced nutrition, less than body requirements is an example of ___ ___.

Answer 24

inference

diagnostic reasoning

Question 25

When uncertain of a diagnosis, continue ___ collection until able to determine a patient’s unique situation.

Answer 25

data

Question 26

Uses patient data gathered to logically explain a clinical judgement.

Answer 26

Diagnostic reasoning

Question 27

Nurses assess and monitor patients closely and compare the patient’s signs and symptoms with those that are common to a:

Answer 27

medical diagnosis.

Question 28

A term used to describe the cognitive process of thinking about patient issues, making inferences, and deciding on the actions to be implemented in a particular situation.

Answer 28

Clinical reasoning

Question 29

Involves collecting cues, processing information, coming to understand the patient’s problem or situation, planning and implementing interventions, evaluating outcomes, and reflecting on and learning from the process.

Answer 29

Clinical reasoning

Question 30

Focuses on defining patient problems and selecting appropriate interventions.

Answer 30

Clinical decision-making

Question 31

Judgement that includes critical and reflective thinking, action, and the application of scientific and practical knowledge.

Answer 31

Clinical decision-making

Question 32

Requires that you recognize the salient aspects of a clinical situation, interpret their meanings, and respond appropriately.

Answer 32

Clinical judgement

Question 33

Includes four components: noticing or grasping the situation, interpreting or developing a sufficient understanding of the situation to respond, responding or deciding on a course of action, and reflecting on or reviewing the actions taken and their outcomes.

Answer 33

Clinical judgement

Question 34

Clinical judgement includes ___ components.

Answer 34

4

Question 35

Considering the context of the situation and relying on analytical processes, intuition, and narrative thinking (i.e., thinking that occurs as a result of telling and interpreting stories) is an example of:

Answer 35

clinical judgement.

Question 36

Reflecting on actions taken helps one acquire clinical ___, which contributes to future clinical judgements.

Answer 36

learning

Question 37

Requires careful reasoning to choose the options for the best patient outcomes based on the patient’s condition, the priority of the problem, or health concern.

Answer 37

Clinical decision-making

Question 38

Improve by knowing patients. For example, an expert nurse who has worked on a general surgery unit for many years is more likely to detect signs of internal hemorrhage (e.g., fall in blood pressure, rapid pulse, change in consciousness) than a new nurse.

Answer 38

Clinical decision-making

Question 39

Built on both clinical knowledge and patient data.

Answer 39

Nursing actions

Question 40

Dependent on the following:

• The identified status and situation of the patient
• Knowledge about the clinical variables (e.g., patient’s age, seriousness of the problem, pathological process of the problem, patient’s pre-existing disease conditions) involved in the situation and how the variables are related
• Knowledge about the usual patterns of any diagnosed problem or prognosis and a judgement about the likely course of events and outcomes of the diagnosed problem, in view of any coexisting health risks the patient also possesses
• Additional relevant information about the patient’s daily living situation, functional capacity, and social resources
• Knowledge about the nursing interventions available and the way in which specific actions will predictably affect the patient’s situation
• Knowledge about the patient’s desired health outcome

Answer 40

Nursing actions

Question 41

Enables you to set priorities for nursing action.

Answer 41

Clinical-decision

Question 42

Nurses apply this process as a critical thinking competency when delivering patient care.

Answer 42

Nursing process

Question 43

Five-step clinical decision-making approach that consists of assessment, diagnosis, planning, implementation, and evaluation.

Answer 43

Nursing process

Question 44

Assists nurses in identifying and treating patients’ health-related concerns and helps patients attain agreed-upon health outcomes.

Answer 44

Nursing process

Question 45

Incorporates general (e.g., scientific method, problem-solving, and decision making) and specific critical thinking competencies (e.g., diagnostic reasoning, inference, and clinical decision making) in a manner that focuses on a particular patient’s unique needs.

Answer 45

Nursing process

Question 46

Unique to the discipline of nursing and provides a common language and process for nurses to ‘think through’ patients’ clinical problems.

Answer 46

Nursing process

Question 47

Five-step nursing process model.

Answer 47

Question 48

Often called a blueprint or plan for care.

Answer 48

Nursing process

Question 49

Used to identify a patient’s health-related concerns, clearly define a nursing diagnosis or collaborative problem, determine priorities of care, and set goals and expected outcomes of care. Then develop and communicate a plan of care, perform nursing interventions, and evaluate the effects of the care.

Answer 49

Nursing process

Question 50

Involving patients in each step of this process helps ensure that care is patient-centred.

Answer 50

Nursing process

Question 51

Determines how a successful critical thinker approaches a problem or a situation that necessitates decision-making. For example, when a patient complains of anxiety before undergoing a diagnostic procedure, the curious nurse explores possible reasons for the patient’s concerns. The nurse also exhibits discipline and perseverance in taking responsibility to complete a thorough assessment to find the sources of the patient’s anxiety.

Answer 51

Attitudes

Question 52

Knowing when you need more information, knowing when information is misleading, and recognizing your own knowledge limits and personal biases are examples of how critical thinking a____ play a key role in decision-making.

Answer 52

a-ttitudes

Question 53

Fourth component of the critical thinking model.

Answer 53

Attitudes

Question 54

Fifth component of the critical thinking model.

Answer 54

Standards

Question 55

Includes intellectual and professional standards.

Answer 55

Standards for critical thinking

Question 56

Guideline or principle for rational thought.

Answer 56

Intellectual standard

Question 57

Such standards are applied when conducting the nursing process.

Answer 57

Intellectual standards

Question 58

When considering a patient problem, applying thoroughness, precision, accuracy, and consistency to make sure that all clinical decisions are sound are examples of this standard for critical thinking.

Answer 58

Intellectual standards

Question 59

Ensures that you do not perform critical thinking haphazardly.

Answer 59

Intellectual standards

Question 60

Refer to ethical criteria for nursing judgements, evidence-informed criteria for evaluation, and criteria for professional responsibility.

Answer 60

Professional standards

Question 61

Promote the highest level of quality nursing care for individuals and groups in institutional and community-based settings.

Answer 61

Professional standards

Question 62

Based on core values that serve as a guide to ethical decision-making in nursing practice.

Answer 62

CNA’s Code of Ethics for Registered Nurses

Question 63

CNA

Answer 63

Canadian Nurses Association

Question 64

Among these values and ethical responsibilities are providing safe, compassionate, competent, and ethical care; promoting health and well-being; promoting and respecting informed decision making; preserving dignity; maintaining privacy and confidentiality; promoting justice; and being accountable.

Answer 64

CNA’s Code of Ethics for Registered Nurses

Question 65

Nurses use this type of criteria to assess patients’ conditions, determine a course of action, and evaluate the efficacy of nursing interventions. For example, accurate assessment of symptoms such as pain or shortness of breath requires use of assessment criteria such as the duration, severity, location, aggravating or relieving factors, and effects on daily lifestyle.

Answer 65

evidence-informed

Question 66

This type of criteria enables accuracy in determining the nature of a patient’s symptoms, selecting appropriate interventions, and later evaluating whether the interventions are effective.

Answer 66

Assessment

Question 67

Another example is the use of the criteria incorporated in this to differentiate between delirium, dementia, and depression in older persons in order to make prudent decisions about the care and services needed by patients and their caregivers to optimize clinical outcomes and reduce caregiver burden.

Answer 67

Best Practice Guidelines

Question 68

Standards cited in institutional practice guidelines, professional organizations’ standards of practice, and legislation governing nursing practice.

Answer 68

Standards of professional responsibility

Question 69

Nursing practice standards that govern nurses’ actions in Canada are found on the websites of provincial and territorial professional nursing organizations.

Answer 69

Standards of professional responsibility

Question 70

These standards outline the accountabilities that a nurse assumes in providing high-quality health care to the public.