TEST 2 - UNIT B - CH 8 - CRITICAL THINKING (Fundamentals Book)

Question 1

Nursing practice requires the application of knowledge from and a knowledge of

Answer 1

biological, social, and physical sciences
knowledge of pathophysiology; and knowledge of nursing procedures and skills.

Question 2

Nurses also must use multiple thinking skills—including ______(5) to make clinical judgments about problems in nursing practice.

Answer 2

critical thinking skills (interpretation, analysis, evaluation, inference, and explanation)—

Question 3

These judgments lead the nurse to

Answer 3

choosing actions or interventions through a process called clinical reasoning.

Question 4

A nursing knowledge base w/ foundational thinking skills, including recall and comprehension, is a prerequisite to

Answer 4

critical thinking in nursing.

Question 5

In nursing, critical thinking is an

Answer 5

active, orderly, well-thought‑out reasoning process that

Question 6

critical thinking guides a nurse in

Answer 6

guides a nurse in various approaches to making a nursing judgment by

Question 7

what does the nurse apply when using critical thinking

Answer 7

applying knowledge and experience, problem‑solving, logic, reasoning, and decision‑making.

Question 8

A critical thinker

Answer 8

prioritizes, explores various courses of action, keeps ethics in mind, and determines appropriate outcomes. To have a positive effect on a client’s health

Question 9

Critical thinking discourages

Answer 9

quick judgments that lead to single‑focused solutions.

Question 10

● Critical thinking requires*

Answer 10

lifelong learning and the ability to acquire relevant experiences that can be reflected on continuously to improve nursing judgment.

Question 11

● The components of critical thinking include *

Answer 11

knowledge, experience, critical thinking competencies, attitudes, and intellectual and professional standards.

Question 12

● Critical thinking is facilitated by*

Answer 12

seeking truth in an open-minded manner and being inquisitive about why something is effective or ineffective.

Question 13

● Critical thinking follows a*

Answer 13

systematic process or pattern, not jumping to conclusions but using reason to guide decisions.

Question 14

● Nurses make *

Answer 14

inferences when making clinical decisions by pulling pieces of information together to determine a relationship between the data.

Question 15

● Critical thinking incorporates*

Answer 15

reflection, language, and intuition, and it evolves through three distinct levels as a nurse gains knowledge and experience while maturing into a competent nursing professional.

Question 16

● Reflection

Answer 16

Purposefully thinking back or recalling a situation to discover its meaning and gain insight into the event.

Question 17

A nurse should reflect on the following:

Answer 17

“Why did I say that or do this?”
● “Did the original plan of care achieve optimal client outcomes?”
◯ If so: “Which interventions were successful?”
◯ If not: “Which interventions were unsuccessful?”

Question 18

Language should be

Answer 18

Precise, clear language demonstrating focused thinking and communicating unambiguous messages and expectations to clients and other health care team members.

Question 19

A nurse should ask the following: about their language

Answer 19

● “Did I use language appropriate for the client?”
● “Did I communicate the message clearly to the provider?”

Question 20

Intuition

Answer 20

An inner sensing that facts do not currently support something. Intuition should spark the nurse to search the data to confirm or disprove the feeling.

Question 21

The nurse should ask the following: about intuition

Answer 21

● “Did the vital signs reflect any changes that account for the client’s present status?”
● “When the client’s status changed in this way last month, there was a specific reason for it. Is that what is happening here?”

Question 22

LEVELS OF CRITICAL THINKING

Answer 22

Basic critical thinking
Complex critical thinking
Commitment

Question 23

Basic critical thinking

Answer 23

● A nurse trusts the experts and thinks concretely based on the rules.

Question 24

● Basic critical thinking results from

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limited nursing knowledge and experience, as well as inadequate critical thinking experience.

Question 25

Example: of basic crtiical thinking

Answer 25

A client reports pain 1 hr after receiving a pain medication. Instead of reassessing the client’s pain, the nurse tells the client he must wait two more hours before he can receive another dose.

Question 26

Complex critical thinking

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● The nurse begins to express autonomy by analyzing and examining data to determine the best alternative.

Question 27

● Complex critical thinking results from

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an increase in nursing knowledge, experience, intuition, and more flexible attitudes.

Question 28

Example: of complex crticial thinking

Answer 28

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

Question 29

Commitment

Answer 29

● The nurse expects to make choices without help from others and fully assumes the responsibility for those choices.

Question 30

● Commitment results from

Answer 30

an expert level of knowledge, experience, developed intuition, and reflective, flexible attitudes.

Question 31

Example: of commitmeent level of critical thinking

Answer 31

A nurse increases the rate of an IV fluid infusion when a client’s blood pressure indicates hypovolemic shock 24 hr after surgery.

Question 32

COMPONENTS OF CRITICAL THINKING

Answer 32

Knowledge
Experience
Competence
Attitudes
Standards

Question 33

Knowledge

Answer 33

Information that’s specific to nursing and comes from:

Question 34

Knowledge comes from

Answer 34

● Basic nursing education
● Use of evidence-based practice
● Continuing education courses
● Advanced degrees and certifications

Question 35

Experience

Answer 35

Decision‑making ability derived from opportunities to observe, sense, and interact with clients followed by active reflection. A nurse:

Question 36

Experience is demonstrated by

Answer 36

● Demonstrates an understanding of clinical situations.
● Recognizes and analyzes cues for relevance.
● Incorporates experience into intuition.

Question 37

Competence

Answer 37

Cognitive processes a nurse uses to make nursing judgments.

Question 38

General critical thinking includes (5) and are part of a nurses competence

Answer 38

● Scientific method
● Problem‑solving
● Decision‑making
● Diagnostic reasoning and inference
● Clinical decision‑making; collaboration

Question 39

Specific critical thinking in nursing: is what

Answer 39

The nursing process

Question 40

Attitudes

Answer 40

Mindsets that affect how a nurse approaches a problem.

Question 41

Attitudes of critical thinkers include:

Answer 41

● Confidence:
● Fairness:
● Responsibility:
● Risk-taking:
● Discipline:
● Perseverance:
● Creativity:
● Curiosity:
● Integrity:
● Humility:

Question 42

● Confidence

Answer 42

• Feels sure of abilities.

Question 43

● Independence

Answer 43

*Analyzes ideas for logical reasoning.

Question 44

● Fairness

Answer 44

• Is objective, nonjudgmental.

Question 45

● Responsibility

Answer 45

• Adheres to standards of practice.

Question 46

● Risk-taking

Answer 46

Takes calculated chances in finding better solutions to problems.

Question 47

● Discipline

Answer 47

Develops a systematic approach to thinking.

Question 48

● Perseverance

Answer 48

Continues to work at a problem until there’s a resolution.

Question 49

● Creativity

Answer 49

Uses imagination to find solutions to unique client problems.

Question 50

● Curiosity

Answer 50

Requires more information about clients and problems.

Question 51

● Integrity

Answer 51

Practices truthfully and ethically.

Question 52

● Humility

Answer 52

Acknowledges weaknesses.

Question 53

Standards

Answer 53

Model for comparing care to determine acceptability, excellence, and appropriateness.

Question 54

● Intellectual standards ensure the

Answer 54

thorough application of critical thinking.

Question 55

● Professional standards

Answer 55

◯ Nursing judgment based on ethical criteria
◯ Evaluation that relies on evidence-based practice
◯ Demonstration of professional responsibility
◯ Promotes maximal level of nursing care

Question 56

● The nurse can improve their critical thinking and clinical reasoning ability through

Answer 56

tactics (concept mapping and reflective journaling) which allow the nurse to recognize connections and patterns among data and outcomes.

Question 57

(concept mapping and reflective journaling) which allow the nurse to

Answer 57

recognize connections and patterns among data and outcomes.

Question 58

● Mentoring and peer relationships can positively influence the nurse’s

Answer 58

critical thinking ability, as nurses discuss client care and learn from each other’s experiences.

Question 59

Assessment/Data collection

Answer 59

Collect information about a client’s present health status to identify needs, and to identify additional data to collect based on findings.

Question 60

Collect information about a client’s present health status to

Answer 60

identify needs, and to identify additional data to collect based on findings.

Question 61

CRITICAL THINKING SKILLS of assessment and data collection (5)

Answer 61

● Observe.
● correct techniques collecting data.
● Differentiate relevant / irrelevant data, (important / unimportant data).
● Organize, categorize, validate data.
● Interpret assessment data and draw a conclusion.

Question 62

Planning

Answer 62

Establish priorities and optimal outcomes of care to measure and evaluate. Then, select the nursing interventions to include in a client’s plan of care to promote, maintain, or restore health.

Question 63

CRITICAL THINKING SKILLS for Planning

Answer 63

● Identify goals and outcomes for client care.
● Set priorities.
● Determine appropriate strategies and interventions for inclusion on a client’s plan of care or teaching plan.
● Take knowledge and apply it to more than one situation.
● Create outcome criteria.
● Theorize.
● Consider the consequences of implementation.

Question 64

Implementation

Answer 64

Provide care based on assessment data, analyses, and the plan of care.

Question 65

CRITICAL THINKING SKILLS for implementation

Answer 65

● Use knowledge base.
● Use appropriate skills and teaching strategies.
● Test theories.
● Delegate and supervise nursing care.
● Communicate appropriately in response to a situation.

Question 66

Evaluation

Answer 66

Examine a client’s response to nursing interventions and form a clinical judgment about meeting goals and outcomes.

Question 67

CRITICAL THINKING SKILLS for evauluation

Answer 67

● Determine accuracy of theories.
● Evaluate outcomes based on specific criteria.
● Determine understanding of teaching.

Question 68

1. A nurse is caring for a client who is 24 hr postoperative following an inguinal hernia repair. The client is tolerating clear liquids well, has active bowel sounds, and is expressing a desire for “real food.” The nurse tells the client, “I will call the surgeon and ask for a change in diet.” The surgeon hears the nurse’s report and prescribes a full liquid diet. The nurse used
   which of the following levels of critical thinking?
   A. Basic
   B. Commitment
   C. Complex
   D. Integrity

Answer 68

1. A. CORRECT: At the basic level, thinking is concrete and based on a set of rules (obtaining the prescription for diet progression).
   B. At the commitment level, the nurse expects to have to make choices without help from others and fully assumes the responsibility for those choices. However, postoperative protocols generally involve obtaining a prescription for diet progression.
   C. Advanced experience and knowledge at the complex level will prompt the nurse to request diet progression to full liquids based on active bowel sounds and the client’s tolerance of clear liquid, not solely on the client’s request.
   D. Integrity is a critical thinking attitude that comes into play when the nurse’s opinion differs from that of the client. The nurse must then review their own position and decide how to proceed to help achieve outcomes satisfactory to all parties.

Question 69

2. A nurse receives a prescription for an antibiotic for a client who has cellulitis. The nurse checks the client’s medical record, discovers that the client is allergic to the antibiotic, and calls the provider to request a prescription for a different antibiotic. Which of the following critical thinking attitudes did the nurse demonstrate?
   A. Fairness
   B. Responsibility
   C. Risk-taking
   D. Creativity

Answer 69

2. A. Fairness is using a nonjudgmental, objective approach in looking at clients and situations. This attitude does not apply here.
   B. CORRECT: The nurse is responsible for administering medications in a safe manner and according to standards of practice. Checking the medical record for allergies helps ensure safety.
   C. Risk-taking is a calculated approach to solving a problem that is not responding to traditional methods. This attitude does not apply here.
   D. Creativity is an approach that uses imagination to find solutions to unique client problems. This problem is not unique, and it requires a straightforward solution.

Question 70

3. A newly licensed nurse is considering strategies to improve critical thinking. Which of the following actions should the nurse take? (Select all that apply.)
   A. Find a mentor.
   B. Use a journal to write about the outcomes of clinical judgments.
   C. Review articles about evidence-based practice.
   D. Limit consultations with other professionals involved in a client’s care.
   E. Make quick decisions when unsure about a client’s needs.

Answer 70

3. A. CORRECT: Learning from the experience of peers can improve critical thinking.
   B. CORRECT: Journaling about decision-making can assist the nurse with self-reflections and improve critical thinking.
   C. CORRECT: Improving knowledge by learning new information about evidence-based practice improves the nurse’s ability to think critically.
   D. Although nurses who have advanced critical thinking can do so independently, the nurse should talk to other professionals to share information and remain open-minded and inquisitive.
   E. Quick decision-making can lead to errors. A nurse’s intuition might cause feelings of uncertainty, which should lead the nurse to ask questions about whether the plan of care makes sense and to gather more information.

Question 71

4. A nurse is caring for a client who has a new prescription for antihypertensive medication. Prior to administering the medication, the nurse uses an electronic database to gather information about the medication and the effects it might have on this client. Which of the following components of critical thinking is the nurse using when he reviews the medication information?
   A. Knowledge
   B. Experience
   C. Intuition
   D. Competence

Answer 71

4. A. CORRECT: By using the electronic database, the nurse takes the initiative to increase their knowledge base, which is the first component of critical thinking.
   B. The nurse has had no prior experience w/ administering this medication to this client.
   C. Intuition requires experience, which the nurse lacks in administering this medication to this client.
   D. Competence involves making judgments, but no one can make a judgment about how the nurse handles researching and administering this medication to this client until they perform those tasks.

Question 72

5. A nurse uses a head‑to‑toe approach to conduct a physical assessment of a client who will undergo surgery the following week. Which of the following critical thinking attitudes did the nurse demonstrate?
   A. Confidence
   B. Perseverance
   C. Integrity
   D. Discipline

Answer 72

5. A. Confidence is feeling sure of one’s own abilities. The nurse might feel confident of their physical assessment skills, but choosing a particular method or sequence requires another attitude.
   B. Perseverance is continuing to work at a problem until the nurse resolves it. This attitude does not apply here.
   C. Integrity is a practicing truthfully and ethically. This specific attitude does not apply here.
   D. CORRECT: Discipline includes using a systematic approach to thinking. Using a head-to-toe approach ensures the nurse is thorough and calculated in getting information about the client’s physical status.

Question 73

List at three critical thinking skills for assessment/ data collection step of the nursing process

Answer 73

● Assessment/Data collection
◯ Observe.
◯ Use correct techniques for collecting data.
◯ Differentiate between relevant and irrelevant data and between important and unimportant data.
◯ Organize, categorize, and validate data.
◯ Interpret assessment data and draw a conclusion.

Question 74

List at three critical thinking skills for nalysis/Data Collection step of the nursing process

Answer 74

● Analysis/Data Collection
◯ Identify clusters and cues.
◯ Detect inferences.
◯ Recognize an actual or potential problem or risk.
◯ Avoid making judgments.

Question 75

List at three critical thinking skills for Planning step of the nursing process

Answer 75

● Planning
◯ Identify goals and outcomes for client care.
◯ Set priorities.
◯ Determine appropriate strategies and interventions for inclusion on a plan of care or teaching plan.
◯ Take knowledge and apply it to more than one situation.
◯ Create outcome criteria.
◯ Theorize.
◯ Consider the consequences of implementation.

Question 76

List at three critical thinking skills for Implementation step of the nursing process

Answer 76

● Implementation
◯ Use knowledge base.
◯ Use appropriate skills and teaching strategies.
◯ Test theories.
◯ Delegate and supervise nursing care.
◯ Communicate appropriately in response to a situation.

Question 77

List at three critical thinking skills for Evaluation step of the nursing process

Answer 77

● Evaluation
◯ Determine accuracy of theories.
◯ Evaluate outcomes based on specific criteria.
◯ Determine understanding of teaching.