Chapter 08: Critical Thinking

Chapter 08: Critical Thinking

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A registered nurse is caring for a patient in the trauma unit who had been involved in a motor vehicle accident. Although the patient denied pain, during the nurse’s assessment, the nurse observed that the patient groaned when moving and was protective of the right arm. The nurse believed the patient had pain and reported it to the primary health care provider, who ordered a radiograph (x-ray) of the right arm. The radiograph revealed a fractured arm. Which technique did the nurse use?

a.	Intuition
b.	Critical thinking
c.	Perseverance
d.	Reflection

 

 

ANS:   B

The nurse used critical thinking. Critical thinking involves recognizing that an issue (e.g., patient problem) exists, analyzing information related to the issue (e.g., clinical data about a patient), evaluating information (including assumptions and evidence), and drawing conclusions. Intuition is an inner sensing or “gut feeling” that something is so. Reflection is a part of critical thinking that involves the process of purposefully thinking back or recalling a situation to discover its purpose or meaning. Perseverance means to also keep looking for additional resources until you find a successful approach.

 

PTS:    1                      DIF:    Cognitive Level: Analyzing (Analysis)

REF:    106                  OBJ:    Discuss the nurse’s responsibility in making clinical decisions.

TOP:    Nursing Process: Assessment            MSC:   NCLEX: Basic Care and Comfort

 

2. A registered nurse is caring for a postoperative patient whose systolic blood pressure has dropped 10 points during the shift. The nurse remembers that this was similar to a situation that happened in the past when a patient developed an internal bleed. Based upon the nurse’s thoughts, which skill did the nurse use?

a.	Intuition
b.	Critical thinking
c.	Nursing process
d.	Reflection

 

 

ANS:   D

The nurse is using reflection when thinking about a situation in the past that was similar. Reflection is a part of critical thinking that involves the process of purposefully thinking about or recalling a situation to discover its purpose or meaning. Critical thinking involves recognizing that an issue (e.g., patient problem) exists, analyzing information related to the issue (e.g., clinical data about a patient), evaluating information (including assumptions and evidence), and drawing conclusions. Intuition is an inner sensing or “gut feeling” that something is so. The nursing process is a five-step approach that incorporates diagnostic reasoning and clinical decision making.

 

PTS:    1                      DIF:    Cognitive Level: Analyzing (Analysis)

REF:    107                  OBJ:    Describe how reflection improves clinical decision making.

TOP:    Nursing Process: Evaluation              MSC:   NCLEX: Physiological Adaptation

 

3. A nurse is admitting a 73-year-old woman with a fractured ulna and radius to the trauma unit of the hospital. The patient’s daughter and son-in-law are present. The nurse notices that the patient does not make eye contact when answering questions and the nurse senses that something is not right about the situation. Which technique did the nurse use?

a.	Intuition
b.	Critical thinking
c.	Nursing process
d.	Reflection

 

 

ANS:   A

The fact that the nurse “senses” something is not right about the situation is intuition. Intuition is the inner sensing or “gut feeling” that something is so. For example, a nurse walks into a patient’s room and, by looking at the patient’s appearance without the benefit of a thorough assessment, senses that he or she has worsened physically. Reflection is a part of critical thinking that involves the process of purposefully thinking about or recalling a situation to discover its purpose or meaning. Critical thinking involves recognizing that an issue (e.g., patient problem) exists, analyzing information related to the issue (e.g., clinical data about a patient), evaluating information (including assumptions and evidence), and drawing conclusions. The nursing process is a five-step approach that incorporates diagnostic reasoning and clinical decision making.

 

PTS:    1                      DIF:    Cognitive Level: Applying (Application)

REF:    108                  OBJ:    Discuss the nurse’s responsibility in making clinical decisions.

TOP:    Nursing Process: Assessment            MSC:   NCLEX: Safety and Infection Control

 

4. A student nurse is administering an enema with an instructor in the room. The patient states that he or she can no longer hold the enema solution. The student nurse acknowledges the patient’s request and begins to tell the patient to go to the bathroom but asks the instructor if this is OK. The instructor suggests that the patient wait a few minutes to give the enema solution time to be absorbed into the bowel. In this situation the student nurse demonstrates what level of critical thinking according to Kataoka-Yahiro and Saylor’s model?

a.	Level 1: Basic
b.	Level 2: Complex
c.	Level 3: Commitment
d.	Level 4: Expert

 

 

ANS:   A

The student nurse is at the basic level because he or she asked the instructor what to do. At the basic level of critical thinking a learner trusts that experts have the right answers for every problem. Thinking is concrete and based on a set of rules or principles. Complex critical thinkers begin to separate themselves from experts. In complex critical thinking you learn to synthesize knowledge. This means that you develop a new thought or idea based on your experience and knowledge over time. The third level of critical thinking is commitment. You anticipate the need to make choices without assistance from others. You accept accountability for whatever decisions you make. There is no level 4 in this model.

 

PTS:    1                      DIF:    Cognitive Level: Analyzing (Analysis)

REF:    109

OBJ:    Describe the components of a critical thinking model for clinical decision making.

TOP:    Nursing Process: Implementation      MSC:   NCLEX: Basic Care and Comfort