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6. A nursing instructor needs to evaluate students’ abilities to synthesize data and identify
relationships between nursing diagnoses. Which learning assignment is best suited for this
instructor’s needs?
a. Concept mapping
b. Reflective journaling
c. Lecture and discussion
d. Reading assignment with a written summary
ANS: A
Concept mapping challenges thestudent to synthesize data and identify relationships between
nursing diagnoses. theprimary purpose of concept mapping is to better synthesize relevant
data about a patient, including assessment data, nursing diagnoses, health needs, nursing
interventions, and evaluation measures. Reflective journaling involves thinking back to clarify
concepts. Reading assignments and lecture do not best provide an instructor theability to
evaluate students’ abilities to synthesize data.

DIF:Apply (application)
OBJ:Examine thecomponents of critical thinking in clinical decision making.
TOP:Teaching/Learning MSC: Management of Care

7. A nurse is using a critical thinking model to provide care. Which component is first
implemented when helping a nurse make clinical decisions?
a. Attitude
b. Experience
c. Nursing process
d. Specific knowledge base
ANS: D
The first component of thecritical thinking model is a nurse’s specific knowledge base. After
acquiring a sound knowledge base, thenurse can then apply knowledge to different clinical
situations using thenursing process to gain valuable experience. Clinical learning experiences
are necessary to acquire clinical decision-making skills. thenursing process competency is
thethird component of thecritical thinking model. Eleven attitudes define thecentral features of
a critical thinker and how a successful critical thinker approaches a problem.

DIF:Understand (comprehension)
OBJ:Examine thecomponents of critical thinking in clinical decision making.
TOP:Caring MSC: Management of Care

8. Which action by a nurse indicates application of thecritical thinking model to make thebest
clinical decisions?
a. Drawing on past clinical experiences to formulate standardized care plans
b. Relying on recall of information from past lectures and textbooks
c. Depending on thecharge nurse to determine priorities of care
d. Using thenursing process
ANS: D
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The nursing process competency is thethird component of thecritical thinking model. In your
practice, you will apply critical thinking components during each step of thenursing process.
Care plans should be individualized and recalling facts does not utilize critical thinking skills
to make clinical decisions. thenew nurse should not rely on thecharge nurse to determine
priorities of care.

DIF:Apply (application)
OBJ:Examine thecomponents of critical thinking in clinical decision making.
TOP:Implementation MSC: Management of Care

9. A nurse is using thecritical thinking skill of evaluation. Which action will thenurse take?
a. Examine themeaning of data.
b. Support findings and conclusions.
c. Review theeffectiveness of nursing actions.
d. Search for links between thedata and thenurse’s assumptions.
ANS: C
Reviewing theeffectiveness of interventions best describes evaluation. Examining themeaning
of data is inference. Supporting findings and conclusions provides explanations. Searching for
links between thedata and thenurse’s assumptions describes analysis.

DIF:Apply (application)
OBJ:Explain therelationship of critical thinking to clinical judgment in nursing practice.
TOP:Implementation MSC: Management of Care

10. The patient appears to be in no apparent distress, but vital signs taken by assistive personnel
reveal an extremely low pulse. thenurse then auscultates an apical pulse and asks thepatient
whether there is any history of heart problems. thenurse is utilizing which critical thinking
skill?
a. Evaluation
b. Explanation
c. Interpretation
d. Self-regulation
ANS: C
Interpretation involves being orderly in data collection, looking for patterns to categorize data,
and clarifying uncertain data. This nurse is clarifying thedata in this situation. Evaluation
involves determining theeffectiveness of interventions or care provided. thenurse in this
scenario is assessing thepatient, not evaluating interventions. Self-regulation is reflecting on
experiences. Explanation is supporting findings and conclusions. thenurse in this question is
clarifying uncertain data (determining cause of thelow pulse), not supporting thefinding of a
low pulse.

DIF:Apply (application)
OBJ:Examine thecomponents of critical thinking in clinical decision making.
TOP:Assessment MSC: Physiological Adaptation

11. A patient continues to report postsurgical incision pain at a level of 9 out of 10 after pain
medicine is given. thenext dose of pain medicine is not due for another hour. What should
thecritically thinking nurse do first?
a. Explore other options for pain relief.
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b. Discuss thesurgical procedure and reason for thepain.

c. Explain to thepatient that nothing else has been ordered.
d. Offer to notify thehealth care provider after morning rounds are completed.
ANS: A
The critically thinking nurse should explore all options for pain relief first. thenurse should
use critical thinking to determine thecause of thepain and determine various options for pain,
not just ordered pain medications. thenurse can act independently to determine all options for
pain relief and does not have to wait until after thehealth care provider rounds are completed.
Explaining thecause of thepain does not address options for pain relief.

DIF:Analyze (analysis)
OBJ:Explain therelationship of critical thinking to clinical judgment in nursing practice.
TOP:Implementation MSC: Basic Care and Comfort

12. Which action should thenurse take to best develop critical thinking skills?
a. Study 3 hours more each night.
b. Attend all in-service opportunities.
c. Actively participate in clinical experiences.
d. Interview staff nurses about their nursing experiences.
ANS: C
Nursing is a practice discipline. Clinical learning experiences are necessary to acquire clinical
decision-making skills. Studying for longer hours, interviewing nurses, and attending
in-services do not provide opportunities for clinical decision making, as do actual clinical
experiences.

DIF:Apply (application)
OBJ:Analyze benefits of clinical experiences that contribute to critical thinking.
TOP:Implementation MSC: Management of Care

13. While caring for a hospitalized older-adult female post hip surgery, thenurse is faced with
thetask of inserting an indwelling urinary catheter, which involves rotating thehip into a
contraindicated position. Which action should thenurse take?
a. Postpone catheter insertion until thenext shift.
b. Adapt thepositioning technique to thesituation.
c. Notify thehealth care provider for a urologist consult.
d. Follow textbook procedure with contraindicated position.

ANS: B
The nurse must use critical thinking skills in this situation to adapt positioning technique. In
practice, patient procedures are not always presented as in a textbook, but they are
individualized. A urologist consult is not warranted for positioning problems. Postponing
insertion of thecatheter is not an appropriate action.

DIF:Apply (application)
OBJ:Analyze benefits of clinical experiences that contribute to critical thinking.
TOP:Implementation MSC: Basic Care and Comfort

14. The nurse enters a room to find thepatient sitting up in bed crying. How will thenurse display
a critical thinking attitude in this situation?
a. Provide privacy and check on thepatient 30 minutes later.
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b. Set a box of tissues at thepatient’s bedside before leaving theroom.

c. Limit visitors while thepatient is upset.
d. Ask thepatient what triggered thecrying.
ANS: D
A clinical sign or symptom (crying) often indicates a variety of problems. Explore and learn
more about thepatient so as to make appropriate clinical judgments. This is demonstrating
curiosity, which is an attitude of critical thinking. Checking on thepatient 30 minutes later,
providing tissues, and limiting visitors may be appropriate actions but these actions do not
address critical thinking.

DIF:Apply (application)
OBJ:Examine thecomponents of critical thinking in clinical decision making.
TOP:Assessment MSC: Psychosocial Integrity

15. A patient is having difficulty reaching thewater fountain while holding on to crutches.
thenurse suggests that thepatient place thecrutches against thewall while stabilizing him or
herself with two hands on thewater fountain. Which critical thinking attitude did thenurse use
in this situation?
a. Humility
b. Creativity
c. Risk taking
d. Confidence
ANS: B
The nurse uses creativity in this situation to figure out how thepatient can safely get a drink of
water. Humility is recognizing when more information is needed to make a decision.
Confidence is being well prepared to perform nursing care safely. This question best
illustrates theattitude of creativity. Risk taking is demonstrating thecourage to speak out or to
question orders based on thenurse’s own knowledge base.

DIF:Apply (application)
OBJ:Examine thecomponents of critical thinking in clinical decision making.
TOP:Implementation MSC: Safety and Infection Control

16. A nurse is pulled from thesurgical unit to work on theoncology unit. Which action by thenurse
displays humility and responsibility?
a. Refusing theassignment
b. Asking for an orientation to theunit
c. Admitting lack of knowledge and going home
d. Assuming that patient care will be thesame as on theother units
ANS: B
Humility and responsibility are displayed when thenurse realizes lack of knowledge and
requests an orientation to theunit. theother answer choices represent inappropriate actions in
this situation and are not examples of humility and responsibility. thenurse should explore all
options before refusing an assignment. thenurse should not make assumptions. Assuming is
not an example of critical thinking. Admitting lack of knowledge is an example of humility
but going home does not illustrate an example of responsibility.

DIF:Apply (application)
OBJ:Examine thecomponents of critical thinking in clinical decision making.
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TOP:Implementation MSC: Management of Care

17. A nurse is using professional standards to influence clinical decisions. What is therationale for
thenurse’s actions?
a. Establishes minimal passing standards for testing.
b. Utilizes evidence-based practice based on nurses’ needs.
c. Bypasses thepatient’s feelings to promote ethical standards.
d. Uses critical thinking for thehighest level of quality nursing care.
ANS: D
Professional standards promote thehighest level of quality nursing care. Application of
professional standards requires you to use critical thinking for thegood of individuals or
groups. Bypassing thepatient’s feelings is not practicing according to professional standards.
theprimary purpose of professional standards is not to establish minimal passing standards for
testing. Patient care should be based on patient needs, not on nurses’ needs.

DIF:Understand (comprehension)
OBJ:Explain therelationship of critical thinking to clinical judgment in nursing practice.
TOP:Planning MSC: Management of Care

18. A nurse who is caring for a patient with a pressure ulcer applies therecommended dressing
according to hospital policy. Which standard is thenurse following?
a. Fairness
b. Intellectual standards
c. Independent reasoning
d. Institutional practice guidelines
ANS: D
The standards of professional responsibility that a nurse tries to achieve are thestandards cited
in Nurse Practice Acts, institutional practice guidelines (hospital/facility policy), and
professional organizations’ standards of practice (e.g., theAmerican Nurses Association
Standards of Professional Performance). Intellectual standards are guidelines or principles for
rational thought. Fairness and independent reasoning are two examples of critical thinking
attitudes that are designed to help nurses make clinical decisions.

DIF:Apply (application)
OBJ:Explain therelationship of critical thinking to clinical judgment in nursing practice.
TOP:Implementation MSC: Management of Care

19. A nurse is reviewing care plans. Which finding, if identified in a plan of care, should
theregistered nurse revise?
a. Patient’s outcomes for learning
b. Nurse’s assumptions about hospital discharge
c. Identification of several actual health problems
d. Documentation of patient’s ability to meet thegoal
ANS: B