basic nursing potter perry 7th Test bank

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basic nursing potter perry 7th Test bank

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Potter: Basic Nursing, 7th Edition

Chapter 07: Critical Thinking

Test Bank

MULTIPLE CHOICE

1. A registered nurse is caring for a 68-year-old patient in the trauma unit who had been involved in a motor vehicle accident. Although the patient denied pain, during the nurses assessment, she observed that he groaned when moving and was protective of his right arm. She believed the patient had pain and reported it to the health care provider who ordered a radiograph of his right arm. The radiograph revealed a fractured humerus. This is best described as which of the following?
A.
Intuition
B.
Critical thinking
C.
Nursing process
D.
Reflection

ANS: B
Critical thinking is the active, organized, cognitive process used to carefully examine ones thinking and the thinking of others. It 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.

PTS: 1 DIF: Cognitive Level: Analysis REF: 92
OBJ: Discuss critical thinking skills used in nursing practice
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

2. A registered nurse is caring for a postoperative patient whose systolic blood pressure has dropped 10 points during his shift. He remembers that this was similar to a situation that happened in the past when the patient developed an internal bleed. The nurses thoughts are best described as which of the following?
A.
Intuition
B.
Critical thinking
C.
Nursing process
D.
Reflection

ANS: D
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.

PTS: 1 DIF: Cognitive Level: Analysis REF: 90
OBJ: Discuss critical thinking skills used in nursing practice
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

3. Blair, a student nurse, is assisting a nurse with admitting a 73-year-old woman with a fractured ulna and radius to the trauma unit of the hospital. The patients daughter and son-in-law are with her. Blair notices that the patient does not make eye contact when answering questions and she feels that something is not right about the situation. This can best be explained by which of the following?
A.
Intuition
B.
Critical thinking
C.
Nursing process
D.
Reflection

ANS: A
Intuition is the inner sensing or gut feeling that something is so. For example, a nurse walks into a patients room and, by looking at the patients appearance without the benefit of a thorough assessment, senses that he or she has worsened physically. Intuition is a common experience that many people have when interacting with their environments.

PTS: 1 DIF: Cognitive Level: Application REF: 91-92
OBJ: Discuss critical thinking skills used in nursing practice
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

4. A student nurse is with a medical unit during this clinical rotation. She is administering an enema with her instructor in the room. The patient states that they can no longer hold the enema solution. The student nurse acknowledges the patients request and begins to tell the patient that he can go to the bathroom to expel the enema. 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 Saylors model?
A.
Level 1: Basic
B.
Level 2: Complex
C.
Level 3: Commitment
D.
The student nurse is not demonstrating critical thinking.

ANS: A
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.

PTS: 1 DIF: Cognitive Level: Analysis REF: 92
OBJ: Describe the components of a critical thinking model for clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

5. A novice nursing student will most likely practice nursing at level _____ of critical thinking according to Kataoka-Yahiro and Saylors model.
A.
1
B.
2
C.
3
D.
4

ANS: A
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.

PTS: 1 DIF: Cognitive Level: Application REF: 92
OBJ: Describe the components of a critical thinking model for clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

6. A nursing student learning about the critical thinking process begins with which of the following?
A.
Collecting data
B.
Identifying a problem
C.
Formulating a question
D.
Evaluating the results

ANS: B
The steps of the scientific method are as follows: Problem identification; Collection of data; Formulation of a question or hypothesis; Testing the question or hypothesis; Evaluating results of the study.

PTS: 1 DIF: Cognitive Level: Application REF: 94
OBJ: Describe the components of a critical thinking model for clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

7. A registered nurse is explaining to a 35-year-old woman about what she can expect when her peripherally inserted central line is inserted. Which of the following is the best way for the nurse to explain the procedure?
A.
A PICC line is about the same as a needle in your arm.
B.
A triluminal catheter will be inserted into your basilic vein.
C.
The PICC line will be threaded through your superior vena cava.
D.
A PICC is a catheter that will be inserted in a vein in your arm.

ANS: D
Critical thinkers use language precisely and clearly. When language is unclear and inaccurate, it reflects sloppy thinking. It is important to communicate clearly with patients, their families, and health care professionals. When you use incorrect terminology, jargon or terminology with which a patient is unfamiliar, or vague descriptions, communication is ineffective.

PTS: 1 DIF: Cognitive Level: Analysis REF: 91
OBJ: Describe the components of a critical thinking model for clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

8. A 56-year-old patient receiving blood after an abdominal surgery notified the nurse that her IV pump was alarming. The nurse checked the pump and determined that the tubing was kinked. The tubing was straightened out and the nurse left the room. Five minutes later the IV pump again alarmed. The nurse returned to find the tubing was again kinked. On further investigation, the nurse discovered that the IV tubing had become twisted. This is an example of which of the following on the part of the nurse?
A.
Effective problem solving
B.
Diagnostic reasoning
C.
Scientific method
D.
Commitment level of critical thinking

ANS: A
Effective problem solving involves evaluating the solution over time to be sure that it is still effective.

PTS: 1 DIF: Cognitive Level: Analysis REF: 94
OBJ: Describe the components of a critical thinking model for clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

9. A 16-year-old patient on a pediatric unit who underwent an appendectomy for a ruptured appendix 3 days ago complains of acute pain and has a high fever. The nurse is concerned that she may have an infection and notifies the health care provider of the change in her condition. This concern is based on the nurses experience as a pediatric nurse. Her ability to make a tentative conclusion regarding this patients situation based on observed data is known as what?
A.
Scientific method
B.
Clinical inference
C.
Effective problem solving
D.
Data collection

ANS: B
Clinical inference is a critical thinking skill in which a nurse makes tentative conclusions based on observed data or cues existing in patient situations.

PTS: 1 DIF: Cognitive Level: Analysis REF: 95
OBJ: Describe the components of a critical thinking model for clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

10. Roger, a 34-year-old patient with cancer, is undergoing outpatient chemotherapy. Nancy, the nurse caring for him at the clinic where he goes for his treatments notes that Rogers white blood cell count is very low and he has little energy. Rogers plan of care is based upon the nursing diagnosis Risk for infection. Nancy provides patient teaching in order to reduce Rogers risk for infection. Nancy is using which skill in this situation?
A.
Medical diagnosis
B.
Scientific method
C.
Diagnostic reasoning
D.
Data collection

ANS: C
Diagnostic reasoning involves the use of cognitive thinking, metacognition (thinking about thinking), and assessment skills to structure situations so a nurse can apply knowledge. Expert nurses make diagnostic conclusions in the form of nursing diagnoses.

PTS: 1 DIF: Cognitive Level: Analysis REF: 95
OBJ: Describe the components of a critical thinking model for clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

11. Stacie, a nursing student, is caring for Mrs. Thames, an elderly lady who recently experienced a stroke. Stacie notices that Mrs. Thames coughs after she eats or drinks. Stacie knew that Mrs. Thames was at risk for aspiration because of the stroke that she had experienced and was concerned that Mrs. Thames may have impaired swallowing. Stacie develops a care plan for Mrs. Thames based on the nursing diagnosis Impaired swallowing. Which of the following is Stacie using to make this nursing diagnosis?
A.
Medical diagnosis
B.
Scientific method
C.
Diagnostic reasoning
D.
Data collection

ANS: C
In nursing, diagnostic reasoning is a process of using gathered data, forming inferences, and then logically explaining a clinical judgment.

PTS: 1 DIF: Cognitive Level: Analysis REF: 95
OBJ: Explain the relationship between clinical experience and critical thinking
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

12. A nurse who is demonstrating clinical decision-making is:
A.
collecting information about a patient and coming to a conclusion about his or her health problems.
B.
clarifying the problem and analyze possible causes.
C.
developing a new idea based on experience and knowledge over time.
D.
selecting appropriate treatment after forming a nursing diagnosis.

ANS: D
Clinical decision-making is a problem-solving activity that focuses on selecting appropriate treatment after forming diagnostic conclusions. Clinical decision-making requires careful reasoning so that a nurse chooses the option for the best patient outcome on the basis of the patients condition and priority of the problem.

PTS: 1 DIF: Cognitive Level: Analysis REF: 95
OBJ: Describe the components of a critical thinking model for clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

13. A new registered nurse working for a busy unit of an acute care teaching hospital begins her shift with four patients. She needs to prioritize care. Which of the following patients should she attend to first?
A.
Patient who needs assistance in ambulating the hall
B.
Patient whose blood pressure suddenly drops and who passes out
C.
Recovering surgical patient whose family has just arrived
D.
Patient who was just diagnosed with cancer and is alone

ANS: B
When a nurse provides care for several patients at one time, he or she will need to use decision-making criteria. These criteria include the clinical conditions of the patients, Maslows hierarchy of needs, risks involved in treatment delays, and the patients expectations of care to determine what patients have the greatest priorities for care.

PTS: 1 DIF: Cognitive Level: Analysis REF: 95
OBJ: Describe the components of a critical thinking model for clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

14. The critical thinking competency that is unique to nurses is the nursing process. Which of the following includes all steps of the nursing process in the correct order?
A.
Assessment, diagnosis, planning, implementation, and evaluation
B.
Diagnosis, assessment, planning, implementation, and evaluation
C.
Planning, assessment, diagnosis, implementation, and evaluation
D.
Evaluation, diagnosis, planning, implementation, and assessment

ANS: A
The nursing process is a systematic process that incorporates diagnostic reasoning and clinical decision-making through five steps: assessment, diagnosis, planning, implementation, and evaluation.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 96
OBJ: Discuss the relationship of the nursing process to critical thinking
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

15. A new nurse is working for a surgical unit. One of the postoperative patients has been experiencing a great deal of pain. She notified the surgeon who wrote an order for pain medication. Upon checking the order, she noticed that the dosage was more than three times the normal range for this medication. She called the surgeon to question the order. This is primarily an example of which of the following critical thinking attitudes?
A.
Confidence
B.
Risk-taking
C.
Fairness
D.
Thinking independently

ANS: D
A critical thinker does not accept another persons ideas without question. When thinking independently, a person challenges the ways in which others think and looks for rational and logical answers to problems.

PTS: 1 DIF: Cognitive Level: Analysis REF: 98
OBJ: Discuss the effect attitudes for critical thinking have on clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

16. A nurse for 6 years has always worked for the oncology unit of a hospital. Recently, however, there were cutbacks because more patients are being treated on an outpatient basis, so the nurse transferred to an orthopedic unit where he is caring for a patient who underwent an above-the-knee amputation, something for which he has never provided care. He is to do a dressing change for the amputated leg, so he asks another nurse to help him. He is demonstrating which of the following critical thinking attitudes?
A.
Humility
B.
Confidence
C.
Risk-taking
D.
Fairness

ANS: A
Critical thinkers admit what they do not know and try to find the knowledge they need to make a proper decision. Humility is recognizing when one needs more information to make a decision. When a nurse is new to a clinical division and unfamiliar with the patients, he or she should ask for an orientation to the area and ask nurses regularly assigned to the area for assistance. Nurses should also read professional journals regularly to keep updated on new approaches to care.

PTS: 1 DIF: Cognitive Level: Analysis REF: 99
OBJ: Discuss the effect attitudes for critical thinking have on clinical decision making
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

17. A student nurse in her last semester of nursing school found that keeping a journal of her experiences helped her to understand why she took a certain action and to evaluate whether there was a better way of approaching the task. She has found that this has helped her to grow into the role of a nurse. Which of the following critical thinking attitudes is she demonstrating?
A.
Humility
B.
Confidence
C.
Risk-taking
D.
Reflection

ANS: D
Reflection is an important aspect of critical thinking. Purposeful reflection leads to a deeper understanding of issues and to the development of judgment and skill. One activity that will help a nurse develop into a critical thinker is reflective journaling.

PTS: 1 DIF: Cognitive Level: Application REF: 100
OBJ: Discuss how reflection improves a nurses clinical practice
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

18. A new nurse who has just begun working for an oncology unit is frustrated with trying to figure out the relationships between a patients problems and appropriate nursing interventions. The best tool that she can use to synthesize data into meaningful information is which of the following?
A.
Concept map
B.
Reflective journal
C.
Plan of care
D.
Nursing model

ANS: A
A concept map is a visual representation of patient problems and interventions that shows their relationship to one another. The primary purpose of a concept map is to synthesize relevant data about a patient, including assessment data, nursing diagnoses, health needs, nursing interventions, and evaluation measures.

PTS: 1 DIF: Cognitive Level: Application REF: 101
OBJ: Discuss the relationship of the nursing process to critical thinking
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

19. A nurse walks into a room and finds a patient to be incoherent. As the nurse examines and observes the patient closely, searches for ideas, and considers scientific principles to plan the patients care, the nurse is using:
A.
inferences.
B.
reflection.
C.
intuition.
D.
accountability.

ANS: A
When reflecting, one thinks about or recalls a situation to discover purpose or meaning. Intuition is an inner sensing or gut feeling about something. Accountability refers to being answerable for ones actions.

PTS: 1 DIF: Cognitive Level: Analysis REF: 95
OBJ: Explain the relationship between clinical experience and critical thinking
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

20. Last night a nurse spent time instructing a patient on how to monitor his pulse while taking digoxin. The next day the nurse asks the patient to recount the details of this skill. The nurse is using:
A.
reflection.
B.
evaluation.
C.
perseverance.
D.
assessment.

ANS: A
When a nurse evaluates, he or she is determining if a patient goal has been met. When a nurse perseveres, he or she seeks resources until a successful approach has been found. Assessment involves the act of collecting pertinent patient data.

PTS: 1 DIF: Cognitive Level: Analysis REF: 100
OBJ: Discuss how reflection improves a nurses clinical practice
TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment

21. A patient is admitted with dependent edema. As a nurse assesses the patient for the presence of jugular vein distention, the nurse is using the process of:
A.
evaluation.
B.
data collection.
C.
problem identification.
D.
testing the hypothesis.

ANS: B
When a nurse evaluates, he or she is determining if a patient goal has been met. Problem identification and testing the hypothesis are two steps used in the scientific process.

PTS: 1 DIF: Cognitive Level: Application REF: 94
OBJ: Discuss critical thinking skills used in nursing practice
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

22. When using critical thinking, nurses need to incorporate their cognitive skills and:
A.
integrity.
B.
attitude.
C.
reflection.
D.
assessment.

ANS: B
Integrity refers to the ability to demonstrate honesty and a willingness to admit to mistakes or inconsistencies. When reflecting, one purposefully thinks about or recalls a situation to discover purpose or meaning. Assessment involves the act of collecting pertinent patient data.

PTS: 1 DIF: Cognitive Level: Knowledge REF: 97
OBJ: Discuss the effect attitudes for critical thinking have on clinical decision making
TOP: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment

23. The use of diagnostic reasoning involves a rigorous approach to clinical practice and demonstrates that critical thinking cannot be done in what way?
A.
Logically
B.
Haphazardly
C.
Independently
D.
In a vacuum

ANS: B
Diagnostic reasoning is a process of using gathered data to logically explain a clinical judgment. The information a nurse collects leads to determining the status of a patients condition and to select proper therapies.

PTS: 1 DIF: Cognitive Level: Analysis REF: 96
OBJ: Discuss the effect attitudes for critical thinking have on clinical decision making
TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment

24. The nursing process organizes the approach to delivering nursing care. To provide the best professional care to patients, a nurse needs to incorporate the nursing process and:
A.
decision-making.
B.
problem solving.
C.
intellectual standards.
D.
critical thinking skills.

ANS: D
Nurses use decision-making and problem solving on a daily basis. However, critical thinking skills involve a process and set of skills. Critical thinking includes identification, analysis, evaluation, and making conclusions about a problem.

PTS: 1 DIF: Cognitive Level: Analysis REF: 93
OBJ: Discuss critical thinking skills used in nursing practice
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment

25. While a nurse is assessing a patients chest pain, the patient states, The pain hurts in the middle of my chest. The nurse asks, Can you tell me where the pain is exactly and describe what it feels like? This scenario most accurately depicts application of:
A.
knowledge.
B.
experience.
C.
critical thinking attitudes.
D.
critical thinking standards.

ANS: D
A knowledge base includes information and theory from the basic sciences, behavioral sciences, and nursing. The knowledge base is used to view patient care needs in a holistic manner. Experience is gained when a nurse observes, senses, and talks with patients and then reflects on those experiences. Critical thinking attitudes are guidelines for how to approach a problem or decision-making situation.

PTS: 1 DIF: Cognitive Level: Application REF: 93
OBJ: Discuss critical thinking skills used in nursing practice
TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment

SHORT ANSWER

1. Learning how to correctly administer a bed bath adds to a patients comfort. Additional factors contribute to the concept of comfort. Tying together these concepts demonstrates ____________________.

ANS:
basic critical thinking

Problem solving involves evaluating the solution over time to ensure it is still effective. Complex critical thinking includes alternative and perhaps conflicting solutions as answers to the problem. Commitment to critical thinking implies that a nurse makes choices without assistance from others.

PTS: 1 DIF: Cognitive Level: Application REF: 93
OBJ: Discuss critical thinking skills used in nursing practice
TOP: Nursing Process: Evaluation
MSC: Client Needs: Safe and Effective Care Environment

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