Test Bank of BASIC NURSING ESSENTIALS FOR PRACTICE 7TH EDITION BY POTTER

$20.00

Description

INSTANT DOWNLOAD WITH ANSWERS

BASIC NURSING ESSENTIALS FOR PRACTICE 7TH EDITION BY POTTER

Potter: Basic Nursing, 7th Edition

 

Chapter 06: Evidence-Based Practice

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Which of the following nurses was the first to use evidence-based practice?
A. Mary Brewster
B. Clara Barton
C. Florence Nightingale
D. Lillian Wald

 

 

ANS:   C

Evidence-based practice was first used by the founder of nursing, Florence Nightingale.

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    75

OBJ:    Discuss ways to apply evidence in practice

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A registered nurse has been a nurse for 3 years. She questioned the nurses on the neonatal intensive care unit where she works about the practice of kangaroo care for neonates. She had read literature supporting the practice, but the nurses she works with told her that they had never done anything like that at their institution. She continued to ask questions and began a literature review. Which of the following behaviors was she demonstrating?
A. Nursing process
B. Problem solving methodology
C. Peer review
D. Evidence-based practice

 

 

ANS:   D

More people now question why certain health care approaches are used, which ones work, and which ones do not. Thus evidence-based practice is one response to this shift in thinking, which nurses and other health professionals cannot ignore. Evidence-based practice is a guide for how nurses make accurate, timely, and appropriate clinical decisions.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    75

OBJ:    Discuss ways to apply evidence in practice

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A registered nurse wants to review the latest information regarding prevention of a health care acquired infection. The best place for her to obtain the latest information is which of the following?
A. Latest edition of a nursing textbook
B. Online information
C. Peer-reviewed nursing journal
D. Most recent edition of a nursing magazine

 

 

ANS:   C

The best scientific evidence comes from well-designed, systematically conducted research studies, usually found in peer-reviewed scientific journals. A good textbook incorporates current evidence into the practice guidelines and procedures it describes. However, a textbook relies on the scientific literature, and sometimes information on a particular topic is outdated by the time a book is published.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    75

OBJ:    Explain why critiquing of the literature is a necessary step in evidence-based practice

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A 15-year-old male patient was admitted to the hospital with a bowel obstruction. He underwent surgery and was experiencing postoperative pain. The nurse caring for him had recently read a research article in which a study had been done with neonatal patients and the use of therapeutic touch to assist with pain control. Which of the following is most important for the nurse to consider in this case when applying research to clinical practice?
A. Patient gender
B. Patient preference
C. Stage of patient growth and development
D. Physician orders

 

 

ANS:   B

Using clinical expertise and considering patients’ values and preferences ensures that a nurse will apply the available evidence to practice both safely and appropriately.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    76

OBJ:    Discuss ways to apply evidence in practice

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. Evidence-based practice is a systematic approach to determine the most current and relevant information from which to make patient care decisions. Choose the first step in the evidence-based care process.
A. Collecting the most relevant and best evidence
B. Integrating evidence with one’s clinical expertise
C. Critically appraising the evidence gathered
D. Asking a clinical question

 

 

ANS:   D

EBP is a systematic approach to determine the most current and relevant evidence on which to base patient care decisions. Melnyk and Fineout-Overholt recommend a six-step process for EBP:

  1. Ask a clinical question.
  2. Collect the most relevant and best evidence.
  3. Critically appraise the evidence gathered.
  4. Integrate all evidence with one’s clinical expertise and patient preferences and values in making a practice decision or change.
  5. Evaluate the practice decision or change.
  6. Communicate results of the change.

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    76

OBJ:    Describe the six steps of evidence-based practice

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. The nurse manager of a 30-bed medical surgical unit has noticed that the fall rate of postoperative patients has increased in the past 2 months. This is a clinical situation that he believes should be addressed using evidence-based practice. The clinical question that he is formulating has come about because of which of the following?
A. Literature-focused trigger
B. Problem-focused trigger
C. Knowledge-focused trigger
D. Expectations-focused trigger

 

 

ANS:   B

A problem-focused trigger is one that is experienced in the care for a patient or in an observed trend at a nursing unit.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    76

OBJ:    Develop a PICO or PICOT question

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A registered nurse who works for a surgical intensive care unit (ICU) has recently read several articles in professional nursing journals about the use of quiet time in the ICU to enhance patient outcomes. He would like to apply the research findings to his unit. The clinical question he formulated was generated by which of the following?
A. Literature-focused trigger
B. Problem-focused trigger
C. Knowledge-focused trigger
D. Expectations-focused trigger

 

 

ANS:   C

A knowledge-focused trigger is a question that arises as a result of new information available on the topic. For example, “What is the current evidence for the best way to educate patients with low health literacy?” Important sources of new scientific information are the standards and practice guidelines available from national agencies such as the Agency for Healthcare Research and Quality (AHRQ), the American Pain Society (APS), or the American Association of Critical-Care Nurses (AACN). Other sources of knowledge-focused triggers include recent research publications and nurse experts within an organization.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    76

OBJ:    Develop a PICO or PICOT question

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A nurse’s manager has suggested that she formulate a PICO question to clarify her topic before doing a literature review. The acronym PICO stands for which of the following?
A. Policy, information, comparison, outcome
B. Patient, information, collection, outcome
C. Patient, intervention, comparison, outcome
D. Patient, intervention, communication, outcome

 

 

ANS:   C

P: Patient population of interest. Identify patients by age, sex, ethnicity, disease, or health problem.

I: Intervention of interest. What is the intervention the nurse wants to use in practice (e.g., a treatment, diagnostic test, educational approach)?

C: Comparison of interest. What is the usual standard of care or current intervention used in practice now?

O: Outcome. What result is desired to be achieved or observed as a result of an intervention (e.g., change in patient behavior, physical finding, patient perception)?

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    76

OBJ:    Develop a PICO or PICOT question

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A nurse working on a PICO question has found a large amount of literature available on the topic that she is interested in. There have been multiple studies that have been published. Which of the following types of studies should have the best evidence?
A. Meta-analysis of randomized control trials
B. Opinion of an expert committee
C. One well-designed randomized control trial
D. Systematic review of descriptive and qualitative studies

 

 

ANS:   A

Systematic reviews or meta-analyses are state-of-the-science summaries from an individual researcher or panel of experts. If a nurse is lucky to find a systematic review on the PICO question being asked, it means that a researcher has asked the same PICO question and reviewed the highest level of evidence available.

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    78

OBJ:    Develop a PICO or PICOT question

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A registered nurse is concerned about the quality of life that patients experience after a diagnosis of liver cancer. The most appropriate type of research study from which to gather information about this is which of the following?
A. Quantitative study
B. Randomized trial
C. Qualitative study
D. Case controlled study

 

 

ANS:   C

Qualitative research offers answers when trying to understand patients’ experiences with health problems and the contexts of their experiences. Patients have the chance to tell their stories and share their experiences in qualitative studies. The findings are in-depth because patients usually describe their experiences in detail.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    79

OBJ:    Explain how nursing research improves nursing practice

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. The National Data Base for Nursing Quality Indicators (NDNQI) collects information regarding patient falls, pressure ulcer incidence, and nursing satisfaction. Which of the following organizations require affiliated health care organizations to collect and report this information?
A. The Joint Commission
B. Magnet Recognition Program
C. Centers for Disease Control and Prevention
D. Department of Health and Human Services

 

 

ANS:   B

All Magnet-designated hospitals maintain the National Database of Nursing Quality Indicators (NDNQI). The database includes information from Magnet hospitals on falls, pressure ulcer incidence, and nurse satisfaction.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    79

OBJ:    Explain the relationship between evidence-based practice and performance improvement   TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A student nurse is looking for research articles that she can use to complete her research paper. Where can she look to quickly find out if an article is research or clinically based?
A. Manuscript narrative
B. Abstract
C. Literature review
D. Results or conclusions

 

 

ANS:   B

An abstract is a brief summary of the article that quickly shows whether the article is research or clinically based. An abstract summarizes the purpose of the study or clinical review, the major themes or findings, and the implications for nursing practice.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    80

OBJ:    Discuss the levels of evidence in the literature

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. As a nurse working in an acute care setting, Greta wanted to determine the most accurate way to take patient’s temperatures. She noticed that the tympanic thermometers used by her unit were often not accurate. Greta wrote a PICO question and reviewed the literature. She found that the literature showed tympanic thermometers were not the most accurate method of obtaining a temperature. Greta wanted to change the nursing practice of her unit. What is the most logical next step?
A. Discuss the findings with a physician to gain support.
B. Gain the support of a multidisciplinary team.
C. Share the findings with the nursing practice council.
D. Discuss the findings with an administrator.

 

 

ANS:   C

A key feature of a practice environment that supports the use of best evidence is requiring clinical practice policies and procedures to be evidence based (Oman and others, 2008). Many organizations involve staff nurses and research-prepared advanced practice nurses in reviewing scientific articles relevant to policies and procedures and then making appropriate revisions. Policies and procedures are important tools for supporting hospital-based nurses in using evidence in their everyday practice and promoting positive patient outcomes.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    83

OBJ:    Discuss ways to apply evidence in practice

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. After a practice change has taken place, the final step in the application of evidence-based practice is to do which of the following?
A. Evaluate
B. Educate
C. Implement
D. Plan

 

 

ANS:   A

After applying evidence in practice, the next step is to evaluate the effect.

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    82

OBJ:    Describe the six steps of evidence-based practice

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. The most effective way to evaluate the effectiveness of an evidence-based practice change is to do which of the following?
A. Review literature
B. Survey patients
C. Measure outcomes
D. Educate staff

 

 

ANS:   C

To effectively evaluate the effects of an evidence-based practice change, nurses and staff must measure outcomes.

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    82

OBJ:    Discuss factors to consider in the selection of outcome measures for an evidence-based practice change            TOP:               Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. At a health care organization, patients are turned every two hours to help prevent pressure ulcers. Because of this nursing intervention, patients exhibit far fewer pressure ulcers than the national average. This is known as what?
A. Clinical variable
B. Qualitative research
C. Quantitative research
D. Nursing-sensitive outcome

 

 

ANS:   D

A nursing-sensitive outcome focuses on how nursing interventions affect patients and offers a measure of nursing’s contribution to patient care (Oncology Nursing Society ONS, 2008). Nursing-sensitive outcomes look at the effects of interventions within the scope of nursing practice and are integral to the processes of nursing care.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    82

OBJ:    Discuss factors to consider in the selection of outcome measures for an evidence-based practice change            TOP:               Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. The most important thing that a nurse can do to ensure outcome measurements are accurate is to:
A. communicate results to all clinicians.
B. train all clinicians who are involved in collecting data.
C. maintain a small group of patients in the study.
D. collect all data on the same day.

 

 

ANS:   B

It is important to be consistent and accurate when collecting outcome measures. Clinicians who are involved in outcome measurement should receive proper training in data measurement and collection.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    82

OBJ:    Discuss factors to consider in the selection of outcome measures for an evidence-based practice change            TOP:               Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

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 nurse’s 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 one’s 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

 

  1. 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 nurse’s 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

 

  1. 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 patient’s 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 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. 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

 

  1. 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 patient’s 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 Saylor’s 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

 

  1. A novice nursing student will most likely practice nursing at level _____ of critical thinking according to Kataoka-Yahiro and Saylor’s 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

 

  1. 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

 

  1. 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

 

  1. 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

 

  1. 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 nurse’s experience as a pediatric nurse. Her ability to make a tentative conclusion regarding this patient’s 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

 

  1. 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 Roger’s white blood cell count is very low and he has little energy. Roger’s plan of care is based upon the nursing diagnosis Risk for infection. Nancy provides patient teaching in order to reduce Roger’s 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

 

  1. 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

 

  1. 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 patient’s 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

 

  1. 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, Maslow’s 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

 

  1. 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

 

  1. 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 person’s 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

 

  1. 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

 

  1. 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 nurse’s clinical practice

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A new nurse who has just begun working for an oncology unit is frustrated with trying to figure out the relationships between a patient’s 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

 

  1. 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 patient’s 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 one’s 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

 

  1. 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 nurse’s clinical practice

TOP:    Nursing Process: Evaluation

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. 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

 

  1. 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

 

  1. 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 patient‘s 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

 

  1. 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

 

  1. While a nurse is assessing a patient’s 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 patient’s 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