NUR 304 Final Exam Study Guide – Chapter 15 – Comprehensive Review
Material
Chapter 15: Critical thinking in nursing 2 questions - ANS ✔✔What is clinical decision making
and how does it set the nurse apart from assistive personnel?
How does questioning promote critical thinking?
What are the three levels of critical thinking?
Clinical decision making - ANS ✔✔separates professional nurses from assistive personnel (AP)
For example, an RN:
- observes for changes in patient's conditions
- collects data about the changes
- recognizes and identifies new and potential problems
- plans nursing strategies
- takes immediate action when a patient's clinical condition worsens
Nurses direct AP to perform basic aspects of care based on patient need
- AP do not have the knowledge or critical thinking skills to analyze why or when patients'
clinical conditions change and what strategies are required
Good clinical decision making requires you to investigate and analyze all aspects of a clinical
problem and then apply scientific and nursing knowledge to choose the best course of action
,How does questioning promote critical thinking? - ANS ✔✔Following a set of questions or
criteria about the data helps a nurse make thorough and thoughtful decisions
Socratic questioning is a technique for looking beneath the surface, recognizing and examining
assumptions, searching for inconsistencies, examining multiple points of view, and
differentiating what one knows from what one merely believes
What are the three levels of critical thinking? - ANS ✔✔Level 1 = Basic
Level 2 = Complex
Level 3 = Commitment
clinical judgment - ANS ✔✔is a conclusion about a patient's needs or health problems and/or
the decisions to take or avoid action, use or modify standard approaches, or create new
approaches based on the patient's response
components of critical thinking - ANS ✔✔specific knowledge base
experience
competencies
attitudes
standards
, Basic Critical Thinking - ANS ✔✔Beginning nursing students are task oriented as they focus on
performing skills and organizing nursing care activities
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
- ex. as a nursing student you use a hospital procedure manual to confirm how to change an
intravenous (IV) dressing
- you are likely to follow the procedure step by step without adjusting it to meet a patient's
unique needs (e.g., positioning to minimize the patient's pain or mobility restrictions)
---> you do not have enough experience to anticipate how to individualize the procedure when
problems arise
At this level, answers to complex problems are perceived as either right or wrong (e.g., when
the IV is not infusing correctly, the rate must not be regulated correctly), and a single solution
usually resolves each problem (e.g., adjusting the rate instead of trying to position the patient's
arm to prevent catheter kinking)
Basic critical thinking is an early step in developing reasoning
basic - ANS ✔✔A _____________ critical thinker learns to accept the diverse opinions and
values of experts (e.g., instructors and staff nurse preceptors). However, inexperience, weak
competencies, and inflexible attitudes restrict a person's ability to move to the next level of
critical thinking
Complex Critical Thinking - ANS ✔✔Complex critical thinkers begin to rely less on experts and
trust their own decisions more
- ex. while teaching a patient how to use an inhaler, you recognize that your patient cannot
deliver a dose correctly
Material
Chapter 15: Critical thinking in nursing 2 questions - ANS ✔✔What is clinical decision making
and how does it set the nurse apart from assistive personnel?
How does questioning promote critical thinking?
What are the three levels of critical thinking?
Clinical decision making - ANS ✔✔separates professional nurses from assistive personnel (AP)
For example, an RN:
- observes for changes in patient's conditions
- collects data about the changes
- recognizes and identifies new and potential problems
- plans nursing strategies
- takes immediate action when a patient's clinical condition worsens
Nurses direct AP to perform basic aspects of care based on patient need
- AP do not have the knowledge or critical thinking skills to analyze why or when patients'
clinical conditions change and what strategies are required
Good clinical decision making requires you to investigate and analyze all aspects of a clinical
problem and then apply scientific and nursing knowledge to choose the best course of action
,How does questioning promote critical thinking? - ANS ✔✔Following a set of questions or
criteria about the data helps a nurse make thorough and thoughtful decisions
Socratic questioning is a technique for looking beneath the surface, recognizing and examining
assumptions, searching for inconsistencies, examining multiple points of view, and
differentiating what one knows from what one merely believes
What are the three levels of critical thinking? - ANS ✔✔Level 1 = Basic
Level 2 = Complex
Level 3 = Commitment
clinical judgment - ANS ✔✔is a conclusion about a patient's needs or health problems and/or
the decisions to take or avoid action, use or modify standard approaches, or create new
approaches based on the patient's response
components of critical thinking - ANS ✔✔specific knowledge base
experience
competencies
attitudes
standards
, Basic Critical Thinking - ANS ✔✔Beginning nursing students are task oriented as they focus on
performing skills and organizing nursing care activities
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
- ex. as a nursing student you use a hospital procedure manual to confirm how to change an
intravenous (IV) dressing
- you are likely to follow the procedure step by step without adjusting it to meet a patient's
unique needs (e.g., positioning to minimize the patient's pain or mobility restrictions)
---> you do not have enough experience to anticipate how to individualize the procedure when
problems arise
At this level, answers to complex problems are perceived as either right or wrong (e.g., when
the IV is not infusing correctly, the rate must not be regulated correctly), and a single solution
usually resolves each problem (e.g., adjusting the rate instead of trying to position the patient's
arm to prevent catheter kinking)
Basic critical thinking is an early step in developing reasoning
basic - ANS ✔✔A _____________ critical thinker learns to accept the diverse opinions and
values of experts (e.g., instructors and staff nurse preceptors). However, inexperience, weak
competencies, and inflexible attitudes restrict a person's ability to move to the next level of
critical thinking
Complex Critical Thinking - ANS ✔✔Complex critical thinkers begin to rely less on experts and
trust their own decisions more
- ex. while teaching a patient how to use an inhaler, you recognize that your patient cannot
deliver a dose correctly
