,Chapter 1: Critical Thinking, Clinical Judgment, and the Nursing
Process
1. Which of the following best describes the relationship between critical
thinking and clinical judgment in nursing practice?
A) Critical thinking is a skill used only in emergencies, while clinical
judgment applies to routine care
B) Clinical judgment is the outcome of applying critical thinking to
patient care situations
C) Critical thinking involves following protocols strictly without
adaptation, whereas clinical judgment allows for flexibility
D) Clinical judgment is intuitive and not related to critical thinking
✅ Correct Answer: B
Rationale: Clinical judgment is the result of applying critical thinking
skills to analyze patient data, make decisions, and take appropriate
nursing actions.
Case Study 1
Case Scenario:
A 55-year-old patient admitted for pneumonia shows fluctuating oxygen
saturation levels despite supplemental oxygen. The nurse must assess the
patient and decide on immediate interventions while considering
possible complications such as respiratory distress or sepsis.
Key Issues:
Monitoring vital signs and oxygenation levels
Recognizing early signs of deterioration
Prioritizing nursing interventions
Communicating changes promptly to the healthcare team
,Guiding Questions:
What data should the nurse collect to evaluate the patient’s
respiratory status?
How does the nurse prioritize assessment and interventions in this
case?
What are the critical signs that indicate escalation of care is
needed?
Suggested Solution:
The nurse should continuously monitor respiratory rate, oxygen
saturation, lung sounds, and work of breathing. Early signs like
increased respiratory effort or confusion warrant immediate notification
of the provider. Administering oxygen, preparing for possible advanced
airway support, and coordinating with the team ensures patient safety.
2. What is the first step in the nursing process?
A) Planning
B) Implementation
C) Assessment
D) Evaluation
✅ Correct Answer: C
Rationale: Assessment is the initial step of the nursing process where
the nurse collects comprehensive data about the patient’s health status.
Case Study 2
Case Scenario:
During a home visit, a nurse evaluates an elderly patient with diabetes
who has poor wound healing on the foot. The patient lives alone and
reports difficulty managing medications.
, Key Issues:
Comprehensive patient assessment in a home environment
Identifying barriers to self-care
Risk for infection due to delayed wound healing
Coordinating community resources and follow-up care
Guiding Questions:
What assessment techniques are appropriate for evaluating the
wound and overall health?
How can the nurse address medication management challenges?
What referrals or interventions should be considered to support the
patient?
Suggested Solution:
The nurse should perform a detailed wound assessment, review
medication regimen and adherence, and evaluate home safety. Teaching
proper wound care, involving a wound care specialist, and arranging for
home health support or social services can improve outcomes.
3. Which critical thinking skill involves distinguishing relevant from
irrelevant data in patient assessment?
A) Interpretation
B) Analysis
C) Inference
D) Explanation
✅ Correct Answer: B
Rationale: Analysis involves breaking down information and evaluating
its relevance and accuracy to make informed decisions.
Process
1. Which of the following best describes the relationship between critical
thinking and clinical judgment in nursing practice?
A) Critical thinking is a skill used only in emergencies, while clinical
judgment applies to routine care
B) Clinical judgment is the outcome of applying critical thinking to
patient care situations
C) Critical thinking involves following protocols strictly without
adaptation, whereas clinical judgment allows for flexibility
D) Clinical judgment is intuitive and not related to critical thinking
✅ Correct Answer: B
Rationale: Clinical judgment is the result of applying critical thinking
skills to analyze patient data, make decisions, and take appropriate
nursing actions.
Case Study 1
Case Scenario:
A 55-year-old patient admitted for pneumonia shows fluctuating oxygen
saturation levels despite supplemental oxygen. The nurse must assess the
patient and decide on immediate interventions while considering
possible complications such as respiratory distress or sepsis.
Key Issues:
Monitoring vital signs and oxygenation levels
Recognizing early signs of deterioration
Prioritizing nursing interventions
Communicating changes promptly to the healthcare team
,Guiding Questions:
What data should the nurse collect to evaluate the patient’s
respiratory status?
How does the nurse prioritize assessment and interventions in this
case?
What are the critical signs that indicate escalation of care is
needed?
Suggested Solution:
The nurse should continuously monitor respiratory rate, oxygen
saturation, lung sounds, and work of breathing. Early signs like
increased respiratory effort or confusion warrant immediate notification
of the provider. Administering oxygen, preparing for possible advanced
airway support, and coordinating with the team ensures patient safety.
2. What is the first step in the nursing process?
A) Planning
B) Implementation
C) Assessment
D) Evaluation
✅ Correct Answer: C
Rationale: Assessment is the initial step of the nursing process where
the nurse collects comprehensive data about the patient’s health status.
Case Study 2
Case Scenario:
During a home visit, a nurse evaluates an elderly patient with diabetes
who has poor wound healing on the foot. The patient lives alone and
reports difficulty managing medications.
, Key Issues:
Comprehensive patient assessment in a home environment
Identifying barriers to self-care
Risk for infection due to delayed wound healing
Coordinating community resources and follow-up care
Guiding Questions:
What assessment techniques are appropriate for evaluating the
wound and overall health?
How can the nurse address medication management challenges?
What referrals or interventions should be considered to support the
patient?
Suggested Solution:
The nurse should perform a detailed wound assessment, review
medication regimen and adherence, and evaluate home safety. Teaching
proper wound care, involving a wound care specialist, and arranging for
home health support or social services can improve outcomes.
3. Which critical thinking skill involves distinguishing relevant from
irrelevant data in patient assessment?
A) Interpretation
B) Analysis
C) Inference
D) Explanation
✅ Correct Answer: B
Rationale: Analysis involves breaking down information and evaluating
its relevance and accuracy to make informed decisions.
