Thinking in Nursing Practice Test
Bank with Solved Solutions.
*Two pt deaths have occurred on a medical unit in the last month. The staff notices that
everyone feels pressured and team members are getting into more arguments. As a nurse on
the unit, what will best help you manage this stress*
A. keep a journal
B. participate in a unit meeting to discuss feelings about the pt deaths
C. ask the nurse manager to assign you to less difficult patients
D. review the policy and procedure manual on proper care of patients after death - Answer
*Answer: B*
Rationale: By connecting and meeting with staff colleagues, the nurse can talk about the
experiences of caring for dying patients and learn that her feelings are likely shared by others. A
journal is helpful but not the best way to relieve stress. A policy and procedure manual will not
help the nurse examine and understand the nature of the stress. Asking for a different
assignment is no guarantee that another stressful experience will develop.
*A nurse has seen many cancer patients struggle with pain management bc they are afraid of
becoming addicted to the medicine. Pain control is a priority for cancer care. By helping patients
focus on their values and beliefs about pain control, a nurse can best make clinical decisions.
This is an example of:*
A. creativity
B. fairness
C. clinical reasoning
D. applying ethical criteria - Answer *Answer: D*
Rationale: The use of ethical criteria for nursing judgment allows a nurse to focus on a patient's
values and beliefs. Clinical decisions are then just, faithful to the patient's choices, and
beneficial to the patient's well-being.
*A nurse prepares to insert a Foley catheter. The procedure manual calls for the pt to lie in the
dorsal recumbent position. The pt complains of having back pain when lying on her back.
Despite this, the nurse positions the pt supine with knees flexed as the manual recommends
and begins to insert the catheter. This is an example of:*
A. accuracy
, Rationale: Basic critical thinking is concrete and based on a set of rules or principles, such as the
guidelines in a hospital procedure manual. The nurse's approach is not accurate, as accuracy
requires use of all of the facts (e.g. the patient's discomfort). A critical thinker is willing to take
risks in trying different ways to solve problems; following one basic approach is not risk taking.
This is also not an example of reflection.
*A nurse is preparing medications for a patient. The nurse checks the name of the medication
on the label with the name of the medication on the doctor's order. At the bedside the nurse
checks the patient's name against the medication order as well. The nurse is following which
critical thinking attitude:*
A. responsible
B. complete
C. accurate
D. broad - Answer *Answer: A*
Rationale: The nurse is demonstrating responsibility for correct medication and patient
identification. The other three choices are critical thinking intellectual standards.
*A nurse on a busy medicine unit is assigned to 4 patients. It is 10am. Two patients have
medications due and one of those has a specimen of urine to be collected. One patient is having
complications from surgery and is being prepared to return to the operating room. The fourth pt
requires instruction about activity restrictions before going home this afternoon. Which of the
following should the nurse use in making clinical decisions appropriate for the pt group? (select
all that apply)*
A. consider availability of assistive personnel to obtain the specimen
B. combine activities to resolve more than one pt problem
C. analyze the diagnoses/problems and decide which are most urgent based on patient's need
D. plan a family conference for tomorrow to make decisions about resources the pt will need to
go home
E. Identify the nursing diagnoses for the pt going home - Answer *Answer: A, B, C*
Rationale: Analyzing urgency of problems helps in prioritization as does considering the
resources that are available (such as assistive personnel) to complete patient care activities.
Deciding on how to combine activities is good time management. Holding a family conference is
a good idea but in this case would be too late to be beneficial to the patient. The nurse must
identify nursing diagnoses for all patients in order to determine priorities.
*By using known criteria in conducting an assessment such as reviewing with a pt the typical
characteristics of pain, a nurse is demonstrating which critical thinking attitude?*