Davis Advantage for Understanding Medical-Surgical Nursing 7th Edition Linda S. Williams Test Bank
Chapter 1. Critical Thinking, Clinical Judgment, and the Nursing Process
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is caring for a group of patients on a medical–surgical unit.
The licensed practical nurse/licensed vocational nurse (LPN/LVN)
assesses the patient experiencing a low blood glucosefirst. Which
process was needed to make this decision?
1. Application of clinical judgment
2. Recommendation of the registered nurse (RN)
3. Understanding of what regulates blood glucose levels
4. Knowing the patient’s past medical history
ANS: 1
Chapter: Chapter 1. Critical Thinking, Clinical Judgment, and the Nursing Process
Objective: 7. Explain the difference between critical thinking and clinical judgment.
Page: 2
Heading: Clinical Judgment
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordinated Care
Cognitive Level: Comprehension [Understanding]
Concept: Clinical Judgment
Difficulty: Difficult
Feedback
1 Clinical judgment is the observed outcome of critical thinking and decision
making. The nurse identified the patient at high risk and decided to assess this
person first.
2 The LPN/LVN needs to make clinical decisions independently from the RN.
3 Understanding the pathophysiology of the disease does not determine how
decisions are made.
4 Past medical history is important, but the current clinical cues will determine
prioritized nursing actions.
PTS: 1
CON: Patient-Centered Care
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Davis Advantage for Understanding Medical-Surgical Nursing 7th Edition Linda S. Williams Test Bank
2. The LPN/LVN enters the room of a patient who is angry and yells, “I asked 5 minutes ago for my
pain medication. You’re so worthless!” Which action by the nurse demonstrates intellectual
integrity?
1. Refusing to share details of the interaction with colleagues
2. Responding to the patient that the unlicensed assistive personnel (UAP) did not
communicate the information
3. Refusing to provide care for the patient
4. Getting the medication without saying another word
ANS: 1
Chapter: Chapter 1. Critical Thinking, Clinical Judgment, and the Nursing Process
Objective: 4. Describe attitudes of good critical thinkers.
Page: 3
Heading: Critical Thinking Attitudes
Integrated Process: Communication and Documentation
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Communication
Difficulty: Moderate
Feedback
1 This action demonstrates intellectual integrity, as the nurse refuses to speak
poorly about a patient’s behavior.
2 This action does not allow for accountability and places blame.
3 This action does not demonstrate the attitudes of critical thinking.
4 Nurses should not allow patients to demean them. The nurse should tell the
patient that they now have the opportunity to obtain the medication and will do
so.
PTS: 1
CON: Communication
3. The nurse is collecting data on a patient. Which data is considered cues?
1. Respiratory rate of 26 per minute
2. The doctor will be at the agency in 5 minutes
3. The patient has three daughters
4. The client prefers to use a bedpan rather than a commode chair
ANS: 1
Chapter: Chapter 1. Critical Thinking, Clinical Judgment, and the Nursing Process
Objective: 2. Discuss why critical thinking and clinical judgment are essential in nursing.
Page: 4
Heading: Clinical Judgment Process
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
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Davis Advantage for Understanding Medical-Surgical Nursing 7th Edition Linda S. Williams Test Bank
Client Need: SECE: Coordinated Care
Cognitive Level: Application [Applying]
Concept: Clinical Judgment
Difficulty: Moderate
Feedback
1 Respiratory rate of 26 per minute is an example of a cue that alerts the nurse to a
possible problem.
2 The doctor’s presence is not a cue, but just information.
3 The number of children that a patient has is informational, unless the nurse
needs the support of the children to provide care, then it becomes important.
4 This is patient preference and not a cue.
PTS: 1
CON: Patient-Centered Care
4. Which items are a part of “generate solutions” when using the clinical judgment process?
1. Reposition the patient.
2. Leg pain is rated at an 8/10.
3. Pain medication allowed the patient to sleep.
4. The leg pain is caused from immobility.
ANS: 1
Chapter: Chapter 1. Critical Thinking, Clinical Judgment, and the Nursing Process
Objective: 2. Discuss why critical thinking and clinical judgment are essential in nursing.
Page: 4
Heading: Clinical Judgement Process
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordinated Care
Cognitive Level: Comprehension [Understanding]
Concept: Patient-Centered Care
Difficulty: Easy
Feedback
1 Repositioning is an action or solution the nurse can use to provide comfort.
2 A pain scale rating is a cue.
3 The nurse is evaluating the outcome of the pain medication by recognizing that
the patient is not sleeping.
4 Recognizing that the pain is from immobility is the step of prioritizing
hypotheses.
PTS: 1
CON: Patient-Centered Care
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Davis Advantage for Understanding Medical-Surgical Nursing 7th Edition Linda S. Williams Test Bank
5. The nurse is prioritizing care based on Maslow’s hierarchy of needs. Which need does the nurse
identify as having the highest priority?
1. Job-related stress
2. Feelings of loneliness
3. Poor sleep habits
4. Lack of confidence
ANS: 3
Chapter: Chapter 1. Critical Thinking, Clinical Judgment, and the Nursing Process
Objective: 7. Prioritize patient care activities based on Maslow’s hierarchy of human needs.
Page: 6
Heading: Prioritize Care
Integrated Process: Caring
Client Need: SECE: Coordinated Care
Cognitive Level: Comprehension [Understanding]
Concept: Patient-Centered Care
Difficulty: Easy
Feedback
1 Job-related stress falls under safety, according to Maslow, and is addressed after
physiological needs.
2 According to Maslow, loneliness is addressed under social needs, following
physiological and safety needs.
3 Sleep is a physiological need and is the highest priority.
4 Lack of confidence falls under self-esteem, according to Maslow, and is
addressed following physiological, safety, and social needs.
PTS: 1
CON: Patient-Centered Care
6. The nurse is using the clinical judgment process to provide care to a patient experiencing nausea.
During the process of generating solutions, the patient begins to vomit. What should the nurse do
next?
1. Take actions as prepared.
2. Evaluate outcomes of the solutions generated.
3. Identify and analyze the new cues presented.
4. Generate different solutions.
ANS: 3
Chapter: Chapter 1. Critical Thinking, Clinical Judgment, and the Nursing Process
Objective: 2. Discuss why critical thinking and clinical judgment are essential.
in nursing.