NSG 3100 Exam 1 Questions & Answers 2026/2027 | Latest Updated (Graded A+) | Galen
College of Nursing
Question 1 of 24
The patient is complaining of severe incisional pain 2 days after surgery. The patient has morphine ordered intravenously or by
mouth. When the nurse chooses to give the medication orally, this is an example of which thought process?
• Problem recognition
• Clinical decision-making*
• Clinical reasoning
• Reflection
Clinical judgment is also known as clinical decision-making. It is the observed outcome of critical thinking and clinical reasoning. It is
a repetitious process that uses nursing knowledge to observe and access presenting situations, identify a prioritized client concern, and
generate the best possible evidence-based solutions to deliver safe patient care. Clinical reasoning is the ability to focus and filter
clinical data to recognize what is most and least important, so the nurse can identify if an actual problem is present. Early problem
recognition is critical to safe patient care. Noticing slight or dramatic changes in a patient’s condition and preventing complications is
expected of all nurses. Accurate and ongoing assessment of a patient’s condition is essential throughout nurse–patient interaction.
Reflection, thinking about actions and outcomes, is an integral part of professional development. Practice experiences and negative
and positive patient outcomes can trigger the need for reflection.
Question 2 of 24
The nurse is reviewing the last 3 days of a patient’s pain history and notes that the pain level has remained constant. The nurse
validates the pain level with the patient and decides to contact the provider for further orders. In this scenario, which process is the
nurse is using?
• Clinical reasoning
• Problem recognition
• Reflection
• Clinical judgment*
Clinical judgment is defined by the National Council of State Boards of Nursing (NCSBN) as, “the observed outcome of critical
thinking and decision-making. It is an iterative (repetitious) process that uses nursing knowledge to observe and access presenting
situations, identify a prioritized client concern, and generate the best possible evidence-based solutions in order to deliver safe client
care.” Reflection, thinking about actions and outcomes, is an integral part of professional development. Practice experiences and
negative and positive patient outcomes can trigger the need for reflection. Clinical reasoning is the ability to focus and filter clinical
data to recognize what is most and least important, so the nurse can identify if an actual problem is present. Early problem recognition
is critical to safe patient care. Early problem recognition is critical to safe patient care. Noticing slight or dramatic changes in a
patient’s condition and preventing complications is expected of all nurses. Accurate and ongoing assessment of a patient’s condition is
essential throughout nurse–patient interaction.
Question 3 of 24
The nurse has been hired for a first job and is nervous about making errors in clinical judgment. It is important for the nurse to
realize that clinical reasoning and the ability to make decisions in a clinical setting occurs at which time?
• When it is solely based in clinical experience
• When it has been instilled in the content covered in nursing school
• When it is an expectation of all nurses regardless of experience
• When it develops over time with increased knowledge and expertise*
Clinical reasoning skills are essential to developing strong clinical judgment. It involves knowledge development, psychomotor
competencies, and certain attitudes and behaviors to acquire. A nurse’s clinical reasoning skills develop over time as knowledge and
expertise increase.
,Question 4 of 24
The nurse is taking an advanced cardiac life support (ACLS) recertification class. As part of that class, the nurse and other nurses in
the group rotate responsibilities during multiple mock code exercises simulating cardiac arrest scenarios. The nurse recognizes
what process is assigning the nurses to these different responsibilities?
• Simulation*
• Concept mapping
• Collaborative group work
• Literature review
Simulated experiences enable the student to apply previously learned content in a safe and realistic environment that allows time for
questioning, clarifying, and feedback. Students develop confidence in providing direct nursing care. The concept map is a way to
organize and visualize data to identify relationships and solve problems. Collaborative group work combines the knowledge, ideas,
and experiences of each group member to guide the decision-making process. Adding collaboration with an expert role model such as
an experienced nurse, faculty member, or mentor can further increase the learning that takes place. Because critical thinking cannot
occur about subjects that are unknown, a review of literature may foster this type of thinking by addressing knowledge deficits.
Question 5 of 24
The nurse is preparing to administer an anticoagulant when the patient says, “Why do I have these bruises on my arms?” The nurse
reviews the patient’s blood tests and notes an abnormal bleeding time. When the nurse then decides to hold the medication and
notify the health care provider, the nurse recognizes this to be an example of which action?
• Reviewing the literature
• Thinking ahead
• Critical thinking*
• Analyzing cues
Critical thinking involves the application of knowledge and experience to identify patient problems and to direct clinical judgments
and actions that result in positive patient outcomes. In this case, the nurse is able to connect the medication, physical signs, and
laboratory data to determine a course of action. Thinking ahead requires being prepared, anticipating potential challenges, and
identifying necessary resources that can provide helpful information. The literature review is used to address knowledge gaps through
the review of scholarly journals. Analyzing cues is being able to organize and link the recognized cues to the patient’s clinical
presentation.
Question 6 of 24
The nurse is preparing to restart a patient’s intravenous line and discovers that the patient has no usable veins in either arm. When
working to solve this problem, the nurse should carry out which action?
• Contact the provider and report the concern.
• Not start the intravenous line.
• Discuss the problem with the nurse in charge.*
• Conduct an Internet search for infusion journal articles.
Experienced nurses who have confidence and strong clinical judgment know when to seek help and collaborate with more experienced
colleagues. It is critical for students and nurses at all stages of their education and careers to know when, and from whom, to seek
guidance. Through dialog with others who have expertise or experience with the issue being faced, knowledge gaps can be filled,
erroneous assumptions exposed, and unconscious biases addressed. Not starting the intravenous line is not an option at this point. A
literature review to gain published information about intravenous complications may be appropriate after the patient’s concern has
been addressed. Initially contacting the provider without fully exploring the options for alternate insertion sites is neither wise nor
recommended.
,Question 7 of 24
The nurse has finished a shift and is on the way home. During the shift, one of the patients attempted to climb out of bed and fell.
When the nurse is returning home and is thinking about what could have been done differently to be prevent the fall, this would be
an example of what concept?
• Reflection*
• Intuition
• Critical thinking
• Attributes
Reflection is an effective tool that enables students and nurses to think about how best to improve their future caregiving in similar
situations. The results of deliberate thinking are used to guide further thinking. Many nurses refer to intuition as a “gut feeling” or
“sixth sense” that something is wrong or about to happen with a patient before any clear evidence of an impending change or crisis
exists. Intuition is a by-product of knowledge and experience. It allows a nurse to respond to situations automatically or know what to
do because of having been exposed to similar circumstances in the past. Some personal characteristics are associated with critical
thinking. Critical thinking needs to be assessed and evaluated according to standards to ensure the quality of thinking. Individual
attributes and environmental factors influence a nurse’s clinical judgment skills.
Question 8 of 24
When working on the ability to critically think, the nurse needs to assess for personal critical thinking indicators that includes which
quality?
• Being reactive
• Having rigid behavior
• Being honest*
• Showing complete independence
To develop critical thinking, the nurse needs to assess for the personal critical thinking indicators. Included in these indicators is being
honest and upright, which is looking for the truth, even if it sheds unwanted light and demonstrating integrity (adheres to moral and
ethical standards; admits flaws in thinking). Rather than being rigid, an indicator is being flexible, which is changing approaches as
needed to get the best results. Rather than showing complete independence, an indicator is being careful and prudent, which is seeking
help as needed, suspending or revising judgment as indicated by new or incomplete data. Rather than being reactive, an indicator is
being proactive, which is anticipating consequences, planning ahead, and acting on opportunities.
Question 9 of 24
The nurse administers an ordered intravenous pain medication that is expected to decrease a patient’s pain level within 5 minutes,
but the patient cries out in pain and reports a pain level of 10 at the end of that time frame. What type of refection is it when should
the nurse looks for interventions that could be initiated to reduce the patient’s severe pain?
• Positive reflection
• Reflect-on-action
• Reflect-in-action*
• Negative reflecting
Reflection, which is thinking about actions and outcomes, is an integral part of professional development. Practice experiences and
negative and positive patient outcomes can trigger the need for reflection. Research studies have found that reflection is a key attribute
to improving a nurse’s clinical judgment. Reflection-in-action refers to nurses’ ability to “read” the patient—how he or she is
responding to the nursing intervention—and adjust the interventions based on assessment. Reflection-in-action may take place more
frequently in situations when expected outcomes for patients are not achieved. Reflection-on-action takes place retrospectively.
Negative reflecting and positive reflection are not types of reflection.
, Question 10 of 24
The NCSBN Clinical Judgment Measurement Model (NCSBN-CJMM) contains six clearly defined steps, with each one identifying a
thought process integral to making sound clinical judgments/decisions. The nurse identifies which question to be an example of the
step of analyzing cues?
• “Why is a particular cue or subset of cues of concern?”*
• “Would other interventions have been more effective?”
• “What information is relevant/irrelevant?”
• “Which possible explanations are the most serious?”
Organizing and linking the recognized cues to the client’s clinical presentation is analysis. The question “Why is a particular cue or
subset of cues of concern?” is analyzing cues. Evaluating and ranking hypotheses according to priority (urgency, likelihood, risk,
difficulty, time, etc.) is prioritizing hypotheses. The question “Which possible explanations are the most serious?” is an example of
this step. Identifying relevant and important information from different sources (e.g., medical history, vital signs) is recognizing cues.
The question “What information is relevant/irrelevant?” is an example of this step. Evaluating outcomes is comparing observed
outcomes against expected outcomes. The question “Would other interventions have been more effective?” is an example of this step.
Question 11 of 24
The nurse identifies what characteristic that would not be needed for personal critical thinking skills to be established?
• Health-oriented
• Defensive*
• Alert to context
• Courageous
Being defensive is not a personal critical thinking indicator for nurses. Health-oriented (promotes a healthy lifestyle; uses healthy
behaviors to manage stress), courageous (stands up for beliefs; advocates for others; doesn’t hide from challenges), and alert to
context (looks for changes in circumstances that warrant a need to modify approaches; investigates thoroughly when situations
warrant precise, in-depth thinking) are characteristics of personal critical thinking skills.
Question 12 of 24
The nurse identifies which statement to be false regarding professional autonomy?
• Novice nurses are by nature not autonomous and must rely on more experienced colleagues for guidance.
• New graduates may be especially challenged in their clinical judgment when starting their nursing practice in specialty areas.
• Nursing units within a hospital maintain identical rules about what interventions nurses practicing on all units are permitted to
perform.*
• Professional autonomy implies self-sufficiency and independence.
Often each nursing unit within a medical center or hospital has different rules about what interventions nurses practicing on that unit
are permitted to perform. For instance, a nurse practicing in the intensive care unit may be required to draw arterial blood gases
(ABGs) on assigned patients. However, the same nurse may be required to call a respiratory therapist to draw ABGs when working on
a medical-surgical unit. Options a, c, and d are all true statements regarding professional autonomy.
Question 13 of 24
The nurse recognizes that the Lasater Clinical Judgment Rubric does not include which of the following concepts?
• These four key aspects are listed along the side of the Lasater rubric.*
• Lasater’s Clinical Judgment Rubric seeks to expand on Tanner’s Clinical Judgment Model that identifies four key aspects of clinical
judgment: Noticing, Interpreting, Responding, and Reflecting.
• Lasater’s Clinical Judgment Rubric identifies 11 dimensions (specific actions) involved in clinical judgment.
• The rubric is an extremely helpful tool for student self-evaluation and faculty assessment of student clinical judgment progress.
Tanner’s four key aspects are listed across the top of the Lasater rubric. The remaining options (A, B and D) are all true concepts.
College of Nursing
Question 1 of 24
The patient is complaining of severe incisional pain 2 days after surgery. The patient has morphine ordered intravenously or by
mouth. When the nurse chooses to give the medication orally, this is an example of which thought process?
• Problem recognition
• Clinical decision-making*
• Clinical reasoning
• Reflection
Clinical judgment is also known as clinical decision-making. It is the observed outcome of critical thinking and clinical reasoning. It is
a repetitious process that uses nursing knowledge to observe and access presenting situations, identify a prioritized client concern, and
generate the best possible evidence-based solutions to deliver safe patient care. Clinical reasoning is the ability to focus and filter
clinical data to recognize what is most and least important, so the nurse can identify if an actual problem is present. Early problem
recognition is critical to safe patient care. Noticing slight or dramatic changes in a patient’s condition and preventing complications is
expected of all nurses. Accurate and ongoing assessment of a patient’s condition is essential throughout nurse–patient interaction.
Reflection, thinking about actions and outcomes, is an integral part of professional development. Practice experiences and negative
and positive patient outcomes can trigger the need for reflection.
Question 2 of 24
The nurse is reviewing the last 3 days of a patient’s pain history and notes that the pain level has remained constant. The nurse
validates the pain level with the patient and decides to contact the provider for further orders. In this scenario, which process is the
nurse is using?
• Clinical reasoning
• Problem recognition
• Reflection
• Clinical judgment*
Clinical judgment is defined by the National Council of State Boards of Nursing (NCSBN) as, “the observed outcome of critical
thinking and decision-making. It is an iterative (repetitious) process that uses nursing knowledge to observe and access presenting
situations, identify a prioritized client concern, and generate the best possible evidence-based solutions in order to deliver safe client
care.” Reflection, thinking about actions and outcomes, is an integral part of professional development. Practice experiences and
negative and positive patient outcomes can trigger the need for reflection. Clinical reasoning is the ability to focus and filter clinical
data to recognize what is most and least important, so the nurse can identify if an actual problem is present. Early problem recognition
is critical to safe patient care. Early problem recognition is critical to safe patient care. Noticing slight or dramatic changes in a
patient’s condition and preventing complications is expected of all nurses. Accurate and ongoing assessment of a patient’s condition is
essential throughout nurse–patient interaction.
Question 3 of 24
The nurse has been hired for a first job and is nervous about making errors in clinical judgment. It is important for the nurse to
realize that clinical reasoning and the ability to make decisions in a clinical setting occurs at which time?
• When it is solely based in clinical experience
• When it has been instilled in the content covered in nursing school
• When it is an expectation of all nurses regardless of experience
• When it develops over time with increased knowledge and expertise*
Clinical reasoning skills are essential to developing strong clinical judgment. It involves knowledge development, psychomotor
competencies, and certain attitudes and behaviors to acquire. A nurse’s clinical reasoning skills develop over time as knowledge and
expertise increase.
,Question 4 of 24
The nurse is taking an advanced cardiac life support (ACLS) recertification class. As part of that class, the nurse and other nurses in
the group rotate responsibilities during multiple mock code exercises simulating cardiac arrest scenarios. The nurse recognizes
what process is assigning the nurses to these different responsibilities?
• Simulation*
• Concept mapping
• Collaborative group work
• Literature review
Simulated experiences enable the student to apply previously learned content in a safe and realistic environment that allows time for
questioning, clarifying, and feedback. Students develop confidence in providing direct nursing care. The concept map is a way to
organize and visualize data to identify relationships and solve problems. Collaborative group work combines the knowledge, ideas,
and experiences of each group member to guide the decision-making process. Adding collaboration with an expert role model such as
an experienced nurse, faculty member, or mentor can further increase the learning that takes place. Because critical thinking cannot
occur about subjects that are unknown, a review of literature may foster this type of thinking by addressing knowledge deficits.
Question 5 of 24
The nurse is preparing to administer an anticoagulant when the patient says, “Why do I have these bruises on my arms?” The nurse
reviews the patient’s blood tests and notes an abnormal bleeding time. When the nurse then decides to hold the medication and
notify the health care provider, the nurse recognizes this to be an example of which action?
• Reviewing the literature
• Thinking ahead
• Critical thinking*
• Analyzing cues
Critical thinking involves the application of knowledge and experience to identify patient problems and to direct clinical judgments
and actions that result in positive patient outcomes. In this case, the nurse is able to connect the medication, physical signs, and
laboratory data to determine a course of action. Thinking ahead requires being prepared, anticipating potential challenges, and
identifying necessary resources that can provide helpful information. The literature review is used to address knowledge gaps through
the review of scholarly journals. Analyzing cues is being able to organize and link the recognized cues to the patient’s clinical
presentation.
Question 6 of 24
The nurse is preparing to restart a patient’s intravenous line and discovers that the patient has no usable veins in either arm. When
working to solve this problem, the nurse should carry out which action?
• Contact the provider and report the concern.
• Not start the intravenous line.
• Discuss the problem with the nurse in charge.*
• Conduct an Internet search for infusion journal articles.
Experienced nurses who have confidence and strong clinical judgment know when to seek help and collaborate with more experienced
colleagues. It is critical for students and nurses at all stages of their education and careers to know when, and from whom, to seek
guidance. Through dialog with others who have expertise or experience with the issue being faced, knowledge gaps can be filled,
erroneous assumptions exposed, and unconscious biases addressed. Not starting the intravenous line is not an option at this point. A
literature review to gain published information about intravenous complications may be appropriate after the patient’s concern has
been addressed. Initially contacting the provider without fully exploring the options for alternate insertion sites is neither wise nor
recommended.
,Question 7 of 24
The nurse has finished a shift and is on the way home. During the shift, one of the patients attempted to climb out of bed and fell.
When the nurse is returning home and is thinking about what could have been done differently to be prevent the fall, this would be
an example of what concept?
• Reflection*
• Intuition
• Critical thinking
• Attributes
Reflection is an effective tool that enables students and nurses to think about how best to improve their future caregiving in similar
situations. The results of deliberate thinking are used to guide further thinking. Many nurses refer to intuition as a “gut feeling” or
“sixth sense” that something is wrong or about to happen with a patient before any clear evidence of an impending change or crisis
exists. Intuition is a by-product of knowledge and experience. It allows a nurse to respond to situations automatically or know what to
do because of having been exposed to similar circumstances in the past. Some personal characteristics are associated with critical
thinking. Critical thinking needs to be assessed and evaluated according to standards to ensure the quality of thinking. Individual
attributes and environmental factors influence a nurse’s clinical judgment skills.
Question 8 of 24
When working on the ability to critically think, the nurse needs to assess for personal critical thinking indicators that includes which
quality?
• Being reactive
• Having rigid behavior
• Being honest*
• Showing complete independence
To develop critical thinking, the nurse needs to assess for the personal critical thinking indicators. Included in these indicators is being
honest and upright, which is looking for the truth, even if it sheds unwanted light and demonstrating integrity (adheres to moral and
ethical standards; admits flaws in thinking). Rather than being rigid, an indicator is being flexible, which is changing approaches as
needed to get the best results. Rather than showing complete independence, an indicator is being careful and prudent, which is seeking
help as needed, suspending or revising judgment as indicated by new or incomplete data. Rather than being reactive, an indicator is
being proactive, which is anticipating consequences, planning ahead, and acting on opportunities.
Question 9 of 24
The nurse administers an ordered intravenous pain medication that is expected to decrease a patient’s pain level within 5 minutes,
but the patient cries out in pain and reports a pain level of 10 at the end of that time frame. What type of refection is it when should
the nurse looks for interventions that could be initiated to reduce the patient’s severe pain?
• Positive reflection
• Reflect-on-action
• Reflect-in-action*
• Negative reflecting
Reflection, which is thinking about actions and outcomes, is an integral part of professional development. Practice experiences and
negative and positive patient outcomes can trigger the need for reflection. Research studies have found that reflection is a key attribute
to improving a nurse’s clinical judgment. Reflection-in-action refers to nurses’ ability to “read” the patient—how he or she is
responding to the nursing intervention—and adjust the interventions based on assessment. Reflection-in-action may take place more
frequently in situations when expected outcomes for patients are not achieved. Reflection-on-action takes place retrospectively.
Negative reflecting and positive reflection are not types of reflection.
, Question 10 of 24
The NCSBN Clinical Judgment Measurement Model (NCSBN-CJMM) contains six clearly defined steps, with each one identifying a
thought process integral to making sound clinical judgments/decisions. The nurse identifies which question to be an example of the
step of analyzing cues?
• “Why is a particular cue or subset of cues of concern?”*
• “Would other interventions have been more effective?”
• “What information is relevant/irrelevant?”
• “Which possible explanations are the most serious?”
Organizing and linking the recognized cues to the client’s clinical presentation is analysis. The question “Why is a particular cue or
subset of cues of concern?” is analyzing cues. Evaluating and ranking hypotheses according to priority (urgency, likelihood, risk,
difficulty, time, etc.) is prioritizing hypotheses. The question “Which possible explanations are the most serious?” is an example of
this step. Identifying relevant and important information from different sources (e.g., medical history, vital signs) is recognizing cues.
The question “What information is relevant/irrelevant?” is an example of this step. Evaluating outcomes is comparing observed
outcomes against expected outcomes. The question “Would other interventions have been more effective?” is an example of this step.
Question 11 of 24
The nurse identifies what characteristic that would not be needed for personal critical thinking skills to be established?
• Health-oriented
• Defensive*
• Alert to context
• Courageous
Being defensive is not a personal critical thinking indicator for nurses. Health-oriented (promotes a healthy lifestyle; uses healthy
behaviors to manage stress), courageous (stands up for beliefs; advocates for others; doesn’t hide from challenges), and alert to
context (looks for changes in circumstances that warrant a need to modify approaches; investigates thoroughly when situations
warrant precise, in-depth thinking) are characteristics of personal critical thinking skills.
Question 12 of 24
The nurse identifies which statement to be false regarding professional autonomy?
• Novice nurses are by nature not autonomous and must rely on more experienced colleagues for guidance.
• New graduates may be especially challenged in their clinical judgment when starting their nursing practice in specialty areas.
• Nursing units within a hospital maintain identical rules about what interventions nurses practicing on all units are permitted to
perform.*
• Professional autonomy implies self-sufficiency and independence.
Often each nursing unit within a medical center or hospital has different rules about what interventions nurses practicing on that unit
are permitted to perform. For instance, a nurse practicing in the intensive care unit may be required to draw arterial blood gases
(ABGs) on assigned patients. However, the same nurse may be required to call a respiratory therapist to draw ABGs when working on
a medical-surgical unit. Options a, c, and d are all true statements regarding professional autonomy.
Question 13 of 24
The nurse recognizes that the Lasater Clinical Judgment Rubric does not include which of the following concepts?
• These four key aspects are listed along the side of the Lasater rubric.*
• Lasater’s Clinical Judgment Rubric seeks to expand on Tanner’s Clinical Judgment Model that identifies four key aspects of clinical
judgment: Noticing, Interpreting, Responding, and Reflecting.
• Lasater’s Clinical Judgment Rubric identifies 11 dimensions (specific actions) involved in clinical judgment.
• The rubric is an extremely helpful tool for student self-evaluation and faculty assessment of student clinical judgment progress.
Tanner’s four key aspects are listed across the top of the Lasater rubric. The remaining options (A, B and D) are all true concepts.
