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CHAPTER 15: CRITICAL THINKING AND CLINICAL JUDGMENT {Potter: Fundamentals of Nursing, 11th Edition}

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MULTIPLE CHOICE 1. A patient continues to report postsurgical incision pain at a level of 9 out of 10 after pain medicine is given. The next dose of pain medicine is not due for another hour. What should the critically thinking nurse do first? a. Explore other options for pain relief. b. Discuss the surgical procedure and reason for the pain. c. Explain to the patient that nothing else has been ordered. d. Offer to notify the health care provider after morning rounds are completed. ANS: A The critically thinking nurse should explore all options for pain relief first. The nurse should use critical thinking to determine the cause of the pain and determine various options for pain, not just ordered pain medications. The nurse can act independently to determine all options for pain relief and does not have to wait until after the health care provider rounds are completed. Explaining the cause of the pain does not address options for pain relief. DIF: Analyze (analysis) OBJ: Explain the relationship of critical thinking to clinical judgment in nursing practice. TOP: Implementation MSC: Basic Care and Comfort 2. Which action should the nurse take to best develop critical thinking skills? a. Study 3 hours more each night. b. Attend all in-service opportunities. c. Actively participate in clinical experiences. d. Interview staff nurses about their nursing experiences. ANS: C Nursing is a practice discipline. Clinical learning experiences are necessary to acquire clinical decision-making skills. Studying for longer hours, interviewing nurses, and attending in-services do not provide opportunities for clinical decision making, as do actual clinical experiences. DIF: Apply (application) OBJ: Analyze benefits of clinical experiences that contribute to critical thinking. TOP: Implementation MSC: Management of Care 3. While caring for a hospitalized older-adult female post hip surgery, the nurse is faced with the task of inserting an indwelling urinary catheter, which involves rotating the hip into a contraindicated position. Which action should the nurse take? a. Postpone catheter insertion until the next shift. b. Adapt the positioning technique to the situation. c. Notify the health care provider for a urologist consult. d. Follow textbook procedure with contraindicated position.

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C HAPTER 15: C RITICAL T HINKING AND
C LINICAL J UDGMENT
Potter: Fundamentals of Nursing, 11th Edition



MULTIPLE CHOICE


1. A patient continues to report postsurgical incision pain at a level of 9 out
of 10 after pain medicine is given. The next dose of pain medicine is not
due for another hour. What should the criticall y thinking nurse do first?
a. Explore other options for pain relief.
b. Discuss the surgical procedure and reason for the pain.
c. Explain to the patient that nothing else has been ordered.
d. Offer to notify the health care provider after morning rounds are
completed.



ANS: A



The criticall y thinking nurse should explore all options for pain relief
first. The nurse should use critical thinkin g to determine the cause of
the pain and determine various options for pain, not just ordered pain
medications. The nurse can act independentl y to determine all options
for pain relief and does not have to wait until after the health care
provider rounds a re completed. Explaining the cause of the pain does
not address options for pain relief.

, DIF: Anal yze (anal ysis) OBJ: Explain the relationship of critical
thinking to clinical judgment in nursing practice. TOP:
Implementation MSC: Basic Care and Comfort



2. Which action should the nurse take to best develop critical thinking
skills?
a. Study 3 hours more each night.
b. Attend all in -service opportunities.
c. Activel y participate in clinical experiences.
d. Interview staff nurses about their nursing experiences.



ANS: C



Nursing is a practice discipline. Clinical learning experiences are
necessary to acquire clinical decision -making skills. Studying for
longer hours, interviewing nurses, and attending in -services do not
provide opportunities for clinical decision making, as do actual clinical
experiences.



DIF: Appl y (application) OBJ: Anal yze benefits of clinical
experiences that contribute to critical thinking. TOP:
Implementation MSC: Management of Care



3. While caring for a hospitalized older -adult female post hip surg ery, the
nurse is faced with the task of inserting an indwelling urinary catheter,
which involves rotating the hip into a contraindicated position. Which
action should the nurse take?
a. Postpone catheter insertion until the next shift.
b. Adapt the positioning technique to the situation.
c. Notify the health care provider for a urologist consult.

, d. Follow textbook procedure with contraindicated position.



ANS: B



The nurse must use critical thinking skills in this situation to adapt
positioning technique. In practice , patient procedures are not always
presented as in a textbook, but they are individualized. A urologist
consult is not warranted for positioning problems. Postponing insertion
of the catheter is not an appropriate action.



DIF: Appl y (application) OBJ: Anal yze benefits of clinical
experiences that contribute to critical thinking. TOP:
Implementation MSC: Basic Care and Comfort



4. The nurse enters a room to find the patient sitting up in bed crying. How
will the nurse display a critical thinking attitude in this situation?
a. Provide privacy and check on the patient 30 minutes later.
b. Set a box of tissues at the patient’s bedside before leaving the room.
c. Limit visitors while the patient is upset.
d. Ask the patient what triggered the crying.



ANS: D



A clinical sign or symp tom (crying) often indicates a variet y of
problems. Explore and learn more about the patient so as to make
appropriate clinical judgments. This is demonstrating curiosity, which
is an attitude of critical thinking. Checking on the patient 30 minutes
later, providing tissues, and limiting visitors may be appropriate
actions but these actions do not address critical thinking.

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