WGU C365 Critical Thinking in Nursing
Exam 2025/2026 – Real 55 Questions with
Correct Answers and Full Explanations
Question 1
A nurse is caring for a client with chest pain who reports sudden shortness of breath. Which
action demonstrates critical thinking in prioritizing care?
A. Administer prescribed pain medication immediately
B. Assess oxygen saturation and respiratory status
C. Obtain a 12-lead ECG
D. Notify the physician before further assessment
Explanation: Critical thinking involves prioritizing life-threatening issues. Shortness of
breath suggests possible hypoxia or acute cardiac event; assessing oxygen saturation and
respiratory status (airway, breathing) is the priority per ABCs. Pain medication (A)
addresses comfort, not urgency; ECG (C) is diagnostic but secondary; notifying physician
(D) follows initial assessment to provide accurate data.
Question 2
A client with diabetes mellitus type 2 has a blood glucose of 350 mg/dL. The nurse notes
shakiness and confusion. What critical thinking step should the nurse take first?
A. Reassess blood glucose to confirm accuracy
B. Administer insulin immediately
C. Provide a high-carbohydrate snack
D. Notify the healthcare provider
Explanation: Critical thinking requires validating data before acting. Shakiness and
confusion with high glucose suggest possible hyperglycemia or misread hypoglycemia.
Reassessing confirms accuracy, preventing errors (e.g., giving insulin for misread
hypoglycemia). Insulin (B) or snack (C) depends on confirmation; notifying (D) follows
assessment.
Question 3
,A nurse is delegating tasks to a licensed practical nurse (LPN). Which task requires the RN’s
critical thinking skills and should not be delegated?
A. Administering oral medications
B. Monitoring vital signs
C. Developing a care plan for a new admission
D. Assisting with ambulation
Explanation: Critical thinking involves complex decision-making. Developing a care plan
(C) requires assessment, analysis, and prioritization, which are RN responsibilities.
Administering medications (A), monitoring vitals (B), and assisting with ambulation (D)
are within LPN scope under RN supervision.
Question 4
A client with heart failure reports a 4-pound weight gain in 2 days. Which critical thinking
approach guides the nurse’s next action?
A. Analyze the data to determine fluid retention
B. Restrict all fluids immediately
C. Administer a diuretic without assessment
D. Ignore the weight gain as insignificant
Explanation: Critical thinking involves analyzing data to identify patterns. A 4-pound gain
in heart failure suggests fluid retention, requiring further assessment (e.g., edema, lung
sounds). Restricting fluids (B) or giving diuretics (C) without assessment is premature;
ignoring (D) dismisses a significant finding.
Question 5
A nurse observes a client with a new tracheostomy coughing and struggling to breathe. What
critical thinking action is most appropriate?
A. Suction the tracheostomy immediately
B. Assess airway patency and respiratory effort
C. Administer oxygen at 10 L/min
D. Call for a respiratory therapist
Explanation: Critical thinking prioritizes assessment to identify the cause (e.g., obstruction,
mucus plug). Assessing airway and breathing guides intervention. Immediate suctioning
(A) or oxygen (C) may be needed but assessment directs; calling RT (D) follows initial
evaluation.
, Question 6
A client with a history of seizures is found unresponsive during a seizure. Which critical thinking
principle guides the nurse’s response?
A. Administer antiseizure medication immediately
B. Restrain the client to prevent injury
C. Ensure safety by protecting the client’s head
D. Insert an airway to maintain breathing
Explanation: Critical thinking focuses on safety first. Protecting the head prevents injury
during a seizure. Medication (A) is post-seizure; restraining (B) risks harm; airway
insertion (D) is unsafe during active seizure.
Question 7
A nurse receives a verbal order for morphine 2 mg IV push. What critical thinking action ensures
safe administration?
A. Clarify the order with the prescriber
B. Administer the medication as ordered
C. Document the order after administration
D. Delegate administration to an LPN
Explanation: Critical thinking requires verifying unclear or verbal orders to prevent
errors. Clarifying ensures accuracy. Administering without verification (B) risks error;
documenting after (C) violates policy; delegating (D) is inappropriate for IV push by RN.
Question 8
A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88%.
What critical thinking approach guides the nurse’s response?
A. Increase oxygen to 6 L/min immediately
B. Assess respiratory status and history
C. Encourage deep breathing exercises
D. Notify the provider without assessment
Explanation: Critical thinking involves assessing before acting. In COPD, 88% saturation
may be baseline; assess respiratory effort, history, and symptoms to determine need.
Increasing oxygen (A) risks CO2 retention; exercises (C) secondary; notifying (D) after
assessment.
Exam 2025/2026 – Real 55 Questions with
Correct Answers and Full Explanations
Question 1
A nurse is caring for a client with chest pain who reports sudden shortness of breath. Which
action demonstrates critical thinking in prioritizing care?
A. Administer prescribed pain medication immediately
B. Assess oxygen saturation and respiratory status
C. Obtain a 12-lead ECG
D. Notify the physician before further assessment
Explanation: Critical thinking involves prioritizing life-threatening issues. Shortness of
breath suggests possible hypoxia or acute cardiac event; assessing oxygen saturation and
respiratory status (airway, breathing) is the priority per ABCs. Pain medication (A)
addresses comfort, not urgency; ECG (C) is diagnostic but secondary; notifying physician
(D) follows initial assessment to provide accurate data.
Question 2
A client with diabetes mellitus type 2 has a blood glucose of 350 mg/dL. The nurse notes
shakiness and confusion. What critical thinking step should the nurse take first?
A. Reassess blood glucose to confirm accuracy
B. Administer insulin immediately
C. Provide a high-carbohydrate snack
D. Notify the healthcare provider
Explanation: Critical thinking requires validating data before acting. Shakiness and
confusion with high glucose suggest possible hyperglycemia or misread hypoglycemia.
Reassessing confirms accuracy, preventing errors (e.g., giving insulin for misread
hypoglycemia). Insulin (B) or snack (C) depends on confirmation; notifying (D) follows
assessment.
Question 3
,A nurse is delegating tasks to a licensed practical nurse (LPN). Which task requires the RN’s
critical thinking skills and should not be delegated?
A. Administering oral medications
B. Monitoring vital signs
C. Developing a care plan for a new admission
D. Assisting with ambulation
Explanation: Critical thinking involves complex decision-making. Developing a care plan
(C) requires assessment, analysis, and prioritization, which are RN responsibilities.
Administering medications (A), monitoring vitals (B), and assisting with ambulation (D)
are within LPN scope under RN supervision.
Question 4
A client with heart failure reports a 4-pound weight gain in 2 days. Which critical thinking
approach guides the nurse’s next action?
A. Analyze the data to determine fluid retention
B. Restrict all fluids immediately
C. Administer a diuretic without assessment
D. Ignore the weight gain as insignificant
Explanation: Critical thinking involves analyzing data to identify patterns. A 4-pound gain
in heart failure suggests fluid retention, requiring further assessment (e.g., edema, lung
sounds). Restricting fluids (B) or giving diuretics (C) without assessment is premature;
ignoring (D) dismisses a significant finding.
Question 5
A nurse observes a client with a new tracheostomy coughing and struggling to breathe. What
critical thinking action is most appropriate?
A. Suction the tracheostomy immediately
B. Assess airway patency and respiratory effort
C. Administer oxygen at 10 L/min
D. Call for a respiratory therapist
Explanation: Critical thinking prioritizes assessment to identify the cause (e.g., obstruction,
mucus plug). Assessing airway and breathing guides intervention. Immediate suctioning
(A) or oxygen (C) may be needed but assessment directs; calling RT (D) follows initial
evaluation.
, Question 6
A client with a history of seizures is found unresponsive during a seizure. Which critical thinking
principle guides the nurse’s response?
A. Administer antiseizure medication immediately
B. Restrain the client to prevent injury
C. Ensure safety by protecting the client’s head
D. Insert an airway to maintain breathing
Explanation: Critical thinking focuses on safety first. Protecting the head prevents injury
during a seizure. Medication (A) is post-seizure; restraining (B) risks harm; airway
insertion (D) is unsafe during active seizure.
Question 7
A nurse receives a verbal order for morphine 2 mg IV push. What critical thinking action ensures
safe administration?
A. Clarify the order with the prescriber
B. Administer the medication as ordered
C. Document the order after administration
D. Delegate administration to an LPN
Explanation: Critical thinking requires verifying unclear or verbal orders to prevent
errors. Clarifying ensures accuracy. Administering without verification (B) risks error;
documenting after (C) violates policy; delegating (D) is inappropriate for IV push by RN.
Question 8
A client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 88%.
What critical thinking approach guides the nurse’s response?
A. Increase oxygen to 6 L/min immediately
B. Assess respiratory status and history
C. Encourage deep breathing exercises
D. Notify the provider without assessment
Explanation: Critical thinking involves assessing before acting. In COPD, 88% saturation
may be baseline; assess respiratory effort, history, and symptoms to determine need.
Increasing oxygen (A) risks CO2 retention; exercises (C) secondary; notifying (D) after
assessment.
