Critical Thinking Assessment Test Nurses

  • 1. 

    What is the "Nursing Process"? Select all that apply

    • A. 

      Organizational framework for the practice of Nursing

    • B. 

      Systematic method by which nurses plan and provide care for patients

    • C. 

      The application of the nursing process only applies to RN's and not LPN's

    • D. 

      The Nursing Scope and Standards of Practice of the ANA outlines the steps of the nursing process

  • 2. 

    Match the Nursing Process on the left with its description on the right 

    • C. Plan and Identify Outcome
  • 3. 

    ANA defines it as a"systematic dynamic process by which the nurse, through interaction with the client, significant others  and health care providers collect and analyzes data about the client

    • A. 

    • B. 

    • C. 

    • D. 

  • 4. 

    Which of the following is not true about Focused ASSESSMENT

    • A. 

      When patient is critically ill or disoriented

    • B. 

      When patient is unable to respond

    • C. 

      Preferably early in the morning before breakfast.

    • D. 

      When drastic changes are happening to a patient.

  • 5. 

    A synonym for significant data that usually demonstrate an unhealthy response. 

    • A. 

    • B. 

    • C. 

    • D. 

  • 6. 

    Headache, itchiness, warmth

    • A. 

    • B. 

    • C. 

    • D. 

  • 7. 

    Secondary Source of Data. (Select all that apply) 

    • A. 

    • B. 

    • C. 

    • D. 

  • 8. 

    Which of the following is not a method of data collection?

    • A. 

    • B. 

    • C. 

    • D. 

  • 9. 

    If the first method of data collection is to conduct an interview, what is the second method?

    • A. 

    • B. 

    • C. 

    • D. 

      Performance of a physical examination

  • 10. 

    After establishing a database and before the identification of nursing diagnosis, what does a nurse do? 

    • A. 

      Documentation of database

    • B. 

    • C. 

    • D. 

      Acquiring a database of information

  • 11. 

    Data Clustering

    • A. 

      Analyzing signs and symptoms

    • B. 

      Identifying patient statements

    • C. 

      Grouping related cues together

    • D. 

      Entering patient data in the computer

  • 12. 

    Deficient Fluid Volume (Select all that apply)

    • A. 

    • B. 

      Dry skin and dry oral mucous

    • C. 

    • D. 

  • 13. 

    Which of the following refers to the definition of a Nursing Problem?

    • A. 

      Nurse overload and nurse burnout

    • B. 

      When the nurse calls in sick

    • C. 

      Any health care condition that requires diagnostic, therapeutic, or educational actions.

    • D. 

  • 14. 

     Clinical judgment

    • A. 

    • B. 

      Job description of a clinical nurse

    • C. 

    • D. 

  • 15. 

    Components of a Nursing Diagnosis. Select all that apply  

    • A. 

      Nursing diagnosis title or label

    • B. 

      Definition of the title or label

    • C. 

    • D. 

      Contributing, etiologic or related factors

    • E. 

  • 16. 

    Which of the following are true regarding nursing diagnosis? 

    • A. 

      A nursing diagnosis is any problem related to the health of a patient

    • B. 

      When writing a nursing diagnosis, place the adjective before the noun modified

    • C. 

      A nursing diagnosis is usually the etiology of the disease

    • D. 

      Both medical and nursing diagnosis can be converted into a nursing intervention.

  • 17. 

    Clear, precise description of a problem 

    • A. 

    • B. 

    • C. 

    • D. 

  • 18. 

    Risk factors

    • A. 

    • B. 

      Analysis of a health issue

    • C. 

    • D. 

      Circumstances that increase the susceptibility of a patient to a problem

  • 19. 

    Clinical cues, signs, symptoms that furnish evidence that the problem exists. 

    • A. 

    • B. 

    • C. 

    • D. 

  • 20. 

    How cues, signs and symptoms identified in patient's assessment are written

    • A. 

    • B. 

    • C. 

    • D. 

  • 21. 

    "Constipation related to insufficient fluid intake manifested by increased abdominal pressure". What is the defining characteristic? 

    • A. 

    • B. 

    • C. 

      Increased abdominal pressure

    • D. 

  • 22. 

    What is RISK NURSING DIAGNOSIS as described by NANDA-I?  Select all that apply

    • A. 

      Human responses to health conditions/life processes that may develop in a vulnerable individual/family

    • B. 

      Describes the symptoms of the disease

    • C. 

      Supported by risk factors that contribute to increased vulnerability

    • D. 

      Proof that the person is suffering from an illness

  • 23. 

    How many parts does a RISK NURSING DIAGNOSIS have?

    • A. 

    • B. 

    • C. 

    • D. 

  • 24. 

    Which of the following is a Risk Nursing Diagnosis statement? 

    • A. 

      Risk for falls related to unstable balance

    • B. 

      Constipated because of fecal impaction

    • C. 

    • D. 

      Constipation related to dehydration

  • 25. 

    Syndrome Nursing Diagnosis

    • A. 

      An isolated disease with numerous symptoms

    • B. 

      Numerous symptoms describing a single disease

    • C. 

      Used when a cluster of actual or risk nursing diagnosis are predicted to be present

    • D. 

      Numerous symptoms leading to an idiopathic disorder

  • 26. 

    Wellness Nursing Diagnosis

    • A. 

    • B. 

    • C. 

      Human responses to levels of good health in an individual, family or community

    • D. 

  • 27. 

    Certain Physiologic complications that nurses monitor to detect their onset or changes in the patient's status.    

    • A. 

    • B. 

    • C. 

    • D. 

  • 28. 

    Potential complications: hypoglycemia.  This is a sample of what?

    • A. 

    • B. 

    • C. 

    • D. 

  • 29. 

    Identification of a disease or condition by a scientific evaluation of physical signs, symptoms, history, laboratory test and procedures. 

    • A. 

    • B. 

    • C. 

    • D. 

  • 30. 

    Difference between Medical and Nursing Diagnoses

    • A. 

      Medical is etiology; Nursing is human response

    • B. 

      Medical is disease; Nursing is the cause of disease

    • C. 

      Medical is illness; Nursing is illness too

    • D. 

      Medical is to heal the disease: Nursing is to discover the disease

  • 31. 

    Difference between a goal statement and an outcome statement

    • A. 

      A good outcome statement is specific to the patient

    • B. 

      Goals are general deadlines that are to be met

    • C. 

      An outcome statement refers to what the nurse will do

    • D. 

      Goals and Statements are practically the same

  • 32. 

    The purpose to which an effort is directed 

    • A. 

    • B. 

    • C. 

    • D. 

  • 33. 

    Which of the following statements describe a well-written patient outcome statement? Select all that apply.  

    • A. 

    • B. 

      Focuses on the completion of nursing interventions

    • C. 

      Does not interfere with the medical care plan

    • D. 

      Includes a time frame for patient reevaluation

  • 34. 

    A common framework that helps guide the prioritization of nursing tasks during the process of planning

    • A. 

      Ericsson's psychosocial development

    • B. 

    • C. 

    • D. 

  • 35. 

    Nursing interventions

    • A. 

      Depend on the tasks delegated by the nursing supervisor

    • B. 

      A sequence of prioritized tasks that describe a nurse's job

    • C. 

      Activities that promote the achievement of the desired patient outcome

    • D. 

      An act of taking care of the sick

  • 36. 

    Which of the following is not a Physician Prescribed intervention?

    • A. 

      Ordering diagnostic tests

    • B. 

    • C. 

    • D. 

      Elevating an edematous leg

  • 37. 

    Which of the following is not a nurse-prescribed intervention?

    • A. 

      Turning the patient every two hours

    • B. 

    • C. 

      Offering a vitamin supplement

    • D. 

      Monitoring a patient for complications

  • 38. 

    Which of the following statements about the nursing process is true. 

    • A. 

      A nursing process is written together with a nursing care plan

    • B. 

      A nursing care plan is a product of the nursing process

    • C. 

      Both the nursing process and the nursing care plan are purely critical thinking strategies

    • D. 

      The nursing process is not an accurate clinical theory

  • 39. 

    IN which of the following scenarios would a standardized nursing care plan be appropriate? 

    • A. 

    • B. 

      Center for infection control

    • C. 

    • D. 

      Maternity floor without a single Cesarean delivery

  • 40. 

    Prioritization of tasks belongs to which phase of the Nursing Process? 

    • A. 

    • B. 

    • C. 

    • D. 

    • E. 

  • 41. 

    Documentation is a vital component of which phase of the nursing process?

    • A. 

    • B. 

    • C. 

    • D. 

    • E. 

  • 42. 

    Validation of patient outcome and goals

    • A. 

    • B. 

    • C. 

    • D. 

  • 43. 

    Evidence based practice

    • A. 

      Past educational knowledge

    • B. 

    • C. 

    • D. 

      Integration of research and clinical experience

  • 44. 

    Which of the following is not considered a standardized language in nursing?

    • A. 

    • B. 

    • C. 

    • D. 

  • 45. 

    Variance

    • A. 

    • B. 

      Patient does not achieve expected outcome

    • C. 

    • D. 

  • 46. 

    Which of the following is not the role of the LPN/LVN in the nursing process?

    • A. 

    • B. 

      Gather further data to confirm problems

    • C. 

      Discuss details of the disease as part of patient education

    • D. 

      Observe and report signficant cues

  • 47. 

    Which of the following are functions of managed care? Select all that apply. 

    • A. 

      Provides control over health care services

    • B. 

      Standardized diagnosis and treatment

    • C. 

    • D. 

      Primary resource for patient advocacy

  • 48. 

    Clinical pathway

    • A. 

      Nursing career development plan

    • B. 

    • C. 

      A concept map for care plans

    • D. 

      Specific location in a healthcare facility

  • 49. 

    A reflective reasoning process that guides a nurse in generating, implementing and evaluating approaches for dealing with client care and professional concerns

    • A. 

    • B. 

    • C. 

    • D. 

  • (Penny Heaslip, 1993, Revised 2008 Thompson Rivers University, Box 3010, 900 McGill Road, Kamloops, BC Canada, V2C 5N3 pheaslip@tru.ca )

    To become a professional nurse requires that you learn to think like a nurse. What makes the thinking of a nurse different from a doctor, a dentist or an engineer?  It is how we view the client and the type of problems we deal with in practice when we engage in client care. To think like a nurse requires that we learn the content of nursing; the ideas, concepts and theories of nursing and develop our intellectual capacities and skills so that we become disciplined, self-directed, critical thinkers.


    Critical thinking is the disciplined, intellectual process of applying skilful reasoning as a guide to belief or action (Paul, Ennis & Norris). In nursing, critical thinking for clinical decision-making is the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care (Heaslip). Critical thinking when developed in the practitioner includes adherence to intellectual standards, proficiency in using reasoning, a commitment to develop and maintain intellectual traits of the mind and habits of thought and the competent use of thinking skills and abilities for sound clinical judgments and safe decision-making.

    Intellectual Standards for Reasoning

    Practitioners in nursing who are critical thinkers value and adhere to intellectual standards. Critical thinkers strive to be clear, accurate, precise, logical complete, significant and fair when they listen, speak, read and write. Critical thinkers think deeply and broadly. Their thinking is adequate for their intended purpose (Paul, Scriven, Norris & Ennis). All thinking can be examined in light of these standards and as we reflect on the quality of our thinking we begin to recognize when we are being unclear, imprecise, vague or inaccurate. As nurses, we want to eliminate irrelevant, inconsistent and illogical thoughts as we reason about client care. Nurses use language to clearly communicate in-depth information that is significant to nursing care. Nurses are not focused on the trivial or irrelevant.

    Nurses who are critical thinkers hold all their views and reasoning to these standards as well as, the claims of others such that the quality of nurse's thinking improves over time thus eliminating confusion and ambiguity in the presentation and understanding of thoughts and ideas.


    Elements of Reasoned Thinking

    Reasoning in nursing involves eight elements of thought. Critical thinking involves trying to figure out something; a problem, an issue, the views of another person, a theory or an idea. To figure things out we need to enter into the thinking of the other person and then to comprehend as best we can the structure of their thinking. This also applies to our own thinking as well. When I read an author I'm trying to figure out what the author is saying; what problem or issue the author is addressing, what point of view or frame of reference he is coming from, what the goal or purpose is of this piece of writing, what evidence, data or facts are being used and what theories, concepts, principles or ideas are involved. I want to understand the interpretations and claims the author is making and the assumptions that underlie his thinking. I need to be able to follow the author's lines of formulated thought and the inferences which lead to a particular conclusion. I need to understand the implications and consequences of the author's thinking. As I come to understand the author in-depth I will also begin to recognize the strength and weakness of his reasoning. I will be able to offer my perspective on the subject at hand with a clear understanding of how the author would respond to my ideas on the subject.


    The Elements of Thought

    All thinking, if it is purposeful, includes the following elements of thought (Paul, 1990).

    1. The problem, question, concern or issue being discussed or thought about by the thinker. What the thinker is attempting to figure out.
    2. The purpose or goal of the thinking. Why we are attempting to figure something out and to what end. What do we hope to accomplish.
    3. The frame of reference, points of view or even world view that we hold about the issue or problem.
    4. The assumptions that we hold to be true about the issue upon which we base our claims or beliefs.
    5. The central concepts, ideas, principles and theories that we use in reasoning about the problem.
    6. The evidence, data or information provided to support the claims we make about the issue or problem.
    7. The interpretations, inferences, reasoning, and lines of formulated thought that lead to our conclusions.
    8. The implications and consequences that follow from the positions we hold on the issue or problem.

    When nurses reason they use these elements of thought to figure out difficult questions and recognize that their thinking could be flawed or limited by lack of in-depth understanding of the problem at issue therefore, they critically monitor their thinking to ensure that their thinking meets the standards for intellectual thought.

    In summary, as a critical thinker, I am able to figure out by reading or listening critically what nurse scholars believe about nursing and on what basis nurses act as they practice nursing. To do this I must clearly comprehend the thinking of another person by figuring out the logic of their thinking. I must comprehend clearly the thinking of myself by figuring out my own thoughts on the subject at hand. Finally, I must use intellectual standards to evaluate my thinking and the thinking of others on a given problem such that I can come to a defensible, well reasoned view of the problem and therefore, know what to believe or do in a given circumstance. To do this I must be committed to developing my mind as a self-directed, independent critical thinker. I must value above all else the intellectual traits and habits of thought that critical thinkers possess.

    Intellectual Traits and Habits of Thought

    To develop as a critical thinker one must be motivated to develop the attitudes and dispositions of a fair-minded thinker. That is, one must be willing to suspend judgments until one truly understands another point of view and can articulate the position that another person holds on an issue. Nurses come to reasoned judgments so that they can act competently in practice. They continually monitor their thinking; questioning and reflecting on the quality of thinking occurring in how they reason about nursing practice. Sloppy, superficial thinking leads to poor practice.

    Critical inquiry is an important quality for safe practice. Nurses must pose questions about practice and be willing to attempt to seek answers about practice. Nurses must be willing to attempt to seek answers to the difficult questions inherent in practice, as well as the obvious. Question posing presupposes intellectual humility and a willingness to admit to one's areas of ignorance as well as, intellectual curiosity and perseverance and willingness to seek answers. Critical thinkers in nursing are truth seekers and demonstrate open-mindedness and tolerance for others' views with constant sensitivity to the possibility of their own bias.

    Nurse's who are critical thinkers value intellectually challenging situations and are self-confident in their well reasoned thoughts. To reason effectively, nurses have developed skills and abilities essential for sound reasoning.


    Critical Thinking Skills and Abilities

    Critical thinkers in nursing are skilful in applying intellectual skills for sound reasoning. These skills have been defined as information gathering, focusing, remembering, organizing, analyzing, generating, integrating and evaluating (Registered Nurse's Association of British Columbia, 1990). The focus of classroom and clinical activities is to develop the nurse's understanding of scholarly, academic work through the effective use of intellectual abilities and skills. As you encounter increasingly more complex practice situations you will be required to think through and reason about nursing in greater depth and draw on deeper, more sophisticated comprehension of what it means to be a nurse in clinical practice. Nursing is never a superficial, meaningless activity. All acts in nursing are deeply significant and require of the nurse a mind fully engaged in the practice of nursing. This is the challenge of nursing; critical, reflective practice based on the sound reasoning of intelligent minds committed to safe, effective client care.


    To accomplish this goal, students will be required to reason about nursing by reading, writing, listening and speaking critically. By doing so you will be thinking critically about nursing and ensuring that you gain in-depth knowledge about nursing as a practice profession.

    Critical Thinking...a Holistic Approach

    Critical Listening: A mode of monitoring how we are listening so as to maximize our accurate understanding of what another person is saying. By understanding the logic of human communication - that everything spoken expresses point of view, uses some ideas and not others, has implications, etc., critical thinkers can listen so as to enter empathetically and analytically into the perspective of others.

    Critical Thinking: 1) Disciplined, self-directed thinking which implies the perfection of thinking appropriate to a particular mode or domain of thinking. 2) Thinking that displays master of intellectual skills and abilities. 3) The art of thinking about your thinking while you are thinking in order to make your thinking better: more clear, more accurate, or more defensible.

    Critical Writing: To express oneself in languages required that one arrange ideas in some relationships to each other. When accuracy and truth are at issue, then we must understand what our thesis is, how we can support it, how we can elaborate it to make it intelligible to others, what objections can be raised to it from other points of view, what the limitations are to our point of view, and so forth. Disciplined writing requires disciplined thinking; disciplined thinking is achieved through disciplined writing.


    Critical Reading: Critical reading is an active, intellectually engaged process in which the reader participates in an inner dialogue with the writer. Most people read uncritically and so miss some part of what is expressed while distorting other parts. A critical reader realizes the way in which reading, by its very nature, means entering into a point of view other than our own, the point of view of the writer. A critical reader actively looks for assumptions, key concepts and ideas, reasons and justifications, supporting examples, parallel experiences, implications and consequences, and any other structural features of the written text to interpret and assess it accurately and fairly. ( Paul, 1990, pp 554 & 545 )

    Critical Speaking: Critical speaking is an active process of expressing verbally a point of view, ideas and thoughts such that others attain an in-depth understanding of the speaker's personal perspective on an issue. Monitoring how we express ourselves verbally will ensure that we maximize accurate understanding of what we mean through active dialogue and openness to feedback on our views. (Heaslip, 1993).


    References:

    Paul, R.W. (1990). Critical Thinking: What Every Person Needs to Survive in a Rapidly Changing World. Rohnert Park, California: Center for Critical Thinking and Moral Critique

    Norris, S. P. & Ennis, R.H. (1989). Evaluating critical thinking. Pacific Grove, CA: Midwest Publications, Critical Thinking Press

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