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Basic Nursing Concepts, Skills & Reasoning 1st Edition by Treas , Leslie S – Test Bank
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Chapter 2. Critical Thinking & the Nursing Process
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Which of the following characteristics do the various definitions of critical thinking have in common? Critical thinking
1)
Requires reasoned thought
2)
Asks the questions “why?” or “how?”
3)
Is a hierarchical process
4)
Demands specialized thinking skills
____ 2. A few nurses on a unit have proposed to the nurse manager that the process for documenting care on the unit be changed. They have described a completely new system. Why is it important for the nurse manager to have a critical attitude? It will help the manager to
1)
Consider all the possible advantages and disadvantages
2)
Maintain an open mind about the proposed change
3)
Apply the nursing process to the situation
4)
Make a decision based on past experience with documentation
____ 3. The nurse has just been assigned to the clinical care of a newly admitted patient. To know how to best care for the patient, the nurse uses the nursing process. Which step would the nurse probably do first?
1)
Assessment
2)
Diagnosis
3)
Plan outcomes
4)
Plan interventions
____ 4. Which of the following is an example of theoretical knowledge?
1)
A nurse uses sterile technique to catheterize a patient.
2)
Room air has an oxygen concentration of 21%.
3)
Glucose monitoring machines should be calibrated daily.
4)
An irregular apical heart rate should be compared with the radial pulse.
____ 5. Which of the following is an example of practical knowledge? (Assume all are true.)
1)
The tricuspid valve is between the right atrium and ventricle of the heart.
2)
The pancreas does not produce enough insulin in type 1 diabetes.
3)
When assessing the abdomen, you should auscultate before palpating.
4)
Research shows pain medication given intravenously acts faster than by other routes.
____ 6. Which of the following is an example of self-knowledge? The nurse thinks, “I know that I
1)
Should take the client’s apical pulse for 1 minute before giving digoxin”
2)
Should follow the client’s wishes even though it is not what I would want”
3)
Have religious beliefs that may make it difficult to take care of some clients”
4)
Need to honor the client’s request not to discuss his health concern with the family”
____ 7. Which of the following is the most important reason for nurses to be critical thinkers?
1)
Nurses need to follow policies and procedures.
2)
Nurses work with other healthcare team members.
3)
Nurses care for clients who have multiple health problems.
4)
Nurses have to be flexible and work variable schedules.
____ 8. The nurse administering pain medication every 4 hours is an example of which aspect of patient care?
1)
Assessment data
2)
Nursing diagnosis
3)
Patient outcome
4)
Nursing intervention
____ 9. How does nursing diagnosis differ from a medical diagnosis? A nursing diagnosis is
1)
Terminology for the client’s disease or injury
2)
A part of the client’s medical diagnosis
3)
The client’s presenting signs and symptoms
4)
A client’s response to a health problem
____ 10. Which statement about the nursing process is correct?
1)
It was developed from the ANA Standards of Care.
2)
It is a problem-solving method to guide nursing activities.
3)
It is a linear process with separate, distinct steps.
4)
It involves care that only the nurse will give.
____ 11. What do critical thinking and the nursing process have in common?
1)
They are both linear processes used to guide one’s thinking.
2)
They are both thinking methods used to solve a problem.
3)
They both use specific steps to solve a problem.
4)
They both use similar steps to solve a problem.
____ 12. A nurse admits a patient to the unit after completing a comprehensive interview and physical examination. To develop a nursing diagnosis, the nurse must now
1)
Analyze the assessment data
2)
Consult standards of care
3)
Decide which interventions are appropriate
4)
Ask the client’s perceptions of her health problem
____ 13. The nurse developed a care plan for a patient to help prevent Impaired Skin Integrity. She has made sure that nursing assistive personnel change the patient’s position every 2 hours. In the evaluation phase of the nursing process, which of the following would the nurse do first?
1)
Determine whether she has gathered enough assessment data.
2)
Judge whether the interventions achieved the stated outcomes.
3)
Follow up to verify that care for the nursing diagnosis was given.
4)
Decide whether the nursing diagnosis was accurate for the patient’s condition.
____ 14. In caring for a patient with comorbidities, the nurse draws upon her knowledge of diabetes and skin integrity. In a spirit of inquiry, she looks up the latest guidelines for providing skin care and includes them in the plan of care. The nurse provides skin care according to the procedural guidelines and begins regular monitoring to evaluate the effectiveness of the interventions. These activities are best described as
1)
Full-spectrum nursing
2)
Critical thinking
3)
Nursing process
4)
Nursing knowledge
____ 15. The nurse is preparing to admit a patient from the emergency department. The transferring nurse reports that the patient is obese. The nurse has been overweight at one time and works very hard now to maintain a healthy weight. She immediately thinks, “I know I tend to feel negatively about obese people; I figure if I can stop eating, they should be able to. I must remember how very difficult that is and be very careful not to be judgmental of this patient.” This best illustrates
1)
Theoretical knowledge
2)
Self-knowledge
3)
Using reliable resources
4)
Use of the nursing process
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 1. Which aspects of healthcare are affected by a client’s culture? Select all that apply.
1)
How the clients views healthcare
2)
How the client views illness
3)
How the client will pay for healthcare services
4)
The types of treatments the client will accept
5)
When the client will seek healthcare services
6)
The environment where the healthcare services are provided
7)
The ease of accessibility of healthcare services
Matching
Match the critical thinking attitude on the left with the appropriate example on the right.
1) Reading the instruction manual of a new glucose monitoring machine
2) Asking for help with a procedure because you have not done it before
3) Obtaining the latest research about a new diagnostic procedure even though the articles are difficult to find
4) Questioning the reason for a new staffing policy
5) Realizing your feelings about alternative medicine may interfere with the care you give a patient
6) Asking a patient’s feelings about his cancer diagnosis
7) Questioning your feelings when a patient’s family requests withholding nutrition for a terminally ill client
____ 1. Independent thinking
____ 2. Intellectual curiosity
____ 3. Intellectual humility
____ 4. Intellectual empathy
____ 5. Intellectual courage
____ 6. Intellectual perseverance
Match the terms from the critical thinking model in your text with the correct example.
1) I wonder if my values about quality of life have affected my thinking.
2) What should I have done differently?
3) I need to talk with the client to make sure the family gave me the correct information.
4) I have been through a situation like this before.
5) There are several interventions that would work in this situation.
6) I need to follow the steps in the procedure manual.
____ 7. Contextual awareness
____ 8. Inquiry
____ 9. Considering alternatives
____ 10. Analyzing assumptions
____ 11. Reflecting skeptically
Chapter 4. Nursing Process: Diagnosis
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Which of the following is an example of a problem that nurses can treat independently?
1)
Hemorrhage
2)
Nausea
3)
Fracture
4)
Infection
____ 2. Which of the following is an example of a cluster of related cues?
1)
Complains of nausea and stomach pain after eating
2)
Has a productive cough and states stools are loose
3)
Has a daily bowel movement and eats a high-fiber diet
4)
Respiratory rate 20 breaths/min, heart rate 85 beats/min, blood pressure 136/84
____ 3. Which of the following explains why it is important to have the correct etiology for a nursing diagnosis? The etiology
1)
Is the cause of the problem
2)
Cannot always be observed
3)
Directs nursing care
4)
Is an inference
____ 4. How does a risk nursing diagnosis differ from a possible nursing diagnosis?
1)
A risk diagnosis is based on data about the patient.
2)
A possible diagnosis is based on partial (or incomplete) data.
3)
Nurses collect the data to support risk diagnoses.
4)
A possible diagnosis becomes an actual diagnosis when symptoms develop.
____ 5. Which of the following describes the difference between a collaborative problem and a medical diagnosis?
1)
A collaborative problem is treated by the nurse; a physician is responsible for the treatment of a medical problem.
2)
A collaborative problem is a nursing diagnosis that requires specific orders from a physician; a medical diagnosis directs all nursing care.
3)
A collaborative problem has the potential to become an actual nursing diagnosis; a medical diagnosis rarely changes.
4)
A collaborative problem requires intervention by the nurse and physician or other professional; a medical diagnosis requires intervention by a physician.
____ 6. Which of the following is the best approach to validate a clinical inference?
1)
Have another nurse evaluate it.
2)
Have the physician evaluate it.
3)
Have sufficient supportive data.
4)
Have the client’s family confirm it.
____ 7. What is wrong with the following diagnostic statement? “Impaired Physical Mobility related to laziness and not having appropriate shoes.” The statement is
1)
Judgmental
2)
Too complex
3)
Legally questionable
4)
Without supportive data
____ 8. When making a diagnosis using NANDA-I, which of the following provides support for the diagnostic label you choose?
1)
Etiology
2)
Related factors
3)
Diagnostic label
4)
Defining characteristics
____ 9. Based only on Maslow’s hierarchy of needs, which nursing diagnosis should have the highest priority?
1)
Self-care Deficit
2)
Risk for Aspiration
3)
Impaired Physical Mobility
4)
Disturbed Sensory Perception
____ 10. Which of the following describes the most important use of nursing diagnosis? (All statements are true.)
1)
Differentiates the nurse’s role from that of the physician
2)
Identifies a body of knowledge unique to nursing
3)
Helps nursing develop a more professional image
4)
Describes the client’s needs for nursing care
____ 11. Which of the following is a criticism of standardized nursing diagnoses developed by NANDA-I?
1)
There is little research to support nursing diagnoses labels.
2)
A perfect nursing diagnosis must be written for it to be useful.
3)
They are not included in all states’ nurse practice acts.
4)
Other professions do not recognize nursing diagnoses.
____ 12. Which of the following most accurately describes nursing diagnoses? A nursing diagnosis
1)
Supports the nurse’s diagnostic reasoning
2)
Supports the client’s medical diagnosis
3)
Identifies a client’s response to a health problem
4)
Identifies a client’s health problem
____ 13. The diagnostic label, or patient problem, is used primarily to suggest
1)
Client goals
2)
Cue clusters
3)
Interventions
4)
Etiology
____ 14. Which nursing diagnosis is written in the correct format when using the NANDA-I taxonomy?
1)
Bowel Obstruction related to recent abdominal surgery A.M.B. nausea, vomiting, and abdominal pain
2)
Inability to Ingest Food related to imbalanced nutrition: less than body requirements A.M.B. inadequate food intake, weight less than 20% under ideal body weight
3)
Impaired Skin Integrity related to physical immobility A.M.B. skin tear over sacral area
4)
Caregiver Role Strain related to alienation from family and friends A.M.B 24-hour care responsibilities
____ 15. What is wrong with the format of this diagnostic statement:
Possible Risk for Constipation related to irregular defecation habits A.M.B. statement that “When I’m busy, I can’t always take the time to go to the bathroom.”
1)
Possible nursing diagnoses do not have signs and symptoms.
2)
A nursing diagnosis is either a possible risk or a risk, not both.
3)
Constipation is a medical diagnosis.
4)
The etiology is actually a defining characteristic.
____ 16. Which nursing diagnosis is written in the correct format?
1)
Imbalanced Nutrition: Less than Body Requirements related to body weight less than 20% under ideal weight
2)
Ineffective Airway Clearance related to increased respiratory rate and irregular rhythm
3)
Impaired Swallowing related to absent gag reflex
4)
Excess Fluid Volume related to 3 lb weight gain in 24 hours
____ 17. The patient shows the necessary defining characteristics, and the nurse has diagnosed Decisional Conflict related to unclear personal values and beliefs. What essential action should the nurse take to help ensure the accuracy of this diagnosis?
1)
Ask a more experienced nurse to confirm it.
2)
Have a social worker interview the patient.
3)
Ask the patient to confirm the diagnosis.
4)
Read about Decisional Conflict in the NANDA-I handbook.
____ 18. The client’s weight is appropriate for his height. His laboratory values and other assessments reflect normal nutritional status. However, he has told the nurse, “I probably eat a little too much red meat. And what is this I hear about needing omega 3 oils in my diet? I don’t like to take supplements, and I think I could really improve my nutrition.” Which of the following nursing diagnoses should the nurse use?
1)
Balanced Nutrition
2)
Possible Imbalanced Nutrition: Less Than Body Requirements
3)
Risk for Imbalanced Nutrition: Less Than Body Requirements
4)
Readiness for Enhanced Nutrition
____ 19. The patient verbalizes an overwhelming lack of energy. He says, “I still feel exhausted even after I sleep. I feel guilty when I can’t keep up with my usual daily activities or sleep during the day. I’ve been a little depressed lately, too.” The patient seems to have difficulty concentrating but has no apparent physical problems. Which of the following diagnoses best describes his health status?
1)
Fatigue related to depression
2)
Fatigue related to difficulty concentrating
3)
Guilt related to lack of energy
4)
Chronic confusion related to lack of energy
____ 20. Which of the following nursing diagnoses is written in correct format? Assume the facts are correct in all of them.
1)
Readiness for Enhanced Nutrition
2)
Pain related to stating, “On a scale of 1 to 5, it’s a 5.”
3)
Impaired Mobility related to pain A.M.B. hip fracture
4)
Risk for Infection related to compromised immunity A.M.B. fever
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 1. Which of the following are cues? Select all that apply.
1)
Taking a brisk walk five times a week
2)
Using laxatives to have a bowel movement
3)
Needing more sleep than usual
4)
Decreasing the amount of fat in the diet
5)
Weighing less than indicated by developmental norms
____ 2. Using Maslow’s hierarchy of needs, rank the following nursing diagnoses in order of importance, beginning with the highest-priority diagnosis.
1)
Anxiety
2)
Risk for infection
3)
Disturbed body image
4)
Sleep deprivation
Matching
Using problem urgency as your framework, rank the following nursing diagnoses as low, medium, or high priority.
1)
low
2)
medium
3)
high
____ 1. Risk for Spiritual Distress
____ 2. Decreased Cardiac Output
____ 3. Chronic Confusion
Label the parts of the following nursing diagnosis statement: “Activity Intolerance related to prolonged bedrest A.M.B. increased heart rate, decreased blood pressure with activity, statements of weakness, and dyspnea with exertion.”
1)
diagnostic label or problem
2)
etiology
3)
cues or defining characteristics
____ 4. Activity Intolerance
____ 5. Prolonged bedrest
____ 6. Increased heart rate, decreased blood pressure with activity, statements of weakness, dyspnea with exertion
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