1
Critical Thinking
1. The Patient: A 65-year- old male.
The Situation: The family brings the patient to the emergency room because he just
took an entire bottle of pills.
The Question: What action should the nurse take first?
Answer – Determine the patient’s level of consciousness.
2. The Patient: An 80 year-old male who has used continuous oxygen for the past three
years.
The Situation: While making a home visit, the wife tells the nurse that her husband
was doing well on 2 litres of oxygen per minute until late last night when he
developed severe shortness of breath on the way to the bathroom. The Question:
What action should the nurse take first?
Answer – Assess the patient’s oxygen saturation by pulse oximeter.
3. The Patient: A 41-year-old male.
The Situation: The patient is complaining of severe stomach pain and states that he
has been “vomiting all the time.”
The Question: What should the nurse do first?
Answer – Administer a prescribed pain medication.
4. The Patient: The wife of a wealthy owner of the town’s bank.
The Situation: The patient and her husband arrive on the unit. While orienting the
patient to the hospital room, the nurse notices that the patient has placed a large
amount of cash and some expensive earrings in the drawer of the bedside table. The
Question: What is the best action for the nurse to take?
Answer – Advise the patient to have her husband take the items home when he leaves.
5. The Patient: A 45-year-old female who is 5’ 2” tall, weighs 200 pounds, and has
smoked since age 21.
The Situation: The patient comes to the clinic with a complaint of “leg pain.” The
Question: It is most important for the nurse to obtain information about which
previous occurrence?
Answer – A previous blood clot in the leg.
6. The Patient: A 61-year-old female.
The Situation: The patient has a fever of unknown origin. The nurse administered a
fever-reducing medication 30 minutes ago. At this time there has been no decrease in
the patient’s fever.
The Question: What action would be best for the nurse to take?
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, Answer – Sponge the patient with cool water.
7. The Patient: A 70-year-old male who is relatively healthy.
The Situation: A liquid mediation is prescribed for this patient.
The Question: Prior to administering the prescribed medication, what intervention has
the highest priority?
Answer – Determine if the patient is allergic to the medication.
8. The Patient: A fifty-eight-year-old female.
The Situation: While the nurse is offering the patient her morning medications, she
tells the nurse that she does not recall ever taking a pill that was pink-colored.
The Question: What should the nurse do in response to this patient’s comment?
Answer – Withhold the mediation until the patient’s prescription is verify.
9. The Patients:
1. A 63-year-old with a burn on the left lower leg who is complaining of pain.
2. A 45-year-old with pneumonia, complaining of shortness of breath.
3. A 31-year-old with abdominal pain who has just vomited blood.
4. An 88-year-old who has right-sided paralysis and wants to be helped to the
bathroom immediately.
The Situation: The nurse is caring for these patients.
The Question: Who should the nurse see first?
Answer – The 45-years old with pneumonia and shortness of breath.
10. The Patients:
1. A 13-year-old female with a kidney infection who reports that there is “lots of
blood” in her urine.
2. An 18-year-old male with acute alcohol poisoning who is seeing “bugs on the
walls.”
3. A 21-year-old female with inflammatory bowel disease who has soaked a dressing
three hours after surgery.
4. A 25-year old male who is sobbing in his room after being told that he has
testicular cancer.
The Situation: The nurse is caring for these four patients.
The Question: Who should the nurse see first?
Answer – The 21-years old who is three hours postoperative and has a soaked
dressing.
11. The Patients:
1. A 42-year-old with diabetes who is blind and is asking to get up and moved to a
chair.
2. An 88-year-old with lower body paralysis who wants to be turned in bed.
, 1
3. A 17-year-old with asthma who smokes and has been in the bathroom for 30
minutes.
4. A 55-year-old with cardiac disease who tells the nurse, “Get the TV fixed or I am
leaving this place.”
The Situation: The nurse is caring for these four patients.
The Question: Which patient should the nurse see first?
Answer – The 17-year old with asthma who may be smoking in the bathroom.
12. The Patient: An elderly female accompanied by her middle-aged son.
The Situation: The patient is being discharged after 15-day stay on the medical unit,
and the son offers the nurse a box of candy as a gesture of thanks for caring for his
mother. The Question: What should the nurse do in response to the offer of this gift?
Answer – Sincerely thank the son, and share the candy with all staff member on the
unit.
13. The Patient: A 25-year-old female who has smoked since age 12.
The Situation: The patient is complaining of “skipped heart beats.”
The Question: Which instruction is most important for the nurse to provide this
patient?
Answer – Call for assistance if she feels weak or dizzy when getting out of bed.
14. The Patient: A frail 88-year-old male who has recently become slightly confused. The
Situation: The nurse is making a home visit and assesses the safety features of the
home environment.
The Question: Which suggestion would be most important for the nurse to provide the
family?
Answer – Eliminate any throw rugs from floor.
15. The Patient: A 55-year-old female with a family history of hypertension.
The Situation: The patient is concerned about her health and states, “I have had severe
headaches for the last six months. I think I might have high blood pressure.” The
nurse determines that the woman’s blood pressure is 138/86 (high normal).
The Question: What action would be best for the nurse to take?
Answer – Ask the patient about the frequency, timing and quality of her headaches.
16. The Patient: A 35-year-old female with a history of asthma.
The Situation: The patient has been using a steroid inhaler because she is short of
breath. However, she states that her shortness of breath is “no better.” The
Question: What is the most important information for the nurse to obtain?
Answer – Method of using the inhaler.
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Critical Thinking
1. The Patient: A 65-year- old male.
The Situation: The family brings the patient to the emergency room because he just
took an entire bottle of pills.
The Question: What action should the nurse take first?
Answer – Determine the patient’s level of consciousness.
2. The Patient: An 80 year-old male who has used continuous oxygen for the past three
years.
The Situation: While making a home visit, the wife tells the nurse that her husband
was doing well on 2 litres of oxygen per minute until late last night when he
developed severe shortness of breath on the way to the bathroom. The Question:
What action should the nurse take first?
Answer – Assess the patient’s oxygen saturation by pulse oximeter.
3. The Patient: A 41-year-old male.
The Situation: The patient is complaining of severe stomach pain and states that he
has been “vomiting all the time.”
The Question: What should the nurse do first?
Answer – Administer a prescribed pain medication.
4. The Patient: The wife of a wealthy owner of the town’s bank.
The Situation: The patient and her husband arrive on the unit. While orienting the
patient to the hospital room, the nurse notices that the patient has placed a large
amount of cash and some expensive earrings in the drawer of the bedside table. The
Question: What is the best action for the nurse to take?
Answer – Advise the patient to have her husband take the items home when he leaves.
5. The Patient: A 45-year-old female who is 5’ 2” tall, weighs 200 pounds, and has
smoked since age 21.
The Situation: The patient comes to the clinic with a complaint of “leg pain.” The
Question: It is most important for the nurse to obtain information about which
previous occurrence?
Answer – A previous blood clot in the leg.
6. The Patient: A 61-year-old female.
The Situation: The patient has a fever of unknown origin. The nurse administered a
fever-reducing medication 30 minutes ago. At this time there has been no decrease in
the patient’s fever.
The Question: What action would be best for the nurse to take?
P a g e 1 | 18
, Answer – Sponge the patient with cool water.
7. The Patient: A 70-year-old male who is relatively healthy.
The Situation: A liquid mediation is prescribed for this patient.
The Question: Prior to administering the prescribed medication, what intervention has
the highest priority?
Answer – Determine if the patient is allergic to the medication.
8. The Patient: A fifty-eight-year-old female.
The Situation: While the nurse is offering the patient her morning medications, she
tells the nurse that she does not recall ever taking a pill that was pink-colored.
The Question: What should the nurse do in response to this patient’s comment?
Answer – Withhold the mediation until the patient’s prescription is verify.
9. The Patients:
1. A 63-year-old with a burn on the left lower leg who is complaining of pain.
2. A 45-year-old with pneumonia, complaining of shortness of breath.
3. A 31-year-old with abdominal pain who has just vomited blood.
4. An 88-year-old who has right-sided paralysis and wants to be helped to the
bathroom immediately.
The Situation: The nurse is caring for these patients.
The Question: Who should the nurse see first?
Answer – The 45-years old with pneumonia and shortness of breath.
10. The Patients:
1. A 13-year-old female with a kidney infection who reports that there is “lots of
blood” in her urine.
2. An 18-year-old male with acute alcohol poisoning who is seeing “bugs on the
walls.”
3. A 21-year-old female with inflammatory bowel disease who has soaked a dressing
three hours after surgery.
4. A 25-year old male who is sobbing in his room after being told that he has
testicular cancer.
The Situation: The nurse is caring for these four patients.
The Question: Who should the nurse see first?
Answer – The 21-years old who is three hours postoperative and has a soaked
dressing.
11. The Patients:
1. A 42-year-old with diabetes who is blind and is asking to get up and moved to a
chair.
2. An 88-year-old with lower body paralysis who wants to be turned in bed.
, 1
3. A 17-year-old with asthma who smokes and has been in the bathroom for 30
minutes.
4. A 55-year-old with cardiac disease who tells the nurse, “Get the TV fixed or I am
leaving this place.”
The Situation: The nurse is caring for these four patients.
The Question: Which patient should the nurse see first?
Answer – The 17-year old with asthma who may be smoking in the bathroom.
12. The Patient: An elderly female accompanied by her middle-aged son.
The Situation: The patient is being discharged after 15-day stay on the medical unit,
and the son offers the nurse a box of candy as a gesture of thanks for caring for his
mother. The Question: What should the nurse do in response to the offer of this gift?
Answer – Sincerely thank the son, and share the candy with all staff member on the
unit.
13. The Patient: A 25-year-old female who has smoked since age 12.
The Situation: The patient is complaining of “skipped heart beats.”
The Question: Which instruction is most important for the nurse to provide this
patient?
Answer – Call for assistance if she feels weak or dizzy when getting out of bed.
14. The Patient: A frail 88-year-old male who has recently become slightly confused. The
Situation: The nurse is making a home visit and assesses the safety features of the
home environment.
The Question: Which suggestion would be most important for the nurse to provide the
family?
Answer – Eliminate any throw rugs from floor.
15. The Patient: A 55-year-old female with a family history of hypertension.
The Situation: The patient is concerned about her health and states, “I have had severe
headaches for the last six months. I think I might have high blood pressure.” The
nurse determines that the woman’s blood pressure is 138/86 (high normal).
The Question: What action would be best for the nurse to take?
Answer – Ask the patient about the frequency, timing and quality of her headaches.
16. The Patient: A 35-year-old female with a history of asthma.
The Situation: The patient has been using a steroid inhaler because she is short of
breath. However, she states that her shortness of breath is “no better.” The
Question: What is the most important information for the nurse to obtain?
Answer – Method of using the inhaler.
P a g e 3 | 18
