Davis Advantage for Understanding Medical Surgical Nursing, 7th Edition by Linda S. Williams
Chapter 1: Critical Thinking, Clinical Judgment, and the Nursing Process
Multiple Choice: Identify the choice that best completes the statement or answers the question
1).
The nurse is providing care to a cohort of patients in a medical-surgical unit. The licensed practical
nurse/licensed vocational nurse (LPN/LVN) prioritizes the assessment of the patient with low blood
glucose. What specific decision-making process was employed in this situation?
a. Application of clinical judgment
b. Recommendation of the registered nurse (RN)
c. Understanding of what regulates blood glucose levels
d. Knowing the patient’s past medical history
Chapter: Chapter 1—Critical Thinking, clinical judgment, and the nursing process
Objective 7: Explain the difference between critical thinking and clinical judgment
Page: 2
Heading: Clinical judgment
Integrated process: Clinical problem-solving process (nursing process)
Client need: SECE: Coordinated care
Cognitive level: Comprehension (understanding)
Concept: Clinical judgment
Difficulty: Difficult
Feedback
1 Clinical judgment represents the observable result of employing critical thinking and decision-
making skills. The nurse recognized that the patient was at a heightened risk and chose to
prioritize the assessment of this individual.
2 The licensed practical nurse/licensed vocational nurse (LPN/LVN) is required to exercise
autonomous clinical decision-making separate from the registered nurse (RN).
3 The process of decision-making is not solely determined by an understanding of the
pathophysiology of the disease.
4 While the past medical history holds significance, the current clinical cues take precedence in
determining the prioritized nursing actions.
PTS: 1
CON: Patient-centered care
2).
The LPN/LVN encounters a patient who is visibly angry and exclaims, "I requested my pain medication
five minutes ago. You're utterly useless!" What action by the nurse exemplifies intellectual integrity?
a. Choosing not to disclose the specifics of the interaction with colleagues demonstrates
intellectual integrity.
, b. Informing the patient that the unlicensed assistive personnel (UAP) did not relay the information
constitutes the response
c. Declining to administer care to the patient.
d. Procuring the medication in silence, without uttering any further words
Chapter: Chapter 1—Critical Thinking, clinical judgment, and the nursing process
Objective 4: Describing attitudes of good critical thinkers.
Page: 3
Heading: Clinical Thinking Attitudes
Integrated process: Communication and Documentation
Client need: Psychosocial Integrity
Cognitive level: Application (Applying)
Concept: Communication
Difficulty: Moderate
Feedback
1 This action showcases intellectual integrity, as the nurse abstains from speaking negatively
about the patient's behavior.
2 This action disregards accountability and shifts blame onto others.
3 This action fails to exemplify the mindset associated with critical thinking.
4 Nurses should not tolerate demeaning behavior from patients. The nurse should communicate
to the patient that they have the opportunity to receive the medication and assure them that it
will be provided.
PTS: 1
CON: Communication
3).
As the nurse collects data on a patient, which specific information is regarded as cues?
a. Respiratory rate of 26 per minute
b. The doctor will be at the agency in 5 minutes
c. The patient has three daughters
d. The client prefers to use a bedpan rather than a commode chair
Chapter: Chapter 1—Critical Thinking, clinical judgment, and the nursing process
Objective 2: Discuss why critical thinking and clinical judgment are essential in nursing
Page: 4
Heading: Clinical judgment process
Integrated process: Clinical problem-solving process (nursing process)
Client need: SECE: Coordinated care
Cognitive level: Application (Applying)
Concept: Clinical Judgment
Difficulty: Moderate