Critical Thinking in Nursing

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. Adelaide Nutting:

a) was the founder of modern nursing
b) required nursing students to keep diaries
c) published an analysis of nurse training in the United States
d) defined critical thinking

2. In 1953, Louise McManas proposed which of the following be taught:
  1. the nursing process
  2. medical ethics
  3. statistics
  4. a nursing diagnosis

a) 1, 2, and 4
b) 2 and 3
c) 2 only
d) 1 and 4

3. Critical thinking includes attitudes as well as cognitive skills.

a) true
b) false

4. _________ involves being sensitive to your own prejudices or biases.

a) Courage
b) Humility

5. Striving for truth or for better understanding in spite of repeated frustrations and difficulties because you feel it is worth the effort in the long run is the definition of:

a) intellectual perseverance
b) intellectual integrity

6. In this critical thinking attitude, you assess all viewpoints similarly without regard to vested interest or feelings of friends, community or nation.

a) faith in reason
b) intellectual integrity
c) intellectual courage
d) intellectual sense of justice

7. This is a conclusion or deduction drawn about data:

a) inference
b) analysis
c) evaluation
d) hypothesis

8. ____________ reasoning involves generalizations.

a) Deductive
b) Inductive

9. Critical thinkers pay attention to their intuitions and integrate their feelings into thinking and decision making. This is the definition of:

a) creativity
b) reflection

10. Which of the following involves the use of known facts and background knowledge:

a) clarification
b) reflection
c) basic support
d) divergent thinking

11. In the emergency room, the nurse assessed which of the following on the client with abdominal pain:

a) cyanosis of the lips and nail beds
b) a large pulsating mass
c) edema of the lower extremities
d) an irregular heart rate

12. In the client with acute pulmonary edema, the pH of the blood is __________ and the potassium is __________.

a) alkaline, low
b) acid, high
c) alkaline, high
d) acid, low

13. The client diagnosed with adenocarcinoma of the colon had an output of 600 mLs of dark brownish urine in 8 hours. This would be considered:

a) inadequate
b) adequate

14. A Sengstaken-Blakemore tube is used to:

a) measure urine output
b) relieve pain of hemorrhoids
c) decrease thirst
d) control esophageal bleeding

15. When evaluating the glucose levels of complicated diabetes mellitus, the nurse should:

a) do nothing
b) encourage the client to increase fluids
c) call the physician and follow protocols
d) treat the nausea

16. Photophobia as described in hyperthyroidism is best defined as:

a) an enlarged thyroid
b) fear of treatment
c) light causing pain with vision
d) aware of your heartbeat

17. A demand pacemaker is inserted when there is:

a) tachycardia and palpitations
b) chest pain and hypotension
c) a life threatening arrhythmia
d) bradycardia and a second degree heart block

18. The initial diagnosis of multiple sclerosis was statements that the client frequently dropped things for no reason. Additional symptoms primarily affected the:

a) eyes
b) hearing
c) respiratory rate
d) gastro-intestinal tract

19. A quadriplegic client has a reflex neurogenic bladder. The caregiver will do which of the following:

a) stand the client at the bedside to urinate
b) massage the lower abdomen
c) do intermittent catheterizations
d) allow the client to listen to running water

20. T cells are produced by the :

a) bone marrow
b) thymus
c) liver
d) spleen

21. Which of the following symptoms of Alzheimer’s disease is particularly traumatic:

a) urinary incontinence
b) forgetfulness
c) pacing
d) not recognizing a spouse of 47 years

22. The stool from the sigmoid colostomy would normally be:

a) watery and brown
b) formed and black
c) semi-formed and brown
d) liquid with food particles

23. Which of the following should a client monitor when taking Lanoxin:

a) pulse
b) respirations
c) urine output
d) temperature

24. The best prevention for decubitus ulcers is to:

a) ensure a high protein diet
b) turn the patient every two hours
c) massage reddened areas
d) encourage oral fluids

25. The normal fasting blood glucose level is approximately _____ to _____ mg/dl.

a) 40, 80
b) 130, 180
c) 150, 200
d) 80, 120

26. The left lung has 2 lobes, a superior lobe and an inferior lobe.

a) true
b) false

27. Tuberculosis can be diagnosed by:

a) a pulmonary function test
b) arterial blood gases
c) chest x-ray
d) incentive spirometry

28. The highest Apgar score is:

a) 9
b) 10
c) 12

29. In addition to surgery, this client with an ectopic pregnancy will require which of the following:

a) a lactation suppressant
b) an injection of Aquamephyton
c) a Pitocin drip
d) blood transfusions

30. A newborn infant whose mother has gestational diabetes and elevated blood sugars will likely be:

a) premature
b) low-birth weight
c) lethargic
d) large for gestational age

31. When a client is dehydrated, as is the client with hyperemesis gravidarum, the skin will “tent” when examined.

a) true
b) false

32. The 4-day old infant with slightly sunken fontanelles is most likely:

a) afebrile
b) dehydrated
c) constipated
d) normal

33. When an infant is receiving feedings through a gastro-jejunostomy tube the infant should be positioned in a:

a) supine position
b) prone position
c) left lateral position
d) semi-fowler’s position

34. Hirschprung’s disease was diagnosed in an infant 48 hours after birth when he:

a) passed transitional stool
b) had no wet diapers in 8 hours
c) failed to pass meconium stool
d) did not display a startle reflex

35. Which of the following would be appropriate for an 8-month-old infant with iron deficiency anemia:

a) rice cereal
b) hard cooked egg yolks
c) pureed meat
d) whole milk

36. When the nurse practitioner observed a bulging tympanic membrane, it could be explained to the mother that this is the:

a) auricle
b) auditory nerve
c) ear drum
d) external ear canal

37. When a client is receiving Vancomycin, a blood test or trough is done:

a) after receiving the medication
b) prior to receiving the medication

38. At 30 weeks gestation, an infant weighed 1.69 kg. This is ______ pounds.

a) 2.9
b) 3.7
c) 4.5
d) 5.2

39. While caring for a client with septic osteomyelitis, daily iron has been prescribed. Which of the following will enhance absorption of iron:

a) vitamin D
b) folic acid
c) vitamin C
d) vitamin K

40. The nurse should observe which of the following that would signal bleeding in the post- operative 8-year-old tonsillectomy client:

a) frequent swallowing
b) cyanotic nail beds
c) lethargy
d) pallor

41. A common complication of third-degree burns is infection.

a) true
b) false

42. A client who is able to obey a command such as “lift your hand” would receive a score of _____ on the Glasgow Coma Scale for Best Motor Response.

a) 5
b) 4
c) 3

43. When a client is physically restrained, neurovascular checks must be done:

a) according to policy of the institution
b) as the client’s condition warrants
c) every two hours
d) on a prn basis

44. Lanugo, as seen on the client with anorexia nervosa, is best defined as :

a) patches of dry, scaly skin
b) opened reddened areas
c) fine, downy hair
d) small blisters, especially on the back

45. The client with an antisocial personality disorder often does which of the following:
  1. admits he made mistakes
  2. makes excuses for his behavior
  3. shows remorse when breaking the law
  4. blames others for his failures

a) 1 and 2
b) 2 and 3
c) 1 and 4
d) 2 and 4

46. When preparing the client for discharge who has anxiety and panic attacks, the nurse:

a) reminds the client to avoid alcohol when taking lorazepam
b) tries to help the client learn more about anxiety and stress reduction
c) encourages the client to get professional help sooner
d) makes an appointment for the client to see a counselor

47. The client with delusional behavior also has which of the following:
  1. glycosuria
  2. metabolic acidosis
  3. hypoglycemia
  4. ketonuria

a) 3 only
b) 1 and 3
c) 1, 2, and 4
d) 1, 3, and 4

48. The client with depression on phenelzine sulfate(Nardil) will need to avoid foods high in _______ because a hypertensive crisis may occur.

a) tyramine
b) alcohol
c) sodium
d) MSG

49. The full antidepressant effect of fluoxetine hydrochloride(Prozac) may not be seen for up to 4 weeks.

a) true
b) false

50. When caring for a long-term client, the staff has become tired of her behavior and may feel:

a) sympathetic to the client
b) overworked
c) compassionate
d) remorseful

51. The client with paranoid schizophrenia must adhere to taking clozapine (Clozaril) as ordered because abrupt discontinuation could cause:

a) urinary retention
b) anxiety attacks
c) a hypertensive crisis
d) acute psychotic symptoms

52. When caring for her 89-year-old mother, the daughter is exhibiting feelings of ________ , stating, “I’m at my wit’s end.”

a) frustration
b) embarrassment
c) hostility
d) resentment

53. You enter a home of a new client with a history of paranoid schizophrenia and find a gun laying on the table next to his chair. You should say:

a) “Is that gun loaded?”
b) “Do you plan on using that gun?”
c) “Is that gun real?”
d) “Tell me how you’ve been feeling the past few days.”

54. When a client is in four-point restraints, one extremity should be released:

a) at the nurse’s discretion
b) according to policy
c) on a prn basis

55. Who of the following are more prone to develop tardive dyskinesia, such as lip smacking and repetitive tongue protrusion:

a) a 65-year-old female
b) a 17-year-old male