Chapter 1 Critical Thinking and the Nursing Process 3
SUBJECTIVE AND OBJECTIVE DATA 12. Serum potassium 3.6 mEq/L
13. Palpitations (feeling of racing heart)
Identify the following data as subjective (symptom) or
objective (sign). 14. Blood pressure 130/82 mm Hg
15. White blood cell count 7000/mm3
1. Pain
2. Shortness of breath CRITICAL THINKING
3. Edema (swelling) Sometimes cognitive maps are used to organize thinking. Look
4. Capillary refill 2 seconds at samples in any of the Function and Assessment chapters
under Aging Changes. Some of the workbook chapters will ask
5. Nausea
you to make a cognitive map, so here is an opportunity to prac-
6. Vomiting tice. Consider a time when you have had a headache or other
7. Dizziness discomfort. Fill in the spaces with information related to the
8. Cyanosis WHAT’S UP? questions. See Chapter 1 Answers for one pa-
tient’s responses. Once you have the questions answered, you
9. Numbness
could go even further and make links with possible interven-
10. Indigestion tions. There is no one right way to make a cognitive map—use
11. Pale your imagination!
Patient's Where is it? Quality Aggravating and
perception alleviating factors
Headache
Useful other Severity Timing
data
REVIEW QUESTIONS—CONTENT REVIEW
Choose the best answer unless directed otherwise. 3. An LPN wishes to learn why a patient’s lung sounds
have crackles and questions the physician during morn-
1. Which one of the following is a nursing diagnosis?
ing rounds. Which critical thinking attitude is the nurse
1. Peptic ulcer
exhibiting?
2. Pneumonia
1. Intellectual humility
3. Ineffective airway clearance
2. Intellectual sense of justice
4. Myocardial infarction
3. Intellectual empathy
4. Intellectual integrity
2. Which one of the following is a medical diagnosis?
1. Hiatal hernia
2. Impaired mobility
3. Powerlessness
4. Anxiety
,
,4 Understanding Health Care Issues
4. The LVN is caring for a patient with diabetes. In what 5. Which of the following statements best defines critical
order should the nurse carry out the nursing process? thinking?
Place all steps in correct sequential order. 1. Orderly, goal-directed thinking
1. Implement plan of care 2. Clear thinking during critical situations
2. Assist with evaluation 3. Constructive feedback about nursing actions
3. Collect data 4. Critical evaluation of patient responses to care
4. Assist with development of nursing diagnoses
5. Assist with planning of outcomes and interventions
REVIEW QUESTIONS—TEST PREPARATION
Choose the best answer unless directed otherwise. 10. A patient has a nursing diagnosis of impaired swallow-
ing related to muscle weakness as evidenced by drool-
6. The LPN is reviewing the nursing care plan for a patient
ing, coughing, and choking. Which of the following
with acute pain related to a fractured ankle. Which of
outcomes is appropriate for this patient’s nursing
the following would determine whether the care plan is
diagnosis?
effective?
1. Improved airway clearance within 8 hours as evi-
1. Assessment of the patient’s ability to walk
denced by clear lung sounds and productive cough
2. Evaluation of the patient’s fracture on X-ray
2. Baseline body weight maintained as evidenced by
3. Elevating the patient’s foot on two pillows
no weight loss
4. Evaluation of the patient’s pain rating on a
3. Improved muscle strength as evidenced by ability to
10-point scale.
sit up while eating
4. Improved swallowing within 48 hours as evidenced
7. A patient with a history of cardiac disease reports a feel-
by no coughing or choking
ing of tightness in the chest that radiates down the left
arm. Which of the following actions by the LPN should
11. The LPN is providing care for a patient with a medical
be carried out immediately?
diagnosis of congestive heart failure who is very short
1. Check the patient’s vital signs.
of breath. Which of the following is a nursing diagno-
2. Formulate nursing diagnoses related to an acute
sis that is correctly stated in the PES (problem, etiology,
myocardial infarction.
and signs and symptoms) format?
3. Determine the patient’s outcome after nitroglycerin
1. Deficient knowledge related to disease process and
has been administered.
self-care for shortness of breath
4. Plan interventions to reduce long-term cardiac
2. Impaired gas exchange related to excess interstitial
damage.
fluid as evidenced by respiratory rate of 32 per
minute and patient stating he feels short of breath
8. The LPN is documenting patient data. Which of the fol-
3. Congestive heart failure related to decreased cardiac
lowing should the nurse document under objective data?
output as evidenced by abnormal arterial blood
1. Denies nausea
gasses
2. Shortness of breath
4. Acute dyspnea related to congestive heart failure
3. Heart rate 72 beats per minute
as evidenced by swollen lower extremities and
4. Midsternal chest pain
confusion.
9. A patient is admitted with chest pain, which has re-
solved. The patient states, “I hope I can live a normal
life.” According to Maslow’s hierarchy of needs,
which of the following levels is best reflected by
this statement?
1. Physiological needs
2. Safety and security
3. Love and belonging
4. Self-esteem
,
SUBJECTIVE AND OBJECTIVE DATA 12. Serum potassium 3.6 mEq/L
13. Palpitations (feeling of racing heart)
Identify the following data as subjective (symptom) or
objective (sign). 14. Blood pressure 130/82 mm Hg
15. White blood cell count 7000/mm3
1. Pain
2. Shortness of breath CRITICAL THINKING
3. Edema (swelling) Sometimes cognitive maps are used to organize thinking. Look
4. Capillary refill 2 seconds at samples in any of the Function and Assessment chapters
under Aging Changes. Some of the workbook chapters will ask
5. Nausea
you to make a cognitive map, so here is an opportunity to prac-
6. Vomiting tice. Consider a time when you have had a headache or other
7. Dizziness discomfort. Fill in the spaces with information related to the
8. Cyanosis WHAT’S UP? questions. See Chapter 1 Answers for one pa-
tient’s responses. Once you have the questions answered, you
9. Numbness
could go even further and make links with possible interven-
10. Indigestion tions. There is no one right way to make a cognitive map—use
11. Pale your imagination!
Patient's Where is it? Quality Aggravating and
perception alleviating factors
Headache
Useful other Severity Timing
data
REVIEW QUESTIONS—CONTENT REVIEW
Choose the best answer unless directed otherwise. 3. An LPN wishes to learn why a patient’s lung sounds
have crackles and questions the physician during morn-
1. Which one of the following is a nursing diagnosis?
ing rounds. Which critical thinking attitude is the nurse
1. Peptic ulcer
exhibiting?
2. Pneumonia
1. Intellectual humility
3. Ineffective airway clearance
2. Intellectual sense of justice
4. Myocardial infarction
3. Intellectual empathy
4. Intellectual integrity
2. Which one of the following is a medical diagnosis?
1. Hiatal hernia
2. Impaired mobility
3. Powerlessness
4. Anxiety
,
,4 Understanding Health Care Issues
4. The LVN is caring for a patient with diabetes. In what 5. Which of the following statements best defines critical
order should the nurse carry out the nursing process? thinking?
Place all steps in correct sequential order. 1. Orderly, goal-directed thinking
1. Implement plan of care 2. Clear thinking during critical situations
2. Assist with evaluation 3. Constructive feedback about nursing actions
3. Collect data 4. Critical evaluation of patient responses to care
4. Assist with development of nursing diagnoses
5. Assist with planning of outcomes and interventions
REVIEW QUESTIONS—TEST PREPARATION
Choose the best answer unless directed otherwise. 10. A patient has a nursing diagnosis of impaired swallow-
ing related to muscle weakness as evidenced by drool-
6. The LPN is reviewing the nursing care plan for a patient
ing, coughing, and choking. Which of the following
with acute pain related to a fractured ankle. Which of
outcomes is appropriate for this patient’s nursing
the following would determine whether the care plan is
diagnosis?
effective?
1. Improved airway clearance within 8 hours as evi-
1. Assessment of the patient’s ability to walk
denced by clear lung sounds and productive cough
2. Evaluation of the patient’s fracture on X-ray
2. Baseline body weight maintained as evidenced by
3. Elevating the patient’s foot on two pillows
no weight loss
4. Evaluation of the patient’s pain rating on a
3. Improved muscle strength as evidenced by ability to
10-point scale.
sit up while eating
4. Improved swallowing within 48 hours as evidenced
7. A patient with a history of cardiac disease reports a feel-
by no coughing or choking
ing of tightness in the chest that radiates down the left
arm. Which of the following actions by the LPN should
11. The LPN is providing care for a patient with a medical
be carried out immediately?
diagnosis of congestive heart failure who is very short
1. Check the patient’s vital signs.
of breath. Which of the following is a nursing diagno-
2. Formulate nursing diagnoses related to an acute
sis that is correctly stated in the PES (problem, etiology,
myocardial infarction.
and signs and symptoms) format?
3. Determine the patient’s outcome after nitroglycerin
1. Deficient knowledge related to disease process and
has been administered.
self-care for shortness of breath
4. Plan interventions to reduce long-term cardiac
2. Impaired gas exchange related to excess interstitial
damage.
fluid as evidenced by respiratory rate of 32 per
minute and patient stating he feels short of breath
8. The LPN is documenting patient data. Which of the fol-
3. Congestive heart failure related to decreased cardiac
lowing should the nurse document under objective data?
output as evidenced by abnormal arterial blood
1. Denies nausea
gasses
2. Shortness of breath
4. Acute dyspnea related to congestive heart failure
3. Heart rate 72 beats per minute
as evidenced by swollen lower extremities and
4. Midsternal chest pain
confusion.
9. A patient is admitted with chest pain, which has re-
solved. The patient states, “I hope I can live a normal
life.” According to Maslow’s hierarchy of needs,
which of the following levels is best reflected by
this statement?
1. Physiological needs
2. Safety and security
3. Love and belonging
4. Self-esteem
,
