Question 1

The nurse manager is calculating the cost of offering two bonus incentives to nursing staff for covering call-ins for sickness. After reviewing the statistics, the manager finds that option A is more cost-effective than option B but decides to implement option B because it seems safer. Which option best describes the basis of this decision?
A) Probability
B) Probability analysis
C) Objective probability
D) Subjective probability

Accepted Answer

1. Probability is the likelihood, expressed as a percentage, that an event will or will not occur.
2. Probability analysis is a method of calculating expected risk; this is the method the nurse used to compare the two options.
3. Objective probability is the likelihood that an event will or will not occur, based on facts and reliable information.
4. Even though option A is more cost-effective, the manager believes option B to be in the best interest of the unit. Subjective probability is the likelihood that an event will or will not occur based on personal judgment and beliefs.

Question 2

A newly promoted nurse manager would like staff to solve problems without relying on preconceived ideas. How should the manager role-model this ability?
A) When disagreements occur on the unit, the manager privately asks the dissenters to be silent about the issue at meetings.
B) Tell staff members that they must present one opinion regarding the solutions they desire.
C) Demonstrate a genuine desire to find our why there is dissention.
D) Develop "tunnel vision" when it comes to problems on the unit.

Accepted Answer

1. Managers should not assume that only one opinion can be voiced and that others will be silent.
2. Managers should not assume that only one opinion can be voiced.
3. Good managers start out with a commitment to find out why others disagree.
4. Tunnel vision makes it difficult to see things from another perspective and will not encourage staff to avoid preconceived ideas.

Question 3

A nursing task force has been created to determine whether a new model of differentiated practice would be more effective than the current model. The task force analyzes data as a basis to examine alternatives. Which activity does this represent?
A) Group problem solving
B) Critical thinking
C) Groupthink
D) Satisficing

Accepted Answer

1. Group problem solving implies that a problem exists, which is not the case in this situation. The task force is comparing two models of practice, not solving a problem.
2. Critical thinking is a higher-level cognitive process that involves the examination of assumptions, interpretation and analysis of arguments, and the development of a conclusion that can be justified.
3. Groupthink is a negative phenomenon that occurs in highly cohesive groups that become isolated. There is no evidence that groupthink has occurred in this situation.
4. Satisficing is a type of decision-making strategy that identifies a strategy that is minimally acceptable. There is no evidence that satisficing has occurred in this situation.

Question 4

The nurse manager has scheduled a series of meetings with employees to solve a unit problem. The manager purposefully created a two-week gap in the meetings to allow which portion of the creative process to occur?
A) Farsight
B) Verification
C) Preparation
D) Incubation

Accepted Answer

1. Farsight is not part of this process.
2. Verification is evaluation of the solution's effectiveness.
3. Preparation is planning time.
4. The time lapsed before a decision is made is the "incubation" time.

Question 5

Which situation requires an adaptive decision?
A) The nurse manager discovers that two clients require the use of a new piece of equipment and that the one the hospital has is the only one in the state.
B) The nurse has made a medication error on an experimental medication.
C) The nursing student makes an error when changing a client dressing.
D) The nurse manager scheduled too many nurses for the client census on the night shift, and all of the nurses scheduled have already been asked to take a low-census unpaid day off this month.

Accepted Answer

1. Adaptive decisions must be made when the situation is unusual and there is no clear-cut policy for decision making.
2. Making a medication error is not an unusual situation, and a policy exists for handling this issue.
3. A policy exists for handling procedure errors.
4. A policy exists for handling staffing errors.

Question 6

The nurse manager is challenged to find an innovative way to adequately staff the unit and provide quality nursing care. Which ability would be most useful to the nurse in this situation?
A) Creativity
B) Problem solving
C) Brainstorming
D) Decision making

Accepted Answer

1. Creativity is a part of the critical-thinking process that fosters the development and implementation of new approaches to different situations.
2. Problem solving implies there is a problem that needs a solution.
3. Brainstorming generates diverse ideas with many superficial solutions.
4. Decision making identifies one effective strategy that is not necessarily innovative.

Question 7

A nurse manager's supervisor reports that many staff members have complained about the manager's rigidity. What situations reflect this rigidity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) The manager has historically used trial and error as a decision-making strategy.
B) The manager takes unnecessary risks when staffing the unit.
C) The manager is not concerned when staff members arrive late to work.
D) The manager uses old ways of thinking to solve the day-to-day issues of the unit.
E) The manager does not consider the advice of the assistant manager when making a decision.

Accepted Answer

1. A history of ineffective trial-and-error solutions to problems tends to make the manager rigid.
2. Generally, fear of risk taking is characteristic of a rigid management style.
3. Rigidity in personality often translates to rigidity in management style. A rigid manager would be upset if staff members routinely came to work late.
4. Using old ways of thinking to solve new problems is characteristic of rigid management.
5. Rigid managers typically prefer to make decisions independently.

Question 8

Which statements exemplify the attributes of critical thinking essential to nurses? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) "I am always curious about why we do things the way we do."
B) "I think we need to hurry up and make a decision."
C) "Can you help me understand your perspective a little better?"
D) "I don't think that your concern is necessarily pertinent to this issue."
E) "I don't think I can make that decision until I have more information."

Accepted Answer

1. Curiosity and a willingness to examine underlying assumptions are characteristic of a critical thinker.
2. A critical thinker is not in a hurry to make a decision but waits until all the facts are known and can be considered.
3. The critical thinker considers the possible alternative perspectives.
4. The critical thinker does not discount the concerns of others who have knowledge of the issue.
5. The critical thinker collects and analyzes the facts before considering any decision.

Question 9

Currently, clients on a unit are bathed in the morning between 8:00 a.m. and 11:00 a.m. The nursing staff is contemplating changing that routine to bathing clients in the evening between 7:00 p.m. and 9:00 p.m. Which statement reflects an underlying assumption that might affect the staff's ability to think critically about this change? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) "The day shift just wants to shift work onto the evening shift."
B) "Everyone likes to bathe right before bed."
C) "I read a research article that reported that clients sleep better if they have been bathed right before bedtime."
D) "The physician staff will be upset if we change our morning routine."
E) "If we let them change this, they will want to make lots of other changes, too."

Accepted Answer

1. This is an underlying assumption about why this change is being considered.
2. This speaker assumes that everyone likes to bathe right before bed, not taking into consideration that some like to bathe in the morning.
3. A research article report is not an assumption but based on evidence.
4. This is an assumption that might well be erroneous.
5. This is an assumption.

Question 10

Which statement by the formal leader of a nursing unit reflects the personality required to energize the staff and promote creativity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) "I would like to change the format we use for shift report, but I'm afraid it would upset staff members who have been here a long time."
B) "This is the decision I have made, and there is no room for discussion."
C) "I would like to thank everyone for your hard work and dedication while we have been short staffed."
D) "I am certain that our new assignment system is going to make the workload more equitable."
E) "I know this week has been rough. I feel a little like sandpaper myself."

Accepted Answer

1. Basing decisions on placating staff indicates the leader is insecure and does not energize staff or promote creativity.
2. The leader who does not value input from staff will not promote creativity.
3. The leader who recognizes the staff's efforts and sacrifices is more likely to energize the staff.
4. Optimism is crucial to energizing staff and promoting creativity.
5. Humor is a good method to help energize staff and promote creativity.

Question 11

Although the postoperative assessment of a client reveals no abnormalities, the nurse believes the client's condition is deteriorating and orders frequent vital signs. This intervention was made on the basis of which type of problem solving? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) Experimentation
B) Intuition
C) Satisficing
D) Past experience
E) Trial-and-error method

Accepted Answer

1. Experimentation involves testing a theory to produce a prediction.
2. Intuition and past experiences enable the expert nurse to make clinical judgments based on wisdom, sensitivity to the client, and a "gut feeling" that a change in the client is imminent.
3. Satisficing involves choosing a solution to meet minimum standards of care.
4. Intuition and past experience enable the expert nurse to make clinical judgments based on wisdom, sensitivity to the client, and a "gut feeling" that a change in the client is imminent.
5. The trial-and-error method is not based on prior experience; rather, one approach after another is tried until the problem is solved.

Question 12

Which statement describes the primary difference between group and individual decision making, besides the number of individuals involved? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
A) A decision made by a group is often better than a decision made by one person.
B) A decision made by an individual results in greater commitment.
C) Groups can provide more input into the process.
D) A decision made by a group can create a greater obligation to achieve results.
E) Routine decisions are more often made by individuals.

Accepted Answer

1. Decisions made by groups are often better than those made by individuals because there is more input into the process.
2. There is no evidence to support that a decision made by an individual results in greater commitment.
3. Decisions made by groups are often better than those made by individuals because there is more input into the process.
4. The peer pressure of a group can create a greater commitment or feeling of obligation to achieve results.
5. Routine decisions are often made by individuals, with no group input necessary.

Question 13

A nurse working in a rehabilitation center notices that clients frequently asking for something to drink. Which response indicates the use of creativity in finding a solution to this problem?
A) Calling local beverage distributors to inquire about service pricing
B) Asking all employees to write down their ideas about a solution
C) Determining what type of drinks most clients might want
D) Encouraging clients to bring a drink from home

Accepted Answer

1. Calling a local beverage distributor is a "classic" way to address this problem and does not engage the creativity of the staff.
2. Asking others to think about different options opens up the possibilities beyond one individual's ideas. This is part of the preparation stage of creativity.
3. Finding out the drink preferences of the clients is part of the standard information gathering stage of providing drinks and does not reflect creativity.
4. Simply encouraging clients to bring a drink from home is not a creative approach to solving this problem.

Question 14

A newly licensed nurse working on a unit committee challenges every detail of a proposal the committee is developing. How should other committee members interpret this behavior?
A) This nurse is too inexperienced to realize the behavior is inappropriate.
B) This nurse is learning to be creative.
C) This nurse believes that new nurses are more knowledgeable than those who have worked several years.
D) This nurse misunderstands the work of the committee.

Accepted Answer

1. This behavior is not inappropriate.
2. Challenging details is a part of the preparation portion of learning to be creative.
3. There is no indication that this is the belief of this nurse.
4. There is no indication that this nurse does not understand the work of the committee.

Question 15

The nursing group has been charged with the task of solving a patient care problem on the unit. Which step should this group take first in this process?
A) Investigate what has already been tried to solve the issue.
B) Brainstorm about potential solutions.
C) Gather information to define the problem.
D) Categorize information in order of reliability.

Accepted Answer

1. Once the problem has been identified, the group would then look at solutions that have already been tried.
2. Brainstorming is used to develop solutions after information about the problem is analyzed.
3. Problem solving begins with collecting the facts, which provides clues to the scope and solution of the problem.
4. Information cannot be sorted into an orderly arrangement until it has been collected.

Question 16

The nurse is using critical thinking skills to decide which of several options is the best. Which question is most important for the nurse to take into consideration?
A) Are there different situational effects or contexts to be considered?
B) How has the problem usually been handled?
C) What is the easiest and least expensive alternative?
D) Can the problem be solved using the nursing process?

Accepted Answer

1. Critical thinking involves choosing the best alternative from among several, depending on the situation in which the problem occurred. This is the context of the problem.
2. Handling the problem the way it is usually handled may be easy but would not involve critical thinking.
3. Choosing the easiest or least expensive alternative may be easy but would not involve critical thinking.
4. The nursing process should be used in critical thinking, but the changing situation is the more defining and specific characteristic of critical thinking.

Question 17

Which statement indicates understanding how a nurse could improve personal decision-making skills?
A) "We should gather a group together to make important unit decisions to ensure fairness."
B) "I should practice making decisions by developing potential solutions and then choosing one."
C) "We can make a decision and then ask for input from others to make sure it was the right choice."
D) "I know I will never be able to improve my decision-making skills because I am not a strong person."

Accepted Answer

1. Depending on a group is not likely to help the nurse improve personal decision-making skills.
2. Practicing making decisions will increase the nurse's experience, comfort, and overall skill.
3. Including a "we" in this process is not as likely to improve the nurse's personal decision-making skills as making an individual decision. Asking for input to make certain the choice was correct indicates lack of certainty.
4. Decision-making skills can be learned regardless of one's perceived personal strength.

Question 18

The nurse manager generally uses a stepwise method to arrive at decisions that are logical and that serve to maximize the achievement of the desired objective. Which decision-making model does this manager use?
A) Political decision-making model
B) Experimentation process
C) Rational decision-making model
D) Trial-and-error method

Accepted Answer

1. The premise of the political decision-making model is that decisions align with the interests of powerful stakeholders such as hospital boards and regulatory bodies.
2. Experimentation involves the use of a pilot project to test the effectiveness of a solution.
3. The rational decision-making model is a series of steps that managers take to make logical, rational choices that maximize the achievement of successful outcomes.
4. The trial-and-error method is used by inexperienced managers and involves the application of one solution after another to improve a problem.

Question 19

The nursing faculty would like to incorporate problem-based learning into the curriculum. Which action is essential?
A) Obtain funding for a simulation mannequin.
B) Write standardized scripts for volunteers who will portray clients.
C) Add more information to existing care plans as the study unfolds.
D) Assign client care debate topics to teams of three or four students.

Accepted Answer

1. Simulation mannequins are not essential for problem-based learning.
2. It is not essential to have a person who portrays a client in order to conduct problem-based learning.
3. Problem-based learning exists when students are exposed to "what comes next" in a case study. Additional information is revealed as the case study progresses.
4. Debates are a way to encourage innovation but are not essential for problem-based learning.

Question 20

The nurse has determined that in order to provide the highest quality care it is important to become more creative. What is the most effective way for the nurse to increase creativity?
A) Watch others implement creative solutions.
B) Work with a group to implement a creative solution.
C) Evaluate the effectiveness of creative solutions.
D) Practice the steps of the process as often as possible.

Accepted Answer

1. Watching others implement creative solutions would be helpful in improving the nurse's creativity, but it is not the best of these choices.
2. Working with a group to implement a creative solution would be helpful in improving the nurse's creativity, but it is not the best of these choices.
3. Evaluating the effectiveness of creative solutions would be helpful in improving the nurse's creativity, but it is not the best of these choices.
4. The most effective of these methods would be practicing the steps. Creativity is a skill that can be learned and improved through practice, just like technical skills.

Quiz 9: Thinking Critically, Making Decisions, Solving Problems

A newly promoted nurse manager would like staff to solve problems without relying on preconceived ideas. How should the manager role-model this ability?

A nursing task force has been created to determine whether a new model of differentiated practice would be more effective than the current model. The task force analyzes data as a basis to examine alternatives. Which activity does this represent?

The nurse manager has scheduled a series of meetings with employees to solve a unit problem. The manager purposefully created a two-week gap in the meetings to allow which portion of the creative process to occur?

Which situation requires an adaptive decision?

The nurse manager is challenged to find an innovative way to adequately staff the unit and provide quality nursing care. Which ability would be most useful to the nurse in this situation?

A nurse manager's supervisor reports that many staff members have complained about the manager's rigidity. What situations reflect this rigidity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Which statements exemplify the attributes of critical thinking essential to nurses? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Which statement by the formal leader of a nursing unit reflects the personality required to energize the staff and promote creativity? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Which statement describes the primary difference between group and individual decision making, besides the number of individuals involved? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A nurse working in a rehabilitation center notices that clients frequently asking for something to drink. Which response indicates the use of creativity in finding a solution to this problem?

A newly licensed nurse working on a unit committee challenges every detail of a proposal the committee is developing. How should other committee members interpret this behavior?

The nursing group has been charged with the task of solving a patient care problem on the unit. Which step should this group take first in this process?

The nurse is using critical thinking skills to decide which of several options is the best. Which question is most important for the nurse to take into consideration?

Which statement indicates understanding how a nurse could improve personal decision-making skills?

The nurse manager generally uses a stepwise method to arrive at decisions that are logical and that serve to maximize the achievement of the desired objective. Which decision-making model does this manager use?

The nursing faculty would like to incorporate problem-based learning into the curriculum. Which action is essential?

The nurse has determined that in order to provide the highest quality care it is important to become more creative. What is the most effective way for the nurse to increase creativity?