Chapter 1 : Decision Making, Problem Solving, Critical Thinking, and Clinical Reasoning: Requisites for Successful Leadership and Management 1. A nurse is applying a decision -making process to a clinical challenge. When applying this process, the nurse must: a. analyze the root causes of a situation. b. begin by solving the underlying problem. c. choose between different courses of action. d. prioritize the maximum good for the maximum number of people. ANS: C Feedback: Decision making is a complex, cognitive process often defined as choosing a particular course of action. Problem solving is part of decision making and is a systematic process that focuses on analyzing a difficult situation. It is not always realistic for the nurse to solve each of the problems contributing to a larger challenge, especially at the beginning of the decision -making process. The nurse often lacks the time, information, or resources to analyze the root causes of a situation. Many times, the nurse makes a decision that benefits the largest number of people, but this is not always feasible or desirable. PTS: 1 DIF: Moderate REF: Page and Header: 3, Decision Making, Problem Solving, Critical Thinking, Clinical Reasoning, and Elastic Thinking OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC: Nursing Concepts: Clinical Decision Making, Leadership & Management TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 2. A nurse is applying the traditional problem -solving model when mediating a conflict between two colleagues. When applying this model, the nurse should prioritize what task? a. Identifying the root cause of the conflict b. Implementing a solution as quickly as possible c. Eliciting input from other nurses d. Encouraging each nurse to reflect on their actions ANS: A Feedback: The traditional problem -solving model attempts to identify the root problem in situations, a task that requires much time and energy. Efficiency is desirable, but trying to implement a solution as quickly as possible can result in a hasty and incorrect solution. Outside input may or may not be necessary; this varies with each individual problem. Reflective thinking is always beneficial, but this is not a specific component of the traditional problem -solving model. PTS: 1 DIF: Moderate REF: Page and Header: 3, Decision Making, Problem Solving, Critical Thinking, Clinical Reasoning, and Elastic Thinking OBJ: 1 NAT: Client Needs : Safe and Effective Care Environment: Management of Care LOC: Nursing Concepts: Clinical Decision Making, Collaboration TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 3. Which statement is true regarding decision making? a. Scientific methods provide identical decisions by different individuals for the same problems. b. Decisions are greatly influenced by each person’s value system. c. Personal beliefs can be adjusted for when the scientific approach to problem solving is used. d. Past experience has little to do with the quality of the decision. ANS: B Feedback: Values, life experience, individual preference, and individual ways of thinking will influence a person’s decision making. No matter how objective the criteria will be, value judgments will always play a part in a person’s decision making, either consciously or subconsciously. It is not possible for a nurse to fully “set aside” personal beliefs when making a decision, even if the nurse applies the principles of self -reflection. PTS: 1 DIF: Moderate REF: Page and Header: 16, Choose and Act Decisively OBJ: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC: Nursing Concepts: Leadership & Management TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice 4. The nurse -manager of a short -staffed unit needs to make a decision about a nurse’s request for an unpaid leave of absence. In order to increase the chance of making a good decision, the manager should: a. involve as many people in the decision -making process as possible. b. begin the decision -making process by presuming the status quo to be the best option. c. generate as many different alternatives as possible. d. prioritize the option that is most innovative. ANS: C Feedback: The greater the number of alternatives that can be generated by the decision maker, the better the final decision will be. Generating multiple alternatives may require involving more people in the decision -making process, but the process can easily become unwieldy if too many people are involved. The manager should always consider the status quo as a possible option, but this is not always considered to be the default option. Innovation is often a desirable characteristic, but it would be inappropriate to choose an option solely because it is innovative; many other values must be consider ed. PTS: 1 DIF: Moderate REF: Page and Header: 14, Generate Numerous Alternatives OBJ: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC: Nursing Concepts: Clinical Decision Making, Leadership & Management TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 5. An experienced nurse -manager has been described as being a “right -brained thinker.” Which is an example of this manager’s decision -making process? a. Uses data sets to generate solutions b. Uses thinking that is outside the normal standards to find a solution c. Has the ability to ask all those involved in the decision making d. Focuses on the intended process to reach a solution or goal ANS: B Feedback: Right -brained thinkers have traditionally been characterized as creative and intuitive, and thinking outside of normal standards to find a solution. Linear analysis, such as the ability to generate solutions based on data sets, is mor e closely aligned with left-brained thinking. Transparency, such as getting all those involved, and efficiency, which focuses on the process to reach a goal, are desirable qualities that are not particularly aligned with either of these two paradigms. PTS: 1 DIF: Easy REF: Page and Header: 18, Brain Hemisphere Dominance and Thinking Styles OBJ: 3 | 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC: Nursing Concepts: Human Development, Leadership & Management TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 6. A nurse -manager is applying an evidence -based approach to a clinical question around client mobilization. When using a PICO (patient or population, intervention, comparison, and outcome) format to search for evidence, the nurse should identify what? a. The role of intuition in the decision -making process b. The preferences of clients and their families c. The clients for whom the intervention would be relevant d. Costs associated with a potential change in practice ANS: C Feedback: The PICO format is used in evidence -based practice to guide the search for the current best evidence to address a problem. Client and family preferences and cost are included in evidence -based practice but are not explicit components of the PICO format. Intuition is a component of decision making but is not specifically included in the PICO format. PTS: 1 DIF: Moderate REF: Page and Header: 13, Use an Evidence -Based Approach OBJ: 5 | 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care LOC: Nursing Concepts: Clinical Decision Making, Leadership & Management, Evidence -Based Practice TOP: Chapter: 1 KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 7. A nurse -manager is applying the decision -making process when addressing a nurse’s high rate of absenteeism. This process should result in: a. an outcome that is desired by all. b. a chosen course of action. c. an action that guarantees success. d. a new understanding of the problem.
