Frequently Asked Questions
Chapter 10: Critical Thinking and The Nursing Process

What are the five cognitive skills necessary to apply critical thinking to clinical problems?

The five cognitive skills necessary to apply critical thinking to clinical problems are (1) a systematic approach to problem solving, (2) caring sensitivity to the client’s perspective of a problem or need, (3) unbiased inquiry and creative analysis of cause and effect, (4) intuition, and (5) reflection-in-action (evaluation), in which valid conclusions are based on logical consistency.

How is critical thinking related to the problem-solving and decision-making processes?

Critical thinking includes both problem solving and decision making. In problem solving, problems are identified, information is gathered, a specific problem is named, a plan for solving the problem is developed, the plan is put into action, and results of the plan are evaluated. Decision making is the consideration and selection of interventions from a repertoire of actions that facilitate the achievement of a desired outcome.

What is the relationship between the problem-solving process and the nursing process?

The nursing process is a specific type of problem-solving method, used by nurses and applied to client care.

What is the difference between subjective assessment data and objective assessment data?

Subjective data are feelings, perceptions, and concerns from the client’s point of view, including a health history. Objective data are observable and measurable data that are obtained through both standard assessment techniques performed during the physical examination and diagnostic tests.

How are nursing diagnoses different from medical diagnoses?

Nursing diagnoses differ from medical diagnoses because (1) they focus on actual or potential health problems or life processes, rather than on disease; (2) they change as the client’s health problems change; and (3) they identify a problem for which a nurse is licensed and qualified to intervene independent from the physician.

How do an actual nursing diagnosis, a risk nursing diagnosis, a possible nursing diagnosis, and a wellness nursing diagnosis differ?

An actual nursing diagnosis indicates that a problem actually exists. A risk nursing diagnosis (potential problem) indicates that a problem does not yet exist, but risk factors are present. A possible nursing diagnosis indicates a situation in which a problem could arise unless preventive action is taken or a statement of a hunch by the nurse that cannot be confirmed or eliminated until more data have been collected. A wellness nursing diagnosis indicates the client’s expression of a desire to attain a higher level of wellness in some area of function.

What is a “collaborative problem,” and how does it differ from a nursing diagnosis?

A collaborative problem is one managed through the use of interventions prescribed by other health care practitioners and/or nurses. A nursing diagnosis states a problem that is amenable to nursing intervention.

How would you characterize a “priority” nursing diagnosis?

A priority nursing diagnosis is one related to a life-threatening situation, such as “ineffective breathing pattern.” Other priorities should consider client input.

What is the difference between a goal and an expected outcome?

Goals are broad statements that describe an intended or desired change in the client’s behavior. Expected outcomes are specific objectives related to the goals. They are used to evaluate nursing interventions, so they should be measurable, achievable within a certain time limit, and realistic.

What are the skills needed for the nurse to implement a plan of care?

The skills needed for implementation include the ability to assess the client throughout the nursing process, psychomotor skills, interpersonal skills, critical thinking skills, and the ability to accurately report and document client data.

What are the reasons why goals are not met or are only partially met?

When goals are not met or are only partially met, the reasons may be that (1) the initial assessment data may have been incomplete, (2) the goals and expected outcomes may not have been realistic, (3) the time frame may have been too optimistic, or (4) the goals and/or nursing interventions may not have been appropriate for the client.