A nurse is caring for a client who has a fever, cough, and shortness of breath. The nurse suspects that the client has pneumonia and orders a chest x-ray and blood cultures. Which of the following actions by the nurse demonstrate critical thinking?

Choice A:

Assessment. This is the first step of the nursing process, where the nurse collects data about the patient's health status, needs, and problems. This step does not describe the research project, which already has data from the pretest and posttest.

Choice B:

Diagnosis. This is the second step of the nursing process, where the nurse analyzes the data and identifies the patient's actual or potential nursing diagnoses. This step does not describe the research project, which does not focus on individual patients or diagnoses.

Choice C:

Planning. This is the third step of the nursing process, where the nurse sets goals and outcomes for the patient and selects appropriate nursing interventions. This step does not describe the research project, which already has a plan for the intervention and the control group.

Choice D:

Implementation. This is the fourth step of the nursing process, where the nurse carries out the planned interventions and documents the care provided. This step partially describes the research project, which involves implementing the intervention for the experimental group. However, this is not the best answer because it does not capture the whole purpose of the project.

Choice E:

Evaluation. This is the fifth and final step of the nursing process, where the nurse evaluates the patient's progress toward the goals and outcomes and modifies the plan of care as needed. This step best describes the research project, which involves evaluating the effectiveness of the intervention by comparing the pretest and posttest scores of both groups. The nurse uses a standardized test of critical thinking skills as a measure of evaluation.

Choice A:.

This statement does not indicate a lack of critical thinking because the nurse is planning to monitor the client's blood glucose level more frequently to evaluate the effectiveness of the insulin therapy. This is an appropriate nursing intervention for a client who has hyperglycemia.

Choice B :.

This statement does not indicate a lack of critical thinking because the nurse is checking the medication administration record to see if the client received his insulin as prescribed. This is an important step to identify any possible errors or omissions that could have contributed to the client's high blood glucose level.

Choice C:.

This statement indicates a lack of critical thinking because the nurse is increasing the insulin dose by 2 units as per the sliding scale protocol without considering other factors that could affect the client's blood glucose level, such as diet, exercise, stress, or infection. The nurse should not adjust the insulin dose without consulting the provider or following a specific protocol that takes into account the client's individual needs and goals.

Choice D:.

This statement does not indicate a lack of critical thinking because the nurse is asking the client if he ate anything that could have raised his blood sugar level. This is a relevant question to assess the client's dietary intake and adherence to the prescribed meal plan. The nurse should also educate the client about the importance of following a consistent carbohydrate diet and avoiding foods that can spike blood glucose levels.