A nurse is reviewing the laboratory results of a client who has diabetes mellitus and is receiving insulin therapy. The nurse notices that the client's blood glucose level is 250 mg/dL, which is higher than the target range. The nurse decides to increase the dose of insulin for the next administration. Which of the following statements by the nurse indicates a lack of critical thinking?

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.

Choice A:

This statement is correct and does not indicate a need for further teaching. Reflection is one of the key elements of critical thinking in nursing, as it allows nurses to examine their own actions and decisions and learn from them.

Choice B:

This statement is also correct and does not indicate a need for further teaching. Analysis is another key element of critical thinking in nursing, as it involves breaking down a complex situation into smaller parts that can be understood and evaluated.

Choice C:

This statement is incorrect and indicates a need for further teaching. Inference is not making assumptions based on one's experience, but rather drawing logical conclusions from the available evidence. Making assumptions can lead to errors in judgment and compromise patient safety. Nurses should use critical thinking to question their assumptions and biases and seek reliable and valid information.

Choice D:

This statement is correct and does not indicate a need for further teaching. Evaluation is another key element of critical thinking in nursing, as it involves checking the reliability and validity of information that is used to make decisions. Nurses should use critical thinking to assess the sources, methods, and outcomes of information they encounter in their practice.