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Chapter 17-DECISION MAKING
MULTIPLE CHOICE
1. Which of the following refers to improved thinking about a subject using skill and intellectual
standards?
a. problem solving
b. critical thinking
c. rational thinking
d. anticipation
ANS: B
RAT: The National Council for Excellence in Critical Thinking Instruction defines critical thinking as
“a mode of thinking—about any subject, content, or problem—in which the thinker improves the
quality of their thinking by skilfully taking charge of the structures inherent in thinking and imposing
intellectual standards upon them.”
PTS: 1
REF: p. 349
BLM: Remembering
2. From which three perspectives should critical thinking be viewed?
a. thinking ahead, thinking in action, and thinking back
b. thinking about clients, the physician, the nurse
c. thinking about management, cost, outcomes
d. thinking of client, nurse, or management
ANS: A
RAT: Critical thinking is contextual and changes depending on circumstances. It can be viewed from
three perspectives: thinking ahead, thinking in action, and thinking back.
PTS: 1
REF: p. 349
BLM: Remembering
3. Which of these is another way of describing thinking ahead?
a. decision making
b. refection
c. planning
d. being proactive
ANS: D
RAT: Thinking ahead is the ability to anticipate what might happen and be proactive. Novice nurses or
novice nurse managers are limited in their ability to think proactively because they have not yet
acquired enough experience. They need to consult with experienced nurses and refer to appropriate
texts or manuals for guidance.
PTS: 1
REF: p. 349
BLM: Remembering
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4. Who stated that nurses must “demonstrate critical thinking, reflection, and problem-solving skills” in
order to thrive as effective practitioners in the 21st century?
a. Paul
b. Euripides
c. Pesut and Herman
d. Pew Health Professions Commission
ANS: D
RAT: Critical thinking is essential when making decisions and solving problems. The American Pew
Health Professions Commission identified that nurses must “demonstrate critical thinking, reflection,
and problem-solving skills” in order to thrive as effective practitioners in the 21st century.
PTS: 1
REF: p. 349
BLM: Remembering
5. Which of these can the student best improve by “journaling” on a regular basis?
a. problem solving
b. critical thinking
c. reflective thinking
d. using nurse process
ANS: C
RAT: Nursing students can become better reflective thinkers through the use of clinical journals.
Reflection helps the student learn from their experiences and develop critical thinking skills. A good
critical thinker is able to use their recent experiences to examine their decisions from all sides and take
into account varying points of view.
PTS: 1
REF: p. 351
BLM: Understanding
6. What is the correct order of the steps in the problem-solving process?
a. select an action; implement the selected action; generate alternatives; gather and analyze
data; identify the problem; and evaluate the action
b. gather and analyze data; identify the problem; select an action; implement the selected
action; generate alternatives; and evaluate the action
c. identify the problem; gather and analyze data; generate alternatives; select an action;
implement the selected action; and evaluate the action
d. identify the problem; generate alternatives; gather and analyze data; select an action;
implement the selected action; and evaluate the action
ANS: C
RAT: The problem-solving process consists of the following steps: identify the problem, gather and
analyze data, generate alternatives, select an action, implement the selected action, and evaluate the
action. These steps are similar to those of the nursing process.
PTS: 1
REF: p. 351
BLM: Remembering
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full file at http://testbankcorner.eu
7. To which of the following has the nursing profession in Canada been compared?
a. a highly visible force
b. a strong force
c. a sleeping giant
d. other female-dominated occupations
ANS: C
RAT: Nursing comprises the largest health care professional group in Canada yet has exerted a
relatively small influence on decision making. The nursing profession has been described as a sleeping
giant that once awakened will be a formidable force. Consistent and effective decision making will
move individual nurses and the profession as a whole into a more powerful position.
PTS: 1
REF: p. 352
BLM: Understanding
8. What is the term for making a selection and implementing a course of action from a group of
alternatives?
a. problem solving
b. decision making
c. critical thinking
d. reflective thinking
ANS: B
RAT: Decision making is a cognitive process leading to selection of a course of action from among
possible alternatives that have been identified. It is a process of reasoning that begins with a perceived
need to do something, accompanied by indecision about the best course of action. Nurses are most
often involved in clinical decision making that occurs in the context of client care.
PTS: 1
REF: p. 352
BLM: Remembering
9. Which of these findings about decision making was made by the Stanford School of Medicine?
a. Decision making is easily learned.
b. Decision making is a natural skill.
c. Decision making is hard to learn.
d. Decision making is a simple task.
ANS: C
RAT: Researchers at the Stanford School of Medicine’s Center for Immersive and Simulation-based
Learning have found that, despite the fact decision making is so commonplace, it is “ very complicated
and hard to learn.” They further found that decision making is more difficult to learn in situations in
which decisions are complex and involve substantial discussion with clients, or in settings such as
critical care units or the operating room where time is a major factor. These are the same situations in
which nurses are frequently involved.
PTS: 1
REF: p. 352
BLM: Remembering
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full file at http://testbankcorner.eu
10. What type of choice would include a decision to continue using the same technique or procedure rather
than trial a new one?
a. maintenance
b. bureaucratic
c. individual
d. positive change
ANS: A
RAT: Reluctance to try new ways of doing things leads to the choice to maintain the status quo or the
tendency to hang on to what we have created or inherited from the past. Maintenance thinking is
cautious and safe but does not encourage progress or greatness.
PTS: 1
REF: p. 352
BLM: Understanding
11. Which of the following is the main requirement for “greatness” thinking in decision making?
a. group cohesiveness
b. self-awareness
c. courage
d. management support
ANS: C
RAT: Greatness thinking means giving up pessimism and the need for insulation, predictability, and
organizational safety. The main requirement is courage, along with knowledge and energy. We
associate greatness with leaders such as Mandela but it is possible for anyone possessing the
requirements to choose greatness over maintenance.
PTS: 1
REF: p. 353
BLM: Understanding
12. Which factors influence decision making through organizational culture and legal frameworks?
a. organizational factors
b. extrinsic factors
c. personal factors
d. intrinsic factors
ANS: B
RAT: Extrinsic factors that can serve to enhance or impede decision making include organizational
culture and climate, clients’ rights and choice, and legal legislative frameworks.
PTS: 1
REF: p. 354
BLM: Understanding
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13. What kind of perspective is employed when an individual views a problem as if standing outside their
body?
a. autonomous perception
b. management perception
c. objective perception
d. subjective perception
ANS: C
RAT: Personal perceptions influence our decision making. Those using an objective perception can
view a problem or decision point from a distance as if standing outside their body. This represents a
more rational, unemotional and impersonal viewpoint on which to base a decision. This type of
decision maker may be seen by others to be cold and heartless.
PTS: 1
REF: p. 354
BLM: Understanding
14. Which term describes those who use a type of perception opposite to the objective/rational
perspective?
a. feelers
b. left-brain thinkers
c. evidenced-based thinkers
d. intuitive
ANS: A
RAT: Feelers use a subjective lens to consider values and the feelings of others when making a
decision. They are influenced by empathy, relationships, and the need to preserve harmony. They are
right-brain dominant as opposed to objective thinkers, who tend to be left-brain dominant.
PTS: 1
REF: p. 354
BLM: Understanding
15. Which of the following is an advantage of group decision making?
a. less time involved
b. less costly
c. less conflict
d. higher quality outcomes
ANS: D
RAT: More ideas can be generated with groups, thus allowing for more choices. This increases the
likelihood of higher quality outcomes. Another advantage of groups is that when followers participate
in the decision-making process, acceptance of the decision is more likely to occur. A disadvantage of
group decision making is the time involved.
PTS: 1
REF: p. 361
BLM: Understanding
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16. Which is the correct order of the steps in the nominal group process?
a. present ideas; write ideas; discuss ideas and evaluate ideas; vote on ideas
b. write ideas; present ideas; discuss ideas and evaluate ideas; vote on ideas
c. present ideas; discuss ideas and evaluate ideas; write ideas; vote on ideas
d. discuss ideas and evaluate ideas; write ideas; present ideas; vote on ideas
ANS: B
RAT: The nominal group technique is a method to facilitate group decision making. The steps in the
process are as follow: group members write their ideas, present their ideas, discuss ideas and evaluate
ideas, and vote on ideas.
PTS: 1
REF: p. 364
BLM: Remembering
17. What is the term for the group decision-making strategy that involves distributing questionnaires to
members asking for their opinions, then summarizing and disseminating the summaries to the group
members?
a. consensus
b. group think
c. Delphi technique
d. nominal technique
ANS: C
RAT: In the Delphi technique, questionnaires are distributed to group members for their opinions,
which are then summarized and disseminated with the summaries to the group members.
PTS: 1
REF: p. 364
BLM: Remembering
18. Which of these activities is a symptom of groupthink?
a. basing decisions on anecdotal evidence
b. developing an illusion of invulnerability
c. stereotyping insiders
d. discouraging questioning
ANS: B
RAT: There are three symptoms of groupthink: members develop an illusion of invulnerability,
outsiders are stereotyped, and data are interpreted as correct regardless of the evidence. In groupthink,
the characteristic goal is for everyone to be in 100 percent agreement.
PTS: 1
REF: p. 364
BLM: Understanding
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full file at http://testbankcorner.eu
19. Which of these outcomes is a pitfall identified by Hammond, Keeney, and Raiffa to effective decision
making?
a. Decisions are based on large amounts of information.
b. Decisions are based on positive and negative evidence.
c. Decisions are made to effect change.
d. Decisions are made to justify previous decisions.
ANS: D
RAT: The following have been identified as obstacles to effective decision making: making decisions
to justify previous decisions even if those decisions are no longer satisfactory; making the decision
based on the first available information; comfortable with the status quo, or not wanting to rock the
boat; pursuing supporting evidence that verifies the decision while ignoring evidence that is to the
contrary; presenting the issue in a biased manner or with a leading question; and assigning
probabilities to alternatives where inaccurate estimates are made.
PTS: 1
REF: p. 365
BLM: Understanding
20. According to the text, what is the best source of clinical decision making?
a. technology
b. professional practitioner
c. policies and procedures
d. client classification system
ANS: B
RAT: The best source of clinical decision making and judgment is still the professional practitioner.
Technology, client classification system, inventory control, scheduling staff, policies, and procedures
are best used as supports for the skill, knowledge, and experience that the practitioner brings to
decision making.
PTS: 1
REF: p. 366
BLM: Understanding
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