A nurse is working in an emergency department and receives a call from a paramedic who is transporting a client who was involved in a motor vehicle crash. The paramedic reports that the client has multiple injuries, including a head trauma, chest trauma, and abdominal bleeding. The nurse prepares to receive the client and triage him accordingly. Which of the following statements by the nurse reflects critical thinking?

Choice A :.

This statement reflects critical thinking because the nurse prioritizes the most important assessments for a client with multiple injuries and follows the ABC (airway, breathing, circulation) principle of trauma care. Assessing the level of consciousness, airway, breathing, and circulation is essential to determine the client's condition and plan appropriate interventions.

Choice B :.

This statement does not reflect critical thinking because the nurse expresses a hope rather than a fact or an action. Hoping for no internal injuries or organ damage does not help the nurse to provide effective care for the client. The nurse should focus on assessing the client's injuries and providing appropriate interventions based on the findings.

Choice C :.

This statement does not reflect critical thinking because the nurse wonders about irrelevant information that does not affect the client's care. The cause of the crash and the use of seat belt are not important for the nurse to know at this point. The nurse should focus on assessing the client's injuries and providing appropriate interventions based on the findings.

Choice D :.

This statement does not reflect critical thinking because the nurse jumps to a conclusion without assessing the client first. Calling the trauma surgeon and the neurologist right away may not be necessary or appropriate depending on the client's condition. The nurse should assess the client first and then consult with other health care professionals as needed.

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.