NURS: Ch 5 NCLEX

A team of nurse educators are preparing to implement an evidence-based practice (EBP) change in the way that change-of-shifts reports are organized and conducted at their hospital. Place the following stages of the EBP process that the educators will follow in the correct sequence. a) Critically appraise the evidence. b) Formulate a clear clinical question. c) Integrate evidence with clinical expertise and patient preferences. d) Collect the most relevant and best evidence. e) Evaluate the practice decision or change.

b) Formulate a clear clinical question. d) Collect the most relevant and best evidence. a) Critically appraise the evidence. c) Integrate evidence with clinical expertise and patient preferences. e) Evaluate the practice decision or change.

A nurse researcher has proposed a study that will examine the effects of a preoperative teaching module on patients' levels of anxiety. In order to carry out the study, the researcher needs to identify a test that can reliably quantify each participant's anxiety. Which of the following tools will accomplish this task? a) a test b) a framework c) an instrument d) a scale

c) an instrument An instrument is a research tool that can be used to collect, record, and quantify data. Typically, instruments are surveys, tests, or questionnaires that have been shown to be reliable and valid in capturing the phenomenon in question.

An obstetrical nurse wishes to identify whether patients' perceptions of a high level of support from their partner is associated with a decreased length of the second stage of labor. Which type of quantitative research is most appropriate for this research question? a) descriptive research b) experimental research c) correlational research d) quasi-experimental research

c) correlational research Correlational quantitative research is used to examine relationships between two or more variables. In this case, the variables are perceptions of partner support and length of stage two labor. There is no manipulation of the variables as there would be in an experimental or quasi-experimental study and the focus on the relationship between the two variables goes beyond simple description of events.

When conducting research, information is collected. This would be identified as which of the following? a) subject b) analysis c) data d) abstract

c) data Data are observable and verifiable information collected to describe, explain, or predict events.

A nurse researcher is studying the effects of exercise and sleep on blood pressure. The researcher identifies blood pressure as which type of variable? a) exploratory b) correlational c) dependent d) independent

c) dependent The dependent variable is the variable being studied and is determined by manipulating conditions (the independent variables).

A staff development nurse is asking a group of new staff nurses to read and be prepared to discuss a qualitative study that focuses on nursing events of the past in an attempt to increase understanding of the nursing profession today. What method of qualitative research is used in this article? a) grounded theory b) ethnography c) historical d) phenomenology

c) historical This article uses historical methodology, which examines events of the past to increase understanding of the nursing profession today. Phenomenology is used to describe experiences as they are lived by the subjects being studied. Grounded theory is the discovery of how people describe their own reality and how their beliefs are related to their actions in a social scene. Ethnography is used to examine issues of a culture that are of interest to nursing.

When describing the term concept to a group of students, which word would the instructor most likely use? a) fact b) science c) idea d) truth

c) idea A concept, like an idea, is an abstract impression of reality.

A group of nurses are planning to investigate the effectiveness of turning immobilized stroke patients more frequently in order to prevent skin breakdown. The team has begun by formulating a PICO question. Which of the following will the "O" in the teams PICO question refer to? a) The currently-used turning schedule b) Turning patients more frequently c) Patients who have experienced a stroke d) Preventing skin breakdown

d) Preventing skin breakdown Within the PICO question framework, the "O" denotes the outcome of interest. In this case, the desired outcome is the prevention of skin breakdown. Stroke patients are the "P", or population of interest, while turning patients more frequently is the "I", or intervention. The current turning schedule is the "C", referring to the comparison of interest.

Which of the following skills is foundational for a nursing student's participation in the evidence-based practice process? a) Become involved in evidence-based practice research. b) Publish an article on evidence-based practice findings. c) Critically analyze research articles and the findings. d) Read and understand a research article.

d) Read and understand a research article. The use of evidence-based research requires critical analysis and extensive, systematic reviews of research articles and findings. However, a beginning nursing student has not acquired the knowledge to publish new research. The first stop for a student is to be able to read and understand a research article.

Which of the following theories emphasizes the relationships between the whole and the parts and describes how parts function and behave? a) developmental theory b) adaptation theory c) nursing theory d) general systems theory

d) general systems theory General systems theory describes how to break whole things into parts and then to learn how the parts work together in "systems". Nursing theory attempts to describe, explain, predict, and control desired outcomes of nursing care practices. Adaptation theory defines adaptation as the adjustment of living matter to other living things and to environmental conditions. Developmental theory outlines the process of growth and development of humans as orderly and predictable.

When you ask an older student why it is necessary to change the patient's bed every day, he says, "I guess we have always done it that way." This answer is an example of which of the following? a) unsubstantiated knowledge b) scientific knowledge c) authoritative knowledge d) traditional knowledge

d) traditional knowledge Traditional knowledge is the part of nursing practice passed down from generation to generation, often without research data to support it.

A theory of nursing will primarily inform which of the following aspects of a nursing student's activities and interactions at the bedside? a) Framing and giving meaning to student-patient interactions. b) Prioritizing nursing activities according to an established criteria. c) Assessing and addressing patients' illnesses. d) Choosing interventions based on evidence.

a) Framing and giving meaning to student-patient interactions. A theory of nursing provides broad, macro-level meaning to the practice of nursing by describing and explaining the nature of nurse-person interactions. Nursing theories do not typically address or inform the more micro-level aspects of nursing such as choosing interventions, acting on assessments, or prioritizing patient needs.

Which of the following principles underlies the ethical conduction of research in a hospital setting? a) Patients must grant informed consent if they are to participate. b) The patient must directly and personally benefit from the research. c) Descriptive studies are more ethical than experimental studies. d) Any interventions must be approved by the Food and Drug Administration (FDA).

a) Patients must grant informed consent if they are to participate. Informed consent is an absolute prerequisite for patients who are asked to participate as subjects in a research study. Many interventions in healthcare settings lie beyond the scope of the FDA. The risks and benefits of research are considered carefully in light or ethical principles, but this does not necessarily mean that every participant in a study stands to benefit from it. Ethical standards are applicable and achievable in every type of research, and descriptive studies are not necessarily more ethical than experiments.

A nursing student is reading a research article from a nursing journal. The student is aware that the paragraph at the beginning of the article that summarizes the article and the findings of the research is a good place to start when reading this article. What part of the article is the nursing student reading? a) abstract b) review of the literature c) results d) conclusions

a) abstract The abstract is located at the beginning of the article, and it summarizes the entire article and usually provides the purpose of collection and data analysis, and a summary of important findings. The review of literature discusses relevant studies that have been conducted in the area of this study, and it is included in the introduction. The results are the findings of the study and are often presented both in words and charts, tables, or graphs. The conclusions are the discussions of the results and suggestions for further study.

A nurse researcher is examining the cause-and-effect relationship between the consumption of tap water containing minimal amounts of bleach and the incidence of cancer in rats. The research is taking place in a laboratory setting. What type of quantitative research is the researcher using based upon this description? a) experimental research b) correlational research c) quasi-experimental research d) descriptive research

a) experimental research Experimental research examines the cause-and-effect relationships between variables under highly controlled conditions. Experimental research studies often occur in a laboratory setting. Descriptive research explores and describes events in a real-life situation to identify relationships between and among events. Correlational research examines the type and degree of relationships between two or more variables. quasi-experimental research examines the cause-and-effect relationships between selected variables and is typically situated outside of a laboratory setting.

After reviewing information about the four concepts common to nursing theories, the students demonstrate understanding of the information when they identify which concept as most important? a) person b) environment c) health d) nursing

a) person Of the four concepts, the most important is the person.

Which type of theory focuses on clinical nursing practice? a) prescriptive theory b) descriptive theory c) developmental theory d) systems theory

a) prescriptive theory Prescriptive theories address nursing interventions and are designed to control, promote, and change clinical nursing practice.

A nurse researcher is studying perceptions of vocational rehabilitation for patients after a spinal cord injury. What type of research method will the researcher use to study the perceptions of this group of individuals? a) qualitative research b) applied research c) quantitative research d) basic research

a) qualitative research The nurse researcher will use qualitative research methods to investigate perceptions, and the researcher will analyze words instead of numbers, which are analyzed in quantitative research. Basic and applied research are quantitative research methods.

After reviewing several research articles, the clinical nurse specialist on a medical-surgical unit rewrites the procedure on assessing placement of a nasogastric tube. What source of nursing knowledge did the nurse use in this situation? a) scientific knowledge b) authoritative knowledge c) traditional knowledge d) philosophical knowledge

a) scientific knowledge The clinical nurse specialist utilized scientific knowledge, which is arrived at through the research-based scientific method. Philosophical knowledge is not a source of nursing knowledge, but is a type of general knowledge. Authoritative knowledge comes from an expert and is accepted as truth based on the person's perceived expertise. Traditional knowledge is that part of nursing practice passed down from generation to generation and is not based upon scientific inquiry.

In understanding the historical influences on nursing knowledge, nursing as a profession struggled for years to establish its own identity and to receive recognition for its contributions to healthcare because: a) the conceptual and theoretical basis for nursing practice came from outside the profession. b) women were independent and refused to work collectively. c) nurses spent most of their time in laboratory settings conducting research. d) nurses were too busy working in practice to increase the public awareness associated with the role of the nurse.

a) the conceptual and theoretical basis for nursing practice came from outside the profession. Despite Nightingale's belief in the uniqueness of nursing, the training of nurses was initially carried out under the direction and control of the medical profession. Because the conceptual and theoretical basis for nursing practice came from outside the profession, nursing struggled for years to establish its own identity and to receive recognition for its significant contributions to healthcare.

A nursing student has been asked to correlate her clinical experiences with two different theories of nursing. The student will recognize that which of the following concepts are common to all theories of nursing? Select all that apply. a) the patient b) the environment c) illness d) needs e) nursing f) health

a) the patient b) the environment e) nursing f) health While nursing theories vary significantly in their conceptualizations, the elements that are common to all include the patient (person), the environment, health, and nursing. The concepts of needs and illness are addressed by some theories while these are not explicitly defined by other theories.

A 79-year-old male patient who is postoperative day three following hip replacement surgery has been approached by a nurse researcher and asked to participate in a research study that will test a new rehabilitation strategy. What aspect of the nursing research process addresses the patient's understanding of the potential risks and benefits of this study? a) Obtaining the patient's witnesses signature on a permission document. b) Going through the informed consent process with the patient. c) Giving the patient the opportunity to ask questions about the study. d) Meeting with the hospital's institutional review board (IRB).

b) Going through the informed consent process with the patient. Informed consent is a process in which the details of the study and the patient's rights are explained and discussed in detail. This goes beyond simply obtaining the patient's signature or allowing him to ask questions. Meeting with the IRB is a necessary step in the research process but this does not directly affect the patient's understanding of risks and benefits.

Which type of quantitative research is conducted to directly influence or improve clinical practice? a) basic research b) applied research c) experimental research d) descriptive research

b) applied research Applied research, a type of quantitative research, is designed to directly influence or improve clinical practice.

One method of developing a theory is by first examining a general idea and then considering specific actions or ideas. What is this method called? a) inductive reasoning b) deductive reasoning c) conceptual modeling d) concept development

b) deductive reasoning Moving from a general idea to specific ideas is deductive reasoning.

Of the following types of qualitative research, which method developed in anthropology? a) historical b) ethnography c) grounded theory d) phenomenology

b) ethnography Ethnographic research was developed by the discipline of anthropology and is used to examine issues of culture of interest to nursing.

When looking at a model for evidence-based practice, what is the final step of the process? a) appraising evidence b) evaluating practice change c) searching the literature d) formulating a clinical question

b) evaluating practice change The fifth and final step in the process of implementing evidence-based practice is to evaluate and critically appraise the change in practice. Formulating a clinical question and searching and appraising the literature precede this step.

Nurse researchers have predicted that a newly created mentorship program will result in decreased absenteeism, increased retention, and decreased attrition among a hospital's nursing staff. Which of the following does the predicted relationship represent? a) methodology b) hypothesis c) abstract d) dependent variable

b) hypothesis A hypothesis is an expected statement of the relationship between variables in a study. In this study, the dependent variables are absenteeism, retention and attrition while the independent variable is the mentorship program. The methodology of a study is the logistical framework that guides the planning and execution of the study and an abstract is a summary of a research study published in a journal.

For which of the following research activities is a phenomenological research method most appropriate? a) Understanding how patients cope with a new diagnosis of Alzheimer's disease. b) Explaining how the particular characteristics of the Vietnam War affected the roles of nurses. c) Describing the health maintenance activities that are practiced by homeless intravenous drug users. d) Attempting to understand non-English speaking immigrants' experiences of being hospital patients.

d) Attempting to understand non-English speaking immigrants' experiences of being hospital patients. Phenomenology is the type of qualitative research that attempts to understand individuals' experiences and the meanings they assign to these. Research that is undertaken within a specific culture, such as that of homeless intravenous drug users, is characteristic of ethnography. Examining the significance of past events, such as war, is associated with historical qualitative research. Processes such as coping are the most common focuses of grounded theory.

A nurse is formulating a clinical question in PICO format. Which of the following is represented by the letter P? a) Comparison to another similar treatment. b) Clearly defined, focused literature review. c) Specific identification of the desired outcome. d) Explicit descriptions of population of interest.

d) Explicit descriptions of population of interest. The P in the PICO format represents an explicit description of the patient population of interest.

What nursing theorist focuses on rehabilitation as a major outcome of nursing care? a) Jean Watson b) Martha Rogers c) Sr. Callista Roy d) Lydia Hall

d) Lydia Hall The central theme of Lydia's Hall nursing theory has a focus on rehabilitation. The major outcome of nursing care under her theory focuses on rehabilitation and feelings of self-actualization by the patient. Martha Rogers emphasized the science and art of nursing, with the unitary human being central to the discipline of nursing. Jean Watson was concerned with promoting and restoring health, preventing illness, and caring for the sick. Sr. Callista Roy's theme focused on human beings as biopsychosocial beings existing within an environment.