THEORY EXAM 2 - Practice Questions to Work On

he researcher must critically appraise evidence following a literature review. Which questions should the researcher pose in this appraisal? (Select all that apply.) "How many studies were found during the review?" "What were the results of each study?" "Are the results of each study valid and reliable?" 'Will the results of each study improve client care?" "Where was each study conducted?"

"How many studies were found during the review?" "What were the results of each study?" "Are the results of each study valid and reliable?" 'Will the results of each study improve client care?" "Where was each study conducted?"

Palpation is the use of hands and fingers to gather information through touch. Different parts of the hand are more suitable for different tactile sensations. Which part of the hand is best for sensing temperature? the dorsum the palm the fingertips the knuckles

The Dorsum Explanation: The skin over the dorsum of the hand is sensitive to temperature because it is thin and its nerve density is great. The palm of the hand is sensitive to vibration and is useful in locating a vibration associated with a heart murmur. The fingertips are concentrated with nerve endings and can sense fine difference in texture and consistency. The knuckles are not used in palpation.

A nurse fails to communicate a change in the client's condition to the physician. Which element related to proving malpractice has been met? Duty Breach of duty Proximate cause Damages

Breach of duty Failing to communicate a change in the client's condition reflects a breach of duty. Duty describes the relationship between the person and the person being sued. Nurses have a duty to care for their clients. The existence of a duty is rarely an issue in a malpractice suit. The action or lack of action must be proven as the cause of the injury. Damages refer to the injury sustained by the client.

Which are examples of ways that a nurse can use theories to guide client care? (Select all that apply.) Collect client data. Organize client information. Classify client data. Make client assignments on the unit. Analyze client situations.

Collect client data. Organize client information. Classify client data. Make client assignments on the unit. Analyze client situations.

A nurse admitting a new client to the hospital needs to determine the client's needs and current problems. What is the priority action of the nurse? Complete an assessment. Contact the health care provider. Review the client's past medical records. Assist the client with activities of daily living.

Complete an assessment. Before the nurse can determine what care a person requires, the nurse must determine the client's needs and problems. This requires the use of assessment skills and data collection, which include interviewing, observing, and examining the client, and in some cases, the client's family. Following the assessment, the nurse can also use the client's medical record and contact other health care providers.

A nurse caring for clients in a hospital setting focuses on the ill person in the health care setting. The nurse also provides care based on helping clients to adapt to the health care environment. Whose nursing theory principle is the nurse following? Imogene King Myra E. Levine Martha Rogers Dorothea Orem

Imogene King Myra E. Levine Martha Rogers Dorothea Orem

A nurse's personal philosophy is developed by learning through which of the following? (Select all that apply.) Interpersonal relationships Formal and informal education Religion and culture Focus on adaptation Environment

Interpersonal relationships Formal and informal education Religion and culture Focus on adaptation Environment

A nurse caring for clients in a hospital setting focuses on the ill person in the health care setting. The nurse also provides care based on helping clients to adapt to the health care environment. Whose nursing theory principle is the nurse following? Imogene King Myra E. Levine Martha Rogers Dorothea Orem

Myra E. Levine

A nurse researcher is preparing to conduct a research study that involves human subjects. Prior to conducting the study, what approval should the nurse obtain? hospital administration The Joint Commission institutional review board American Nurses Association

institutional review board Research involving human subjects also needs approval by institutional review boards (IRBs) before implementation. It is not unusual for more than one IRB to be involved in the research approval process (e.g., a university IRB and a hospital IRB). If a hospital was participating in the research, it would be the hospital's IRB, not the administration, that would give approval. It is not necessary to obtain approval from The Joint Commission. The American Nurses Association would not be involved.

A nurse researcher who plans to collect and analyze data for the purpose of improving clinical practice should select which method of research? Quantitative research Qualitative research Basic research Applied research

Applied research Applied research is used to improve clinical practice. Basic research is used to generate or refine theory. Qualitative research uses words or narrative for data rather than numbers. Quantitative research uses numerical values and statistical analysis of data.

A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" Which is the most appropriate response by the nurse? "A living will can only be used in the state in which it was created." "Take it with you. It is recognized universally in the United States." "As long as your family knows your medical wishes, you will not need it." "We have it on file here, so any hospital can call and get a copy."

"Take it with you. It is recognized universally in the United States." A separate or different advance directive is not needed for each state; an advance directive can be used in any state, regardless of where it was created. The nurse should advise the client to take it when travelling out of state. The client should not assume that the family knows the client's wishes; the whole purpose of having an advance directive is to avoid the ambiguity and potential confusion that making such assumptions can cause. Other hospitals may not know who to contact to request a copy of the advance directive; therefore, it would be much safer for the client to take a copy of it while travelling.

A nurse who will be conducting a research study asks an experienced nurse researcher, "When do I write my problem statement?" Which response by the nurse researcher would be appropriate? 1.) "It's the very first thing that you must do." 2.) "You need to develop your hypothesis first." 3.) "Your problem statement will become clear after the first set of data collected." 4.) "You'll do this after reviewing the literature and identifying your framework."

"You'll do this after reviewing the literature and identifying your framework." Explanation: The problem statement is a key step in the research process and comes after the review of the literature and identification of the theoretical framework. The first step is to identify the problem. After the problem statement is developed, then the nurse would develop the hypothesis.

Which criterion is not used for critically evaluating websites when doing a literature review? Authority Currency Objectivity Coverage Accessibility

Authority Currency Objectivity Coverage Accessibility

List the steps of Quantitative research.

1. State the research problem. This is often stated as a question, which should be focused narrowly on the problem being studied. For example: "What is the optimal time for taking a rectal temperature with a digital thermometer?" 2. Define the purpose of the study. The purpose explains "why" the problem is important and what use the findings will be. 3. Review-related literature. The literature review provides information about what is already known, as well as providing information about concepts and how the concepts have been measured. It also identifies gaps in knowledge that will be studied. 4. Formulate hypotheses and variables. Hypotheses are statements about two or more variables. Scientific hypotheses must be testable using variables that can be measured, manipulated, or controlled in a study. 5. Select the research design. The design is a carefully determined, systematic, and controlled plan for finding answers to the question of the study. This provides a "road map" for all aspects of the study, including how to collect and analyze the data. 6. Select the population and sample. The population is the group to be studied. The sample refers to specific people or events in the population from which data will be collected. 7. Collect the data. Sources of data may include people, literature, documents, and findings (e.g., from sources such as laboratory data or measurements of vital signs). Data may be collected from interviews, questionnaires, direct measurement, or examinations (such as physical or psychological tests). 8. Analyze the data. Statistical procedures are used to analyze the data and provide answers to the research question. 9. Communicate findings and conclusions. Through publications and presentations, the researcher explains the results of the study and links them to the existing body of knowledge in the literature. The researcher also describes the implications of the study and suggests directions for further research.

Name the steps of EBP

1.) Cultivate a spirit of inquiry. 2.) Ask the burning clinical question in (PICOT) format. -----> P - Population/Patient/Problem -----> I - Intervention -----> C - Comparison -----> O - Outcome -----> T - Time 3.) Search for and collect the most relevant best evidence. 4.) Critically appraise the evidence (i.e., rapid critical appraisal, evaluation, and synthesis). 5.) Integrate the best evidence with one's clinical expertise and patient preferences and values in making a practice decision or change. 6.) Evaluate outcomes of the practice decision or change based on evidence. 7.) Disseminate the outcomes of the EBP decision or change.

The following events occurred as part of the growth of nursing research.

1.) Establishment of the first Canadian nursing research journal 2.) ANA recommendation for further research in areas of health promotion and illness prevention 3.) Institute of Medicine's urge to increase the level of federal funding for nursing research 4.) ANA's identification of 11 priorities for nursing research 5.) Establishment of the journal Applied Nursing Research Explanation: In 1969, the first Canadian nursing research journal was started. This was followed, in 1981, by the ANA Commission on Nursing Research recommendation for further research in areas of health promotion, illness prevention, cost-effective health care, and nursing care for high-risk clients. In a 1983 study, the Institute of Medicine urged for increased federal funding for nursing research. In 1985, The journal Applied Nursing Research was established.

The evolution of nursing research has significant markers in time. Place the following events in the correct order.

1.) Florence Nightingale kept records while caring for victims of the Crimean War. 2.) Nursing research was deemed to be increasingly important, and research was utilized for the development of nursing practice standards. 3.) Clinical research became the emphasis of nursing research resulting in procedures for primary client care, such as vital signs and treatments. 4.) The National Institute for Nursing Research funded research for the scientific basis for client care.

Nursing research is conducted by what two methods

1.) Quantitative methodology 2.) Qualitative methodology

What are the most common impediments to nursing research?

1.) Restricted access to resources 2.) Limited time to participate in research-related activities 3.) Lack of educational preparation needed by nurses for research

What are the four properties identified by Diers that comprise the holistic perspective of nursing research?

1.) The focus of nursing research must be on a variance that makes a difference in improving client care. 2.) Nursing research has the potential for contributing to the development of theory and the body of scientific nursing knowledge. 3.) A research problem is a nursing research problem when nurses have access to and control over the phenomena being studied. 4.) A nurse interested in research must have an inquisitive, curious, and questioning mind.

Resistance to using EBP may arise in the current health care setting as a result of ?

1.) nursing shortage 2.) the acuity level of patients 3.) nurses' skill in reading and evaluating published research 4.) an organizational culture that does not support change Other factors include..... 5.) insufficient time to implement new ideas 6.) insufficient time to read research 7.) lack of authority to change patient care procedures 8.) lack of support from physicians, managers, & other staff members 9.) Inadequate infrastructure support, such as libraries and ethics committees

Which scenario is an example of a time-lapse reassessment? Seeing a client down on the floor, the nurse assesses the client's airway, breathing, and circulation, calls for help, and begins a quick neurological exam. A nurse just coming on shift performs a focused physical assessment on each client, based on the client's diagnosis. A nurse in a long-term skilled nursing facility assesses a new resident's baseline health status. A nurse assesses a client with mobility issues to see how the client is doing with fall prevention strategies they practiced before.

A nurse assesses a client with mobility issues to see how the client is doing with fall prevention strategies they practiced before. The four types of assessment a nurse may perform are initial, focused, time-lapse, and emergency. A time-lapse reassessment is performed to reevaluate any changes in the client's health from a previous assessment. It is used to monitor the status of an already identified problem for a client with whom the nurse is already familiar. In this question the only scenario that depicts these components is that of the client with mobility issues. The assessment of the client who is found down on the floor is an emergency assessment. The assessment of each client based on the client's specific diagnosis is a focused assessment. The baseline assessment of the new resident in the long-term care facility is an initial assessment.

A nurse researcher ensures that a research subject's privacy is protected by which method? Select all that apply. Anonymity Confidentiality Beneficence Justice Autonomy

Anonymity Confidentiality

A nurse is assessing the lungs of a client and auscultates soft, low-pitched sounds over the base of the lungs during inspiration. What would be the nurse's next action?

Document normal breath sounds. Soft, low-pitched, whispering sounds are normal sounds heard over most of the lung fields. Inflammation of the pleura would result in a friction rub. There are no signs of pneumonia, and recommending testing for pneumonia is not in the nurse's scope of practice. Asthma usually results in wheezing.

A client states that the client's recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow? 1. Document the client's claims and the events surrounding the alleged incident. 2. Consult with the hospital's legal department as soon as possible. 3. Consult with practice advisors from the state board of nursing. 4. Enlist support from nursing and nonnursing colleagues from the unit.

Document the client's claims and the events surrounding the alleged incident. It is imperative for nurses to carefully and accurately document assessment findings and the nursing care that they provide, especially when legal action is anticipated. This thorough and accurate assessment should precede consultation with the legal department, the state board of nursing, and colleagues.

What is the definition of EBP?

EBP is a problem-solving approach to making clinical decisions, using the best evidence available (considered "best" because it is collected from sources such as published research, national standards and guidelines, and reviews of targeted literature).

A nurse manager is attempting to switch the medical records in an orthopedic office to a computerized format. The nurse asks questions about the accuracy and efficiency of the current record keeping system by using the PICO format. Which statements illustrate the components of this process? Select all that apply. P: The nurse purchases computers from a computer store. P: The nurse chooses the population involved (orthopedic clients). I: The nurse considers interventions to make the plan work. C: The nurse calculates the cost of the new program. C: The nurse compares the written records to the computerized records. O: The nurse determines the occurrence of problems in the systems.

P: The nurse purchases computers from a computer store. P: The nurse chooses the population involved (orthopedic clients). I: The nurse considers interventions to make the plan work. C: The nurse calculates the cost of the new program. C: The nurse compares the written records to the computerized records. O: The nurse determines the occurrence of problems in the systems.

Which are goals of nursing theory? (Select all that apply.) 1.) Increase the nursing body of knowledge 2.) Identify and define concepts that are important to nursing 3.) Provide knowledge and a rationale for client interventions 4.) Provide a rationale for appropriate nursing actions in a given situation 5.) Provide a definition for nursing

Provide knowledge and a rationale for client interventions Provide a rationale for appropriate nursing actions in a given situation Identify and define concepts that are important to nursing Increase the nursing body of knowledge Explanation: Nursing theory does not provide a precise definition of nursing, but does direct nursing to a common goal. The other statements are all true with regard to the goals of nursing theory.

A nurse wants to implement Sister Callista Roy's Adaptation Theory in the acute care setting. Which nursing action demonstrates proper use and implementation of this theory? Providing a supportive environment Assessing for factors interfering with healing Creating a clean, quiet environment Restoring self-care capability

Providing a supportive environment Assessing for factors interfering with healing Creating a clean, quiet environment Restoring self-care capability

What is Qualitative research?

Qualitative Research is a method of research conducted to gain insight by discovering meanings. Researcher primarily analyzes words or narratives rather than numbers.

What is Quantitative research?

Quantitative research involves the concepts of basic and applied research. Basic research, sometimes called pure or laboratory research, is designed to generate and refine theory, and the findings are often not directly useful in practice. Applied research, also called practical research, is designed to directly influence or improve clinical practice. The types of quantitative research depend on the level of current knowledge about a research problem.

A nurse is performing eye assessments at a community clinic. Which assessment would the nurse document as normal? The client's eyes do not converge when the nurse moves a finger toward his nose. The client's pupils are black, equal in size, and round and smooth. An older adult's pupils are pale and cloudy. The client's pupils dilate when looking at a near object and constrict when looking at a distant object.

The client's pupils are black, equal in size, and round and smooth. Explanation: The pupils should be black, equal in size, and round and smooth. When an object moves towards the client's nose, the eyes should converge towards the object. Pale and cloudy pupils are indication of a problem such as cataracts. The client's pupils should constrict when looking at a near object and dilate when looking at a distant object.

Nurse researchers use both quantitative and qualitative research in their practices. Which actions are examples of the use of qualitative research? Select all that apply. The nurse examines nursing issues related to Native American/First Nation clients. The nurse investigates past nursing trends to understand the current profession. The nurse examines the effect of nursing interventions on client outcomes. The nurse examines cause-and-effect relationships between variables in a lab. The nurse discovers how people describe the effect of illness in their lives. The nurse explores events in real-life situations to generate new knowledge.

The nurse examines nursing issues related to Native American/First Nation clients. The nurse investigates past nursing trends to understand the current profession. The nurse examines the effect of nursing interventions on client outcomes. The nurse examines cause-and-effect relationships between variables in a lab. The nurse discovers how people describe the effect of illness in their lives. The nurse explores events in real-life situations to generate new knowledge. Explanation: Qualitative research focuses on words and narratives of the subjects, not numbers. Examining nursing issues related to Native American/First Nation clients is an example of ethnography qualitative research. This type of research examines issues of a culture. Investigating past nursing trends to understand the current profession is historical qualitative research. Discovering how people describe the effect of illness in their lives is an example of phenomenological qualitative research. Phenomenology is used to describe experiences as they are lived by the subjects being studied. The exploration of real-life situations and events to generate new knowledge, the examination of the effect of nursing interventions on client outcomes, and the examination of cause-and-effect relationships between variables in a lab are all characteristics of quantitative research.

After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances? 1. The nurse is legally held to the same standards of care as when staffing levels are normal. 2. Understaffing constitutes an extenuating circumstance that creates a temporarily lower expectation for care for the nurse. 3. The nurse must document that float staff, nurses on overtime, and part-time staff were contacted in an effort to fill the gaps in care. 4. The nurse is legally obliged to refuse to provide care when understaffing creates the potential for unsafe conditions.

The nurse is legally held to the same standards of care as when staffing levels are normal. Explanation: The claim of being overworked does not constitute a legal defense, and both the potential for liability and standards of care remain unchanged despite an increased client assignment. Although it is prudent to make all realistic attempts to fill the gaps in staffing, documenting these efforts does not change the nurse's legal position. A nurse has the right to refuse an unsafe client assignment but the nurse is not legally obliged to withhold care.

A nurse enters the client's room and finds the client lying on the floor experiencing a seizure. After stabilizing the client, the nurse informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report? 1. To determine the nurse's fault in the incident 2. To evaluate the quality of care provided and assess the potential risks for injury to the client 3. To provide information to local, state, and federal agencies 4. To evaluate the immediate care provided by the nurse to the client

To evaluate the quality of care provided and assess the potential risks for injury to the client An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. Incident reports determine how to prevent hazardous situations and serve as a reference in case of future litigation. Accurate and detailed documentation often helps to prove that the nurse acted reasonably or appropriately in the circumstances. It may not always serve as a method of determining the nurse's fault in the incident. The document does not evaluate the immediate care provided to the client but states the actions taken.

True? or False? In any discipline, science is the result of the relationship between the process of inquiry (research) and the product of knowledge (theory).

True

True? or False? The relationship between theory and practice is reciprocal. Practice is the basis for the development of nursing theory whereas nursing theory must be validated in practice.

True

True? or False? A theory is developed based on researchers.

True

True? or False? Nursing theory is defined as "a creative and rigorous structuring of ideas that project a tentative, purposeful, and systematic view of phenomena". Through systematic inquiry, whether in nursing research or practice, nurses are able to develop knowledge relevant to improving the care of patients.

True