chapter 2-prep u

Place the steps of evidence-based practice in the correct order.

-Design a question related to a clinical area of interest. -Collect the most relevant and best evidence available. -Critically evaluate the collected evidence. -Integrate the evidence with clinical expertise, client preferences, and values as the decision is made to make a change. -Evaluate the decision or change.

Which group of nurses would be least likely involved in direct research? Select all that apply.

-Novice nurses -Student nurses

Which are core concepts in nursing theory? (Select all that apply.)

-Person (client) -Environment -Health -Nursing

The process of considering an idea as a whole and then dividing it into smaller, more specific ideas is which?

Deductive reasoning

A parent has brought a 6-year-old child into the clinic. The parent is concerned that the child does not seem to skip as well as the other children in the child's class. In planning assessments and care for this child, the nurse would be best served by choosing which theory as a foundation for decision making?

Developmental theory

Which is a focus of medical research rather than nursing research?

Drug metabolism

A nurse who works in a pediatric practice assesses the developmental level of children of various ages to determine their psychosocial development. These assessments are based on the work of:

Erikson

What type of research study would a hospital conduct to explore clients' and families' perceptions of receiving care?

Qualitative

Which aspect of the nursing research process addresses a client's understanding of the potential risks and benefits of the study?

Undergoing the informed consent process with the client

When describing how to formulate a hypothesis, which item would a nurse researcher identify as the focus of the study?

Variables

A novice nurse is sharing a newly published research article which outlines a different approach in preventing a wound infection after surgery with a colleague and states the nurse is going to try this new method. Which is the best response from the colleague?

Wait until the method is analyzed to ensure it will be appropriate for their clients.

A conceptual framework is defined as:

a set of concepts and propositions.

A student nurse interacting with patients on a cardiac unit recognizes the four concepts in nursing theory that determine nursing practice. Of these four, which is most important?

a. Person Of the four concepts, the most important is the person. The focus of nursing, regardless of definition or theory, is the person.

A nurse researcher is reviewing the Privacy Rule under the Health Insurance Portability and Accountability Act (HIPAA) and finds information about handling protected health information (PHI). The nurse researcher would most likely find rules for which aspects of PHI? Select all that apply.

-Access -Usage -Sharing

A nurse is using quantitative research for a question related to nursing practice. When conducting the research, which aspect would the nurse need to keep in mind? Select all that apply.

-Concepts are fairly well-developed. -An existing body of literature is available. -Statistical processes are used to interpret the data.

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 discovers how people describe the effect of illness in their lives.

The scientific process and nursing research have the same methodologies for investigating and solving problems. Place the steps of the scientific process and nursing research in order. Use all options.

-identifying what one needs to know or is curious about -deciding the approach to seeking the answer -devising a plan -implementing the plan -assessing the outcomes

A nurse is reading a research article from a nursing journal. The nurse is aware that the opening paragraph summarizing the article and the research findings is a good place to start. What part of the article is the nurse reading?

Abstract

Which theory describes how humans adjust to life with other living things and with the environment?

Adaptation theory

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

Applied research

A community health nurse has been visiting a diabetic client whose morning fasting glucose levels are constantly elevated. Upon further assessment, the nurse determines that the client's spouse does not understand how to prepare meals following the prescribed diabetic diet. Using Dorothea Orem's Self-Care Theory, how can the nurse help meet the needs of this client?

Arrange an evaluation appointment with a dietitian.

A nurse subscribes to the Basic Needs theory. Which action by the nurse exemplifies this theory?

Assisting the client to the bedside commode

Knowledge gained from someone with a great deal of perceived experience is which type of knowledge?

Authoritative knowledge

A nurse develops the following foreground question using the PICOT format in preparation for a research study: "In overweight clients, how do chromium supplements compared to no supplements help with weight loss?" Which part of the question reflects the intervention?

Chromium supplements

An abstract idea or object that relates to other abstract ideas or objects is which?

Concept

A nursing theory differs from a theoretical framework in which way?

Concepts and propositions are more specific

Which is true of concepts?

Concepts describe objects, properties, and events and the relationships among them.

A nurse researcher develops a foreground question in preparation for conducting a research study. The question is: "In clients with intravenous catheters, how does replacing administration sets every 72 hours (h) compared with other frequent intervals (24h, 48h, or 96h) decrease infection rates?" Applying the PICO framework, which part of the statement reflects the "O"?

Decrease infection rates

When looking at a model for evidence-based practice, what is the final step of the process?

Evaluating practice change

What nursing activity forms the bridge between theory and practice?

Evidence-based research

Which activity best helps the nurse apply theory to practice?

Evidence-based research

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 being used based upon this description?

Experimental research

Who is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment?

Florence Nightingale

A nursing theorist examines a hospital environment by studying each ward and how it works individually, and then relates this information to the hospital as a whole working entity. This is an example of the use of which theory?

General systems theory

In order for the nurse to be able to apply the knowledge that has been obtained in the formal education process, which theory would best break whole concepts into parts and then determine how the parts would work together as a whole?

General systems theory

Which theory emphasizes the relationships between the whole and the parts, and describes how parts function and behave?

General systems theory

The statement, "More frequent handwashing will significantly lower the rate of infection in hospitalized clients," is an example of what research component?

Hypothesis

A nurse researcher is involved in an experimental research study. Which component would the nurse researcher manipulate?

Independent variable

A nurse observes that the past five clients referred from a community clinic have been treated for drug and/or alcohol overdose. Based on this information, the nurse assumes that the clinic specializes in the treatment of substance use. This is an example of what type of reasoning?

Inductive reasoning

What is the process of considering a group of specific ideas and then drawing conclusions that relate to a general idea?

Inductive reasoning

A nurse is reviewing nursing theory for usefulness in a home healthcare setting. Which is the appropriate application of Dorothea Orem's Self-Care Model in a home healthcare setting?

Match the client's self-care needs with appropriate supportive interventions.

What is the central theme of Florence Nightingale's nursing theory?

Meeting the personal needs of the client within the environment.

A nurse is planning to conduct a nursing research study and is seeking federal funding. Which institution would be most helpful for the nurse to contact regarding acquiring funding?

National Institute of Nursing Research

What is the best explanation for the way evidence-based practice (EBP) has changed the way nursing care is delivered?

Nursing care now uses EBP as a means of ensuring quality care.

What was the focus of nursing research during the first half of the twentieth century,?

Nursing education

Which represents the basic framework of the research process?

Nursing process

If a nurse describes a study of people and the nursing profession including studies of education, policy development, ethics, and nursing history, then what is the nurse defining?

Nursing research

Which activity systematically inquires about the problems encountered in nursing practice and into the modalities of client care?

Nursing research

Nurses in an ICU noticed that their clients required fewer interventions for pain when the ICU was quiet. They then asked a researcher to design a study about the effects of noise on the pain levels of hospitalized clients. How does this demonstrate the ultimate goal of expanding the nursing body of knowledge?

Nursing research helps improve ways to promote and maintain health.

Which theory describes, explains, predicts, and controls outcomes in nursing practice?

Nursing theory

A nurse is developing a foreground question for nursing research using the PICO model. Which component would be represented by the statement, "a 45-year-old male with coronary heart disease and atrial fibrillation"?

P

The focus of nursing is always on which of the four common concepts in nursing theory?

Person

A group of nurses is planning to investigate the effectiveness of turning immobilized stroke clients more frequently in order to prevent skin breakdown. The team has begun by formulating a PICO question. Which element will the "O" in the team's PICO question refer to?

Preventing skin breakdown

The nurse researcher would like to gather data about the attitudes of young adults on spirituality and health care. What is the most effective form of research on this topic?

Qualitative research

When a researcher begins to form plans for a research project, the researcher must decide on the method for conducting the research. The nurse researcher that plans to emphasize collection of narrative data and the analyses would select which of the following methods of research?

Qualitative research

A nurse researcher must decide on the method for conducting the research. The researcher that plans to emphasize collection of numerical data and analysis would select which method of research?

Quantitative research

A nurse is discussing dietary issues with a Latino client in the clinic. The client states, "I read a research article about the importance of beans in the Latino diet. The findings from the study suggested that inclusion of meat and beans in the diet would help in the development of muscles and bones." The information that the client is expressing is known as what?

Scientific knowledge

A nurse is planning to participate in a research project and is looking for information about what is already known about the topic. The nurse is involved in which step of the research process?

Scientific literature review

The second step in implementation of evidence-based practice includes systematic review. To complete a systematic review of the literature, what must the nurse do?

Summarize findings from multiple studies that are related to a particular nursing practice.

The nurse is preparing to submit a research project to the institutional review board (IRB). The nurse understands that if the IRB were to reject the research project, it would most likely be for which reason?

The project lacks sufficient safeguards to protect human subjects.

A nurse is discussing dietary issues with a Latino client in the clinic. The client states, "My grandmother always told me that I needed to include beans in my diet so that my muscles would grow." The information that the client is expressing is known as what?

Traditional knowledge

A nurse working in a long-established hospital learned a specific approach to administering intravenous injections from the previous generation of nurses at the hospital. This is an example of which type of knowledge?

Traditional knowledge

When conducting quantitative research, the researcher collects information to support a hypothesis. This information would be identified as:

c. Data Data refer to information that the researcher collects from subjects in the study (expressed in numbers). A variable is something that varies and has different values that can be measured. Instruments are devices used to collect and record the data, such as rating scales, pencil-and-paper tests, and biologic measurements.

A nurse is conducting quantitative research to examine the effects of following nursing protocols in the emergency department (ED) on patient outcomes. This is also known as what type of research?

c. Quasi-experimental Quasi-experimental research is often conducted in clinical settings to examine the effects of nursing interventions on patient outcomes. Descriptive research is often used to generate new knowledge about topics with little or no prior research. Correlational research examines the type and degree of relationships between two or more variables. Experimental research examines cause-and-effect relationships between variables under highly controlled conditions.

A group of objects with relationships is which?

concept

A nurse is formulating a clinical question in PICOT format. What does the letter P represent?

d. Explicit descriptions of the population of interest The P in the PICOT format represents an explicit description of the patient population of interest. I represents the intervention, C represents the comparison, O stands for the outcome, and T stands for the time.

A student nurse asks an experienced nurse why it is necessary to change the patient's bed every day. The nurse answers: "I guess we have just always done it that way." This answer is an example of what type of 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. Scientific knowledge is that knowledge obtained through the scientific method (implying thorough research). Authoritative knowledge comes from an expert and is accepted as truth based on the person's perceived expertise. Instinct is not a source of knowledge.

Evidence-based care emphasizes decision making based on the best available evidence and:

use of outcome studies to guide decisions.

One of the primary reasons for conducting nursing research is to:

generate knowledge to guide practice.

A well-constructed problem statement formulated at the beginning of a nursing research study should:

indicate the population.

From 1900 to 1940, research in nursing focused on:

nursing education and teaching.

A nurse is preparing to conduct a research study and uses the PICO format to develop the foreground question which is: "In adults, does reducing salt intake, compared to no change in salt intake, lower blood pressure?" The nurse identifies the "P" as:

adults

A nurse is using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model PET as a clinical decision-making tool when delivering care to patients. Which steps reflect the intended use of this tool? Select all that apply.

a-A nurse recruits an interprofessional team to develop and refine an EBP question. c-A nurse searches the Internet to find the latest treatments for type 2 diabetes. e-A nurse questions the protocol for assessing postoperative patients in the ICU. The JHNEBP model is a powerful problem-solving approach to clinical decision making, and is accompanied by user-friendly tools to guide individual or group use. It is designed specifically to meet the needs of the practicing nurse and uses a three-step process called PET: practice question, evidence, and translation. The goal of the model is to ensure that the latest research findings and best practices are quickly and appropriately incorporated into patient care. Steps in PET include, but are not limited to, recruiting an interprofessional team, developing and refining the EBP question, and conducting internal and external searches for evidence.

A charge nurse meets with staff to outline a plan to provide transcultural nursing care for patients in their health care facility. Which theorist promoted this type of caring as the central theme of nursing care, knowledge, and practice?

a. Madeline Leininger Madeline Leininger's theory provides the foundations of transcultural nursing care by making caring the central theme of nursing. Jean Watson stated that nursing is concerned with promoting and restoring health, preventing illness, and caring for the sick. The central theme of Dorothy E. Johnson's theory is that problems arise because of disturbances in the system or subsystem or functioning below optimal level. Betty Newman proposed that humans are in constant relationship with stressors in the environment and the major concern for nursing is keeping the patient system stable through accurate assessment of these stressors.

A nurse manager schedules a clinic for the staff to address common nursing interventions used in the facility and to explore how they can be performed more efficiently and effectively. The nurse manager's actions to change clinical practice are an example of a situation described by which nursing theory?

a. Prescriptive theory Prescriptive theories address nursing interventions and are designed to control, promote, and change clinical nursing practice. Descriptive theories describe a phenomenon, an event, a situation, or a relationship. Developmental theory outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death. General systems theory describes how to break whole things into parts and then to learn how the parts work together in "systems."

A nurse is using general systems theory to describe the role of nursing to provide health promotion and patient teaching. Which statements reflect key points of this theory? Select all that apply.

b-The whole system is always greater than the sum of its parts. c-Boundaries separate systems from each other and their environments. e-To survive, open systems maintain balance through feedback. According to general systems theory, a system is a set of interacting elements contributing to the overall goal of the system. The whole system is always greater than its parts. Boundaries separate systems from each other and their environments. Systems are hierarchical in nature and are composed of interrelated subsystems that work together in such a way that a change in one element could affect other subsystems, as well as the whole. To survive, open systems maintain balance through feedback. An open system allows energy, matter, and information to move freely between systems and boundaries, whereas a closed system does not allow input from or output to the environment.

A nurse studies the culture of Native Alaskans to determine how their diet affects their overall state of health. Which method of qualitative research is the nurse using?

b. Ethnography Ethnographic research was developed by the discipline of anthropology and is used to examine issues of culture of interest to nursing. Historical research examines events of the past to increase understanding of the nursing profession today. The basis of grounded theory methodology is the discovery of how people describe their own reality and how their beliefs are related to their actions in a social scene. The purpose of phenomenology (both a philosophy and a research method) is to describe experiences as they are lived by the subjects being studied.