Chapter 2: Theory, Research, and Evidence Based Practice

Asking clinical questions in PICO format

P= patient, population, or problem of interest I= intervention of interest C= comparison of interest O= outcome of interest T= time

The nurse working in research correctly identifies which of the following to be mandatory for the ethical conduction of research in the hospital setting? A. descriptive studies are more ethical than experimental studies B. the client must directly and personally benefit from the research C. clients must grand informed consent if they are to participate D. all interventions must benefit all clients

C. clients must grant informed consent if they are to participate

Information is collected for analysis in both qualitative and quantitative research. What is this information called? A. surveys B. answers C. data D. interviews

C. data

When looking at a model for evidence-based practice, what is the final step of the process? A. formulating a clinical question B. apprising evidence C. evaluating practice change D. searching the literature

C. evaluating practice change

What is the best explanation for the way EBP has changed the way nursing care is delivered? A. nurses now have to take part in research B. nurses now spend time looking at the best way to give nursing care C. nursing care now uses EBP as a means of quality care D. nursing care now incorporates research studies into client care

C. nursing care now uses EBP as a means of ensuing quality care Rationale: the other answers were used even before EBP became a major force in the delivery of nursing care

Nurses in the 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 level of hospitalized clients. How does this demonstrate the ultimate goal of expanding the nursing body of knowledge? A. research explains ongoing medical studies to clients, and asks for participation B. research draws conclusions about the quality of patient care C. research helps improve ways to promote and maintain health D. research involves clients in their care while hospitalized

C. nursing research helps improve ways to promote and maintain health

Authoritative knowledge

Comes from an expert and is accepted as truth based on the person's seen expertise. Gained knowledge through experience. Ex: How to put an IV in.

What is the essence of evidence based practice?

Conceptual framework

The nursing instructor asks a group of students to identify a theory that describes the maturation of humans through stages. Which of these theories is correct? A. adaptation theory B. nursing theory C. systems theory D. developmental theory

D. developmental theory Rationale: this theory describes maturation of humans through stages

A nurse is formulating a clinical question in PICO format. What does the letter P represent? A. comparison to another similar protocol B. clearly defined, focused literature review of procedures C. specific identification of the purpose of the study D. explicit descriptions of the population of interest

D. explicit descriptions of the population of interest

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

D. general systems theory

Which theory emphasizes the relationships between the whole and the parts, and describe how parts function and behave? A. nursing theory B. developmental theory C. adaptation theory D. general systems theory

D. general systems theory

One of the primary focuses of nursing research is to: A. determine outcomes for clients B. prevent further disease and death C. quantify outcomes related to clients D. generate knowledge to guide practice

D. generate knowledge to guide practice Rationale: one of the major reasons for conducting research is to expand a profession's knowledge base

What is the central theme of Florence Nightingale's nursing theory? A. humans are in a constant relationship with stressors in the environment B. nursing is an art C. nursing is a therapeutic, interpersonal, and goal oriented process D. meeting the personal needs of the client within the environment

D. meeting the personal needs of the patient within the environment

There are four common concepts of nursing theory. While all concepts are important, the focus of nursing is always on which of the following? A. health B. environment C. nursing D. person

D. person Rationale: the patient is always the most important focus

Following the identification of a researchable problem, what must the nurse do? A. evaluate the number of ways to collect data B. obtain a list of possible outcomes C. determine a source appropriate to collect data D. select literature relevant to the problem

D. select literature relevant to the problem

Which statement best explains the importance of theoretic frameworks? A. they guide physiologic nursing care B. they guide psychosocial nursing care C. they advance the ethical aspects of nursing D. they advance nursing knowledge and practice

D. they advance nursing knowledge and practice

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? A. instinctive knowledge B. scientific knowledge C. authoritative knowledge D. traditional knowledge

D. traditional knowledge

Deductive reasoning

examines general ideas and considers specific actions or ideas (closer to scientific)

Goals of nursing research

improve care of people in clinical setting and the profession of nursing, study people and the nursing process, and developing a greater autonomy and strength as a profession

Scientific knowledge

obtained through the scientific method (research) this is the basis for evidence based practice

Developed theory

orderly and predictable growth and development from conception to death (based on theories from Erik Erikson and Abraham Maslow)

Traditional knowledge

passed down from generation to generation (things taught by elders saying "this is how we've always done things

Evidence based practice

problem solving approach to clinical decisions using the best evidence available, blends the science and the art of nursing so that the best patient outcomes are achieved

General systems theory

theory for universal application; breaks whole things into parts to see how they work together in systems

What are the three sources of nursing knowledge?

1. Traditional 2. Authoritative 3. Scientific

A nursing student is reading a research article from a nursing journal. The student 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 nursing student reading? A. Abstract B. Results C. Conclusions D. Review of the literature

A. abstract

For which research activity is a phenomenological research method most appropriate? A. attempting to understand non-english speaking immigrant's experiences of being hospital clients B. explaining how particular characteristics of the Vietnam War affected the roles of nurses C. understanding how clients cope with a new diagnosis of Alzheimer's disease D. describing the health maintenance activities that are practice by homeless, intravenous drug users

A. attempting to understand non-English speaking immigrants experiences of being hospital clients Rationale: phenomenology is the type of qualitative research that attempts to understand individuals' experiences and the meanings they assign to these

A mother has brought her 6 y/o child to the clinic. The mother is concerned that her child does not seem to skip as well as the other children in her class. In planning assessments and care for this child, the nurse might choose which theory as a foundation for decision making? A. developmental theory B. general systems theory C. Maslow's theory D. adaptation theory

A. developmental theory Rationale: this theory is concerned with growth and development across the lifespan

A student nurse is interacting with patients on a cardiac unit recognize the four concepts in nursing theory that determine nursing practice. Of these four, which is most important? A. person B. environment C. health D. nursing

A. person Rationale: the focus of nursing, regardless of definition or theory, is the person or patient

A nurse is using general systems theory to describe the role of nursing provide health promotion and patient teaching. Which statement reflects key points of this theory? (select all that apply) A. a system is a set of individual elements that rarely interact with each other B. the whole system is always greater than the sum of its parts C. boundaries separate systems from each other and their environments D. a change in one subsystem will not effect other subsystems E. to survive, open systems maintain balance through feedback F. a closed system allows input from or output to the environment

B, C, and E Rationale: a system is a set of interacting elements, the whole system is greater than all of its parts, boundaries separate the systems from each other, changing one element would affect the others, and open systems maintain balance through feedback and a closed system does not allow input from or output to the environment

Who is considered to be the first nursing researcher? A. Lillian Wald B. Florence Nightingale C. Dorothea Dix D. Clara Barton

B. Florence Nightingale

A nurse is developing a question for nursing research using the PICO model. Which component would be represented by the statement, "a 45 y/o male with coronary heart disease and atrial fibrillation"? A. C B. P C.I D. O

B. P Rationale: the P stands for the patient or problem, the I signifies the intervention considered, the C denotes the comparison if appropriate, and the O represents the outcome of interest or relevant outcomes

How would a nursing student define a conceptual framework? A. set of phenomena and related abstractions B. a group of interrelated objects that follow a pattern C. an explanation of nursing practice D. a foundation for nursing skills and care

B. a group of interrelated objects that follow a pattern

The nursing instructor asks a group of students to identify a theory that describes how humans adjust to life with other living things and with the environment. One student correctly identifies this as which theory? A. systems theory B. adaptation theory C. nursing theory D. developmental theory

B. adaptation theory

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? A. historical B. ethnography C. grounded theory D. phenomenology

B. ethnography Rationale: ethnography is used to examine issues of culture of interest to nursing

Which of the following represents the basic framework of the research process? A. quantitative data B. nursing process C. nursing theory D. qualitative data

B. nursing process

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 of the following will the "o" in the question refer to? A. turning clients more frequently B. preventing skin breakdown C. the currently used turning schedule D. clients who have experienced a stroke

B. preventing skin breakdown Rationale: the "O" denotes the outcome of interest. The desired outcome here is to prevent skin breakdown. P is the stroke patients, I is turning the patient more frequently, and C is the turning schedule

She says, "some knowledge is passed from one generation to another." One of the students correctly describes this source as being what? A. authoritative knowledge B. traditional knowledge C. philosophy knowledge D. scientific knowledge

B. traditional knowledge

What is the most important concept of nursing theory?

The patient!

Adaptation theory

adjustment of living matter to other living things and environment; how do we as humans adapt?

Inductive reasoning

builds from specific ideas or actions to conclusions about general ideas (we use it a lot but the conclusion at the end may or may not be true)