EBP - midterm
The clinic nurse has just accessed a client's chart on the computer. The resident comes over and asks her to stay logged on because he needs to add a note to that client's chart. She should say:
"I'm sorry, but you will have to enter the information using your own password."* "Just make sure that you sign your note because it's under my password." "No problem. Just log me off when you're done. "I'll put the note in for you. What do you want to say?"
When reading study results, which of the following provides information on the clinical meaningfulness of the results?
"P-value" Confidence interval Alpha level Beta level
A nurse hears a co-worker state that anybody could be a nurse since it is so automated with infusion devices and electronic monitoring; technology is doing the work. What is the nurse's best response?
"The focus of effective nursing care is technology." "If it's so easy, why don't you do it?" "Technology use has to be combined with nursing judgment."* "That is true in the 21st century."
Sarah is a nurse manager in a surgical unit. She is concerned about a conflict between Lucy (a staff nurse) and one of the maintenance personnel. Sarah explains to Lucy that unsatisfactory resolution of the conflict is typically destructive and will result in:
A good relationship with the maintenance department Decreased frustration between the maintenance worker and her Decreased productivity on her part* Eventual resolution of the problem without further intervention
Which of the following best describes qualitative research?
A method to determine which nursing model is most effective. A comparison of two medications to determine which is most cost effective. Review of historical development of wound care. Description of health care needs and understanding of needs from the lived experience.
Kala, a unit manager, in discussing a role the CEO would like her to perform, makes the following statement, "I will sit on the hospital task force on improving morale if you send me to the hospital's leadership training classes next week, so I can further develop my skills and thus be more effective." Which of the following conflict management styles is Kala using?
Accommodating Avoiding Negotiating* Collaborating
Two nurses on a psychiatric unit come from different backgrounds and have graduated from different universities. They are given a set of new orders from the unit manager. Each nurse displays different emotions in response to the orders. Nurse A indicates that the new orders include too many changes; Nurse B disagrees and verbally indicates why. This step in the process is which of the following in Thomas' stages of conflict?
Action Outcomes Conceptualization* Frustration
A staff nurse is taking leadership classes in an advanced degree program. The instructor requires the students to create a journal and make notes of their feelings when they experience conflicts at work. What is the purpose of this assignment?
Analyses of student conflicts Log of conflicts which occur at work Assess conflict management skills Reflection of self-awareness*
As a charge nurse, you counsel your RN staff member that they have had their duty of care by notifying a child's physician regarding concerns about deterioration in the child's status at 0330 hours. The physician does not come in to assess the child and does not provide additional orders. The child dies at 0630 hours. As the charge nurse, you could be held liable for what?
Assault Avoidance Professional negligence* Murder
What is the role of an effective follower?
Assuming a position submissive to leadership Say "yes" I agree to every suggestion put forth by others Being able and willing to influence team members* Performing tasks flawlessly
The nursing value that is reflected by the nurse's concern and advocacy for the welfare of patients, other nurses, and other healthcare professionals is which of the following?
Autonomy Courage Social Justice Altruism*
Three gravely ill patients are candidates for the only available bed in the ICU. As the supervisor, you assign the bed to the patient with the best chance of recovery. This decision reflects which of the following ethical principles?
Autonomy Nonmaleficence Beneficence (act of charity, mercy, and kindness with a strong connotation of doing good to other including moral obligation)* Veracity (conformity to facts; accuracy)
A patient suffered a brain injury and has no brain activity. The patient has a living will which states no heroic measures. The family requests that no additional heroic measures be instituted for their loved one. The nurse respects this decision in keeping with the nursing value of:
Autonomy* Nonmaleficence Accountability Integrity
The term "authentic" when applied to leadership is defined as which of the following?
Being voted into a leadership position by constituents Being yourself and honest in relationships* Being born into a family with a history of leadership Passing a certification exam
A home health nurse has been assigned to cover a 300-square-mile area of remote Montana. Mrs. Baker has just been discharged home and will need daily contacts for the next week. Because it is not possible to visit Mrs. Baker in person every day and see all of the other clients, the nurse gives her a laptop computer with net meeting software installed. Each morning, both dial in at an agreed-upon time and discuss her progress. The home health nurse assesses whether or not the client needs to be seen that day. This type of technology is called:
Biomedical technology Telecommunications* Knowledge software Distance learning
In an ICU, you order new devices to measure heart rhythm and rate, respiratory rate, oxygen levels, and intracranial pressure. These devices involve:
Biomedical technology* Retrieval of patient history information Telecommunications Internet
The head nurse and a staff nurse are having a conflict over how to use and apply a new procedure for dressings in the medical/surgical area. The staff nurse wishes to use the new procedure based on newly released nursing research. The head nurse wishes to use a protocol that has been used in the department for a number of years. The head nurse later makes comments to other staff on her unit about the credibility of the staff nurse. This behavior is associated with:
Bullying* Lateral violence Horizontal violence Confrontation
Which database houses primarily nursing and allied health literature
CINAHL PubMed Cochrane Google Scholar
"I really wish that my supervisor would realize and acknowledge all the things I do well." In nursing, this has been identified as a problem. Which statement is part of the solution? Focus on:
Care assignments with which the individual is not familiar New staff Making corrections The strengths of the individual rather than the weaknesses*
In an emergency department, the team uses a whiteboard to track patients and their treatments by name and room. For maximum visibility, the whiteboard is hung on a large wall in a central location where there is frequent traffic by members of the health care team, patients, and patients' family members. Which of the following is being violated?
Civil law Tort law HIPAA* OSHA
Which database houses systematic reviews
Cochrane Guidelines Clearinghouse PubMed Ebsco
The unit manager was addressing nursing students in the lounge area and was discussing team leadership and team effectiveness. She stated, "One can agree to disagree with another team member's perspective even when one doesn't necessarily see that perspective as being the correct one." In being creative, what did she mean?
Commiting to resolution* Championing one's own opinion Being compassionate Being flexible
The C in PICO represents
Comparison Collaboration Cooperation Cooperative
Common exemplars of professional nursing behaviors include: (select all that apply)
Compassion* Integrity* Courage* Judgement
Jill is the head nurse on a unit in a large hospital. Two of the staff nurses are constantly arguing and blaming each other, and a resolution has not occurred in months. To solve the existing conflict, which is the most creative conflict resolution?
Competing Avoiding Compromising Collaborating*
Which of the following would be a barrier that inhibits nurses from using clinical practice guidelines (CPGs)? Clinical practice guidelines are:
Complicated and challenging to implement Always a Level 1 evidence Difficult to access Not based on research findings
A member of a patient's family calls the nurse manager of the palliative care unit to express concern that a member of the family, who died on the weekend, had requested analgesics from the RNs on duty. An RN came with the analgesic nearly 45 minutes later, just after the patient had died. The manager is aware that the unit was especially busy that weekend because many patients were seriously ill, staff had called in ill, and the staffing manager was unable to completely replace staff who were absent. The manager is deeply troubled that the family member had to die in pain because it violates what she knows should have been done. This manager is experiencing:
Compromised agency Moral distress (most often occurs when one is faced with situation in which two ethical principles compete, such as when the nurse is balancing the patient's autonomy issues with attempting to do what the nurse knows is in the patient's best interest)* Moral sensitivity Moral dilemma
John is a circulating nurse in the operating room. He is usually assigned to general surgery, but on this day he is assigned to the orthopedic room. He is unfamiliar with the routines and studies the doctor's preference cards before each patient. The fourth patient comes into the room and John prepares a site for a biopsy using a Betadine solution. The surgeon prefers another solution. He notices what John has done and immediately corrects him by rudely insulting John. What is the appropriate approach to conflict resolution in this example?
Compromising* Withdraw Collaboration Avoiding
A student nurse observes that her preceptor handles emotionally laden interactions with patients, families, and other staff in a calm, professional and empathetic manner. Before engaging in these types of interactions, he takes time to think about the situation and what he is going to say. The student identifies this as an example of which of the following types of characteristics?
Conflict management Emotional-intelligence* Sympathy Problem solving
Select the true statement about clinical practice guidelines. Clinical practice guidelines are:
Created to determine best practice for one health profession. Used exclusively in the United States. Based only on level I meta-analysis. Used to guide practice and improve clinical outcomes.
By following a shared leadership model, the nurse manager believes that staff members will learn to function synergistically. Some teams function synergistically because members:
Do not volunteer unwanted information Do not speak unless they are absolutely sure they are correct in their views Listen to the person who believes he or she is an expert Actively listen to each other*
The probability of an event or outcome occurring in repeated trials under similar conditions is known as the:
Effect size Odds ratio Likelihood ratio P value
What type of leadership position is that of a Chief Nursing Officer (CNO )? Considered?
Elected leadership Personal leadership Informal leadership Formal leadership*
Which of the following is NOT a component of intervention fidelity?
Enactment Training Delivery Internal validity
A researcher is reviewing a study that investigated the development of asthma in children who were diagnosed with respiratory syncytial virus in the first 3 months of life. The odds ratio was calculated to be 1. What does this mean?
Exposure to the virus did not affect odds of developing asthma. Exposure to the virus was associated with higher odds of asthma development. Exposure to the virus was associated with lower odds of asthma development. Asthma development is increasing in children because of exposure to the virus.
The mediator suggested to the unit staff that a group agreement needed to be made so meetings could become productive. For example, the group agreement, "We will speak supportively," prevents:
Expression of opposing ideas. Efforts to ensure that everyone thinks alike. Votes that oppose motions. Gossip and making negative comments about absent team members.*
The principle that requires nurses to uphold a professional code of ethics, to practice within the code of ethics, and to remain competent is which of the following?
Fidelity (faithfulness to a person, cause, or belief, demonstrated by continuing loyalty and support)* Autonomy Veracity Honesty
An evidenced-based practice project would need to evaluate which of the following
Findings from individual studies obtained from a search using keywords. A synthesis of findings from all relevant studies obtained from a search using keywords. Quality of studies obtained from a search using keywords. All of the above are correct.
The chief nursing officer plans a series of staff development workshops for the nurse managers to help them deal with conflicts. The first workshop introduces the four stages of conflict, which are:
Frustration , conceptualization, action, and outcomes* Frustration, conceptualization, negotiation, and action outcomes Frustration, completion, negotiation, and action Frustration, cooperation, collaboration, and action outcomes
Which search engine is appropriate for nurse researchers to use?
Google Scholar Google Bing Safari
As a student nurse at UNMC, you have pledged to: (select all that apply)
Grow as a leader in promoting health throughout your community* Respect those entrusted into your care* Use EBP in planning and intervening in patient care* Hold all patient information in confidence*
The specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice is:
Health Informatics. Translational Bioinformatics. Nursing Informatics.* Clinical Research Informatics.
The Fours Agreements (Don Miguel Ruiz) are agreements a person makes with which of the following?
His boss Him- or herself* Her instructor Her parents
Which of the following would a nurse researcher do to promote intervention fidelity in his/her study?
Identify sources of bias before the study begins. Collect data in the same way from each subject and under the same conditions. Randomize the sample All of the above
Internal validity assess for which of the following?
If the data was collected in a consistent manner. If the change in the dependent variable or study outcome was related to the independent variable. If the sample size was representative of all studied. If the study methods were uniform.
Staff at Valley Hospital are concerned that recent staffing cuts will affect their ability to provide quality patient care, and they express their concerns to senior management. The CEO of Valley Hospital makes the following statement: "We need to contain costs because our funding has been decreased." This is a good example of which of the following conditions that propel a situation toward conflict?
Incompatible goals* Role conflicts Competition for resources Structural conflict
Nurses need to know how to operate a computer, compare data across time, and look for patterns in client responses to treatments. These are examples of:
Information systems Informatics competencies* JCAHO standards Requirements for nursing licensure
Which of the following measures of control are generally easier for the researcher to control?
Internal validity External validity Extraneous variable Generalizability
As more controls are included in a study design,
Internal validity declines and external validity declines. Internal validity declines and external validity improves. Internal validity improves and external validity improves. Internal validity improves, external validity declines
The I in PICO represents
Intervention Independent variable Integrity Interest
According to the evidence hierarchy in LoBiondo-Wood (Figure 2.1 p. 24) what level of evidence is a single qualitative study?
Level I Level III Level V Level VI
To avoid selection bias, it would be best for the researcher to
Maintain constancy Assure homogeneity Include randomized groups Limit maturation
A researcher wishes to apply findings from a sample onto a population. To do this the researcher must utilize:
Mathematical statistics Inferential statistics Descriptive statistics Nonparametric statistics
Which ethical principle is primarily involved in informed consent?
Nonmaleficence Beneficence Veracity Autonomy*
Nurses entering the workforce today are faced with which of the following relationships that could create organizational conflict? (Select all that apply.)
Nurse-physician relationship* Nurse-nurse relationship* Nurse-auxiliary personal relationships* Nurse-patient relationship* Nurse-chief nursing officer relationship*
Which of the following are recognized as one of the 5 tenets of nursing practice: (Select all that apply)
Nursing practice is individualized* Nursing practice is based on a body of recognized evidence Caring and health are central to the practice of the RN* Nurses coordinate care by establishing partnerships*
A group of researchers are working on a practice change in their facility. They have developed a PICO question and completed a search of the literature. The next phase of the practice change involves?
Obtain organizational approval to implement the change Dissemination of the findings to stakeholders Critically appraising the identified studies Plan implementation of the practice change
The nurse manager knows that for change to be successful which of the following must occur?
Only RNs should be involved in the change process. Autocratic approach must be used. Empowerment of those involved in the change.* Physicians should be the initiators of change on the unit
Identify the primary source
Original research article in journal Systematic review Meta-analysis Concept paper
The O in PICO represents
Outcome Outliers Optical Octagonal
Which of the following is associated with qualitative research?
Outcomes are of a primary concern rather than process. Relationships among variables are studied in qualitative research. The "why" something has occurred is described. How many times a particular result occurred is the focus.
A patient refuses a simple procedure that you believe is in the patient's best interest. What two ethical principles are in conflict in this situation?
Paternalism and respect for others Autonomy and beneficence* Veracity and fidelity Fidelity and justice
In nursing theory, one theorist developed the idea of new nurses progressing to experienced nurses and playing an important role in patient care in all stages. The new nurses follow their role and progress through stages to advanced nurse. Who was this theorist?
Patricia Benner* Dorothea Orem Robert E. Kelley Ida Jean Orlando
Two staff nurses are arguing about whose turn it is to work on the upcoming holiday. In trying to resolve this conflict, the nurse manager understands that interpersonal conflict arises when:
People see events differently.* The ways in which people should act do not match the ways in which they do act. Risk taking seems to be unavoidable. Personal and professional priorities do not match.
Which type of qualitative research method is used to generate theories about clinical practice and understanding about many different aspects of health care.
Phenomenology Case Study Ethnography Grounded Theory
The P in PICO represents
Population of interest Probable cause Problem Power
What items in the PICO question may be used as key terms
Population, intervention, outcome Problem, independent variable, casual factors Hypotheses, results, ocular Problem, outage, dependent variable
AN EBP group is preparing to review systematic reviews to answer their PICO question. A systematic review with the best available evidence would include what type of studies?
Quasi-experimental Case-control studies Cohort studies Randomized controlled trials
Data such as satisfaction level where the choices are highly satisfied, neutral and not satisfied are an example of which type of data?
Ratio Interval Ordinal Normal
In nursing theory, one theorist developed the theory of self-care of patients. In the theory, the nursing action of providing care and educating the patients can be interpreted in the form of followership for the patient. Who was this theorist?
Robert E. Kelley Dorothea Orem* Ida Jean Orlando Patricia Benner
In qualitative research, the sampling method that results in a sample that is homogeneous and reflects the population being studied is called what?
Saturated sampling Cross-sectional sampling Random sampling Purposive sampling
The Model of Professional Nursing Practice Regulation culminates at the top to represent:
Self-determination of the nurse in exercising judgements* Foundation: scope and standards of practice Institutional policies and procedures nurse practice act and rules and regulations
The nurse learns in report that the patient in room 223, Mr. X, has no insurance and entered the country illegally. The nurse provides high-quality care to the other patients to which she is assigned, but is slow to answer Mr. X's call light and is dismissive toward his family. Which nursing value has the nurse violated?
Social Justice* Altruism Integrity Autonomy
The mediator noticed that tension was still evident between the nurse manager and staff members. He informed the chief nursing officer that to begin team building, it would be important that everyone
Socialize frequently outside of work Use avoidance techniques when confronted with a conflict Develop a personal friendship with each other Work together in a respectful, civil manner*
In the cardiac intensive care unit, there has been simmering discontent about the new nurse manager, who avoids any discussion about her scheduling and practice decisions. The staff have begun to sort into "different camps" depending on how they feel about the manager or the decisions. Which of the following statements MOST accurately describes this situation?
Staff will become a cohesive group that takes a stand against the manager. The tension that has been generated will result in creative solutions. Patient care may suffer because attention and energy is being diverted toward the unit relationships.* The conflict will result in increased dialogue about practice and scheduling options.
In trying to achieve Magnet® status, the chief nursing officer establishes a shared governance model to help nurses experience job satisfaction. However, some nurses who have enjoyed working with less autonomy resist this change and begin to criticize and make rude comments about managers who embrace this model, as well as colleagues who support it. The comments are largely ignored because those who are making them are well established nurses who are often vocal about their displeasure with the organization. Organizational conflict is arising from which of the following?
Staffing practices Allocation of resources Tolerance of incivility* Increased participation in decision making
Identify the secondary source
Systematic review Original data Original research manuscript Original research article in journal
According to our Yoder-Wise text, what is the first step to becoming an effective leader?
Taking a class on management Being an effective follower* Getting an advanced degree Taking a class on leadership
Who is responsible for developing the scope and standards of nursing practice?
The American Association of of Colleges of Nursing (AACN) The American Nurses Association (ANA)* The National Council of State Boards of Nursing (NCSBN) The National League of Nursing (NLN)
Which of the following best describes external validity?
The degree to which one can infer that the experimental treatment rather than another condition or variable resulted in the outcome or observed effect. Assessment that the intervention the subject performs is completed as intended. Similarity of conditions among all participants present. The degree to which findings can be generalized to other populations or other environments.
The nurse is caring for a patient with diabetes who was admitted with an elevated blood glucose level. The patient is on an insulin pump to deliver one unit of insulin per hour through her intravenous (IV) line. How does this technology improve safety for this patient?
The pump eliminates the need for providers to be involved in the patient's medication management. Sensors in the pump will help regulate the patient's blood glucose to normal levels not the insulin in the pump. The pump eliminates all possibilities of any medication errors. The pump helps automate a complex care process.*
Which of the following statements regarding qualitative research is true?
The sample size is large. Randomized controlled sampling is most often used. The common data collection method is an interview with verbatim transcription of exactly what the participants have said. A predetermined time for discussion between the researcher and participant is followed for all interviews.
You volunteer at a free community clinic. A 13-year-old girl presents with chlamydia. The team leader at the clinic advises that:
The state-defined age of legal consent is 18; therefore, no treatment can be delivered Treatment is provided as long as telephone consent is obtained from a parent or legal guardian Care can be provided as long as consent is voluntary and information about treatment and options is provided*
The nurse manager is aware that conflict is occurring on her unit; however, she is focused on preparing for a state health department visit, so she ignores the problem. What factor can increase stress and escalate conflict?
The use of avoidance* Accepting that some conflict is normal And enhanced nursing workforce Managing the effects of fatigue and error
An individual in a wheelchair is applying for the position of receptionist in an outpatient clinic. What does the nurse manager understand based on The Americans with Disabilities Act of 1990 requirements for employers?
Treat, for purposes of employment, homosexuals and bisexuals as disabled Allow modified job expectations for persons recovering from alcoholism Make reasonable accommodations for persons who are disabled* Hire disabled individuals before hiring other qualified, nondisabled persons
A conscious effort to establish confidence in an accurate interpretation of the meaning of qualitative data is known as
Trustworthiness Credibility Confirmability Transferability
When a research team develops conclusions from their study and report that the findings are significant when they actually are not, the situation is referred to as:
Type I error Effect size Type II error Null value
Which of the following is an example of a formal leadership position in a nursing unit?
Unit secretary Nursing assistant Unit manager* Staff nurse
Which of the following is a criteria to critique the quality and rigor of qualitative research?
Validity Confirmability Reliability Objectivity
A part of the ethical code of conduct for nurses is to: (select all that apply)
Violate HIPPA if necessary Maintain the integrity of the profession* Takes care of herself/himself* Collaborate with other health professionals*
One of your staff nurses asks for your advice because a patient refuses to sign a consent for surgery. The patient says that he won't sign because he doesn't understand the nature of the surgery. You advise that: (Select all that apply.)
Witnessing a consent is related only to the voluntary nature of the signature* The patient must sign the consent because the doctor wants him to sign The patient has a right to choose not to consent* Consent must not be coerced*
A nurse educator is giving a workshop on conflict. During the sessions, he makes various statements regarding conflict. All of the statements are true except:
all conflicts involve some level of disagreement. conflict can decrease creativity, thus acting as a deterrent for the development of new ideas.* horizontal violence involves those with similar status but little power in the larger context. interprofessional collaboration reduces unresolved conflicts.
As part of a going-away party for a nurse, photos are taken of colleagues around the unit. A patient is accidentally included in one photo and no consent was obtained. This is an example of:
battery. (intentional violation of a patient's right to direct their own medical treatments) defamation. (the action of damaging the good reputation of someone) invasion of privacy.* assault.
Measures the researcher uses to hold the conditions of the study consistent to minimize possible bias in selection of subjects, randomization, or assignment to experimental and control group as well as error in the measurement of the dependent variables is referred to as
external validity control internal validity Homogeneity
All of the following are terms to describe criteria for determining the trustworthiness of a qualitative research except
generalizability confirmability credibility transferability
From the information presented in this chapter, which of the following statements best defines an accomplished team? Effective teams:
may or may not have a clear plan that is followed and revisited and has an ongoing evaluation scheme. do not always have effective communication patterns. do not necessarily need goals, objectives, vision, and a clearly stated purpose. can create a form of synergism in which the outcome is greater than the sum of the individual performances.*
While walking past a patient's room, you overhear one of the RN staff telling a patient that the patient has no right to refuse chemotherapy treatment because the family and the doctor think the treatment is the best option for the patient. This patient is 40 years of age and alert. When you meet later to discuss what you heard with the RN, it is important to:
remind the nurse to provide clearer explanations to aid in the patient's comprehension of the treatment and compliance. discuss that statute law provides for patient autonomy and refusal of treatment.* discuss how statute law enforces the right of the doctor, but not of families, to ensure that patients comply with recommended treatment plans. acknowledge the nurse's role in ensuring that she does not fail in her duty of care for the patient.
In qualitative research, data collection continues until
statistical significance is achieved. the predetermined sample size is achieved. data saturation occurs. the predetermined sampling time frame has ended.
Meta-analysis is a quantitative epidemiological technique that is considered a subset of systematic review.
true
Interventions for building a professional identity include: (select all that apply)
value debriefing* develop personal self care habits* be accountable for your learning* engage in reflection*