Nursing 250 Final Exam PrepU
A client rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the client that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics? A. Fidelity B. Autonomy C. Nonmaleficence D. Justice
A.
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 team's PICO question refer to? A. preventing skin breakdown B. clients who have experienced a stroke C. turning clients more frequently D. the currently-used turning schedule
A.
A mother always thanks clerks at the grocery store. Her daughter, age 6 years, echoes her thank you. The child is demonstrating what mode of value transmission? A. Modeling B. Moralizing C. Reward and punishment D. Responsible choice
A.
A nurse assesses a client with psychotic symptoms and determines that the client needs vest restraints. However, the client asks the nurse not to put on vest restraints. What would be the best nursing action? A. Contact the physician and obtain necessary orders. B. Restrain the client with vest restraints. C. Apply restraints after giving a sedative. D. Apply wrist restraints instead of vest restraints.
A.
A nurse is providing care for three clients on a medical unit, two of whom are significantly more acute than the third. The nurse is making a concerted effort to ensure that the less acute client still receives a reasonable amount of time, attention, and care during the course of the shift. Which of the following is the nurse attempting to enact? A. Justice B. Beneficence C. Fidelity D. Nonmaleficence
A.
An employee health nurse is assisting a stressed, working mother with value clarification. Which of the following best defines value clarification? A. a process by which people come to understand their own values and value systems B. a belief about the worth of something, about what matters, that acts as a standard to guide one's behavior. C. an organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct. D. a systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct.
A.
An obstetrical nurse wishes to identify whether clients' 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. Correlational research B. Descriptive research C. Quasi-experimental research D. Experimental research
A.
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. What does this predicted relationship represent? A. Hypothesis B. Dependent variable C. Abstract D. Methodology
A.
One step in implementing evidence-based practice is to ask a question about a clinical area of interest or an intervention. The most common method is the PICO format. Which of the following accurately defines the letters in the PICO acronym? A. P = population B. I = institution C. C = compromise D. O = output
A.
A client on a surgical unit asks for the nurse's opinion of the surgeon. The nurse replies, "He is rude. His clients always end up with infections." The nurse is at risk of being accused of which of the following? A. Libel B. Slander/defamation C. Negligence D. Assault
B.
A client undergoing chemotherapy for a brain tumor believes that having a good attitude will help in the healing process. This is an example of what type of knowledge? A. Science B. Philosophy C. Process D. Virtue
B.
A nurse is contributing to the analysis of an ethical dilemma. Ethics is best defined as the branch of philosophy that addresses: A. the relationship between law and values. B. standards of conduct. C. conflict between competing priorities. D. decision making.
B.
A parent teaches his or her children not to drink and drive; however, the parent does drink and drive. This action causes A. Conflict with society B. Failure to reflect own values C. Insecurity and lack of safety D. Disruption in consistency
B.
Staff nurses in an ICU setting have noticed that their clients required less interventions for pain when the ICU was quiet. They passed their observations on to a nurse researcher and asked the 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? A. Nursing research involves clients in their care while hospitalized. B. Nursing research helps improve ways to promote and maintain health. C. Nursing research draws conclusions about the quality of client care. D. Nursing research explains ongoing medical studies to clients and asks for participation.
B.
Which ethical principle refers to the obligation to do good? A. Fidelity B. Beneficence C. Veracity D. Nonmaleficence
B.
While at lunch, a nurse heard other nurses at a nearby table talking about a client they did not like. When they asked him what he thought, he politely refused to join in the conversation. What value was the nurse demonstrating? A. the importance of food in meeting a basic human need B. basic respect for human dignity C. men do not gossip with women D. a low value on collegiality and friendship
B.
A client with cancer of the stomach tells the nurse, "I cannot bear the pain anymore. Please give me something to end all my suffering and this agonizing pain." The nurse faces a value conflict. Which of the following would be most important for the nurse to keep in mind in this situation? A. The responsibility is to focus solely on the values of the client. B. Value conflict has no effect on the client's compliance. C. Human need may affect the values conflict. D. Values conflict is consistently destructive in nature.
C.
A nurse working in a long-term care facility has an older adult male client who is very confused. Which ethical dilemma is posed when using restraints in a long-term care setting? A. It limits personal safety. B. It increases confusion. C. It threatens autonomy. D. It prevents self-directed care.
C.
A postanesthesia nurse is reporting about a client to the intensive care unit nurse in the elevator. There are staff members and visitors in the elevator. The postanasthesia nurse is doing what? A. implementing therapeutic communication B. interacting to maintain coordination of care C. breaching the client's confidentiality D. maintaining the continuity of care
C.
A client gets out of bed following hip surgery, falls, and re-injures her hip. The nurse caring for her knows that it is her duty to make sure an incident report is filed. Which statement accurately describes the correct procedure for filing an incident report? A. The physician in charge should fill out the report. B. The names of the staff involved should not be included. C. The reports are used for disciplinary action against the staff. D. The report should contain all the variables related to the incident.
D.
A client who is scheduled for hernioplasty needs clarification regarding the procedure. The nurse calls the physician at the client's insistence. The physician, who is in a bad mood, is overheard telling the client that the nurse does not know anything. Which legal tort has the physician committed? A. Libel B. Battery C. Assault D. Slander
D.
A competent adult client is scheduled for surgery. Who signs the informed consent form to allow the surgery? A. A relative B. The physician C. A nurse D. The client
D.
A conceptual framework is defined as: A. an explanation of nursing and nursing practice. B. a set of phenomena and related abstractions. C. a foundation for nursing skills and care. D. a set of concepts and propositions.
D.
A nurse is arrested for possession of illegal drugs. What kind of law is involved with this type of activity? A. Civil B. Private C. Public D. Criminal
D.
Information is collected for analysis in both quantitative and qualitative research. What is the information called? A. Surveys B. Answers C. Interviews D. Data
D.
A nurse is caring for a woman 28 years of age who has delivered a baby by Cesarean section. She describes her pain as a 9. The nurse medicates her for pain. This is an example of which ethical framework? A. Justice B. Fidelity C. Beneficence D. Nonmaleficence
C.
A client who is a chronic alcoholic is admitted to the healthcare facility with cirrhosis of the liver, reporting pain in the abdomen. The client expresses to the nurse that his family does not love and respect him because of his addiction to alcohol. He admits that is unable to perform his role as the bread winner of the family. Which of the following needs should be a priority for the nurse? A. Pain in the abdomen B. Low self-esteem C. Ineffective coping D. Impaired family patterns
A.
A client who is scheduled for abdominal surgery gives informed consent. While reviewing the client's medical record, the nurse identifies the consent form, interpreting it as most reflective of: A. protection of the client's right to self-determination in decision making. B. assurance of client's ability to refuse treatment if necessary. C. confirmation of the client's mental capacity. D. client's in-depth knowledge about the treatment options available.
A.
A group of nurse researchers has proposed a study to examine the efficacy of a new wound care product. Which aspect of the methodology demonstrates that the nurses are attempting to maintain the ethical principle of nonmaleficence? A. The nurses are taking every reasonable measure to ensure that no participants experience impaired wound healing as a result of the study intervention. B. The nurses have organized the study in such a way that the foreseeable risks and benefits are distributed as fairly as possible. C. The nurses have given multiple opportunities for potential participants to ask questions, and have been following the informed consent process systematically. D. The nurses have completed a literature review that suggests the new treatment may result in decreased wound healing time.
A.
A nurse in a physician's office has noted on several occasions that one of the physicians frequently obtains controlled-drug prescription forms for prescription writing. The physician reports that his wife has chronic back pain and requires pain medication. One day the nurse enters the physician's office and sees him take a pill out of a bottle. The doctor mentions that he suffers from migraines and that his wife's pain medication alleviates the pain. What type of nurse-physician ethical situation is illustrated in this scenario? A. Unprofessional, incompetent, unethical, or illegal physician practice B. Disagreements about the proposed medical regimen C. Conflicts regarding the scope of the nurse's role D. Claims of loyalty
A.
A nurse provides client care within a philosophy of ethical decision making and professional expectations. What is the nurse using as a framework for practice? A. Code of Ethics B. Standards of Care C. Definition of Nursing D. Values Clarification
A.
A nurse researcher is collecting nominal data. What type of research is being conducted? A. Quantitative research B. Qualitative research C. Interval research D. Experimental research
A.
A nurse states to the client that she will keep her free of pain. However, her family wishes to try a treatment to prolong her life that may necessitate withholding pain medication. This factor will cause an ethical dilemma for the nurse in relation to which ethical principle? A. Fidelity B. Veracity C. Justice D. Autonomy
A.
A nurse using the principle-based approach to client care seeks to avoid causing harm to clients in all situations. What is this principle known as? A. Nonmaleficence B. Justice C. Fidelity D. Autonomy
A.
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. Review of the literature C. Results D. Conclusions
A.
A nursing student learns how to give injections from the nurse manager, who dictates a list of steps to follow. This is an example of the acquisition of what type of knowledge? A. Descriptive rule-based B. Traditional C. Scientific D. Applied
A.
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. Traditional knowledge C. Authoritative knowledge D. Philosophical knowledge
A.
As part of a class assignment, a beginning professional nursing student is to prepare a research paper. Which action would be most appropriate to take when identifying a problem area? A. review scientific literature to develop a research idea B. identify a direction that the research project will take C. express a relationship between the operationalized concepts D. analyze the results to confirm what the problem was
A.
Breaking the healthcare community into separate entities (such as the medical staff, the nursing staff, management, support staff) and analyzing how they work as a whole together is an example of which nursing theory? A. general systems theory B. adaptation theory C. developmental theory D. compartment theory
A.
Evidence-based care emphasizes decision making based on the best available evidence and: A. use of outcome studies to guide decisions. B. evaluation by experts to direct specialty areas. C. care based on pathophysiologic factors. D. cost efficiency of treatment models.
A.
Having recently completed a specialty nursing program in neonatal care, a nurse is now preparing to leave her current position on a medical unit and begin providing care in the hospital's neonatal intensive care unit (NICU). The nurse has completed which of the following processes of credentialing? A. Certification B. Licensure C. Accreditation D. Validation
A.
In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that she has made. The nurse is most clearly demonstrating which professional value? A. Integrity B. Altruism C. Social justice D. Human dignity
A.
The client was diagnosed with diabetes three years ago, but has failed to integrate regular blood glucose monitoring or dietary modifications into his lifestyle. He has been admitted to the hospital for treatment of acute renal failure secondary to diabetic nephropathy, an event that has prompted the client to reassess his values. Which of the following actions most clearly demonstrates that this client is engaging in the step of prizing within his valuing process? A. The client expresses pride that he now has the knowledge and skills to take control of his diabetes management. B. The client states that he will now begin to check his blood glucose before each meal and at bedtime. C. The client is now able to explain how his choices have contributed to his renal failure. D. The client expresses remorse at how his failure to take make lifestyle changes has adversely affected his health.
A.
The nurse finds that there have been several opportunities to share personal prescriptions with family members when they were in need of pain medication or antibiotics. Which area of rules should govern the nurse's moral decision? A. Ethics B. Administrative law C. Common law D. Civil law
A.
The nurse understands that general systems theory has important implications in nursing. Which of the following is an assumption of the general systems theory? A. Human systems are open and dynamic. B. All humans are born with instinctive needs. C. Human needs are motivational forces. D. People grow and change throughout their lives.
A.
There are four concepts common in all nursing theories. Which one of the four concepts is the focus of nursing? A. Person B. Environment C. Health D. Nursing
A.
Upon entering the hospital system, the nurse discusses the rights and responsibilities that the client is entitled to in the institution. The information the nurse discusses is commonly referred to as: A. Patient's Bill of Rights B. Standards of Clinical Nursing Practice. C. The Code of Ethics for Nurses. D. The Bill of Rights for Registered Nurses.
A.
Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when she reflects on the decision-making process and the role it will play in making future decisions? A. Evaluating B. Diagnosing C. Planning D. Implementing
A.
What is the ultimate goal of expanding nursing knowledge through nursing research? A.Learn improved ways to promote and maintain health B. Develop technology to provide hands-on nursing care C. Apply knowledge to become independent practitioners D. Become full-fledged partners with other care providers
A.
When looking at a model for evidence-based practice, what is the final step of the process? A. Evaluating practice change B. Searching the literature C. Appraising evidence D. Formulating a clinical question
A.
Which of the following illustrates the activity of acting in values clarification? A. respecting the human dignity of all clients B. seeking public affirmation for actions C. disregarding several alternatives when choosing D. considering consequences of actions
A.
Which principle underlies the ethical conduction of research in a hospital setting? A. Clients must grant informed consent if they are to participate. B. Any interventions must be approved by the Food and Drug Administration (FDA). C. The client must directly and personally benefit from the research. D. Descriptive studies are more ethical than experimental studies.
A.
Which process evaluates and recognizes educational programs as having met certain standards? A. Accreditation B. Credentialing C. Licensure D. Certification
A.
Which theory emphasizes the relationships between the whole and the parts, and describes how parts function and behave? A. General systems theory B. Nursing theory C. Adaptation theory D. Developmental theory
A.
Which word is best described by the following: the protection and support of another's rights? A. Advocacy B. Paternalism C. Autonomy D. Ethics
A.
Values are known to affect a person's functional health. Which of the following values may be related to the perception of health? Select all that apply. A. Responsibility B. Discipline C. Language D. Cooperation E. Intuition
A. B. D.
Which of the following are examples of characteristics of evidence-based practice (EBP)? Select all that apply. A. It is a problem-solving approach. B. It uses the best evidence available. C. It is generally accepted in clinical practice. D. It is based on current institutional protocols. E. It blends the science and art of nursing.
A. B. E.
A client is discussing informed consent prior to a scheduled procedure. Informed consent includes what rights? Select all that apply. A. Confidentiality B. Care at the lowest cost possible C. Right of refusal to participate D. Right to withdraw from treatment at any time E. Guarantee of positive outcomes
A. C. D.
Which of the following are characteristics of nursing theories? Select all that apply. A. They provide rational reasons for nursing interventions. B. They are based on descriptions of what nursing should be. C. They provide a knowledge base for appropriate nursing responses. D. They provide a base for discussion of nursing issues. E. They help resolve current nursing issues and establish trends.
A. C. D. E.
A client is admitted with symptoms of psychosis. The nurse hurries to the client's room when she hears the client calling for help. She finds the client lying on the ground. The nurse assists the client back to the bed and performs a thorough assessment. The nurse informs the physician and completes the incident report. Which statement should the nurse document in the incident report? A. The client was trying to lower the side rails. B. The client was found lying on the floor. C. The client was trying to get out of the bed. D. The client was not aware that he had fallen.
B.
A dying client tells the nurse that he doesn't want to see his family because he doesn't want to cause them more sadness. Which action by the nurse is most appropriate? A. Arrange a meeting between the family and the client. B. Help the client clarify his values. C. Educate the client on death and dying concepts. D. Allow the client time for quiet reflection.
B.
A nurse has taken a telephone order from a physician for an emergency medication. The dose of the medication is abnormally high. What should the nurse do next? A. Administer the medication based on the order. B. Question the order for the medication. C. Refuse to administer the medication. D. Document concerns about the order.
B.
What is the term for the beliefs held by the individual about what matters? A. Ethics B. Values C. Morals D. Bioethics
B.
What nursing activity forms the bridge between theory and practice? A. Theoretic writing B. Evidence-based research C. Client-focused care D. Case management
B.
What phrase best describes the science of nursing? A. application of clinical skills B. body of nursing knowledge C. holistic client care D. art of individualized nursing
B.
What would be an example of the nurse practicing fidelity? The nurse: A. regulates visitors. B. stays with the client during his death as promised. C. withholds information as requested. D. provides continuity of care.
B.
A client age 46 years has been diagnosed with cancer. He has met with the oncologist and is now weighing his options to undergo chemotherapy or radiation as his treatment. This client is utilizing which ethical principle in making his decision? A. Beneficence B. Confidentiality C. Autonomy D. Justice
C.
A client is unhappy with the health care provided to him. He approaches the nurse and informs her that he is leaving the facility. The client has not been discharged by the physician. The nurse finds that the client has dressed and is ready to go. What would the nurse's action be in this situation? A. The nurse should get the client restrained and call the physician. B. The nurse should let the client go because she cannot do anything. C. The nurse should call the nursing supervisor and inform her about the situation. D. The nurse should warn the client that he cannot come to the hospital again.
C.
A client, unsure of the need for surgery, asks the nurse, "What should I do?" What answer by the nurse is based on advocacy? A. "If I were you, I sure would not have this surgical procedure." B. "Gosh, I don't know what I would do if I were you." C. "Tell me more about what makes you think you don't want surgery." D. "Let me talk to your doctor and I will get back to you as soon as I can."
C.
A nurse has a duty of nonmaleficence. Which of the following would be considered a contradiction to that duty? A. providing comfort measures for a terminally ill client B. assisting the client with ADLs C. refusing to administer pain medication as ordered D. providing all information related to procedures
C.
A nurse is caring for a client who has undergone coronary angioplasty. The cardiac monitor is showing abnormal ECG waves, indicating arterial fibrillation. The nurse does not recognize the importance of the sign; as a result, the client's condition deteriorates and the client has to be taken up for an emergency procedure. Which of the following describes the nurse's legal liability? A. Felony B. Defamation C. Tort D. Slander
C.
A nurse is caring for a client who is a celebrity in the area. A person claiming to be a family member inquires about the medical details of the client. The nurse reveals the information but later comes to find out that the person was not a family member. The nurse has violated: A. veracity. B. fidelity. C. confidentiality. D. autonomy.
C.
A student is conducting a literature review to identify a problem area for his research paper. Which of the following should the student remember when conducting a literature review? A. Books are a primary source for up-to-date information. B. Indexes are rarely found on the Internet. C. Journal reference lists provide sources for original articles. D. Abstracts provide detailed information about a topic.
C.
A woman age 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. This is an example of what ethical principle? A. Nonmaleficence B. Veracity C. Autonomy D. Justice
C.
According to Maslow's Hierarchy of human needs, which of the following is the highest level of need(s)? A. Safety and security B. Physiological needs C. Self-actualization D. Belonginess
C.
Based on Maslow's hierarchy of needs, when prioritizing a patient's plan of care, what would be the nurse's first priority? A. Allowing the family to see a newly admitted patient. B. Ambulating the patient in the hallway. C. Administering pain medication. D. Teaching the patient to self administer insulin
C.
How are the first stages of the nursing process and nursing research linked? A. They will answer a posed question. B. Each begins with goal development. C. The nurse assesses problems initially. D. There is a period of evaluation.
C.
One of the primary focuses of nursing research is to: A. quantify outcomes related to clients. B. determine outcomes for clients. C. generate knowledge to guide practice. D. prevent further disease and death.
C.
The nursing student demonstrates the need for further instruction with which statement concerning moral values? A. "Moral values place an emphasis on emotional attitudes." B. "Moral values are intertwined with one's religion." C. "Moral values give individuals some sense of what is right and wrong." D. "Moral values determine one's beliefs about others."
C.
The student nurse tells her family about a client with AIDS that she cared for in clinical yesterday. Which tort has the student committed? A. Slander B. Assault C. Invasion of privacy D. Fraud
C.
To practice ethically, the nurse should: A. allow a committee to guide her practice. B. review past cases before guiding practice. C. avoid allowing her judgment to guide practice. D. ask the family their views on caring.
C.
What is the best explanation for the way evidence-based practice (EBP) has changed the way nursing care is delivered? A. Nurses now spend time looking up the best way to give nursing care. B. Nurses now have to take part in research. C. Nurses care now uses EBP as a means of ensuring quality care. D. Nursing care now incorporates research studies into client care.
C.
When the nurse informs a client's employer of his autoimmune deficiency disease, the nurse is committing the tort of: A. Breach of contract B. Assault C. Invasion of privacy D. Battery
C.
Which component of nursing practice is central to the care-based approach to bioethics? A. provision of physical care B. relationships with healthcare providers C. nurse-patient relationship D. management of care
C.
Which of the following is a characteristic of the care-based approach to bioethics? A. the need to emphasize the relevance of clinical experience B. The rightness or wrongness of an action is independent of its consequences. C. the promotion of the dignity and respect of clients as people D. the need for an orientation toward service
C.
Which of the following modes of value transmission is most likely to lead to confusion and conflict? A. Modeling B. Moralizing C. Laissez-faire D. Responsible choice
C.
Which phrase best describes a value? A.questions about how one should act and live B. the process by which one decides what is important in life C. a belief about the worth of something to guide behavior D. dispositions of character that motivate goodness
C.
Which statement best explains the importance of theoretic frameworks? A. Theoretic frameworks guide physiologic nursing care. B. Theoretic frameworks guide psychosocial nursing care. C. Theoretic frameworks advance nursing knowledge and practice. D. Theoretic frameworks advance the ethical aspects of practice.
C.
Which type of quantitative research is described as follows: to examine cause-and-effect relationships between selected variables? A. Descriptive B. Correlational C. Quasi-experimental D. Experimental
C.
hich of the following represents the basic framework of the research process? A. Qualitative data B. Quantitative data C. Nursing Process D. Nursing Theory
C.
A hospice nurse is caring for a client with terminal cancer. The family would like the client to continue aggressive therapy to treat the cancer, but the client has voiced to the nurse that, after much thought, he does not want to pursue any further treatment. The nurse speaks to the family about the client's wishes, condition, and terminal state. This action is most likely derived from which nursing obligation? A. Legal responsibilities B. Nursing education principles C. Advanced practice licensure guidelines D. Moral values
D.
A nurse does not assist with ambulation for a postoperative client on the first day after surgery. The client falls and fractures a hip. What charge might be brought against the nurse? A. Assault B. Battery C. Fraud D. Negligence
D.
A nurse is providing homecare to a client with a diabetic foot ulcer who needs daily insulin injections. The family caregivers do not possess the technical skill to inject insulin. Which of the following should the nurse keep in mind? A. The current reimbursement system recognizes the family's nontechnical value priorities B. Nurses should avoid asking the family caregivers to conduct the skilled task C. Family caregivers are always perceived to be supportive of good care D. The nurse needs to be creative in integrating the technical and relational aspects of care
D.
A nurse researcher is conducting a scientific literature review. Which statement would be most important for the nurse researcher to keep in mind? A. Untested theories provide little basis for research topics. B. Literature review should be done with a favorable mind. C. The review needs to be limited to no more than 25 resources. D. Using a systematic approach for this step is most effective.
D.
A nursing student is formulating a problem statement for his research project. What will ensure that the study is a logical extension of the problem cited? A. The problem statement should identify the most likely solution to the problem. B. The problem statement is phrased in a broad, generalized way. C. The statement encourages speculative testing rather than empirical testing. D. The population being studied is specified in the problem statement.
D.
Nursing research is linked most closely to: A. propositions. B. outcome measures. C. treatments. D. nursing process.
D.
The nurse is preparing to submit a research project to the institutional review board (IRB). What outcome does the nurse determine will occur when the project passes through the IRB? A. the research project will be determined valid or invalid B. the cost of the research project will be established C. the research project will be published D. ethical principles will be followed for all participants
D.
What are standards for decision making that endure for a significant time in one's life? A. Beliefs B. Ethics C. Roles D. Values
D.
Which ethics theory focuses on ends or consequences of actions? A. Formalist theory B. Deontological theory C. Adaptation theory D. Utilitarian theory
D.
Which of the following terms is part of quantitative research? A. process B. concept C. ethnography D. variable
D.