Chapter 02: Theory, Research, and Evidence-Informed Practice

A research nurse approaches a client about the possibility of being in a clinical trial. After the nurse explains the research procedure, the client asks, "What will happen if I get the placebo and not the treatment?" Which response by the nurse is best?

"You will receive the same care regardless of whether you get the placebo or the treatment."

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

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

Deductive reasoning

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.

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

Which activity best helps the nurse apply theory to practice?

Evidence-based research

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 group of objects with relationships is which?

concept

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

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

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

A group of concepts and the relationships among them is what?

Theory

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

generate knowledge to guide practice.

A nurse is searching the Cochrane Database of Systematic Reviews for information about evidence-based practice related to pain control measures. The nurse searches this database based on the understanding that these reviews reflect which type of research?

randomized, controlled trials

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

Evaluating practice change

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

Student nurses Novice nurses

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

Nursing research

Which is most similar to a nursing model?

nursing 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

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

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

indicate the population.

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

use of outcome studies to guide decisions.

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.

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

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

A nurse caring for clients in a hospital setting focuses on the ill person in the health care setting. The nurse also provides care based on helping clients to adapt to the health care environment. Whose nursing theory principle is the nurse following?

Myra E. Levine

Which is true of concepts?

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

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

Authoritative knowledge

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

Florence Nightingale

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 researcher is planning to conduct a research study and applies to the appropriate Institutional Review Board (IRB) for approval. When applying to the IRB, which information would the nurse researcher be required to include? Select all that apply.

Detailed plans for data security A proposed consent form

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 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.

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

Nursing theory

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

Qualitative

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 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

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.

A nurse is writing an article for a nursing journal describing a study of the emergency protocols in a hospital emergency department. Which statements accurately describe elements of this process? Select all that apply.

The introduction reviews the literature and states the purpose of the article. The results are often presented in words, charts, tables, or graphs. The method section provides details of how the study was conducted.

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