Chapter 2 The point Questions
A group of concepts and the relationships among them is what?
Theory Explanation: Theory is a group of concepts and the relationships among them. Evidence-based practice is clinical practice that is informed by the best and most current evidence available in the literature. Deductive reasoning provides a basis for theory development as one studies a general idea to more specific properties. Inductive reasoning is derived from consideration of specific properties to make conclusions about a general idea.
The National Institute of Nursing Research (NINR) was established following a study in 1983. The center's purpose is to:
promote research for health promotion. Explanation: The National Institute of Nursing Research was established under the National Institutes of Health to place nursing securely in the sphere of scientific investigation and to support research and training into client care, health promotion, disease prevention, and the mitigation of the effects of acute and chronic disabilities. It does not exist to advance nursing funding, expand nursing theory, or evaluate research.
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 Explanation: Within the PICO question framework, the "O" denotes the outcome of interest. In this case, the desired outcome is the prevention of skin breakdown. Stroke clients are the "P," or population of interest, whereas turning clients more frequently is the "I," or intervention. The current turning schedule is the "C," referring to the comparison of interest
What nursing activity forms the bridge between theory and practice?
Evidence-based research Explanation: Evidence-based research is translational research that forms the bridge between theory and practice. Theoretical writing focuses on theory. Client-focused care and case management are focused on practice.
Which activity best helps the nurse apply theory to practice?
Evidence-based research Explanation: Evidence-based research is translational research that forms the bridge between theory and practice. Theory development is how desirable change in society is best achieved. Client-focused care is care provided to a client that maintains the client as a functional component of healthcare team. Case management is when care is provided to an individual client by a healthcare provider
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 Explanation: In this question, the intervention (I) would be the use of chromium supplements. The population (P) would be overweight clients. The comparison (C) would be no supplements. The outcome (O) would be weight loss. The T is for time, which is not reflected in this scenario.
In selecting sources to include in a literature review for a nursing research project, which would be most helpful?
Cumulative Index to Nursing and Allied Health Literature Explanation: Indexes such as the Cumulative Index to Nursing and Allied Health Literature, International Nursing Index, Index Medicus, Nursing Studies Index, MedLine, and Nursing Research Index are valuable in locating nursing-based literature and research studies. Such indexes would be more helpful than any individual journal.
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 Explanation: Informed consent is a process in which the details of the study and the client's rights are explained and discussed in detail. This goes beyond simply obtaining the client's signature or allowing the client to ask questions. Meeting with the IRB is a necessary step in the research process but does not directly affect the client's understanding of risks and benefits
Question 20 See full question19sReport this Question A student nurse is having difficulties finding appropriate journal articles to prepare for a research project. Which individual will be best for the student to approach for assistance with this process?
Librarian Explanation: A medical librarian is an essential resource in the process of combing through all the various journals and published information. A classmate, the professor, and a preceptor who is a nurse may also be questioned about the process; however, the librarian is the best option to start with.
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. Explanation: Nursing research expands knowledge to learn improved ways to promote and maintain health. The other answers are incorrect because they are not the primary purpose of nursing research.
Which theory describes, explains, predicts, and controls outcomes in nursing practice?
Nursing theory Explanation: Nursing theory describes, explains, predicts, and controls outcomes in nursing practice. Systems theory describes how parts interact together. Adaptation theory describes adjustment of living things to other living things and the environment. Developmental theory describes maturation of humans through stages.
The focus of nursing is always on which of the four common concepts in nursing theory?
Person Explanation: All of these concepts are important in nursing theory; however, the focus of nursing is on the person (client).
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 Explanation: Quantitative research utilizes numerical values and statistical analysis of data. Basic research is utilized to generate or refine theory. Applied research is utilized for its application in clinical practice. The stem of the question did not provide information as to the application of the study. Qualitative research utilizes words or narrative for data rather than numbers.
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 Explanation: Traditional knowledge is known as knowledge that is passed down from one generation to the next. A grandmother passing information is an example of traditional knowledge. Authoritative knowledge is information that is gleaned from an expert based on their perceived experience. Scientific knowledge is derived through the scientific method. Philosophy is the study of wisdom and one perceptions of life.
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 Explanation: Traditional knowledge is passed from one generation to another. Authoritative knowledge is passed from an expert, and scientific knowledge is provided by way of the scientific method. Philosophy is a specific type of knowledge, not a source.
The process of considering an idea as a whole and then dividing it into smaller, more specific ideas is which?
Deductive reasoning Explanation: Deductive reasoning involves looking at an idea as a whole and then considering more specific ideas. Theory is a group of concepts and the relationships among them. Concepts are abstract ideas or objects and their relationships to one another. Inductive reasoning is derived from consideration of specific properties to conclusions about a general idea.
Which represents the basic framework of the research process?
Nursing process Explanation: Much of what bedside nurses routinely do constitutes research. The nursing process (i.e., assessing, diagnosing, planning, implementing, and evaluating) represents the basic framework of the research process. Nursing theory is defined as a creative and rigorous structuring of ideas that project a tentative, purposeful, and systematic view of phenomena. Quantitative research is the systematic empirical investigation of observable phenomena via statistical, mathematical, or computational techniques. Qualitative research is a scientific method of observation to gather non-numerical data.
Evidence-based care emphasizes decision making based on the best available evidence and:
use of outcome studies to guide decisions. Explanation: Evidence-based care emphasizes decision making based on the best available evidence and the use of outcome studies to guide decisions. The other answers do not represent the primary emphasis of evidence-based care but represent other approaches (specialty or expert knowledge, traditional medical model, and economic concerns).
Research is included as an essential component of nursing by which of the following organizations? (Select all that apply.)
ANA International Council of Nurses Nursing specialty organizations Explanation: The IOM and AMA are predominantly based in medicine. The nursing organizations such as the ANA, International Council of Nurses, and specialty organizations are calling for more research in nursing.
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 Explanation: Ludwig von Bertalanffy developed the theory for universal application which is a general systems theory. It describes how to break whole things into parts and then to learn how the parts work together in "systems". It emphasizes relationships between the whole and the parts and describes how parts function and behave. Adaptation theory defines adaption as the adjustment of living matter to other living things and to environmental conditions. Developmental theory outlines the process of growth and development of humans as orderly and predictable. Maslow developed the theory of human needs and the hierarchy of needs.
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. Explanation: Before adopting any new practices presented in research or a study, nurses should take time to ensure it will be appropriate for their clients and suitable for their situation. The nurse should not assume that just because something has been published, it will be appropriate for their situation. It must be analyzed by their facility to ensure it has been properly analyzed and approved for use before implementing. There is no need for the nurses to conduct their own research before implementing the changes.
One of the primary reasons for conducting nursing research is to:
generate knowledge to guide practice. Explanation: One of the major reasons for conducting nursing research is to generate knowledge to guide practice. The other answers pertain to other aspects of nursing practice but not to nursing research.
Who is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment?
Florence Nightingale Explanation: Florence Nightingale conceptualized the nurse's role as manipulating the environment to facilitate and encourage the reparative process. This would be accomplished by attending to ventilation, warmth, light, diet, cleanliness, and noise. Sister Callista Roy, CSJ is an American nun, nursing theorist, professor and author. She is known for creating the adaptation model of nursing. Dorothea Orem was a nursing theorist and creator of the self-care deficit nursing theory, also known as the Orem model of nursing. Lydia Hall was a pioneer in nursing autonomy and nurse-driven care.
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 Explanation: When using PICO, the "P" stands for the patient or problem and its delineation. The "I" signifies the intervention considered; "C" denotes comparison if appropriate, or it may be optional; and "O" represents the outcome of interest or relevant outcomes.
A nurse is discussing dietary issues with a Latino client in the clinic. The client states, "My nutritionist 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?
Authoritative knowledge Explanation: Authoritative knowledge is gleaned from an expert based on their perceived expertise. A nutritionist would be perceived to have expertise in dietary information. Traditional knowledge is known as knowledge that is passed down from one generation to the next. Scientific knowledge is derived through the scientific method. Philosophy is the study of wisdom and one's perceptions of life.
Which are examples of ways that a nurse can use theories to guide client care? (Select all that apply.)
Collect client data. Organize client information. Classify client data. Analyze client situations. Explanation: Assignments on a clinical unit are made by using acuity systems or delegation rather than being based in nursing theory. The other choices are all examples of ways that theory can guide client care.
A group of objects with relationships is which?
Concept Explanation: A concept is a group of abstract ideas or objects and their relationships to one another. Theory is a group of concepts and the relationships among them. Deductive reasoning provides a basis for theory development, as one studies a general idea to more specific properties. Inductive reasoning is derived from consideration of specific properties to make conclusions about a general idea.
A nursing theory differs from a theoretical framework in which way?
Concepts and propositions are more specific Explanation: The concepts and propositions of a theory are more specific than those of a theoretical framework. The other statements are not necessarily true of a theory.
Which is true of concepts?
Concepts describe objects, properties, and events and the relationships among them. Explanation: Concepts describe objects, properties, and events and the relationships among them. Theories are derived through deductive and inductive reasoning and provide a mechanism by which knowledge can be tested, and nursing theory differentiates nursing from other disciplines.
A public health nurse is working with a large group of clients who require a variety of patient care, health teaching, and health promotion. Using Virginia Henderson's Basic Needs Theory, how should the nurse proceed in order to provide a variety of medical, health teaching, and health promotion interventions?
Determine general basic needs of the group and additional needs specific to each client. Explanation: Virginia Henderson's Basic Needs Theory states that people have basic needs that are components of health. The significance and value of these needs are unique to each person. The ability to independently satisfy human needs composed of 14 basic physical, psychological, and social elements. Before the nurse can determine what care a person requires, he or she must determine the client's needs and problems. This requires the use of assessment skills and data collection, which include interviewing, observing, and examining the client. Changing unhealthy environmental factors and facilitating self-care are the focus of other theories, such as Florence Nightingale's focus on the client's environment and Dorothea Orem's Self-Care theory.
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 Explanation: Developmental theory is concerned with growth and development across the lifespan and would provide a foundation for assessment and care of this child. None of the other theories listed is concerned with the maturation of the child.
Which theory emphasizes the relationships between the whole and the parts, and describes how parts function and behave?
General systems theory Explanation: General systems theory describes how to break whole things into parts and then learn how the parts work together in "systems." Nursing theory attempts to describe, explain, predict, and control desired outcomes of nursing care practices. Adaptation theory defines adaptation as the adjustment of living matter to other living things and to environmental conditions. Developmental theory outlines the process of growth and development of humans as orderly and predictable.
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 Explanation: General systems theory is an example of an interdisciplinary base for a nursing theory. This theory describes how to break whole things into parts and then to learn how the parts work together in "systems." It emphasizes relationships between the whole and the parts and describes how parts function and behave. Another example of an interdisciplinary base for nursing theory is the adaptation theory. Adaptation theory defines adaptation as the adjustment of living matter to other living things and to environmental conditions. A third interdisciplinary base for nursing theory is developmental theory. Developmental theory outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death. Erikson's theory of psychosocial development is one type of developmental theory.
What was the focus of nursing research during the first half of the twentieth century,?
Nursing education Explanation: Between 1900 and 1940, research in nursing centered on education, methods of teaching, and methods of evaluating how nurses learned. During and after World War II, research interest turned to supply and demand for nurses, as the need for nurses to serve in both the military and civilian sectors increased. Client care and treatment issues are common areas of interest in current nursing research.
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 Explanation: The nurse is engaged in a review of the scientific literature to find out what is already known about the subject and to prevent duplication of effort if the subject is already well studied. Identifying the problem area is completed first. This then guides the literature review. From there the nurse identifies the theoretical framework as a guide to identify and study systematically the logical relationships between variables. The problem statement identifies the direction the project will take.
Which statement best explains the importance of theoretic frameworks?
Theoretic frameworks advance nursing knowledge and practice. Explanation: Theoretic frameworks are important to the advancement of nursing knowledge and professional practice. The other statements describe that theoretic frameworks guide specific types of nursing care, of which these are only two examples. Research is known to take many years to impact clinical practice, so the possibility of advancing the ethical aspects of nursing practice would be a very long term goal without a guarantee.
A conceptual framework is defined as:
a set of concepts and propositions. Explanation: A conceptual framework or model is defined as a set of concepts and the propositions that integrate them into a meaningful configuration. A conceptual framework is not an explanation of nursing and nursing practice, a set of phenomena and related abstractions, or a foundation for nursing skills and care.
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. Explanation: According to Dorothea Orem's theory, the role of the nurse is to facilitate self-care to sustain life and health, to recover from disease or injury, or to cope with its effects. Arranging an evaluation appointment with a dietitian facilitates self-care because the nurse is providing a service that assists the client and spouse to progressively maximize their self-care potential. People learn behaviors that they perform on their own behalf to maintain life, health, and well-being. The other options are providing care for the client, not facilitating self-care.
A nurse subscribes to the Basic Needs theory. Which action by the nurse exemplifies this theory?
Assisting the client to the bedside commode Explanation: The Basic Needs theory subscribes to the concept that a nurse assists in performing activities that the client would perform if the client could. Therefore, assisting the client to the bedside commode is an example of an action that supports the Basic Needs theory. The other actions do not support this theory.
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 Explanation: The "O" of PICO indicates the outcome, which in this instance is "decrease infection rates." The "P" refers to patients, who in this case have intravenous catheters; "I" refers intervention, which in this case is replacing the administration set every 72 hours; "C" refers to comparison or control group, which in this case is those who have the administration set replaced at other frequencies.
The nurse is reading about nursing theorists for a class. The theory reveals the following, "Individuals who use self-care to sustain life and health, to recover from disease or injury, or to cope with its effects." Which individual developed this theory?
Dorothea Orem Explanation: Dorothea Orem wrote the Self-care theory, referring to individuals using self-care to sustain life and health, recover from disease or injury, or cope with its effects. Sister Callista Roy, Virginia Henderson, and Florence Nightingale wrote other theories.
Which is a focus of medical research rather than nursing research?
Drug metabolism Explanation: Drug metabolism is an example of a focus of medical research. Nursing research is defined as a systematic inquiry into the problems encountered in nursing practice and into the modalities of client care such as health appraisal, prevention of trauma, promotion of recovery, and coordination of health care (Gortner, 1975).
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. Explanation: Erik Erikson based his theory of psychosocial development on the process of socialization, emphasizing how individuals learn to interact with the world. Erikson recognized the role of social, biologic, and environmental factors in development, and defined specific tasks or conflicts that people accomplish or overcome during what he defined as the eight stages of life, based on chronologic age. Abraham Maslow developed his theory of human needs in terms of physical and psychosocial needs considered essential to human life, rather than by chronologic age as Erikson did. Maslow defined five levels of need in a hierarchy, with different needs existing simultaneously. Jean Watson is a nursing theorist who is known for her focus on caring. The central theme of her work is that nursing is concerned with promoting and restoring health, preventing illness, and caring for the sick. Caring is universal and is practiced through interpersonal relationships. Martha Rogers is a nursing theorist who is known for her theory of the individual client being central to the discipline of nursing. Nursing interventions are directed toward repatterning human environment fields or assisting in mobilizing inner resources.
When looking at a model for evidence-based practice, what is the final step of the process?
Evaluating practice change Explanation: The fifth and final step in the process of implementing evidence-based practice is to evaluate and critically appraise the change in practice. Formulating a clinical question and searching and appraising the literature precede this step.
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 Explanation: Experimental research examines the cause-and-effect relationships between variables under highly controlled conditions. Experimental research studies often occur in a laboratory setting. Descriptive research explores and describes events in a real-life situation to identify relationships between, and among, events. Correlational research examines the type and degree of relationships between two or more variables. Quasi-experimental research examines the cause-and-effect relationships between selected variables and is typically situated outside of a laboratory setting.
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 Explanation: The nurse would most likely contact the National Institute of Nursing Research (NINR), which was established under the National Institutes of Health in response to a 1983 study by the Institute of Medicine. The institute's purpose was to place nursing securely in the sphere of scientific investigation and to support research and training in client care, health promotion, and disease prevention, as well as the mitigation of effects of acute and chronic disabilities. The NINR has continued to fund and support nursing research and is instrumental in the support and dissemination of seminal work in nursing. The ANA Cabinet on Nursing Research was responsible for establishing priorities for nursing research.
Which activity systematically inquires about the problems encountered in nursing practice and into the modalities of client care?
Nursing research Explanation: Nursing research is defined as a systematic inquiry into the problems encountered in nursing practice and into the modalities of client care, such as support and comfort, prevention of trauma, promotion of recovery, health education, health appraisal, and coordination of health care. Managed care is an overarching aspect of nursing practice not directly involved with nursing practice or modalities of client care. Outcome criteria are a component of the nursing process which incorporates scientific inquiry into its structure.
Which is most similar to a nursing model?
Nursing theory Explanation: The nursing model or theory acts as a guide to identify and study systematically the logical relationships between variables, thus supporting nursing care. Nursing models and nursing theories are largely synonymous. This is not the case with constructs or propositions. Adaptations are not similar to nursing models.
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. Explanation: A systematic review suggests that the nurse has reviewed multiple studies regarding a particular nursing practice question or topic. Asking the question about a clinical practice would come in the first step. A recommendation for best practice comes after synthesizing all of the data collected by the systematic review. Meta-analysis is concerned with doing a statistical analysis across studies.
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?
The abstract is located at the beginning of the article. It summarizes the entire article and usually provides the purpose of the study; a description of the subjects, data collection, and data analysis; and a summary of important findings. The review of literature discusses relevant studies that have been conducted in the area of this study, and it is included in the introduction. The results are the findings of the study and are often presented both in words and charts, tables, or graphs. The conclusions are the discussions of the results and suggestions for further study.
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. Explanation: Using the PICO format, "P" refers to the population, which in this case is adults. "I" refers to the intervention, which is reducing salt intake. "C" refers to comparison, which is no change in salt intake. "O" refers to the outcome, which would be lower blood pressure.
When the nurse researcher informs the participant that the participant's identity will not be linked with the information that is collected, the researcher is ensuring the participant's:
confidentiality. Explanation: Confidentiality ensures that the participants' identities will not be linked with the information they provide and will not be publicly divulged. An informed consent in necessary to advise potential participants of possible harm associated with their participation in the research. Not linking the participant's identity to the data collected does not ensure the participant's anonymity (the researcher knows the participant's identity). Informed consent prior to the begin of research is the mechanism that grants the participant the right to withdraw at any time.
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." Explanation: A clinical trial often consists of two groups, one that receives the treatment and the other that receives a placebo. People who receive the placebo receive the exact same care as people who are receiving the treatment. Neither the research nurse nor the subject knows who gets the treatment or the placebo. People receiving the placebo do not receive extra compensation, nor are they entitled to more tests than the other group. Treatment and placebo groups are generally equal in number.
What type of research study would a hospital conduct to explore clients' and families' perceptions of receiving care?
Qualitative Explanation: Qualitative research is designed to seek the perceptions that the clients' and families' perceptions of receiving their care that the hospital desires. Quantitative researchers tend to use deductive reasoning, logic, and measurable attributes of human experience, whereas qualitative researchers tend to use dynamic, individual aspects of the human experience in a holistic approach. Ordinal and interval refer to types of variables associated with quantitative research analysis. Qualitative research is considered to be scientific even though it is not experimental.