NSG 301 - Exam 2

Question 9 The nursing faculty is revising their program's curriculum and is developing a conceptual model. What will this faculty develop? 1. A graphic illustration of a conceptual framework. 2. An overall view or orientation to focus thoughts. 3. A system of ideas proposed to explain a given phenomenon. 4. A specific outline of the curriculum's topics and contents.

Correct Answer: 1 Rationale: A conceptual model is a graphic illustration of the program's conceptual framework. A conceptual framework is a group of related concepts that provides an overall view or orientation to focus thoughts. A theory is a system of ideas proposed to explain a given phenomenon. Theories also relate concepts by using definitions that state the concepts' significant relationships. A specific outline of curriculum topics and contents is a topic outline.

Question 16 The psychiatric nurse's practice is based on Peplau's Interpersonal Relations Model. The nurse has developed a relationship with a client in which the client has assumed the power. How would Peplau identify this phase of the relationship? 1. Orientation 2. Identification 3. Exploitation 4. Resolution

orrect Answer: 3 Rationale: Peplau's model identifies the four phases listed as options. Exploitation occurs when the client derives full value from what the nurse offers and the power in the relationship shifts from the nurse to the client. In orientation the client seeks help, and the nurse assists the client in understanding the problem and the extent of the need for help. During the identification phase, the client assumes a posture of dependence, interdependence, or independence in relation to the nurse. The nurse's focus is to assure the person that the nurse understands the interpersonal meaning of the client's situation. Resolution is the final phase in which old needs and goals are put aside and new ones adopted.

Question 22 Which organization has the support of learning, knowledge, and professional development of nurses committed to make a difference in health worldwide as its mission? 1. National League for Nursing 2. State boards of nursing 3. Joint Commission 4. Sigma Theta Tau International

Correct Answer: 4 Rationale: Sigma Theta Tau International is the honor society for nursing, and its mission is to support learning, knowledge, and professional development of nurses committed to make a difference in health worldwide. The other organizations support this learning, but do not have it as a central mission

Question 5 What is the final focus for nursing research? 1. Making a difference that matters for improving client care 2. Contributing to developing theory 3. Contributing to the body of scientific knowledge regarding nursing 4. Describing situations about which little is known

Correct Answer: 1 Rationale: Although all of these options are correct about the importance of research to nursing, the final focus is always making a difference that matters for improving client care.

Question 1 When assessing community needs, where should the nurse be aware that domestic violence is found? 1. All strata of society 2. Exclusively among the less well-educated segment of the population 3. Primarily in lower-income families 4. Mostly in the elderly

Correct Answer: 1 Rationale: Domestic violence crosses all racial, ethnic, socioeconomic, and educational boundaries, and is not confined to any gender or age group.

Question 11 The nurse is planning a research study to test a theory. Which approach is generally best for this endeavor? 1. Deductive using quantitative research methods. 2. Inductive using quantitative research methods. 3. Deductive using qualitative research methods. 4. Inductive using qualitative research methods.

Correct Answer: 1 Rationale: Generally speaking, theory testing uses a deductive approach and applies quantitative research methods. Theory generation uses an inductive approach and is the result of qualitative research. Inductive approach using quantitative research methods and deductive approach using qualitative research methods are not as commonly used in theory testing.

Question 13 According to Carper, which way of knowing reflects the science of nursing? 1. Empirical knowing 2. Personal knowing 3. Esthetic knowing 4. Ethical knowing

Correct Answer: 1 Rationale: In Carper's framework, empirical knowing represents the science of nursing that emphasizes generation of theory that is systematic and controlled by factual evidence. Esthetic knowing represents the art of nursing. Personal knowing focuses on interpersonal processes and the therapeutic use of self. Ethical knowing represents a pattern of knowing related to what ought to be done and focuses on matters of obligation.

Question 25 The nurse's practice is based upon the theory of Jean Watson. What is the primary theme of this theory? 1. Caring 2. Cultural care 3. Goal attainment 4. Environment

Correct Answer: 1 Rationale: Jean Watson's theory is the theory of human caring. Leininger's theory concerns transcultural nursing. King's theory is the goal-attainment theory. Nightingale's theory concerns the environment.

Question 8 An emergency room nurse is caring for a repeated domestic violence victim/client who refuses to leave the abuser. What should the nurse understand as a common reason why victims refuse to leave an abusive relationship? 1. They are economically dependent. 2. They are uneducated. 3. They subconsciously enjoy the abuse. 4. They have a high degree of self-respect.

Correct Answer: 1 Rationale: Many women are financially dependent on their abusive partners; if they have outside employment, they are unlikely to make as much as their male counterparts. Also, when children are involved, the mother may need child support but that is routinely not honored by the abuser. The other options do not apply.

Question 2 Why is research important in nursing? 1. Nurses are expected to adopt evidence-based practice into their decision making. 2. Outcomes are more important than process. 3. The nurses' prime consideration should be cost-effectiveness. 4. It uses the scientific approach.

Correct Answer: 1 Rationale: Nurses are expected to be knowledgeable about research in the field and to use evidence-based findings in their decision making. Outcomes are never more important than the process in health care; the ends do not justify the means. Although cost-effectiveness is important, patient well-being is the nurse's prime consideration. Although research does use the scientific approach, that alone does not justify it as being important to nursing.

Question 22 The nurse reviewing medical records finds that nurses working in a particular hospital state nursing diagnosis in terms of the client's limitations to maintaining self-care. The record reviewer determines that this nursing service follows which theorist? 1. Orem 2. Roy 3. Benner 4. Leininger

Correct Answer: 1 Rationale: Orem's work is the self-care deficit theory of nursing. Roy's work is the Adaptation Model. Benner's work focuses on the development of a nurse from novice to expert. Leininger's work focuses on cultural aspects of care.

Question 11 Which option reflects a quantitative research design? 1. The researcher has created a design that includes control of extraneous variables. 2. The researcher plans to investigate and explain the research question through narrative data. 3. To collect data, the researcher will conduct a series of unstructured interviews with the study participants. 4. The research is designed to explore the way the study participants feel about their experiences with the research topic.

Correct Answer: 1 Rationale: Quantitative research uses precise measurement for data collection and analyzes numerical data. The design is rigorously controlled. The remaining options are reflective of qualitative approach to research.

Question 3 Sibling violence is a form of family violence. Which is correct about sibling violence? 1. It is often unrecognized. 2. It occurs less in the early years and increases with age of the child. 3. Girls are more violent toward their siblings than are boys. 4. Sibling violence leads to less aggressive behavior problems with non-related peers.

Correct Answer: 1 Rationale: Sibling violence is often unrecognized. Many parents assume that it is natural, and even appropriate, for children to use physical force with one another. This leads to underreporting and may lead to future abuser tendencies. Sibling violence is highest in the early years and decreases with age. In all age groups, girls are less violent toward their siblings than are boys. Childhood abuse may have far-reaching consequences for the victim's health. Empirical data link child maltreatment and exposure to domestic violence with numerous outcomes, including aggression and violent behavior problems with peers, delinquency, depression, delayed cognitive functioning, poor academic performance, and symptoms of PTSD.

Question 14 Which level of literature should be the focus of the literature review? 1. Primary 2. Secondary 3. Tertiary 4. Raw data

Correct Answer: 1 Rationale: The literature review should focus on primary literature or publications authored by the person who conducted the research. A secondary source is a description of a study or studies prepared by someone other than the person who conducted the research. Tertiary is not a level of source discussed in the textbook. Raw data are not a part of the literature review.

Question 8 The nursing faculty is revising their program's curriculum and plan to use a specific theory as a basis of their work. What is a theory? 1. A document that relates concepts by defining their significance to one another. 2. An overall view or orientation to focus thoughts. 3. A graphic illustration of a conceptual framework. 4. A specific outline of the curriculum's topics and contents.

Correct Answer: 1 Rationale: Theories relate concepts by using definitions that state significant relationships between concepts. A conceptual framework is a group of related concepts that provides an overall view or orientation to focus thoughts. A graphic illustration of a conceptual framework is a conceptual model. A specific outline of curriculum topics and contents is a topic outline.

Question 8 The physician leading a research study asks a client to participate and infers that unless the client agrees the physician will no longer provide medical care for the client. What client right is violated in this situation? 1. Right of self-determination 2. Right to full disclosure 3. Right not to be harmed 4. Right of privacy and confidentiality

Correct Answer: 1 Rationale: This proposal violates the client's right of self-determination. Right of self-determination means that subjects should feel free from constraints, coercion, or any undue influence to participate in a study. Right to full disclosure means that deception, either by withholding information about a client's participation in a study or by giving the client false or misleading information about what participating in the study will involve, violates ethical principles. Right of privacy and confidentiality is a basic right that allows the client to participate in a study without worrying about later embarrassment or disclosure of personal information. Right not to be harmed is the right to be free of exposure to the possibility of injury going beyond everyday situations. Risks can be physical, emotional, legal, financial, or social.

Question 5 Why has nursing theory not been formally integrated into everyday nursing practice? (Select all that apply.) 1. Historically, nursing education was accomplished following an apprenticeship model. 2. Nursing theories were developed by nurses in graduate school at a time when advanced education in nursing was uncommon. 3. The theoretical basis of nursing was developed centuries ago and does not apply to current nursing practice. 4. There is little evidence that nursing theories are applicable in today's nursing practice. 5. Insufficient numbers of nursing theories exist to guide nursing practice.

Correct Answer: 1, 2 Rationale: The gap between nurse theorists and practicing nurses can be attributed in part to the development of nursing theories in the 1960s by nurses who were pursuing graduate degrees in nursing and related fields. Few other nurses knew or cared about such matters. Until the 1950s nursing practice was based on principles and traditions passed on through an apprenticeship form of education. Nursing theories are current and do apply to today's nursing practice. Although there is room for the development of new nursing theories, sufficient numbers exist to guide practice.

Question 14 What must be done when assessing an injured patient? (Select all that apply.) 1. Ensure privacy 2. Be alert for signs of abuse 3. Provide safety 4. Assert personal values 5. Display a nonjudgmental demeanor

Correct Answer: 1, 2, 3, 5 Rationale: Ensuring victim privacy and safety is paramount for the nurse in order to develop a trusting nurse-client relationship. Only then will a victim feel safe from the perpetrator and allow him or herself to view family violence reality in an objective manner. The nurse should convey a nonjudgmental manner; in other words, the nurse should avoid blaming the victim or the abuser or looking for pathological elements in anyone's behavior. Being nonjudgmental will aid in building a positive interaction with the patient. During the physical assessment the nurse should be alert for signs of abuse and document the findings. Personal values are inappropriate during any assessment

Question 17 What should the nurse do when caring for a victim of abuse? (Select all that apply.) 1. Ensure the client's safety 2. Support the client 3. Empower the client to take control 4. Avoid the team approach when assessing the patient 5. Provide information regarding available services for the patient

Correct Answer: 1, 2, 3, 5 Rationale: Intervention is very important to remove a victim from a violent environment. Once a trusting nurse-client relationship is established, the victim can feel safe and supported and take responsibility to take the necessary steps to remove him or herself from a violent situation. Since the nurse may be the only person the patient has contact with the nurse should provide information regarding available services for the patient. If the nursing assessment reveals abuse, a team assessment should take place to assess both the physical and emotional status of the patient.

Question 13 A literature review before conducting research serves which purpose? (Select all that apply.) 1. It can establish the body of knowledge related to the research problem. 2. It can identify gaps in the literature. 3. It may provide an answer to the question posed. 4. It prevents the researcher from being charged with plagiarism. 5. It may change the problem focus, based upon previous findings.

Correct Answer: 1, 2, 3, 5 Rationale: The literature review identifies other studies related to the topic. It may provide an answer to the problem, eliminate the need for further research, or identify gaps in current research. It may change the focus of the research and establishes the body of remembering related to the research problem. Literature review does not prevent the researcher from being charged with plagiarism

Question 11 For what non-accidental injuries in children should nurses assess when looking for signs of physical abuse? (Select all that apply.) 1. Fractures and bruises 2. Spinal injuries 3. Burns 4. Near drowning 5. Head injuries

Correct Answer: 1, 2, 3, 5 Rationale: The most common types of physical abuse are burns, bruises, fractures, abdominal injuries, and head or spinal injuries. The location and pattern of these injuries help to determine the likelihood of abuse. Near drowning is an accidental injury and has not been identified as one of the most common types of physical abuse of children.

Question 24 How is nursing research related to nursing conceptual models? 1. There is little relationship; researchers choose subjects based on need or interest. 2. These models drive nursing research and provide a way to organize findings. 3. Nursing research has proved that most conceptual models are false. 4. Nursing research can be undertaken only if it is tied to a conceptual model.

Correct Answer: 2 Rationale: Conceptual models can drive nursing research, and nursing research can help to develop and prove new theories. Nursing research can be undertaken without a current model in hopes of generating new theories and models. There is no evidence that nursing research has proven that most conceptual models are false.

Question 10 As a school nurse evaluating a child after a fight, it is imperative to understand that violent acts committed at school are often associated with which characteristics? (Select all that apply.) 1. Social ostracism 2. Physical bullying 3. Close peer relationships 4. Bullying 5. More at high schools than middle schools

Correct Answer: 1, 2, 4 Rationale: Children and youth may use aggression to protect their social position and to meet their social needs. School violence has been studied in terms of direct physical bullying, relational or social bullying, and sexual harassment. Physical bullying can take the form of hitting, kicking, and taking the possessions of another. Relational or social bullying targets social relationships to hurt another person; this can include spreading rumors and threatening social ostracism. Ostracism is the psychological weapon that the school abuser uses to alienate a victim from friends. School violence is youth violence that happens on school property and on the way to or from or during school and school-sponsored events. School violence is a subset of youth violence and typically includes those between the ages of 10 and 24 years, although it can begin much earlier.

Question 23 At the site of a mass disaster the nurse is preparing to provide psychiatric first aid. In which order should the nurse provide these actions? 1. Protect from harm 2. Reduce stimulation 3. Keep families together 4. Provide information and education 5. Provide support to those most distressed 6. Use risk communication techniques if required

Correct Answer: 1, 2, 5, 3, 4, 6 Rationale: Psychiatric first aid (PFA) includes the following elements: 1. Protect survivors from further harm; 2. Reduce physiological arousal; 3. Mobilize support for those who are most distressed; 4. Keep families together and facilitate reunions with loved ones; 5. Provide information, foster communication and education; and 6. Use effective risk communication techniques.

Question 5 A nurse discovers that a person is being abused. What should the nurse do to prevent the abuse from continuing? (Select all that apply.) 1. Appropriate assessment 2. Verbalize to the victim that he or she is a good person and the abuser is the bad person 3. Documentation 4. Intervention 5. Know the laws associated with reporting abuse

Correct Answer: 1, 3, 4, 5 Rationale: Often the nurse is the first one outside a person's family to discover that the person is being abused. A nurse can identify abuse through appropriate assessment and protect the abused through intervention and properly documenting the abuse. Nurses should know the laws associated with reporting abuse. The nurse should also avoid making negative comments about the abuser and to follow established protocols for mandatory reporting, documentation, and use of available support services (e.g., the police department, social service agencies, and child welfare agency).

Question 16 What must the nurse consider when critiquing research? (Select all that apply.) 1. The appropriateness of the design 2. The overall cost of the study 3. The ethical dimensions of the study 4. The significance of the problem 5. The generalizability of the findings

Correct Answer: 1, 3, 4, 5 Rationale: The nurse must consider the significance of the research problem and the appropriateness of the study to the problem, and should also determine whether the rights of human subjects were protected during the study. The nurse should consider whether the findings from the study are generalizable or are limited to a specific study group. The nurse must also consider the presentation of the research. The overall cost of the study is not significant.

Question 1 What are the purposes of scientific research? (Select all that apply.) 1. Description 2. Review 3. Exploration 4. Explanation 5. Prediction

Correct Answer: 1, 3, 4, 5 Rationale: The purposes of scientific research are description, exploration, explanation, and prediction and control. Review is not one of these purposes as listed in the text.

Question 7 The nursing faculty is revising their program's curriculum and is developing a conceptual framework. What will this faculty develop? 1. A document that relates concepts by defining their significance to one another. 2. An overall view or orientation to focus thoughts. 3. A system of ideas proposed to explain a given phenomenon. 4. A specific outline of the curriculum's topics and contents.

Correct Answer: 2 Rationale: A conceptual framework is a group of related concepts that provides an overall view or orientation to focus thoughts. A theory is a system of ideas proposed to explain a given phenomenon. Theories also relate concepts by using definitions that state the concepts' significant relationships. A specific outline of curriculum topics and contents is a topic outline.

Question 17 The nurse has read about a clinical innovation that is evidence-based. The nurse is developing a positive attitude about the use of this innovation. Which stage of Rogers' theory of diffusion of innovation does this reflect? 1. Knowledge 2. Persuasion 3. Decision 4. Implementation

Correct Answer: 2 Rationale: According to Rogers' theory, the knowledge stage is when a nurse learns about an innovation, the persuasion stage is when the nurse develops a positive or negative attitude about the innovation, the decision stage is when the nurse determines whether to adopt or reject the innovation, and the implementation stage is when the nurse uses the innovation regularly

Question 15 Why do most nursing theories reflect such strong influence from other disciplines such as sociology? 1. Those disciplines are more professional than nursing. 2. The theorists who developed nursing theories were often doing graduate work in those disciplines, not nursing. 3. Nursing theories were developed by non-nurses. 4. Nursing is not an independent entity, but a spin-off from other disciplines such as sociology and psychology.

Correct Answer: 2 Rationale: At the time that many nursing theories were developed, advanced education in nursing did not exist, so nurses were doing graduate work in related fields such as sociology and psychology. It does not mean that those disciplines are more professional than nursing or that nursing is not an independent entity. These theories were developed by nurses.

Question 16 A charge nurse does not like working with new graduates and always assigns them the most complicated patients. What does this exemplify? 1. An appropriate work assignment 2. Bullying 3. Professional development 4. Transactional leadership

Correct Answer: 2 Rationale: Bullying is seen as intimidating or malicious behavior associated with abuse of power. In this scenario, there is bullying on the part of the charge nurse who makes the work assignments and gives the new graduates all the difficult patients. This work assignment is not appropriate; the charge nurse is abusing her power, and this behavior leads to nurses leaving the profession. Professional development refers to skills and knowledge obtained for professional advancement or promotion. Transactional leadership is a leadership approach that utilizes rewards and discipline to motivate employees.

The nurse wants to develop an evidence-based practice. What must this nurse do first? 1. Get permission from his or her employer. 2. Learn to critically appraise research reports. 3. Contact a consultant to help him or her learn about EBP. 4. Methodically categorize research findings in the nurse's specialty area.

Correct Answer: 2 Rationale: In order to develop an evidence-based practice, the nurse first needs to learn how to critically appraise research reports. Although the nurse might want to discuss improving practice with all of his or her peers, there is no need to get special permission to improve one's practice. Contracting with a consultant is not necessary as there are many resources available to help the nurse learn about EBP. There is no need to methodically categorize research findings.

Question 19 A nurse assesses a client and strongly suspects child abuse. What should the nurse do next? 1. Ask the child to speak to the police. 2. Report the finding to child protection authorities. 3. Provide necessary immediate care and arrange for follow-up care of the injured. 4. Tell the parents that the nurse suspects abuse.

Correct Answer: 2 Rationale: Laws mandate the reporting of suspected child abuse to child-protection authorities for follow-up. Nurses should not inject themselves into the situation, but rather make an accurate assessment and intervene through proper reporting.

Question 4 Which is true about who perpetrates most intimate partner abuse against whom? 1. By men against other men 2. By men against women 3. By caregivers against elders 4. By adults against children

Correct Answer: 2 Rationale: Most intimate partner abuse is perpetrated by men against women; however, abuse is also perpetrated by women against men and partners of the same gender. Elder abuse by caregivers and child abuse are not instances of intimate partner abuse.

Question 18 The nursing school's curriculum is based on Orem's self-care deficit theory of nursing. How would this curriculum describe nursing interventions designed for individuals who are unable to perform some (but not all) self-care activities? 1. Wholly compensatory 2. Partly compensatory 3. Supportive 4. Educative

Correct Answer: 2 Rationale: Orem postulates that nursing systems form when nurses prescribe design, and provide nursing that regulates the individual's self-care capabilities and meets therapeutic self-care requirements. She identifies three types of nursing systems: (1) wholly compensatory in which the client is unable to control and monitor their environment and process information; (2) partly compensatory designed for individuals who are unable to perform some (but not all) self-care activities; and (3) supportive-educative designed for persons who need to learn to perform self-care measures and need assistance to do so.

Question 12 Which option is characteristic of qualitative research? 1. It uses experimental methods. 2. It explores the subjective experience of human beings. 3. It uses precise measurement for data collection. 4. It analyzes numerical data.

Correct Answer: 2 Rationale: Qualitative research investigates phenomena through narrative data that describe the phenomena in an in-depth and holistic fashion. It is the approach used to explore the subjective experience of human beings. The remaining options are reflective of the quantitative approach to research.

Question 3 The nurse is interested in implementing evidence-based care in practice and is conducting a search for pertinent research studies. Which type of research is most likely to produce best evidence? 1. Literature review of the topic 2. Randomized clinical trial 3. Research that explains phenomena 4. Descriptive research

Correct Answer: 2 Rationale: Randomized clinical trials are typically the gold standard for producing the best evidence. Literature reviews and descriptive research may provide ideas for the nurse to consider when looking for evidence-based topics. Research that explains phenomena is interesting, but less likely to produce best evidence practices

Question 9 The researcher proposes using information from the medical records of clients currently admitted to the nursing unit. The researcher wishes not to tell these clients about the study so that their behavior does not change. What client right does this idea most clearly violate? 1. Right of self-determination 2. Right to full disclosure 3. Right not to be harmed 4. Right of privacy and confidentiality

Correct Answer: 2 Rationale: Right to full disclosure means that deception, either by withholding information about a client's participation in a study or by giving the client false or misleading information about what participating in the study will involve, violates ethical principles. Not telling the client that information is being used violates this right. Right of self-determination holds that the client should be free from coercion; right not to be harmed is the right to be free of exposure to possibility of injury; and right of privacy and confidentiality holds that the client has the right to participate in the study without private information being disclosed. Although these rights might be violated by this researcher's plan, they are not as clearly violated as right to full disclosure.

Question 21 A hospital's nursing assessment form reflects first-level and second-level assessment. From this information, the nurse seeking employment at this facility determines that nursing service follows which theorist? 1. Orem 2. Roy 3. Benner 4. Leininger

Correct Answer: 2 Rationale: Roy's Adaptation Model states that assessment involves two levels. First-level assessment includes collecting data about output behaviors related to the four adaptive modes. Second-level assessment includes collecting data about internal and external stimuli that are influencing the identified behaviors. The other theories and models listed do not direct that assessment involves two levels.

Question 12 What assessment finding indicates that a client is a victim of shaken baby syndrome? 1. Fractures of the long bones 2. Retinal hemorrhages 3. Abrasions 4. Burns

Correct Answer: 2 Rationale: Subdural and retinal hemorrhages accompanied by the absence of external signs of trauma are hallmarks of shaken baby syndrome.

Question18 The nursing group is considering making changes to a policy based upon the evidence found in a recent nursing research publication. What is the most important consideration for this group? 1. Does anyone in the group have previous knowledge of the researcher? 2. What is the scientific merit of the information? 3. Is the study original research? 4. How easy will it be to implement the changes?

Correct Answer: 2 Rationale: The criteria for utilization of research in nursing practice are replication, scientific merit, risk, clinical merit, clinical control, feasibility, cost, and potential for clinical evaluation. Whether anyone in the group has previous knowledge of the researcher, whether the research is original, and the ease of implementation of the changes are less important than the scientific merit of the study.

Question 1 The nurse's research is directed toward testing a specific hypothesis deduced from a theory. Which research approach does this work represent? 1. Dynamicism 2. Positivist 3. Constructivist 4. Naturalistic

Correct Answer: 2 Rationale: The positivist approach deals with natural law and assumes that there is a body of facts and principles to be discovered and understood that is independent of the context. In this approach, hypotheses are deduced from the theory to be tested in research. The dynamic approach is also referred to as constructivist. In this approach theories are inductively constructed and give insights into social contexts and personal meanings. This approach uses naturalistic settings and observational methods.

Question 2 A home health nurse visits a 78-year-old man in his home. The man is ambulatory and shows no physical distress; however, his clothing appears soiled and smells of urine. What do these findings indicate? 1. Institutional abuse 2. Self-neglect 3. Domestic abuse 4. Emotional abuse

Correct Answer: 2 Rationale: The three categories of elder abuse are domestic elder abuse, institutional elder abuse, and self-neglect. Self-neglect is characterized as the behavior of the elderly person that threatens health and safety; it is usually a failure to provide sufficiently for him or herself. Institutional abuse refers to abuse occurring in residential facilities such as nursing homes. Domestic abuse refers to any of several forms of maltreatment of an older person by someone who has a special relationship with the elder. Emotional or psychological abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts.

Question 7 The nurse interacting with a couple and suspecting domestic abuse should look for what traits commonly found among abusive individuals? 1. Career and goal directed 2. Over-possessiveness and jealousy 3. Economically independent 4. Passivity and withdrawal

Correct Answer: 2 Rationale: There are many traits of an abuser, but over-possessiveness and excessive jealousy are key determinants. Control and the need to dominate are also seen significantly within the abuser population, as is dependence on an elder for financial support and accommodation. Being career and goal directed have not been identified as typical characteristics of abusive individuals.

Question 4 Which strategy would be most useful in integrating nursing theory and nursing practice? 1. Link nursing theories to medical theories. 2. Present theories in a compelling, practice-focused manner. 3. Define theories in terms of advanced nursing education. 4. Require each nurse to identify a personal nursing theorist.

Correct Answer: 2 Rationale: There is a gap between nursing theory and practice. This gap must be bridged to achieve theory-based practice. Nursing theories must be seen as supporting and guiding practice, and must be communicated in ways that are compelling to nurses who must apply them in a clinical setting. Nursing theories do not have to be linked to medical theories and doing so may decrease their usefulness in nursing. A part of the gap between theory and practice is based upon the disconnect between academia and practice, so it would not be helpful to define theories in terms of advanced nursing education. Requiring each nurse to identify a personal nursing theorist is not a practical solution.

Question 15 As a nurse assessing abused children, the abused child may display which behavioral characteristics? (Select all that apply.) 1. High need for adult contact 2. Attempt suicide or abuse alcohol or drugs 3. Consistently be measured in the 95th percentile on growth charts 4. Verbalize fault for injuries: "I deserved it" 5. Express violence toward pets

Correct Answer: 2, 4, 5 Rationale: Abused children can display a myriad of behavioral characteristics. Many of the characteristics involve shame, a lack of self esteem, and violence or anger problems. These feelings can manifest themselves in suicide, abusive behavior such as drugs or alcohol, or blaming themselves for the abusive situation. Children may present with fear of a parent or be wary of physical contact with an adult. The child may also manifest developmental delay and failure to thrive.

Question 20 A person comes into the emergency department with injuries consistent with abuse. In which order should the nurse complete the assessment of this person's injuries? 1. Paresthesia 2. Facial bruising 3. Limited joint mobility 4. Abdominal tenderness 5. Skin tenderness and scars

Correct Answer: 2, 5, 3, 4, 1 Rationale: Victims of physical abuse may suffer a variety of injuries. During a head-to-toe assessment, the nurse may observe for indications of abuse, such as the following: Head; evidence of trauma from blows to the head, such as hematoma or facial bruises. Skin; swelling, tenderness or scars. Musculoskeletal system; fractures or evidence of previous fractures, particularly of the face, arms/legs, and ribs, or dislocated joints, especially in the shoulder when the victim is grabbed or pulled by the arm. Abdomen; intra-abdominal injuries. Neurological system; paresthesia.

Question 26 The nursing instructor is preparing information to present to students on the development of nursing knowledge. In which order should the instructor review this information? 1. Theory 2. Concept 3. Paradigm 4. Conceptual model 5. Conceptual framework

Correct Answer: 2, 5, 4, 1, 3 Rationale: Concepts, the building blocks of theory, are abstract ideas or mental images of phenomena. Concepts are words that bring forth mental pictures of the properties and meanings of objects, events, or things. A conceptual framework is a group of related concepts. It provides an overall view or orientation to focus thoughts. A conceptual model, a term often used interchangeably with conceptual framework, is a graphic illustration or diagram of a conceptual framework. A theory is a supposition or system of ideas that is proposed to explain a given phenomenon. A theory goes one step beyond a conceptual framework; a theory relates concepts by using definitions that state significant relationships between concepts. Theories are not discovered; individuals who think and see the world in different ways create them. These worldviews provide contrasting paradigms (structures for organizing theory) and provide different traditions in and approaches to science and knowledge development.

Question 19 Which statement best reflects the essence of Madeleine Leininger's work? 1. Caring and curing cannot exist independently of each other. 2. Persons of all cultures tend to expect similar interventions from nursing care providers. 3. Both differences and commonalities exist in the ways cultures practice caring. 4. Western cultures practice caring at a superior level to that practiced in non-Western cultures.

Correct Answer: 3 Rationale: Central to Leininger's work is the belief that cultures have differences in their ways of perceiving, knowing, and practicing care, but that there are also commonalities about care among cultures. She says there can be no cure without caring, but that there may be caring without curing. She emphasizes that human caring, although a universal phenomenon, varies among cultures in its expressions, processes, and patterns; it is largely culturally derived. She does not believe one culture is superior to any other.

Question 4 In the 1970s there was a focus on translating research findings into practice. What term was used to describe this focus? 1. Evidence-based practice 2. Randomized clinical trials 3. Research utilization 4. Scientific evidence

Correct Answer: 3 Rationale: During the 1970s, research utilization became a buzzword and a focus for translating research findings into practice. It was not until much later when that effort began to be called evidence-based practice. Randomized clinical trials are a way to develop EBP. Scientific evidence is the result of scientific research

Question 9 What is the result of exposure to violence in the community? 1. Inevitable depression 2. Not a problem outside the poor neighborhoods 3. Mediated by the quality of family and social supports 4. Important only for children

Correct Answer: 3 Rationale: Family and social support networks are important to mediate the exposure to community violence toward those of any age or socioeconomic status. Nurses need to be involved in creating safe communities through social policies. Depression is not inevitable.

Question 13 What assessment finding indicates that a child is a victim of sexual abuse? 1. Repeated ear infections 2. Hives 3. Genital and/or anal irritation or trauma 4. Early appearance of secondary sex characteristics

Correct Answer: 3 Rationale: Genital and/or anal irritation or trauma is consistent with sexual abuse. The abused child may also exhibit behavioral signs such as aggression or extreme withdrawal along with any physical trauma. Repeated ear infections, hives, and early appearance of secondary sex characteristics do not indicate sexual abuse.

Question 10 Which option is an example of an inferential concept? 1. Rash 2. Equilibrium 3. Pain 4. Powerlessness

Correct Answer: 3 Rationale: Inferential concepts are indirectly observable and include such ideas as pain and temperature. Rash is a concrete or readily observable concept. Equilibrium and powerlessness are nonobservable or abstract concepts.

Question 20 What is the name of the nursing research journal first published in 1952? 1. American Journal of Nursing 2. Research in Nursing and Health 3. Nursing Research 4. Western Journal of Nursing Research

Correct Answer: 3 Rationale: The journal Nursing Research was established in 1952 to serve as a vehicle to communicate nurses' research and scholarly productivity

Question 20 The nurse who bases practice on the theory of unitary human beings will focus on which set of concepts? 1. Caring factors, transpersonal caring relationships, and caring moments/situations. 2. Regulator, cognator, stimuli, and adaptation. 3. Energy fields, universe of open systems, pattern, and pandimensionality. 4. Self-care deficit, self-care agency, and therapeutic self-care demand.

Correct Answer: 3 Rationale: The major components of Martha Rogers' theory of unitary human beings are energy fields, openness, pattern, and pandimensionality. Caring factors, transpersonal caring relationships, and caring moments/situations are a part of Jean Watson's Human Caring Theory. Regulator, cognator, stimuli, and adaptation are portions of Callista Roy's Adaptation Model. Self-care deficit, self-care agency, and therapeutic self-care demand are parts of Dorothea Orem's general theory of nursing.

Question 6 The nurse has been asked to support and participate in a clinical trial by administering trial medications to clients on the nursing unit. What is the most important question the nurse should ask before answering this request? 1. "Will I get extra pay for participating?" 2. "Who else is participating in the trial?" 3. "Has the study been approved by the IRB?" 4. "Am I responsible if the client doesn't want to participate?"

Correct Answer: 3 Rationale: The most important question for the nurse to ask is whether the study has been approved by the institutional review board, or IRB. Typically there is no extra pay for the nurse who participates in a clinical trial. The nurse is not responsible if the client does not want to participate in the study. The other persons participating in the trial may influence the nurse's decision, but are not as essential as the question about the IRB.

Question 18 What behavior should the nurse demonstrate when caring for victims of abuse? 1. Distant 2. Authoritarian 3. Nonjudgmental 4. Judgmental

Correct Answer: 3 Rationale: The nurse should convey a nonjudgmental manner. The nurse should avoid blaming the victim or the abuser, or looking for pathological elements in anyone's behavior. It is vital not to impose personal values on the family by offering quick and easy solutions to intrafamily violence. The nurse should not be distant or authoritarian when working with victims of abuse.

Question 23 While planning care, the nurse works with the client and chooses a wholly compensatory nursing system to help the client achieve an optimal level of self-care. What is true about this situation? 1. Most nursing theorists support a different form of planning. 2. Nursing theories do not lend themselves to the action of planning nursing care. 3. Orem's general theory of nursing involves this type of planning. 4. This type of planning is only supported by the caring theorists.

Correct Answer: 3 Rationale: The wholly compensatory nursing system is a part of Orem's general theory of nursing. Planning is used by many different theorists and many use the same general planning principles. It is not true that planning is only supported by the caring theorists.

Question 6 Which worker in the service sector is at greatest risk for violence in the workplace? 1. EMTs 2. Physicians 3. Gas station attendants 4. Mail carriers

Correct Answer: 3 Rationale: The workers at greatest risk are those who exchange money with the public, make deliveries, carry passengers in vehicles, work alone or in small groups during late night or early morning hours, or work in community settings in high crime areas.

Question 7 The research team proposes a study in which the client is told that a lab result indicates development of diabetes mellitus when, in fact, that is not true. The purpose of the study is to identify perceptions of diabetes mellitus in the general public. What client right is violated in this proposal? 1. Right of self-determination 2. Right to full disclosure 3. Right not to be harmed 4. Right of privacy and confidentiality

Correct Answer: 3 Rationale: This proposal violates the client's right not to be harmed. The exposure to stress or anxiety that comes from being told a diagnosis that does not exist is potentially harmful to the client. Right of self-determination means that subjects should feel free from constraints, coercion, or any undue influence to participate in a study. Right to full disclosure means that deception, either by withholding information about a client's participation in a study or by giving the client false or misleading information about what participating in the study will involve, violates ethical principles. Right of privacy and confidentiality is a basic right that allows the client to participate in a study without worrying about later embarrassment or disclosure of personal information.

Question 10 The investigator is conducting a study in which the investigator cannot link a specific study subject to the information being reported. Which term reflects this situation? 1. Confidentiality 2. Privacy 3. Anonymity 4. Aggregation

Correct Answer: 3 Rationale: When the study is conducted so that even the investigator cannot link a specific person to information, the study is said to be anonymous. Confidentiality means that any information collected in the study will not be made public or available without the person's consent. Aggregation is grouping of data. Privacy is an overarching concept that includes both confidentiality and anonymity.

Question 24 The staff development instructor is preparing material to introduce the importance of research in nursing practice. In which order should the instructor explain the behaviors associated with nurses adopting evidence-based practice? 1. The innovation is used regularly 2. An attitude about the innovation is formed 3. Information about an innovation is learned 4. The innovation is either adopted or rejected

Correct Answer: 3, 2, 4, 1 Rationale: Research on the process of adoption of research-based innovations has used the theory of diffusion of innovation devised by Everett Rogers (2003). According to this theory, a nurse passes through four stages before adopting research-based ideas or practices: 1. Knowledge stage, when a nurse learns about an innovation; 2. Persuasion stage, when a nurse develops a positive or negative attitude about the innovation; 3. Decision stage, when a nurse determines whether to adopt or reject the innovation; and 4. Implementation stage, when the nurse uses the innovation regularly.

Question 28 A clinical instructor is assisting a student understand the nurse-client relationship. In which order should the instructor introduce the phases of this process? 1. Old needs and goals are put aside and new ones are adopted. 2. The client uses the available services on the basis of self-interest and needs. 3. The nurse assists the client to understand the problem and the extent of the need for help. 4. The nurse's focus is to assure the person that the nurse understands the interpersonal meaning of the client's situation.

Correct Answer: 3, 4, 2, 1 Rationale: This nurse-client relationship evolves in four phases: 1. Orientation. During this phase, the client seeks help, and the nurse assists the client to understand the problem and the extent of the need for help. 2. Identification. During this phase, the client assumes a posture of dependence, interdependence, or independence in relation to the nurse (relatedness). The nurse's focus is to assure the person that the nurse understands the interpersonal meaning of the client's situation. 3. Exploitation. In this phase, the client derives full value from what the nurse offers through the relationship. The client uses the available services on the basis of self-interest and needs. Power shifts from the nurse to the client. 4. Resolution. In this final phase, old needs and goals are put aside and new ones are adopted. Once older needs are resolved, newer and more mature ones emerge.

Question 27 The student nurses are preparing a poster to explain the evolution of nursing theories. In which chronological order should the students display information about these theorists? 1. Roy 2. King 3. Peplau 4. Rogers 5. Watson 6. Leininger

Correct Answer: 3, 4, 2, 1, 5, 6 Rationale: Hildegard Peplau, a psychiatric nurse, introduced her interpersonal concepts in 1952. Martha Rogers first presented her theory of unitary human beings in 1970. Imogene King first published Toward a Theory of Nursing: General Concepts of Human Behavior in 1971. Roy's adaptation model published in book form in 1976. Jean Watson's theory of the science of caring was first published in 1979. Madeleine Leininger first published her cultural care diversity and universality theory in 1985.

Question 21 While assessing an older patient in the emergency department the nurse suspects that the patient has been abused. In which order should the nurse approach the care of this patient? 1. Review options for help 2. Provide information for services to help 3. Determine if the patient is in any danger 4. Emphasize that the patient has the right to be safe 5. Explain that the patient is not to blame for any abuse

Correct Answer: 3, 5, 4. 1. 2 Rationale: When providing short-term interventions to a patient who has been abused the nurse should (1) determine the immediacy of danger, (2) convey that the person is not to blame and has the right to be safe, (3) explore options for help, and (4) provide information regarding available services.

Question 3 Which option is the most general in the scope of nursing theories and looks at the nature of things? 1. Grand theory 2. Middle-range theory 3. A concept 4. Philosophy

Correct Answer: 4 Rationale: A philosophy looks at the nature of things and aims to provide the meaning of nursing phenomena. It is the most general in the scope of nursing theories. A grand theory is broad and complex and tends to be very general. Middle-range theory has a narrower scope and is derived from earlier works, such as philosophies and grand theories. A concept is the abstract idea or mental image of a phenomenon.

Question 12 The nurse's research is designed to generate a new theory. What research approach has this nurse most likely chosen? 1. Deductive using quantitative research methods. 2. Inductive using quantitative research methods. 3. Deductive using qualitative research methods. 4. Inductive using qualitative research methods.

Correct Answer: 4 Rationale: Generally speaking, theory testing uses a deductive approach and applies quantitative research methods. Theory generation uses an inductive approach and is the result of qualitative research. Inductive approach using quantitative research methods and deductive approach using qualitative research methods are not as commonly used in theory generation.

Question 2 The nurse strongly believes that truth is based in experiences. Which research approach is this nurse most likely to favor? 1. Hard science model 2. Positivist 3. Cause and effect 4. Constructivist

Correct Answer: 4 Rationale: In the constructivist approach, truth is found in one's experiences, and research uses naturalistic settings and observational methods to describe phenomena. The positivist approach represents what many people regard as hard science and attempts to look at cause and effect.

Question 14 The nurse says she knows a particular fact is true because "God says it is true." Which of Kneller's types of knowing is this nurse describing? 1. Rational 2. Empirical 3. Intuitive 4. Revealed

Correct Answer: 4 Rationale: Kneller's framework describes five kinds of knowledge: (1) revealed knowledge that is disclosed by God; (2) intuitive knowledge that comes from a process of discovery nurtured by experience; (3) rational knowledge that uses principles of formal logic; (4) empirical knowledge that is tested by observation or experiment; and (5) authoritative knowledge that is vouched for by authorities in the field.

Question 19 What is true about the actions that a nurse should take when accessing information about evidence-based practice from the Agency for Healthcare Research and Quality? 1. A representative from the agency must visit the facility to present an educational session regarding EBP. 2. The nurse or healthcare facility should purchase a book on EBP. 3. The organization requires that nurses or facilities subscribe to a print journal to access the information. 4. The information is available on the organization's Web site.

Correct Answer: 4 Rationale: The Agency for Healthcare Research and Quality is a federal agency that provides evidence reports on numerous topics through its Evidence-Based Practice Centers. The evidence reports may be accessed online through the agency's Web site. A visit from an agency representative, purchasing a book, or subscribing to a print journal is not necessary.

Question 21 In 1993, a center at the National Institutes of Health was established with a nursing perspective. What is the name of that center? 1. The National Center for Nursing Research 2. The National Institute for Human Health and Behavior 3. The Institute for Professional Research 4. The National Institute of Nursing Research

Correct Answer: 4 Rationale: The National Institute of Nursing Research was established as a Center at the National Institutes of Health in 1986. In 1993, it was elevated to an Institute, placing it among the Institutes and Centers within NIH and adding a clinical and nursing perspective to the mainstream of the biomedical and behavioral research in the United States.

Question 6 What are the four concepts that have historically been identified as the focus of nursing theory? 1. Assessment, goals, interventions, and evaluation. 2. Pain, anxiety, stress, and fatigue. 3. Disease, death, care, and cure. 4. Person, environment, health, and nursing.

Correct Answer: 4 Rationale: The four concepts that are the focus of nursing theory are person, environment, health, and nursing. Assessment, goals, interventions, and evaluation are steps of the nursing process. Pain, anxiety, stress, fatigue, disease, death, care, and cure are all aspects of the care that nurses provide.

Question 22 Which are considered weapons of mass destruction? 1. Agricultural, zoological, and robotics 2. Aircraft, ships, and trains 3. Fire, flood, and hurricane 4. Biological, chemical, and nuclear

Correct Answer: 4 Rationale: The three categories of weapons of mass destruction are nuclear, biological, and chemical. The other options do not cite weapons.

Question 17 What is the underlying theme of Virginia Henderson's work? 1. Nurses move in stages from novice to expert in the field. 2. Nursing is best provided when culture is considered. 3. Control of the environment of healing is the most important aspect of nursing. 4. Nursing is independent from and interdependent with other health care disciplines.

Correct Answer: 4 Rationale: Virginia Henderson formulated a definition of the unique function of nursing that defined nursing as unique and separate from medicine. Novice to expert is the theme of Benner's work. Leininger's work is based upon cultural competence. Controlling the environment of healing is central to the work of Nightingale.

Question 25 The nurse is reviewing the results of a literature search and wants to determine the strength of the evidence. In which order, from strongest to weakest, should the nurse analyze this data? 1. Single, well-conducted clinical trials 2. Single descriptive or qualitative study 3. Expert opinion of authorities or committees 4. Single correlational study or observational studies 5. Systematic reviews of randomized and nonrandomized trials 6. Systematic review of descriptive studies including qualitative 7. Systematic review of correlational studies or observational studies

Correct Answer: 5, 1, 7, 4, 6, 2, 3 Rationale: Beginning with the highest level and going to weakest, the hierarchy to evaluate evidence is as follows: (1) evidence from systematic review or meta-analysis of all relevant randomized clinical trials (RCTs) or evidence-based clinical practice guidelines based on systematic reviews of RCTs; (2) evidence obtained from at least one well-designed RCT; (3) evidence obtained from well-designed controlled trials without randomization; (4) evidence from well-designed case-control and cohort studies; (5) evidence from systematic reviews of descriptive and qualitative studies; (6) evidence from a single descriptive or qualitative study; and (7) evidence from the opinion of authorities and/or reports of expert committees.

Question 23 The hospital research committee is contemplating a study to analyze the impact of changing one type of dressing material. In which order should the committee complete this study? 1. Collect data 2. Analyze data 3. Design the study 4. Predict outcomes 5. Identify the problem 6. Interpret the findings 7. Formulate a statement 8. Search existing literature

Correct Answer: 5, 7, 8, 4, 3, 1, 2, 6 Rationale: There are several important steps in the conduct of research, and each of these requires decision making by the researcher. The first step is identification of the problem. Once the problem is clearly identified and a statement is formulated, the next step is a search of existing literature, especially related research. Once the researcher has identified the problem, reviewed the literature, and identified specific research questions or hypotheses (predictions of outcomes), an appropriate study can be designed to answer the questions or test the hypotheses. Data collection can then be done. Once the data are analyzed and results are known, the researcher must be very careful about the interpretation of those