NURS 6700 Module 1 - Chapter 5 + 8

A nurse is using the research process. Place in order the sequence that the nurse will follow. 1. Analyze results. 2. Conduct the study. 3. Identify clinical problem. 4. Develop research question. 5. Determine how study will be conducted.

3, 4, 5, 2, 1

A nurse writes the following PICOT question: How do patients with breast cancer rate their quality of life? How should the nurse evaluate this question?

A true PICOT question regardless of the number of elements

Before conducting any study with human subjects, the nurse researcher must obtain informed consent. What must the nurse researcher ensure to obtain informed consent? (Select all that apply.) a. Gives complete information about the purpose b. Allows free choice to participate or withdraw c. Understands how confidentiality is maintained d. Identifies risks and benefits of participation e. Ensures that subjects complete the study

A, B, C, D

The nurse is preparing to palpate the thorax and abdomen of a patient. Which of these statements describes the correct technique for this procedure? Select all that apply. a. Warm the hands first before touching the patient. b. For deep palpation, use one long continuous palpation when assessing the liver. c. Start with light palpation to detect surface characteristics. d. Use the fingertips to examine skin texture, swelling, pulsation, and presence of lumps. e. Identify any tender areas, and palpate them last. f. Use the palms of the hands to assess temperature of the skin.

A, C, D,E

The nurse is preparing to conduct research that will allow precise measurement of a phenomenon. Which methods will provide the nurse with the right kind of data? (Select all that apply.) a. Surveys b. Phenomenology c. Grounded theory d. Evaluation research e. Nonexperimental research

A, D, E

The nurse is caring for a patient with chronic low back pain. The nurse wants to determine the best evidence-based practice regarding clinical guidelines for low back pain. What is the best database for the nurse to access?

AHRQ

When examining an infant, the nurse should examine which area first?

Abdomen

During an examination of a patients abdomen, the nurse notes that the abdomen is rounded and firm to the touch. During percussion, the nurse notes a drum like quality of the sounds across the quadrants. This type of sound indicates:

Air-filled areas.

A 2-year-old child has been brought to the clinic for a well-child checkup. The best way for the nurse to begin the assessment is

Allow the child to keep a security object such as a toy or blanket during the examination.

The nurse is teaching a class on basic assessment skills. Which of these statements is true regarding the stethoscope and its use?

Although the stethoscope does not magnify sound, it does block out extraneous room noise.

A nurse is reviewing research studies for evidence-based practice. Which article should the nurse use for qualitative nursing research?

An article about emotional needs of dying patients and their families

A nurse has collected several research findings for evidence-based practice. Which article will be the best for the nurse to use?

An article that uses randomized controlled trials (RCT)

A man is at the clinic for a physical examination. He states that he is very anxious about the physical examination. What steps can the nurse take to make him more comfortable?

Appear unhurried and confident when examining him.

Provide feedback that his body is developing normally, and discuss the wide variation among teenagers on the rate of growth and development.

Arrange the sequence of the examination to allow as few position changes as possible.

During auscultation of a patients heart sounds, the nurse hears an unfamiliar sound. The nurse should:

Ask another nurse to double check the finding.

The nurse is examining an infant and prepares to elicit the Moro reflex at which time during the examination?

At the end of the examination

A 6-month-old infant has been brought to the well-child clinic for a check-up. She is currently sleeping. What should the nurse do first when beginning the examination?

Auscultate the lungs and heart while the infant is still sleeping.

The nurse is reviewing nursing research literature related to a potential practice problem on the nursing unit. What is the rationale for the nurse's action? (Select all that apply.) a. Nursing research ensures the nurse's promotion. b. Nursing research identifies new knowledge. c. Nursing research improves professional practice. d. Nursing research enhances effective use of resources. e. Nursing research leads to decreases in budget expenditures.

B, C, D

While auscultating heart sounds, the nurse hears a murmur. Which of these instruments should be used to assess this murmur?

Bell of the stethoscope

A patient has suddenly developed shortness of breath and appears to be in significant respiratory distress. After calling the physician and placing the patient on oxygen, which of these actions is the best for the nurse to take when further assessing the patient?

Bilaterally percuss the thorax, noting any differences in percussion tones.

The nurse is preparing to assess a hospitalized patient who is experiencing significant shortness of breath. How should the nurse proceed with the assessmen

Body areas appropriate to the problem should be examined and then the assessment completed after the problem has resolved.

Before auscultating the abdomen for the presence of bowel sounds on a patient, the nurse should:

Check the temperature of the room, and offer blankets to the patient if he or she feels cold.

The nurse is examining a 2-year-old child and asks, May I listen to your heart now? Which critique of the nurses technique is most accurate?

Children at this age like to say, No. The examiner should not offer a choice when no choice is available

After reviewing the literature, the evidence-based practice committee institutes a practice change that bedrails should be left in the down position and hourly nursing rounds should be conducted. The results indicate over a 40% reduction in falls. What is the committee's next step?

Communicate to staff the results of this project

The nurse researcher is preparing to publish the findings and is preparing to add the limitations to the manuscript. Which area of the manuscript will the nurse researcher add this information?

Conclusion

The nurse uses a PICOT question to develop an evidence-based change in protocol for a certain nursing procedure. However, to make these changes throughout the entire institution would require more evidence than is available at this time. What is the nurse's best option?

Conduct a pilot study to investigate findings

In conducting a research study, the nurse researcher guarantees the subject no information will be reported in any manner that will identify the subject and only the research team will have access to the information. Which concept is the nurse researcher fulfilling?

Confidentiality

When percussing over the liver of a patient, the nurse notices a dull sound. The nurse should:

Consider this a normal finding.

The nurse hears bilateral loud, long, and low tones when percussing over the lungs of a 4-year-old child. The nurse should:

Consider this finding as normal for a child this age, and proceed with the examination.

The nurse is preparing to percuss the abdomen of a patient. The purpose of the percussion is to assess the __________ of the underlying tis

Density

. A nurse identifies a clinical problem with pressure ulcers. Which step should the nurse take next in the research process?

Develop a hypothesis.

The nurse is preparing to use an otoscope for an examination. Which statement is true regarding the otoscope? The otoscope:

Directs light into the ear canal and onto the tympanic membrane.

The nurse is assessing a patients skin during an office visit. What part of the hand and technique should be used to best assess the patients skin temperature?

Dorsal surface of the hand; the skin is thinner on this surface than on the palms.

A nurse uses evidence-based practice (EBP) to provide nursing care. What is the best rationale for the nurse's behavior?

EBP is a guide for nurses in making clinical decisions.

In caring for patients, what must the nurse remember about evidence-based practice (EBP)?

EBP is dependent on patient values and expectations.

The nurse keeps in mind that the most important reason to share information and to offer brief teaching while performing the physical examination is to help the:

Examiner to build rapport and to increase the patients confidence in him or her

The nurse is preparing to examine a 4-year-old child. Which action is appropriate for this age group?

Give the child feedback and reassurance during the examination.

When performing a physical examination, safety must be considered to protect the examiner and the patient against the spread of infection. Which of these statements describes the most appropriate action the nurse should take when performing a physical examination?

Hands are washed before and after every physical patient encounter.

When preparing to perform a physical examination on an infant, the nurse should:

Have the parent remove all clothing except the diaper on a boy

The nurse is unable to identify any changes in sound when percussing over the abdomen of an obese patient. What should the nurse do next?

Increase the amount of strength used when attempting to percuss over the abdomen.

When performing a physical assessment, the first technique the nurse will always use is:

Inspection.

The nurse is reviewing a research article on a patient care topic. Which area should entice the nurse to read the article?

Introduction

The nurse is preparing to use a stethoscope for auscultation. Which statement is true regarding the diaphragm of the stethoscope? The diaphragm:

Is used to listen for high-pitched sounds.

. A nurse is reviewing literature for an evidence-based practice study. Which study should the nurse use for the most reliable level of evidence that uses statistics to show effectiveness?

Meta-analysis

The nurse is preparing to perform a physical assessment. The correct action by the nurse is reflected by which statement? The nurse:

Organizes the assessment to ensure that the patient does not change positions too often.

The nurse would use bimanual palpation technique in which situation?

Palpating the kidneys and uterus

The nurse will use which technique of assessment to determine the presence of crepitus, swelling, and pulsations?

Palpation

Which of these techniques uses the sense of touch to assess texture, temperature, moisture, and swelling when the nurse is assessing a patient?

Palpation

A nurse is developing a care delivery outcomes research project. Which population will the nurse study?

Patients

The nurse is reviewing percussion techniques with a newly graduated nurse. Which technique, if used by the new nurse, indicates that more review is needed?

Percussing once over each area

A nurse is trying to decrease the rate of falls on the unit. After reviewing the literature, a strategy is implemented on the unit. After 3 months, the nurse finds that the falls have decreased. Which process did the nurse institute?

Performance improvement

With which of these patients would it be most appropriate for the nurse to use games during the assessment, such as having the patient blow out the light on the penlight?

Preschool child

When examining a 16-year-old male teenager, the nurse should:

Provide feedback that his body is developing normally, and discuss the wide variation among teenagers on the rate of growth and development.

The nurse is trying to identify common general themes relative to the effectiveness of cardiac rehabilitation from patients who have had heart attacks and have gone through cardiac rehabilitation programs. The nurse conducts interviews and focus groups. Which type of research is the nurse conducting?

Qualitative research

A nurse is implementing an evidence-based practice project regarding infection rates. After reviewing research literature, which other evidence should the nurse review?

Quality improvement data

An examiner is using an ophthalmoscope to examine a patients eyes. The patient has astigmatism and is nearsighted. The use of which of these techniques would indicate that the examination is being correctly performed?

Rotating the lens selector dial to bring the object into focus

Which of these statements is true regarding the use of Standard Precautions in the health care setting?

Standard Precautions are intended for use with all patients, regardless of their risk or presumed infection status.

The nurse is preparing to perform a physical assessment. Which statement is true about the physical assessment? The inspection phase:

Takes time and reveals a surprising amount of information.

The nurse is preparing to assess a patients abdomen by palpation. How should the nurse proceed?

The assessment begins with light palpation to detect surface characteristics and to accustom the patient to being touched.

The nurse is preparing to examine a 6-year-old child. Which action is most appropriate?

The nurse should keep in mind that a child at this age will have a sense of modesty.

The nurse is unable to palpate the right radial pulse on a patient. The best action would be

Use a Doppler device to check for pulsations over the area.

A nurse wants to change a patient procedure. Which action will the nurse take to easily find research evidence to support this change?

Use a PICOT format for the search.

The most important step that the nurse can take to prevent the transmission of microorganisms in the hospital setting is to:

Wash hands before and after contact with each patient.

The nurse is examining a patients lower leg and notices a draining ulceration. Which of these actions is most appropriate in this situation?

Washing hands, putting on gloves, and continuing with the examination of the ulceration

A nurse develops the following PICOT question: Do patients who listen to music achieve better control of their anxiety and pain after surgery when compared with patients who receive standard nursing care following surgery? Which information will the nurse use as the "C"?

Who receive standard nursing care

During the examination, offering some brief teaching about the patients body or the examiners findings is often appropriate. Which one of these statements by the nurse is most appropriate?

Your pulse is 80 beats per minute, which is within the normal range.