Chapter 2: Theory, Research, and Evidence-Informed Practice

A nurse is reviewing nursing theory for usefulness in a home healthcare setting. Which is the appropriate application of Dorothea Orem's Self-Care Model in a home healthcare setting? Match the client's self-care needs with appropriate supportive interventions. Counsel client on methods to adapt to current state to reduce stress. Assist the client to conserve and maintain principles of personal and social integrity. Monitor therapeutic interventions in the client's home.

Match the client's self-care needs with appropriate supportive interventions. Rationale: Match the client's self-care needs with appropriate supportive interventions.

Which is a focus of medical research rather than nursing research? Drug metabolism Health appraisal Prevention of trauma Promotion of recovery

Drug metabolism Rationale: 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).

Which represents the basic framework of the research process? Qualitative data Quantitative data Nursing process Nursing theory

Nursing process Rationale: 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.

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

Qualitative Rationale: 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.

Which skill is foundational for a nurse's participation in the evidence-based practice process? Read and understand a research article. Critically analyze research articles and the findings. Become involved in evidence-based practice research. Publish an article on evidence-based practice findings.

Read and understand a research article. Rationale: The use of evidence-based research requires critical analysis and extensive, systematic reviews of research articles and findings. However, a beginning nurse has not acquired the knowledge to complete that task nor to conduct and publish new research. The first stop for a nurse is to be able to read and understand a research article.

An abstract idea or object that relates to other abstract ideas or objects is which? Theory Concept Deductive reasoning Inductive reasoning

Concept Rationale: Concepts are 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.

Which theory emphasizes the relationships between the whole and the parts, and describes how parts function and behave? General systems theory Nursing theory Adaptation theory Developmental theory

General systems theory Rationale: 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.

What is the process of considering a group of specific ideas and then drawing conclusions that relate to a general idea? Theory Concept Deductive reasoning Inductive reasoning

Inductive reasoning Rationale: Inductive reasoning is derived from consideration of specific properties to draw conclusions about a general idea. Deductive reasoning involves considering 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.

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 Institutes of Health National Institute of Nursing Research Institute of Medicine ANA Cabinet on Nursing Research

National Institute of Nursing Research Rationale: 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.

The nurse researcher would like to gather data about the attitudes of young adults on spirituality and health care. What is the most effective form of research on this topic? Quantitative research Methodologic survey Delphi study Qualitative research

Qualitative research Rationale: Attitudes on spirituality and health care require the nurse to interview clients or informants to obtain qualitative research. Qualitative research involves the systematic collection and analysis of more subjective, narrative materials using procedures in which there tends to be minimal researcher-imposed control. Quantitative research is based more on collecting numerical data and would not be suitable for this type of study. Delphi is a type of quantitative research that would also not produce the desired data. Methodologic surveys focus on method and not on the subjects' experience.

Which type of quantitative research will examine cause-and-effect relationships between selected variables? Descriptive Correlational Quasi-experimental Experimental

Quasi-experimental Rationale: Quasi-experimental research examines cause-and-effect relationships between selected variables. Descriptive research explores and describes events in real-life situations. Correlational research examines the type and degree of relationships between two or more variables. Experimental research examines cause-and-effect relationships between variables under highly controlled conditions, often in a laboratory setting

The researcher must critically appraise evidence following a literature review. Which questions should the researcher pose in this appraisal? (Select all that apply.) "How many studies were found during the review?" "What were the results of each study?" "Are the results of each study valid and reliable?" 'Will the results of each study improve client care?" "Where was each study conducted?"

"What were the results of each study?" "Are the results of each study valid and reliable?" 'Will the results of each study improve client care?" Rationale: Although the number of studies found and where the studies were conducted could be important to the researcher, they are not the basis for a critical appraisal of the evidence. The critical appraisal should focus on the results of studies, the reliability and validity of those studies, and the importance of the studies to client care.

When looking at a model for evidence-based practice, what is the final step of the process? Evaluating practice change Searching the literature Appraising evidence Formulating a clinical question

Evaluating practice change Rationale: 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.

Which group of nurses would be least likely involved in direct research? Select all that apply. Clinical Nurse Specialists Novice nurses Student nurses Nurse Practitioners Nurses at the PhD level

Novice nurses Student nurses Rationale: Direct research, except in the role of data collection or administration of medications and treatments as a protocol in a research project, usually does not involve student nurses and novice nurses. Master's prepared nurses such as clinical nurse specialists and nurse practitioners, as well as nurses at the PhD level, can be involved in direct research.

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? Ask a question about a clinical practice. Provide a statical analysis for studies. Recommend best practices for client care. Summarize findings from multiple studies that are related to a particular nursing practice.

Summarize findings from multiple studies that are related to a particular nursing practice. Rationale: 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.

Which statement best explains the importance of theoretic frameworks? Theoretic frameworks guide physiologic nursing care. Theoretic frameworks guide psychosocial nursing care. Theoretic frameworks advance nursing knowledge and practice. Theoretic frameworks advance the ethical aspects of practice.

Theoretic frameworks advance nursing knowledge and practice Rationale: 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.

Which theory describes, explains, predicts, and controls outcomes in nursing practice? Nursing theory Systems theory Adaptation theory Developmental theory

Nursing theory Rationale: 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.

What was the focus of nursing research during the first half of the twentieth century? Client care Nursing education Treatment issues Available nurse supply

Nursing education Rationale: 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 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. Set up diabetic home meal delivery for the client. Assist the spouse with online grocery shopping. Authorize an unlicensed nursing personnel to cook for the client.

Arrange an evaluation appointment with a dietitian. Rationale: 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.