Exam 1 NUR2242C

Research that experiences a specific group with similar events

Phenomenological Research

A student nurse and clinical instructor are discussing quality in health care. The instructor knows the student understands when the student makes which statement? a. "Quality is apparent in all health care." b. "Quality is an outcome of health care." c. "Quality is seen and unseen in health care." d. "Quality is achieved by collaboration in health care."

"Quality is seen and unseen in health care." Quality in health care is tangible and intangible. Quality in health care is not apparent in all health care, as many areas of health care are lacking. Quality of care does not always affect the outcome of care; the patient may recover no matter what care is given. Quality is not always achieved by collaboration.

The student nurse learning about ethics expresses good knowledge when making which appropriate statement? a. "Ethics are internal values developed outside the influence of societal norms." b. "Ethics are influenced by many variables including family and friends." c. "Ethics are societal in nature and do not involve personal influences." d. "Ethics are totally independent from a person's character."

"Ethics are influenced by many variables including family and friends." Family, friends, beliefs, education, culture, and socioeconomic status influence the development of ethical behavior. The study of ethics considers the standards of moral conduct in a society.

The nurse knows which statement indicates an appropriate understanding of ethical practice by the student nurse? a. "I will be held to the same ethical standards as professional nurses." b. "I will not be held ethically accountable until I graduate." c. "My nurse educators are responsible for my ethical standards." d. "Ethics are not important as a student."

"I will be held to the same ethical standards as professional nurses." The Code of Ethics for Nurses is "a succinct statement of the ethical obligations and duties of every individual (not just nurse educators) who enters the nursing profession," the profession's "nonnegotiable ethical standard," and "an expression of nursing's own understanding of its commitment to society."

The new nurse correctly defines a law when stating which information? a. "Law is a fundamental concept for health care professionals." b. "Law's rule is developed by the employee's organization." c. "Law's rule is enacted by a government agency that defines what must be done in a given circumstance." d. "Law is a mandate from the Joint Commission or other accrediting agency."

"Law's rule is enacted by a government agency that defines what must be done in a given circumstance."

Types of Quantitative Research (4)

-Descriptive -Correlational -Experimental -Quasi-Experimental

Nurses use new information in their practice. In the process of implementing EBP, the nurse carries out which actions? (Select all that apply.) a. Develops clinical questions. b. Creates workshops and in-services. c. Seeks answers to support the clinical decision. d. Applies finding to patients. e. Publishes a bulletin.

-Develops clinical questions. -Seeks answers to support the clinical decision. -Applies finding to patients. Workshops and in-service or focused training may be necessary if the plan involves a comprehensive change in care or it affects the entire health care agency or community. A bulletin can be provided that lists several safe practice concerns with rationales in the form of a safe practice alert.

Types of Qualitative Research (4)

-Phenomenological -Grounded Theory -Ethnography -Historical

Respect for an individual's right to self determination

Autonomy

The nurse is caring for a patient who has had many admissions and readmissions. The nurse believes that the patient keeps coming to the hospital because the patient "wants his drugs," and is "non-compliant" at home with diabetic therapy. To reduce the risk of slander against this patient, the nurse should carry out which action? a. Write opinions in the medical record only. b. Never share observations. c. Make judgmental statements in private. d. Avoid making judgmental statements.

Avoid making judgmental statements. Defamation of character occurs when a public statement is made that is false and injurious to another person. Oral defamation of character is slander. Slander is spoken information that is untrue, causing prejudice against someone or jeopardizing that person's reputation.

Research conducted to generate theories

Basic Research

The nurse recognizes that starting an intravenous (IV) infusion line on a patient against his will may be classified as which wrongdoing? a. Assault b. Battery c. Felony d. Misdemeanor

Battery Actual physical harm caused to another person is battery. Battery may involve angry, forceful touching of people, their clothes, or anything attached to them. Performing a surgical procedure without informed consent is an example of battery.

The duty to do good to others and to maintain a balance between benefits and harms

Beneficence

Who has authority to reprimand nurses for unprofessional conduct

Board of Nursing

Research that explores a relationship between two variables

Correlational Research

Reasoning that takes a large amount of data and formulates a specific conclusion

Deductive Reasoning

An unconscious patient is treated in the emergency department for head trauma. The patient is unconscious and on life support for 2 weeks prior to making a full recovery. The initial actions of the medical team are based on which ethical principle?a. Utilitarianism b. Deontology c. Autonomy d. Veracity

Deontology Deontology is an approach that is rooted in the assumption that humans are rational and act out of principles that are consistent and objective and that compel them to do what is right. Deontologic theory claims that a decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty.

Research that identifies data about the population or phenomenon

Descriptive Research

Research that is close field observation of a sociocultural phenomenon

Ethnography

The nurse in the psychiatric unit is involved in a research study for a depression medication. In the study, patients are randomly assigned to one depression medication and the other group is receiving no medication to treat the depression. What method of research are the patients involved with? a. Descriptive b. Correlational c. Quasi-experimental d. Experimental

Experimental Experimental tests an intervention and includes both a control group and random assignment. This research study tests an intervention and includes both a control group and random assignment.

Research that explores the casual relationship between variables (ex. BP med having an effect on decreasing BP)

Experimental Research

The nurse knows practicing nursing without a license is what wrongdoing? a. Misdemeanor b. Statute c. Felony d. Tort

Felony Practicing nursing without a license is a felony. A misdemeanor is a minor crime, such as stealing an item from a patient that does not have much value. A statute is a law created by legislative bodies.

A nurse on the unit makes an error in the calculation of the dose of medication for a critically ill patient. The patient suffered no ill consequences from the administration. The nurse decides not to report the error or file an incident report. The nurse is violating which principle of ethics? a. Fidelity b. Individuality c. Justice d. Values clarification

Fidelity Fidelity is the principle that requires us to act in ways that are loyal. In the role of a nurse, such action includes keeping your promises, doing what is expected of you, performing your duties, and being trustworthy.

The nurse knows which law protects health care professionals from charges of negligence when providing emergency care at the scene of an accident? a. Good Samaritan Act b. HIPPA c. Licensure d. Living wills

Good Samaritan Act All 50 states have enacted Good Samaritan laws offering protection for physicians and other health care professionals who provide emergency care at the scene of a disaster, emergency, or accident. Good Samaritan laws protect health care professionals from charges of negligence in providing emergency care if: (1) the care is within the professional's scope of knowledge and standards of care and (2) no fee is received or charged for services.

Research that is theory form data collection

Grounded Theory Research

In researching the effectiveness of an antihypertensive medication, the nurse knows that the medication would be what type of variable? a. Dependent b. Independent c. Treatment d. Controlled

Independent In experimental research, the independent variable is referred to as an experimental variable or treatment variable. An independent variable is a concept or idea whose value determines the value of other (dependent) variables. In research, the independent variable comprises the experimental treatment or intervention, and it is manipulated by the researcher to yield various outcomes. The dependent variable is the outcome that is affected by manipulation of the independent variable.

Reasoning that generalizes a specific concept

Inductive Reasoning

The nurse researcher understands a human subject is defined as a living individual about whom an investigator conducting research obtains what information? a. Data without direct or indirect interaction or intervention b. Information that is not expected to be made public c. No diagnostic information and does not manipulate the subject environment d. Information without any communication/contact during the research

Information that is not expected to be made public A human subject is defined as "a living individual about whom an investigator conducting research obtains: (1) data through intervention or interaction with the individual or (2) identifiable private information"

Board that reviews committee established to help protect the rights and welfare of human research subjects

Institutional Review Board

The basis of an objective evaluation process that can help health care organizations measure, assess and improve performance

Joint Commission

The equitable distribution of potential benefits and tasks determining the order in which clients should be cared for

Justice

Research that looks for similarities between statistics in literature to discover similarities and differences

Meta-analysis

One of the first nurse researchers to document evidence-based practice for nursing was Florence Nightingale. What did Nightingale incorporate into her practice that made her practice different from her colleagues? a. Nightingale gathered scientific data. b. Nightingale calculated statistics to report her findings. c. Nightingale communicated her findings to powerful others. d. Nightingale based her nursing practice on her findings.

Nightingale based her nursing practice on her findings. Florence Nightingale had tried to develop the role of researcher by using evidence from her practice and implementing these findings. Evidence-based practice (EBP) includes conducting quality studies, synthesizing the study findings into the best research evidence available, and using that research evidence effectively in practice

The obligation to do or cause no harm to another

Nonmaleficence

The nurse understands "First, do no harm" defines what ethical principle? a. Beneficence b. Justice c. Fidelity d. Nonmaleficence

Nonmaleficence First, do no harm is the colloquial definition of nonmaleficence.

The nurse understands an institutional review board (IRB) is a review committee established to carry out what task? a. Approve research involving animal subjects. b. Approve research that is not government funded. c. Function differently than scholarly journals do. d. Protect the rights of human research subjects.

Protect the rights of human research subjects. An institutional review board (IRB) is a review committee established to help protect the rights and welfare of human research subjects. Regulations require IRB review and approval for research involving human subjects if it is funded or regulated by the federal government.

Answers questions that can't be answered with a quantitative study, focuses on a person's experiences, nonnumeric, uses interviews, and questionnaires

Qualitative Research

The nurse recognizes that when conducting a qualitative research study, what concept is a basis of this type of research? a. Qualitative research is based on a constructivist philosophy. b. Qualitative research assumes that reality is the same for everyone. c. Qualitative research is deductive in nature and approach. d. Qualitative research proceeds from specific facts to generalizations.

Qualitative research is based on a constructivist philosophy. Qualitative research is based on a constructivist philosophy, which assumes that reality is composed of multiple socially constructed realities of each person or group and is therefore value laden, focusing on personal beliefs, thoughts, and feelings.

Testing of a hypothesis through observation and validation, RCTs, cohort studies, longitudinal studies, case-controlled studies

Quantitative Research

Research that examines a casual relationship between variables but may not meet strict guidelines

Quasi-experimental Research

Literature review with strict scientific design

Systemic Review

The nurse recognizes which action by the nursing student would be considered uncivil? a. Prompt arrival to class b. Texting during class c. Attentive listening d. Active participation in class

Texting during class Civility (i.e., acting politely) is essential in all interactions among faculty and nursing students. Respectful interaction between students and faculty members establishes professional communication patterns and affects the way in which students interact with patients.

The nurse correctly devises a dissemination plan at what point during the research process? a. Conclusion of the study b. After the literature review c. The beginning of the research process d. While conducting research

The beginning of the research process A dissemination plan should be devised at the beginning of the research.

Which of the following is true about health care legislation? a. The US Constitution addresses health care law specifically to give the federal government the ability to license professionals and institutions. b. The power of the US Constitution does not have a direct relationship to health care and reserves most of the power to the states. c. State laws are considered the highest source of health care law and trump the federal laws. d. The federal government asserts its power over health care legislation through the US Constitution.

The power of the US Constitution does not have a direct relationship to health care and reserves most of the power to the states. The power of the US Constitution does not have a direct relationship to health care and reserves most of the power to the states.

The nurse understands who is ultimately responsible for explaining the content of the informed consent? a. The registered nurse b. The hospital social worker c. Educated family members d. The provider of the procedure

The provider of the procedure Informed consent is permission granted by a patient after discussing each of the following topics with the physician, surgeon, or advanced practice nurse who will perform the surgery or procedure: (1) exact details of the treatment, (2) necessity of the treatment, (3) all known benefits and risks involved, (4) available alternatives, and (5) risks of treatment refusal.

Test or instrument is accurately recording

Validity

A student nurse is talking with his instructor. The student asks how quality of care is evaluated. What is the best response by the instructor? a. "Quality of care is evaluated by the patient getting well." b. "Quality of care is evaluated on the basis of process and outcomes." c. "Quality of care is evaluated by the physician's assessment." d. "Quality of care is evaluated by the patient's satisfaction."

"Quality of care is evaluated on the basis of process and outcomes." Quality of care is evaluated by process and outcomes. If the outcomes are achieved, then the care has achieved what is was designed to do. The patient getting well may be an action of the body doing what it is supposed to do and not quality of care; the same can be said of the physician's assessment

The nurse is caring for a patient recently diagnosed with cancer that is being asked to participate in a new chemotherapy trial. How would the nurse respond if working under the ethical principle of utilitarianism? a. "The patient should be allowed to decide." b. "As your nurse, I'll support your right to refuse." c. "You should do this because many could benefit from it." d. "If this is against your beliefs, you should not do it."

"You should do this because many could benefit from it." Compared with deontology, utilitarianism is on the opposite end of the ethical theory continuum. Utilitarianism maintains that behaviors are determined to be right or wrong solely based on their consequences.

In addition to maintaining current professional practice knowledge, competent practice skills, and professional relationships with patients and their families, what additional actions should the nurse take to practice within the law? (Select all that apply.) a. Maintain confidentiality. b. Follow legal guidelines for sharing information. c. Block document once per shift. d. Change nursing procedures according to latest journal articles. e. Meet licensure and continuing education requirements.

- Maintain confidentiality. -Follow legal guidelines for sharing information. -Meet licensure and continuing education requirements. In addition to maintaining current professional practice knowledge, competent practice skills, and professional relationships with patients and their families, nurses should follow guidelines to practice legally and avoid charges of malpractice, maintain confidentiality, follow legal and ethical guidelines when sharing information, document punctually and accurately,

The nurse manager knows a Magnet hospital is characterized by which? (Select all that apply.) a. Excellent medical outcomes b. A high level of nursing job satisfaction c. A low number of grievances d. Nursing care leading excellent patient outcomes e. Evidence-based environment support

-A high level of nursing job satisfaction -Nursing care leading excellent patient outcomes -Evidence-based environment support A Magnet hospital is characterized by excellent patient outcomes resulting from nursing, a high level of nursing job satisfaction with a low nurse turnover rate, and appropriate resolution of any grievances.

Which statements by the nurse are correct regarding informed consent and someone who requires an interpreter? (Select all that apply.) a. A professional interpreter is needed. b. A family member may interpret when convenient. c. Detailed medical information remains a priority. d. Professional interpreters are not effective in providing medical information. e. If necessary, family members can make decisions regarding informed consent.

-A professional interpreter is needed. -Detailed medical information remains a priority. -If necessary, family members can make decisions regarding informed consent. If a patient is illiterate or requires an interpreter, the method of obtaining informed consent must be adapted appropriately. Use of a professional interpreter rather than a family member is essential to provide detailed medical information accurately.

A drug-addicted nurse switches a patient's morphine injection with normal saline so that the nurse can use the morphine. The nurse is violating which principles of ethics? (Select all that apply.) a. Autonomy b. Utilitarianism c. Beneficence d. Dilemmas e. Veracity

-Autonomy -Utilitarianism -Beneficence -Veracity Beneficence is providing benefit to others by promoting their welfare. In general terms, to be beneficent is to promote goodness, kindness, and charity. By taking the patient's pain medication and substituting saline, the nurse did harm, not good, for the patient. Autonomy is the principle of respect for the individual person; the nurse does not respect someone upon whom the nurse is inflicting harm. Utilitarianism is the principle that assumes that an action is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences.

The nurse understands that Florence Nightingale is noted to have provided the initial basis for evidence-based practice (EBP) by doing which action? (Select all that apply.) a. Basing her work in trial and error as well as observation b. Using statistical data as a basis for improvements c. Applying statistical methods such as "pie charting" to display results d. Focusing on bedside care and ignoring nursing education e. Publishing the first EBP journal

-Basing her work in trial and error as well as observation -Using statistical data as a basis for improvements -Applying statistical methods such as "pie charting" to display results Florence Nightingale, in her Notes on Nursing in 1859, outlined basic principles of nursing science. Nightingale's method of nursing included rigorous monitoring of the effectiveness of interventions and treatments. This provided the initial basis for EBP.

What are the major attributes of health care quality? (Select all that apply.) a. Conforms to standards b. Sound decision making c. High acuity patients d. Low health care costs e. Identifies adverse events

-Conforms to standards -Sound decision making -Identifies adverse events Major attributes of health care quality include conformation to standards set by regulatory agencies, sound decision making regarding care, and identifying potential adverse events. High acuity of patients does not contribute to quality health care, because the care demand is increased, and low health care costs mean fewer services may be available.

The nurse recognizes barriers to the use of evidence-based practice (EBP) include what points? (Select all that apply.) a. Nurses critiquing research b. Difficulty communicating how to conduct EBP c. Copious amount of literature available d. Short time between research and practice e. Reluctance of organizations to fund research

-Difficulty communicating how to conduct EBP -Copious amount of literature available -Reluctance of organizations to fund research To adequately integrate EBP into patient care, nurses must critique research to differentiate between opinion and evidence and must regularly read current professional journals. Some barriers are common to research use and EBP, including the difficulty of communicating how to conduct EBP and the individual nurse's skills in determining the quality of research available for review.

The focus of quality health care should be on which of the following items? (Select all that apply.) a. Excellent services b. Comprehensive communication c. Private hospital rooms d. Health team collaboration e. Culturally competent care

-Excellent services -Comprehensive communication -Health team collaboration -Culturally competent care Excellent services, communication, collaboration, and culturally competent care brings quality to the health care delivered to the patient. Private hospital rooms may be a preference by some patients, but they do not add to the quality of care.

How does the Iowa model transcend mere nursing care? (Select all that apply.) a. It includes formalized internal feedback loops. b. Its triggers can have their origins practically anywhere. c. It generates change in practice solely through research. d. It implies a layer of policy development. e. It addresses multiple disciplines' impacts on quality.

-It includes formalized internal feedback loops. -Its triggers can have their origins practically anywhere. -It implies a layer of policy development. -It addresses multiple disciplines' impacts on quality. Because the Iowa model is often implemented at a fairly high level of nursing or hospital administration, it scrutinizes the input of nursing and other disciplines in its process. Its output is applied as widely as possible throughout the organization, and it can affect policy within a multihospital system and even across systems.

Which statements are true about the Iowa model of EBP? (Select all that apply.) a. It addresses utilization of research findings at an individual level. b. It prioritizes pressing items of interest related to quality of care. c. Individual nurses enact an Iowa decision tree when they examine risk management data. d. It identifies triggers capable of posing hazard or benefit. e. It reiterates that innovators embrace change far earlier than laggards.

-It prioritizes pressing items of interest related to quality of care. -It identifies triggers capable of posing hazard or benefit. The Iowa model of EBP provides direction for the development of EBP in a clinical agency. This EBP model was initially developed in 1994 and revised in 2001. In a health care agency, there are triggers that initiate the need for change, and the focus should always be to make changes based on best evidence. These triggers can be problem focused and evolve from risk management data, process improvement data, benchmarking data, financial data, and clinical problems.

Health care providers are required to supply patients with written information regarding their rights to make medical decisions and implement advance directives, which consist of three documents. The nurse knows which items are considered "advanced directives"? (Select all that apply.) a. Living will b. Durable power of attorney c. Health care proxy d. Patient's Bill of Rights e. The Uniform Anatomical Gift Act

-Living will -Durable power of attorney -Health care proxy Advance directives consist of three documents: (1) living will, (2) durable power of attorney, and (3) health care proxy, commonly referred to as a durable power of attorney for health care.

The nurse is conducting a review of the literature for pain management techniques. Which of the following would the nurse consider when conducting research that yields solid EBP? (Select all that apply.) a. Search the literature to uncover evidence to answer the question. b. Evaluate the outcome. c. Use the nursing process to evaluate evidence. d. Evaluate the evidence found. e. Develop an answerable question. f. Develop a question that has not been answered. g. Apply the evidence to the practice situation.

-Search the literature to uncover evidence to answer the question. -Evaluate the outcome. -Evaluate the evidence found. -Develop an answerable question. -Apply the evidence to the practice situation.

The nurse has identified a research problem and knows what to be. What is the next step with this problem? a. Conduct a literature review b. Address ethical procedures c. Collect data d. Analyze data

Conduct a literature review The research process involves many different components. The literature review is conducted after a research problem is identified. Ethical procedures must be addressed before the study begins. Data are then collected and analyzed before discussion of the research results.

While conducting a controlled research study, the nurse wants greater assurance that the result is due to treatment itself and not another factor. For this purpose, the researcher should include what other component? a. A treatment group b. An independent variable c. A dependent variable d. A control group

A control group In a controlled study, some of the participants are assigned to the treatment group, and others are assigned to the control group by a random process. The control group does not receive the treatment.

The nurse is conducting a literature review to determine the statistical results of all related studies and identifies this to be what type of review? a. A meta-analysis b. An integrative literature review c. A systematic review d. Grounded theory research

A meta-analysis Literature reviews include scholarly analyses of research. A meta-analysis merges statistical results from related studies to discover similarities and differences in their findings. An integrative literature review synthesizes research findings and formulates ideas about future research.

In which of the following answers is the hospital in compliance with the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA)? a. The emergency department staff asks a patient to stay in the waiting room until the patients with insurance are treated. b. The emergency registration personnel explain to a patient that they must have proper identification to receive treatment. c. A patient with chest pain is triaged directly to a room for evaluation and registration information is obtained after the patient is stabilized. d. The emergency department physician discharges and instructs a patient who is actively suicidal to go the neighbor facility that has psychiatric services.

A patient with chest pain is triaged directly to a room for evaluation and registration information is obtained after the patient is stabilized. EMTALA requires that any hospital that operates an emergency department and receives Medicare funds provide an appropriate screening exam to anyone who presented and stabilize any emergency medical condition prior to transfer to another facility.

The nurse researcher audiotaped interviews with subjects and would like to play these tapes during dissemination. The nurse identifies what steps that may be required to play the tapes? a. Inform the participants that they cannot hear the tapes beforehand. b. None, if the tape is of a group, since there is no expectation of anonymity. c. None, since the tape is a direct "quote" and voice recognition is not controllable. d. A release will need to be obtained from the subjects.

A release will need to be obtained from the subjects. Any videos, photos, or audiotapes require releases if they are to be shown in the dissemination of research findings. The participants have the right to review these tapes before allowing them to be used for research.

The nurse identifies that The Code of Ethics for Nurses is defined in which terms? a. Like the Constitution and not revisable b. A succinct statement of ethical obligations c. Required by entry level nurses only d. A negotiable document dependent on individual conscience

A succinct statement of ethical obligations The current nursing code, the Code of Ethics for Nurses with interpretive statements, was published in 2015. The Code of Ethics for Nurses is "a succinct statement of the ethical obligations and duties of every individual who enters the nursing profession," the profession's "nonnegotiable ethical standard," and "an expression of nursing's own understanding of its commitment to society."

The nurse is ready to analyze the data obtained through a qualitative study. What approach to data analysis should the nurse use? a. Content analysis b. Statistical analysis c. Coding of themes d. Dissemination

Content analysis Data analysis techniques are procedures used to summarize words or numbers and create a meaningful result for interpretation. Qualitative analysis involves content analysis. The qualitative data may contain quotations and require their interpretation.

The nurse realizes that a medication error has been made. The nurse then reports the error and takes responsibility to ensure patient safety despite personal consequences. This nurse has exhibited what ethical concept? a. Autonomy b. Accountability c. Justice d. Advocacy

Accountability Accountability is the willingness to accept responsibility for one's actions. Autonomy, or self-determination, is the freedom to make decisions supported by knowledge and self-confidence. Supporting or promoting the interests of others or doing so for a cause greater than oneself defines advocacy. To do justice is to act fairly and equitably.

The nurse is providing care for a patient who has had a stroke recently and has multiple self-care deficits. The nurse is coordinating care with in-home agencies and arranging for the delivery of needed equipment. Which ethical concept is the nurse applying? a. Advocacy b. Confidentiality c. Autonomy d. Accountability

Advocacy Supporting or promoting the interests of others or doing so for a cause greater than ourselves defines advocacy. Confidentiality is the ethical concept that limits sharing private patient information.

The nurse frequently cares for patients who are nearing the end of life. The nurse identifies what strategy that is designed to prolong the time of death rather than restoring life? a. Establishing a do-not-resuscitate (DNR) order b. Adherence to living will requests c. Removal of extraordinary measures already in place d. Continuance of futile care

Continuance of futile care Ethical dilemmas in end-of-life care exist regarding the establishment of do-not-resuscitate (DNR) orders, adherence to living will and organ donation requests, removal of extraordinary measures already initiated, and continuance of futile care

The nurse knows testing the application of theories in different situations with different populations is what type of research? a. Applied research b. Clinical research c. Basic research d. Quantitative research

Applied research Research conducted to generate theories is basic research. These theories help to provide explanations for phenomena. Testing theories in different situations with different populations is applied research. Clinical research is conducted to test theories about the effectiveness of interventions.

Research that tests the application of theories

Applied Research

The admission personnel working to comply with the Patient Self Determination Act of 1991 would do which of the following? a. Request identification from the patient to complete the registration process. b. Ask the patient if they would like a private or semi-private room. c. Inquire about the patient's reason for their visit. d. Ask the patient or representative if the patient has an advanced directive and inform them of their right to participate in their medical decisions.

Ask the patient or representative if the patient has an advanced directive and inform them of their right to participate in their medical decisions. Inquiring about a patient's advanced directive is a requirement of the Patient Self Determination Act of 1991. Inquiring about identification, type of room requested, and reason for visit are not addressed by the Patient Self Determination Act.

The nurse is faced with an ethical issue. When assessing the ethical issue, which action should the nurse perform first? a. Ask, "What is the issue?" b. Identify all possible alternatives. c. Select the best option from a list of alternatives. d. Justify the choice of action or inaction.

Ask, "What is the issue?" The first step in the situational assessment procedure is to find out the technical and scientific facts and assess the human dimension of the situation—the feelings, emotions, attitudes, and opinions.

A patient suffered a brain injury from a motor vehicle accident and has no brain activity. The patient has a living will which states no heroic measures. The family requests that no additional heroic measures be instituted for their son. The nurse respects this decision in keeping with which principle? a. Accountability b. Autonomy c. Nonmaleficence d. Veracity

Autonomy Patients and families must be treated in a way that respects their autonomy and their ability to express their wishes and make informed choices about their treatment.

The nurse is caring for a patient whose family does not want the patient to be told about the new diagnosis of cancer because of the poor prognosis. Keeping this secret from the patient is in direct conflict with which ethical concepts? a. Autonomy and veracity b. Veracity and advocacy c. Justice and nonmaleficence d. Confidentiality and justice

Autonomy and veracity Autonomy, or self-determination, is the freedom to make decisions supported by knowledge and self-confidence. Truthfulness defines the ethical concept of veracity.

The nurse is preparing to conduct a study involving the "postprandial" blood sugars in patients who have received intensive diabetic rehabilitation versus diabetics undergoing "usual care." For the consent to be valid, the nurse would have to carry out which action? a. Change the language of the consent. b. Keep explanations to a minimum to reduce stress. c. Keep potential risks undisclosed. d. Insist that the participant sign the consent right away.

Change the language of the consent Research participants require an explanation of the study in which they are subjects. Any information provided needs to be in a language that is understandable to them. Procedures and the purpose of the study need to be explained. The way subject anonymity and confidentiality will be protected needs to be explained.

A nursing student is conducting a survey of fellow nursing students. Which ethical concept is the student following when calculating the risk-to-benefit ratio and concluding that no harmful effects were associated with a survey? a. Beneficence b. Human dignity c. Justice d. Human rights

Beneficence Beneficence is a term that is defined as promoting goodness, kindness, and charity. In ethical terms, beneficence means to provide benefit to others by promoting their good. Human dignity is the inherent worth and uniqueness of a person. Justice involves upholding moral and legal principles. Human rights are the basic rights of each individual.

A nurse has been asked to care for a patient who is an inmate from a nearby prison. During shift report, the nurse asks, "Why was the man convicted and imprisoned?" Another nurse responds that this is not important since nurses are required to provide compassionate care for all people in all circumstances. The responding nurse has displayed what concept? a. Beneficence b. Advocacy c. Confidentiality d. Autonomy

Beneficence In its simplest form, beneficence can be defined as doing good. Nurses demonstrate beneficence by acting on behalf of others and placing a priority on the needs of others rather than on personal thoughts and feelings.

Research that tests theories about the effectiveness of interventions

Clinical Research

If the nurse is trying to determine the best treatment or course of action and wants to incorporate the most reliable evidence into the decision, the nurse will use what filtered resource? a. Cochrane Reviews b. UpToDate c. STAT!Ref d. MD Consult

Cochrane Reviews When trying to determine the best treatment or course of action and wanting to incorporate the most reliable evidence into the decision, the nurse can use a filtered resource such as the Cochrane Reviews or the Joanna Briggs Institute Library of Systematic Reviews. The filtered resource provides the best available evidence.

Which is an example of the regulatory power to make law? a. Joint Commission establishing a medication reconciliation standard. b. Centers for Disease Control and Prevention (CDC) developing recommendations for childhood immunizations. c. Institute of Medicine (IOM) defining the approximate number of medication errors that result in significant patient harm or death. d. Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals.

Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals. The Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals refers to the enactment of law, while the other answers discuss the development of standards and recommendations that do not have the authority of law.

Two nurses are discussing health care quality. They agree which event contributes to increased health care quality? a. Magnet status hospitals b. Fewer adverse events c. Collaboration of multiple health care agencies d. Increased patient education

Collaboration of multiple health care agencies Multiple health care agencies are abIe to collaborate and provide better outcomes for health care personnel and patients. Magnet status hospitals may be good, but the status does not always mean a quality outcome.

The nurse is caring for a patient who has been belligerent and is in 4-point "leather" restraints. When the patient continues to be verbally abusive and still tries to kick and punch staff even though he is restrained, the nurse should carry out which action? a. Do not attempt to meet patient needs until the patient has calmed down. b. Only provide care while security is in the room. c. Continue to attempt to meet the patient's needs. d. Inform the patient the police will be called if the patient's behavior does not stop.

Continue to attempt to meet the patient's needs. Provision 1.5 (of the Nursing Code of Ethics) states, "The principle of respect for persons extends to all individuals witNh wRhomItheGnuBrs.e iCnterMacts.

The nurse in the outpatient setting would like to conduct a research study that compares patients who take tramadol (Ultracet) to patients who take oxycodone hydrochloride and acetaminophen (Percocet) for managing back pain. Which quantitative research method should yield the best results? a. Longitude study b. Controlled study c. Systematic reviews/meta-analysis d. Survey study

Controlled study A controlled study is a type of quantitative research that seeks to control and examine the variables to determine effectiveness. In this case, the variables would be those that were administered tramadol (Ultracet) and those that were administered hydrochloride and acetaminophen (Percocet) for managing back pain.

The nurse is providing patient care and pays special attention to meeting the needs of the patient while maintaining the patient's right to privacy, confidentiality, autonomy, and dignity. This nurse is applying what ethical theory? a. Deontology b. Utilitarianism c. Autonomy d. Accountability

Deontology Deontology is an ethical theory that stresses the rightness or wrongness of individual behaviors, duties, and obligations without concern for the consequences of specific actions. Meeting the needs of patients while maintaining their right to privacy, confidentiality, autonomy, and dignity is consistent with the tenets of deontology.

In practice, the nurse has identified an observable phenomenon and wants to conduct research to generate a hypothesis through observation of the situation. The nurse knows what approach to be the best way for the nurse to conduct this type of investigation? a. Correlational research study b. Experimental research study c. Descriptive research study d. Quasi-experimental research study

Descriptive research study Descriptive research identifies data and characteristics about the population or phenomenon. Correlational research is used to explore a relationship between two variables. Experimental research explores the causal relationships between variables.

The nurse understands state legislatures give authority to administrative bodies, such as state boards of nursing, to carry out what action? a. Create statutory laws. b. Establish regulatory laws. c. Try case law cases. d. Create laws based on social mores

Establish regulatory laws Statutory law is created by legislative bodies such as the U.S. Congress and state legislatures. Statutory laws are often referred to as statutes. State legislatures give authority to administrative bodies, such as state boards of nursing, to establish regulatory law, which outlines how the requirements of statutory law will be met.

Which statement by the nurse indicates comprehension of ethical issues? a. Ethical issues are rare occurrences but take a great deal of time to resolve. b. Ethical issues have required The Joint Commission to mandate ethics committees. c. Ethical issues most frequently lead to legal intervention in patient care matters. d. Ethical issues lead to ethics committees made up entirely by nurses.

Ethical issues have required The Joint Commission to mandate ethics committees. All nurses are faced with ethical decisions each day in practice, and some choose to obtain further education and experience in the field of bioethics and participate on institutional ethics committees along with physicians, ethicists, attorneys, and academicians.

Supports or disputes the efficacy of treatment

Evidence

The conscientious, explicit, and judicious use of the theory-derived, research-based information in making decisions about care delivery to individuals or groups of patients and in consideration of individual needs and preferences

Evidence-Based Nursing

The nurse is providing care to a patient experiencing pain. The nurse assesses the pain and promptly administers the ordered analgesics as promised to the patient. This nurse has applied what concept? a. Autonomy b. Accountability c. Confidentiality d. Fidelity

Fidelity Keeping promises or agreements made with others constitutes fidelity. In nursing, fidelity is essential for building trusting relationships with patients and their families. Following through on promises is a critical factor in establishing strong professional relationships with patients and their families.

The nurse is providing care for a patient who demands discharge from the hospital against the physician's orders. What action by the nurse is most appropriate? a. Have the patient sign an "Against medical advice" form. b. Follow the guidelines as presented in the code of Academic and Clinical Conduct. c. Review the ANA's Nursing Code of Ethics for guidance. d. Permit the patient to leave after an informed consent form is signed.

Have the patient sign an "Against medical advice" form. Preventing patients from leaving a health care facility at their request may be considered false imprisonment. To prevent health care providers and institutions from being held liable if a patient chooses to leave a facility when physicians and nurses think that it is in the patient's best interest to remain hospitalized, the patient is asked to sign an against medical advice (AMA) form.

What is one of the major attributes of health care law? a. It defines the expected behavior of persons in the business of health care. b. The law or rule is easy to interpret and comply with. c. It is established by any health care authority. d. The creator must be an expert in health care.

It defines the expected behavior of persons in the business of health care. A health care law or rule defines expected behavior of persons in the business of health care or in health care relationships.

After studying legal issues important to nursing, the student shows appropriate understanding with which statement? a. Laws change often, creating liability issues for nurses. b. Licensure laws are devised to protect the nurse. c. The nurse is not responsible for other disciplines' mistakes. d. Keeping current with changing laws can protect the nurse.

Keeping current with changing laws can protect the nurse. Laws delineate acceptable nursing practice, provide a basis on which many health care decisions are determined, and protect nurses from liability in cases in which safe practice is maintained.

Which of the following is false regarding state licensure laws? a. These laws establish the requirements for licensure to practice. b. Licensure is not necessary if the individual has completed training. c. The state regulatory agencies such as the state board of nursing are responsible for creating and enforcing these rules. d. The scope of practice defines what the professional can and cannot do within the scope of their licensure.

Licensure is not necessary if the individual has completed training. Licensure is required to practice after the completion of all required training for the profession. The state laws establish the requirements to practice and the state regulatory agencies are responsible for creating and enforcing the rules. The scope of practice defines what activities the professional is legally authorized to perform.

The nurse has been involved sexually with a patient. The nurse manages becomes aware of this situation and tells the nurse this behavior is a which type of crime? a. Malpractice b. Libel c. Slander d. Battery

Malpractice Malpractice may occur when a professional such as nurse acts unethically, demonstrates deficient skills, or fails to meet standards of care required for safe practice. Examples of these types of malpractice include engaging in sexual activity with a patient and administering penicillin to a patient with a documented penicillin allergy, resulting in the patient's death from a severe allergic (anaphylactic) reaction.

The American Nurses Association (ANA) standards of professional performance require nurses to use research findings in practice. How do these standards impact nurses in the workplace? a. Nurses need to regulate their practice according to the latest journal articles. b. Nurses need to use the best available evidence to guide practice decisions. c. Nurses only need to participate in research while in advanced practice. d. Nurses may use evidence-based practice to develop procedures but not policies.

Nurses need to use the best available evidence to guide practice decisions. The American Nurses Association standards of professional performance require nurses to use research findings in practice. Two criteria are measured. The first criterion is that nurses need to use the best available evidence, which includes research findings, to guide their practice decisions. The second criterion is that nurses participate in research activities that are appropriate for their position and level of education.

When applying research to practice, the nurse finds what information? a. It is usually easy to access information at the bedside. b. Research articles are clear in defining nursing practice. c. Bedside care is not directly related to research. d. Nursing research should be used to improve care.

Nursing research should be used to improve care. One obstacle to applying research to practice is the difficulty in bedside access to information by nurses. Nurses often lack the time to participate in research-related activities. By reading research articles, the nurse may notice discrepancies in what is recommended in current practice and what is found in the literature.

When providing end-of-life care, the nurse knows it is essential to carry out which action? a. Tell the patient what he might like to hear to relieve anxiety. b. Begin making health care decisions for the patient. c. Provide the patient with the nurse's personal opinions. d. Offer unconditional support for the patient and family.

Offer unconditional support for the patient and family. Two major roles of a nurse caring for a dying patient are: (1) providing accurate information regarding the disease process and treatment options and (2) offering support for the patient and family without interjecting personal opinions.

The acronym PICO assists in remembering the steps to constructing a good research question and the nurse identifies that the "O" in the acronym refers to what term? a. Objectivity b. Ordinal approach c. Outcome d. Observer

Outcome One method of formulating a research question is identified by the acronym PICO (i.e., patient, population, or problem; intervention; comparison intervention; and outcomes).

Which statement is true regarding the patient's perception of his or her care? a. Patent perception is just as important as the outcome of care. b. Patient perception is insignificant compared to the outcome of care. c. Patient satisfaction has no relation to quality of care. d. Patient satisfaction is insignificant compared to the outcome of care.

Patent perception is just as important as the outcome of care. The patient's perception of his or her care is just as important as the outcome of the care. If the patient perceives the care as meeting the aspects of quality, then patient satisfaction increases.

The nurse is preparing to conduct a research study and is interested in exploring the lived experiences of nurses responsible for approaching patients and family members about the donation of organs. Which type of research would this be considered? a. Grounded theory b. Ethnography c. Historical d. Phenomenologic

Phenomenologic Phenomenologic research explores the reactions of a specific group of people who experienced a similar event in their lives.

The nurse is reviewing a research study that includes data in the form of numbers and recognizes that this is likely to be what type of study? a. Qualitative b. Experimental c. Quasi-experimental d. Quantitative

Quantitative Quantitative research usually produces data in the form of numbers. Experimental research explores the causal relationships between variables. Experimental research examines whether one variable has a cause-and-effect relationship with another. Quasi-experimental research examines a causal relationship between variables, but it may not meet the strict guidelines of experimental research

The nurse administrator is doing a study that entails gathering data about new employees over a 10-year period. Which research method would be the best one to use for this type of study? a. Quantitative longitude cohort b. Qualitative longitudinal c. Qualitative interview d. Qualitative case study

Quantitative longitude cohort Quantitative research has been defined as being "focused on the testing of a hypothesis through objective observation and validation." The types of studies that make up this category include randomized controlled studies, cohort studies, longitudinal studies, case-controlled studies, and case reports.

When the nurse is conducting a quantitative research study, what concept is implemented? a. Quantitative research assumes that reality is fixed and stable. b. Quantitative research is based on an inductive approach. c. Quantitative research seeks to gain knowledge through observation. d. Quantitative research usually produces data in narrative format.

Quantitative research assumes that reality is fixed and stable. Quantitative research is based on a postpositivist philosophy, which assumes that reality is objective, fixed, stable, observable, measurable, and value free. Positivism assumes that the approach is deductive in nature, and it seeks to gain knowledge through scientific and experimental research. Quantitative research usually produces data in the form of numbers.

Findings are consistent

Reliability

Findings are verified when repeated

Replicability

What are two major foci of The Joint Commission (TJC) in the delivery of health care? a. Cost containment; safety b. Safety; quality c. Quality; assessment d. Assessment; evaluation

Safety; quality The focus of TJC is quality and safety for patient care. TJC does not address cost containment, assessment of care, or evaluation of care.

The nurse knows that the third phase of evidence-based research involves what action? a. Searching for evidence and evaluating b. Assessing the problem c. Developing a question d. Performing a critical appraisal

Searching for evidence and evaluating Searching the database for the evidence begins the third phase. The nurse may need to consult three categories of information resources, which are reviewed in sequential order depending on need and applicability.

Which of the following is an example of a nurse violating the Health Insurance Portability and Accountability Act (HIPAA) of 1996? a. The nurse asks the unit clerk to look up lab values for her relative recently admitted to the hospital. b. A group of fellow employees are discussing a patient's clinical status in a public place. The nurse manager requests that they step into private room to complete the discussion. c. After entering the progress notes on a patient's electronic medical record, the nurse logs off the computer to allow her coworker to use the terminal. d. As a family approaches the nursing desk, the nurse removes the patient census sheet from view on the counter.

The nurse asks the unit clerk to look up lab values for her relative recently admitted to the hospital. When the nurse asks the unit clerk to look up lab values for her relative recently admitted to the hospital, the nurse is accessing protected health information not required for the nurse to perform his or her job. This is a violation of privacy even if it is a relative.

Which nurse has committed a serious documentation error? a. The nurse who documents all medications for assigned patients prior to administration. b. The nurse who documents medication administration as the medications are given. c. The nurse who documents assessments as soon as they are completed. d. The nurse who documents meal intake as meal trays are picked up.

The nurse who documents all medications for assigned patients prior to administration. Documentation must be accurate to provide a realistic view of a patient's condition. Serious documentation errors include: (1) omitting documentation from patient records, (2) recording assessment findings obtained by another nurse or unlicensed assistive personnel (UAP), and (3) recording care not yet provided.

A male patient suffered a brain injury from a motor vehicle accident and has no brain activity. The spouse has come up to see the patient every day for the past 2 months. She asks the nurse, "Do you think when he moves his hands he is responding to my voice?" The nurse feels bad because she believes the movements are involuntary, and the prognosis is grim for this patient. She states, "He can hear you, and it appears he did respond to your voice." The nurse is violating which principle of ethics? a. Autonomy b. Veracity c. Utilitarianism d. Deontology

Veracity Veracity is the principle of telling the truth in a given situation. Autonomy is the principle of respect for the individual person; this concept states that humans have incalculable worth or moral dignity. Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences.