Funds Exam 3 Ch 5 EAQs and practice questions

The nurse has conducted field research and is now writing a manuscript about the study. Which information should the nurse include in the section following the conclusion? The statistical analysis of the data obtained in the research The procedure or design of the research The explanation of the application of the results in clinical settings The explanation of the relationships predicted between various variables of the study

The explanation of the application of the results in clinical settings The clinical implication section follows the conclusion section and gives the information regarding the application of the research results in the clinical settings. The results section includes the information about the statistical analysis of the data acquired through research. The methods or design section of the research explains the process by which the research was carried out. The purpose statement of the research article provides information regarding relationships predicted between various variables of the study.

The registered nurse is teaching a group of student nurses about quantitative nursing research. Which statement made by a student indicates effective learning? "It focuses on statistical analysis." "It focuses on nonnumeric data." "It includes research methods such as grounded theory." "It provides an opportunity for patients to share their experiences."

"It focuses on statistical analysis." Quantitative nursing research is the study of nursing phenomena that offers precise measurement and quantification. It focuses on numerical data, statistical analysis, and controls to eliminate bias in findings. Qualitative research focuses on nonnumeric data. Qualitative research methods include ethnography, phenomenology, and grounded theory. Qualitative research provides an opportunity for patients to share their experiences.

The nursing student is collecting useful information for a research project. The student has collected more than 100 articles and needs to sort the articles that are similar to the project's PICOT question. Which advice should the professor give the student? Select all that apply. "Read all the articles in detail." "Read abstracts of the articles." "Read the introductions to the articles." "Read literature reviews about the articles." "Read manuscript narratives of the articles."

"Read abstracts of the articles." "Read the introductions to the articles." An abstract is a short summary of a study or an article that highlights the main features of the article, including the objective of the article, methods used, results obtained, and conclusions made. The introduction explains the purpose of the article and the evidence to support it. The abstract and introduction together would indicate whether the article is relevant to the PICOT question being researched. Reading the article in detail is time-consuming. Literature reviews involve thorough search of the relevant scientific studies done in the past to consolidate the purpose of the present study. Reading manuscript narratives is time-consuming and unnecessary if the article is not relevant to the PICOT question.

A professor is explaining the importance of the scientific method of research to a group of nursing students. Which statement by a student suggests that the student requires further explanation? Select all that apply. "The scientific method is without fault." "The scientific method is the foundation of research." "Aspects of the scientific method help in conducting research." "The scientific method may influence the opinions of the researcher in the final outcome." "The scientific method is an advanced, objective means of acquiring and testing knowledge."

"The scientific method is without fault." "The scientific method may influence the opinions of the researcher in the final outcome." Systematic, orderly procedures characterize the scientific method to limit the possibility for error, although it is not without fault. The scientific method minimizes the chance that bias or opinion by a researcher will influence the results of research and thus the knowledge gained. The scientific method is the foundation of research and is the most reliable and objective of all methods of gaining knowledge. Aspects of the scientific method help in conducting research. The scientific method is an advanced, objective means of acquiring and testing knowledge.

The nurse is preparing to conduct research. The nurse understands that a step-by-step approach ensures that the clinical decisions are based on the strongest evidence available. In which order should the nurse proceed to reach a clinical decision through an evidence-based practice (EBP)? Ask a clinical question. Evaluate the practice decision. Collect evidence from databases. Critically appraise the evidence.

1. Ask a clinical question 2. Collect evidence from databases 3. Critically appraise the evidence 4. Evaluate the practice decision Evidence-based practice (EBP) is a step-by-step approach that helps the nurse make logical decisions based on the available evidence. An EBP promotes achievement and incorporation of the best practices into nursing. The first step involves asking a clinical question, followed by collecting relevant and best evidence. The evidence is then critically appraised. The next step is to integrate all evidence with one's clinical expertise, along with patient preferences and values, in making a practice decision or change. Integration is followed by evaluation of the practice decision or change. The final step is to share the outcomes of EBP changes with others.

Arrange the following steps of evidence-based practice (EBP) in the appropriate order. Integrate the evidence. Ask the burning clinical question. Evaluate the practice decision or change. Share the results with others. Critically appraise the evidence you gather. Collect the most relevant and best evidence.

1. Ask the burning clinical question. 2. Collect the most relevant and best evidence. 3. Critically appraise the evidence you gather. 4. Integrate the evidence. 5. Evaluate the practice decision or change. 6. Share the results with others. Implementing evidence-based practice (EBP) follows a logical progression of steps. First ask a focused clinical question. PICOT format can help with developing good clinical questions. Then collect the most relevant and best evidence. Remember that systematic reviews and meta-analyses of randomized controlled trials provide the strongest evidence. After that, critically appraise the evidence you gather. Then integrate all evidence with your clinical expertise, along with patient preferences and values, in making a practice decision or change. Next, evaluate the practice decision or change. Finally, share the outcomes of the change with others

Arrange the steps of the research process in correct order. Formulate recommendations for further research Identify areas of interest or a clinical problem. Design the study protocol. Obtain necessary approvals. Analyze the results of the study.

1. Identify areas of interest or a clinical problem. 2. Design the study protocol. 3. Obtain necessary approvals. 4. Analyze the results of the study. 5. Formulate recommendations for further research

CHAPTER 25 Arrange the levels of cognitive learning in increasing order of complexity. Creating Applying Analyzing Evaluating Remembering Understanding

1. Remembering 2. Understanding 3. Applying 4. Analyzing 5. Evaluating 6. Creating Cognitive learning encompasses the acquisition of knowledge and intellectual skills. The first level of cognitive learning is remembering, which focuses on learning new facts and the ability to recall them. Understanding is the next level of cognitive learning. It is described as the ability to understand the meaning of the learned material. Applying is the third level of cognitive learning and involves using newly learned concepts in actual situations. Analyzing is the next level, which involves the breakdown of information into organized parts. Evaluating is the next level and is the ability to judge the outcome of a given process. Creating is the last level of cognitive learning. It is described as the ability to apply knowledge and skills to create something new.

The nurse helps a researcher conduct a randomized controlled trial (RCT). Which is the correct sequence when conducting an RCT? The researchers measure both groups for the same outcomes to see if there is a difference. The researcher determines if the intervention leads to better outcomes than the standard of care. Subjects are randomly assigned to either the control or treatment group. The treatment group receives the experimental intervention, and the control group receives the usual standard of care.

1. Subjects are randomly assigned to either the control or treatment group. 2. The treatment group receives the experimental intervention, and the control group receives the usual standard of care. 3. The researchers measure both groups for the same outcomes to see if there is a difference. 4. The researcher determines if the intervention leads to better outcomes than the standard of care. A randomized controlled trial (RCT) is performed to test an intervention against the standard of care. The subjects are randomized to the treatment or the control group. The treatment group receives the experimental intervention, and the control group receives the usual standard of care. The researcher observes both groups to determine the outcome. On completion, the researcher will determine if the experimental intervention leads to better outcomes when compared to the standard of care.

CHAPTER 25 Arrange the patient's behaviors in order of increasing complexity according to the affective domain of learning. The patient attaches worth and value to the acquired knowledge as demonstrated by the patient's behavior. The patient develops a value system by identifying and organizing values according to their worth. The patient acts and responds with a consistent value system and requires introspection and self-examination of one's own values in relation to an ethical issue or particular experience. The patient pays attention to the information and receives information. The patient actively participates through listening and reacting orally and verbally.

1.The patient pays attention to the information and receives information. 2.The patient actively participates through listening and reacting orally and verbally. 3.The patient attaches worth and value to the acquired knowledge as demonstrated by the patient's behavior. 4.The patient develops a value system by identifying and organizing values according to their worth. 5. The patient acts and responds with a consistent value system and requires introspection and self-examination of one's own values in relation to an ethical issue or particular experience. According to the affective domain of learning, the simplest behavior is receiving, which involves the patient paying attention to and receiving information. The second simplest behavior is responding, which involves active participation of the patient through listening and reacting orally and verbally. Next is valuing, which involves attaching worth and value to the acquired knowledge as demonstrated by the patient's behavior. The fourth behavior is organizing, which involves developing a value system by identifying and organizing values according to their worth. The fifth and the most complex behavior is characterizing, which involves acting and responding with a consistent value system and requires introspection and self-examination of one's own values in relation to an ethical issue or particular experience.

The nurse finds topics for research studies in different scientific literature databases. Which sources are correct for their respective database? Select all that apply. MEDLINE contains biomedical and pharmaceutical studies. AHRQ contains clinical guidelines and evidence summaries. CINAHL contains studies in nursing, allied health, and biomedicine. EMBASE includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health. PubMed offers free access to journal articles.

AHRQ contains clinical guidelines and evidence summaries. CINAHL contains studies in nursing, allied health, and biomedicine. PubMed offers free access to journal articles. The Agency for Healthcare Research and Quality (AHRQ) database includes clinical guidelines and evidence summaries. Cumulative Index of Nursing and Allied Health Literature (CINAHL) includes studies in nursing, allied health, and biomedicine. PubMed is the health science library at the National Library of Medicine and offers free access to journal articles. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health. EMBASE includes biomedical and pharmaceutical studies.

7. 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. A true PICOT question regardless of the number of elements b. A true PICOT question because the intervention comes before the control c. Not a true PICOT question because the comparison comes after the intervention d. Not a true PICOT question because the time is not designated

ANS: A A meaningful PICOT question can contain only a P and O: How do patients with breast cancer (P) rate their quality of life (O)? Note that a well-designed PICOT question does not have to follow the sequence of P, I, C, O, and T. The aim is to ask a question that contains as many of the PICOT elements as possible.

1. A nurse uses evidence-based practice (EBP) to provide nursing care. What is the best rationale for the nurse's behavior? a. EBP is a guide for nurses in making clinical decisions. b. EBP is based on the latest textbook information. c. EBP is easily attained at the bedside. d. EBP is always right for all situations.

ANS: A Evidence-based practice (EBP) is a guide for nurses to structure how to make appropriate, timely, and effective clinical decisions. A textbook relies on the scientific literature, which may be outdated by the time the book is published. Unfortunately, much of the best evidence never reaches the bedside. EBP is not to be blindly applied without using good judgment and critical thinking skills.

4. A nurse has collected several research findings for evidence-based practice. Which article will be the best for the nurse to use? a. An article that uses randomized controlled trials (RCT) b. An article that is an opinion of expert committees c. An article that uses qualitative research d. An article that is peer-reviewed

ANS: A Individual RCTs are the highest level of evidence or "gold standard" for research. A peer-reviewed article means that a panel of experts has reviewed the article; this is not a research method. Qualitative research is valuable in identifying information about how patients cope with or manage various health problems and their perceptions of illness. It does not usually have the robustness of an RCT. Expert opinion is on the bottom of the hierarchical pyramid of evidence.

15. 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? a. Performance improvement b. Peer-reviewed project c. Generalizability study d. Qualitative research

ANS: A Performance improvement focuses on performance issues like falls or pressure ulcer incidence. A peer-reviewed article is reviewed for accuracy, validity, and rigor and approved for publication by experts before it is published. Generalizability is not a study/research; it is if the results of a study can be compared to other patients with similar experiences. This is a quantitative study, not a qualitative study.

8. 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? a. Meta-analysis b. Systematic review c. Single random controlled trial d. Control trial without randomization

ANS: A The main difference is that in a meta-analysis the researcher uses statistics to show the effect of an intervention on an outcome. In a systematic review no statistics are used to draw conclusions about the evidence. A single random controlled trial (RCT) is not as conclusive as a review of several RCTs on the same question. Control trials without randomization may involve bias in how the study is conducted.

20. 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. a. 3, 4, 5, 2, 1 b. 4, 3, 5, 2, 1 c. 3, 5, 4, 2, 1 d. 4, 5, 3, 2, 1

ANS: A The steps of the research process are as follows: (1) Identify area of interest or clinical problem, (2) develop research question(s)/hypotheses, (3) determine how study will be conducted, (4) conduct the study, and (5) analyze results of the study.

11. 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? a. Conduct a pilot study to investigate findings. b. Drop the idea of making the change at this time. c. Insist that management hire the needed staff to facilitate the change. d. Seek employment in another institution that may have the staff needed.

ANS: A When evidence is not strong enough to apply in practice, the next option is to conduct a pilot study to investigate the PICOT question. Dropping the idea would be counterproductive; insisting that management hire staff could be seen as a mandate and could produce negative results. Seeking employment at another institution most likely would not be the answer because most institutions operate under similar established guidelines.

19. A nurse is implementing an evidence-based practice project regarding infection rates. After reviewing research literature, which other evidence should the nurse review? a. Quality improvement data b. Inductive reasoning data c. Informed consent data d. Biased data

ANS: A When implementing an evidence-based practice project, it is important to first review evidence from appropriate research and quality improvement data. Inductive reasoning is used to develop generalizations or theories from specific observations; this study needs specifics. Informed consent is not data but a process and form that subjects must sign before participating in research projects/studies. Biased data is based on opinions; facts are needed for this study.

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

ANS: A, B, C Experimental research, surveys, and evaluation research are all forms of quantitative research. Phenomenology and grounded theory are forms of qualitative research.

2. 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

ANS: A, B, C, D Informed consent means that research subjects (1) are given full and complete information about the purpose of a study, procedures, data collection, potential harm and benefits, and alternative methods of treatment; (2) are capable of fully understanding the research and the implications of participation; (3) have the power of free choice to voluntarily consent or decline participation in the research; and (4) understand how the researcher maintains confidentiality or anonymity. Completion of the study is not needed for informed consent.

2. Before conducting any study with human subjects, the researcher must obtain approval from the agency's human subjects committee or institutional review board (IRB). The IRB ensures that the researcher (Select all that apply.) a. Obtains informed consent. b. Minimizes risk to subjects. c. Ensures confidentiality. d. Identifies risks and benefits of participation. e. Ensures that subjects complete the study.

ANS: A, B, C, D Researchers must protect the confidentiality of those who participate in the study, obtain informed consent, minimize risk to subjects, identify risks and benefits of participation, ensure that participation in the study is voluntary, and allow subjects to withdraw from studies at any time.

1. 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

ANS: A, D, E Experimental research, nonexperimental research, surveys, and evaluation research are all forms of quantitative research that allow for precise measurement. Phenomenology and grounded theory are forms of qualitative research.

13. 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? a. Bias b. Confidentiality c. Informed consent d. The research process

ANS: B Confidentiality guarantees that any information the subject provides will not be reported in any manner that identifies the subject and will not be accessible to people outside the research team. Biases are opinions that may influence the results of research. Informed consent means that research subjects (1) are given full and complete information about the purpose of the study, procedures, data collection, potential harm and benefits, and alternative methods of treatment; (2) are capable of fully understanding the research; (3) have the power to voluntarily consent or decline participation; and (4) understand how confidentiality or anonymity is maintained. The research process is a broader concept that provides an orderly series of steps that allow the researcher to move from asking a question to finding the answer.

14. 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? a. Abstract b. Conclusion c. Study design d. Clinical implications

ANS: B During results or conclusions, the researcher interprets the findings of the study, including limitations. An abstract summarizes the purpose of the article with major findings. Study design involves selection of research methods and type of study conducted. The researcher explains how to apply findings in a practice setting for the type of subjects studied in the clinical implications section.

18. A nurse is developing a care delivery outcomes research project. Which population will the nurse study? a. Nurses b. Patients c. Administrators d. Health care providers

ANS: B Similar to the expected outcomes you develop in a plan of care, a care delivery outcome focuses on the recipients of service (e.g., patient, family, or community) and not the providers (e.g., nurse or physician/health care provider). Administrators are not recipients of service.

5. The nurse is reviewing a research article on a patient care topic. Which area should entice the nurse to read the article? a. Literature review b. Introduction c. Methods d. Results

ANS: B The introduction contains information about its purpose and the importance of the topic to the audience who reads the article. The literature review or background offers a detailed background of the level of science or clinical information about the topic of the article. The methods or design section explains how a research study was organized and conducted. The results or conclusion section details the results of the study and explains whether a hypothesis is supported.

3. The nurse is doing a literature review related to a potential problem that has been identified on the nursing unit. The nurse realizes that nursing research is important in that it is designed to (Select all that apply.) a. Enhance the nurse's chance at promotion. b. Identify new knowledge. c. Improve professional practice. d. Enhance effective use of resources. e. Lead to decreases in budget expenditures.

ANS: B, C, D Nursing research is a way to identify new knowledge, improve professional education and practice, and use resources effectively. Effective use of resources does not always result in lower budget expenditures, but rather more effective use of resources. A promotion is not a direct result of research.

3. 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.

ANS: B, C, D Nursing research is a way to identify new knowledge, improve professional education and practice, and use resources effectively. Nursing research itself does not lead to a decrease in budget expenditures; however it does lead to using health care resources effectively. A promotion is not a direct result of nursing research.

10. 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"? a. After surgery b. Who listen to music c. Who receive standard nursing care d. Achieve better control of their anxiety and pain

ANS: C Do patients (P) who listen to music (I) achieve better control of their anxiety and pain (O) after surgery (T) when compared with patients who receive standard nursing care following surgery (C)?

2. In caring for patients, what must the nurse remember about evidence-based practice (EBP)? a. EBP is the only valid source of knowledge that should be used. b. EBP is secondary to traditional or convenient care knowledge. c. EBP is dependent on patient values and expectations. d. EBP is not shown to provide better patient outcomes.

ANS: C Even when the best evidence available is used, application and outcomes will differ based on patient values, preferences, concerns, and/or expectations. Nurses often care for patients on the basis of tradition or convenience. Although these sources have value, it is important to learn to rely more on research evidence than on nonresearch evidence. Evidence-based care improves quality, safety, patient outcomes, and nurse satisfaction while reducing costs.

12. 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? a. Nonexperimental research b. Experimental research c. Qualitative research d. Evaluation research

ANS: C Qualitative research involves using inductive reasoning to develop generalizations or theories from specific observations or interviews. Evaluation and experimental research are forms of quantitative research. Nonexperimental descriptive studies describe, explain, or predict phenomena such as factors that lead to an adolescent's decision to smoke cigarettes.

3. A nurse wants to change a patient procedure. Which action will the nurse take to easily find research evidence to support this change? a. Read all the articles found on the Internet. b. Make a general search of the Internet. c. Use a PICOT format for the search. d. Start with a broad question.

ANS: C The more focused the question is, the easier it becomes to search for evidence in the scientific literature. The PICO format allows the nurse to ask focused questions that are intervention based. Inappropriately formed questions (general search or broad question) will likely lead to irrelevant sources of information. It is not beneficial to read hundreds of articles. It is more beneficial to read the best four to six articles that specifically address the question.

16. A nurse identifies a clinical problem with pressure ulcers. Which step should the nurse take next in the research process? a. Analyze results. b. Conduct the study. c. Determine method. d. Develop a hypothesis.

ANS: D After identifying an area of interest or clinical problem, the steps of the research process are as follows: Develop research question(s)/hypotheses; determine how the study will be conducted; conduct the study; and analyze results of the study.

9. A nurse is reviewing research studies for evidence-based practice. Which article should the nurse use for qualitative nursing research? a. An article about the number of falls after use of no side rails b. An article about infection rates after use of a new wound dressing c. An article about the percentage of new admissions on a new floor d. An article about emotional needs of dying patients and their families

ANS: D Studying emotional needs is a qualitative study. Qualitative nursing research is the study of phenomena that are difficult to quantify or categorize, such as patients' perceptions of illness. The number of falls, infection rates, and percentages of new admissions are all examples of quantitative research.

6. 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? a. MEDLINE b. EMBASE c. PsycINFO d. AHRQ

ANS: D The Agency for Healthcare Research and Quality (AHRQ) includes clinical guidelines and evidence summaries. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health. EMBASE includes biomedical and pharmaceutical studies. PsycINFO deals with psychology and related health care disciplines.

17. 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? a. Evaluate the changes in 1 month. b. Implement the changes as a pilot study. c. Wait a month before implementing the changes. d. Communicate to staff the results of this project.

ANS: D The last step of evidence-based practice (EBP) is to share the outcomes of EBP changes with others. Changes must be evaluated before the outcomes are shared. Once communicated, changes should be put in place as the committee deems reasonable (i.e., either hospital wide or as a pilot study). Waiting should not be an option unless the results are not to the committee's liking.

Which part of an evidence-based article includes the major themes or findings and the implications for nursing practice? Abstract Introduction Literature Review Manuscript narrative

Abstract An abstract is a brief summary that quickly tells whether the study is research-based or clinically based. This part of the evidence-based article includes the major themes or findings and the implications for nursing practice. The introduction contains more information about the purpose of the article. The literature review offers an argument about what led the author to conduct the study or report. The manuscript narrative is the middle section, which differs according to the type of evidence-based article it is (that is, a clinical article or a research article).

The nurse has to read many articles while doing research. Studying the full text of a research article to determine whether the article is relevant to the nurse's own research can be tedious. Which section of a reference article would aid the nurse in learning about the study in brief? Abstract Introduction Literature review Methodology section

Abstract The abstract of an article summarizes the purpose of the article and briefly states the methodology, results, discussion, and conclusion. This gives a brief overview of the research. The nurse should read the abstract to find out whether the research article is an appropriate reference for the study. The introduction states the purpose of the article in detail but gives no information about the study results or the conclusion. The literature review provides a detailed background of the level of science or clinical information that exists about the research study. The methodology section only explains the process by which the research was conducted.

Critiquing the evidence is one of the most important steps in the process of implementing evidence-based practice. Which is the most important information required while critiquing evidence? Are the findings clinically applicable? Can the findings be applied in a different patient group? Are the findings applicable to patients of a different ethnicity? Do the findings provide better treatment alternatives than conventional therapy?

Are the findings clinically applicable? The most important information required while critiquing research is whether the findings of the research are clinically applicable and scientifically relevant. Of lower priority when critiquing the research are questions such as whether the findings of the research are applicable to a different group of patients or to patients belonging to a different ethnicity, and whether the findings of the research provide better treatment alternatives than conventional therapy. Unless the clinical applicability of a research finding is confirmed, it cannot be applied to any patient group.

A 55-year-old patient is diagnosed with lung cancer and has a history of smoking. Which type of study would be initiated to find the association between smoking and lung cancer,? Select all that apply. Case-control study Randomized controlled trial Historical research Retrospective study Descriptive research

Case-control study Retrospective study A case-control study is performed to find out the cause for a disease. A retrospective study looks back in time to evaluate the available data and find the variables in a disease. Although randomized controlled trials can be used for investigating cause and effect, they are more suitable for exploring drug therapies. Historical studies are performed to confirm facts and relationships about a past event. Descriptive studies help to measure characteristics of persons, situations, or groups and the frequency with which certain events or characteristics occur.

The nursing student is preparing an evidence-based practice project for which the student has posed a clear and concise clinical question. Which should the student do before incorporating the evidence into practice? Select all that apply. Obtain informed consent. Collect the most relevant and best evidence. Critically appraise the evidence gathered. Share the outcome with others. Get approval from the institutional review board.

Collect the most relevant and best evidence. Critically appraise the evidence gathered. Share the outcome with others. When incorporating evidence into practice, the most relevant and best evidence is collected and critically appraised. The evidence is integrated with the nurse's clinical expertise in making a change. The change is then evaluated, and the outcome is shared with others. The six steps of evidence-based practice are as follows: ask a clinical question; collect the most relevant and best evidence; critically appraise the gathered evidence; integrate all evidence with one's clinical expertise, along with patient preferences and values, in making a practice decision or change; evaluate the practice decision or change; and share the outcomes of evidence-based practice with others. Informed consent and approval from the institutional review board are required in a research process.

The nurse caring for patients in an inpatient unit asks a clinical question using a PICOT format. What does C stand for in a PICOT question? Comparison of interest Client who is admitted Care provided Current diagnosis

Comparison of interest There are five elements of a PICOT question. P stands for the patient identified by age, gender, ethnicity, and disease or health problem. I stands for intervention of interest. C stands for comparison of interest. O stands for outcomes, and T stands for time. C does not stand for client, care, or current diagnosis.

The nurse is referring to various research articles in order to acquire information about a PICOT question for which no pilot study has been done. After studying the references, the nurse finds that the evidence is not strong enough to apply in practice. What should the nurse do to investigate the PICOT question? Choose the best answer. Conduct a pilot study. Conduct a systematic review. Conduct a randomized controlled trial. Implement the change that the nurse predicts in clinical settings.

Conduct a pilot study. If the evidence acquired through varied research is not strong enough to apply in practice, the next option for the nurse is to conduct a pilot study. A pilot study is research done on a small scale. Conducting systematic reviews or randomized controlled trials involves tedious processes and takes a long time to obtain results. Even though these methods provide high quality evidence, they are less likely to be performed by the nurse working in a clinical setting. The nurse does not apply the predicted results of research in clinical settings without suitable evidence.

The nurse helps a researcher to conduct a study on human subjects. The researcher obtains approvals from an institutional review board (IRB). An IRB ensures that researchers follow ethical principles, including respecting the rights of human subjects. The nurse verifies that the subject has signed the informed consent. Which criteria regarding the informed consent will the nurse explain to the subject? Select all that apply. Consent is voluntary. The subject cannot refuse to participate in the research. The subject understands how the researcher maintains confidentiality. The subject is allowed to choose the treatment modality. The subject can withdraw from the study at any time.

Consent is voluntary. The subject understands how the researcher maintains confidentiality. The subject can withdraw from the study at any time. Informed consent is needed to ensure that the subject is given sufficient information about the research to enable the subject to either consent voluntarily to participate or decline to participate. The subject should understand the confidentiality of the data obtained. The subject has the right to withdraw from the study when desired. Informed consent does not limit the subject's ability to decline participation; the subject can decline participation anytime in the course of the study. The informed consent does not allow the subject to choose his or her own treatment.

The nurse is providing care to a patient who is experiencing major abdominal trauma following a car accident. The patient is losing blood quickly and needs a blood transfusion. The nurse finds out that the patient is a Jehovah's Witness and cannot have blood transfusions because of religious beliefs. The nurse notifies the patient's health care provider and receives an order to give the patient an alternative to blood products. Of what is this an example? A quality improvement study A change in practice based on evidence A time when calling the hospital's ethics committee is essential Consideration of patient preferences and values while providing care

Consideration of patient preferences and values while providing care This example illustrates a situation in which the health care providers take the patient's values and beliefs into consideration while providing care. This is not an example of a quality improvement study or change in practice based on evidence. Although ethics is a critical consideration in this instance if the patient's life is in danger and the patient refuses treatment, the provider orders an alternative to blood products, which in itself is not an ethical dilemma.

Which type of research explores the interrelationships among variables of interest without any active intervention by the researcher? Historical research Evaluation research Correlational research Experimental research

Correlational research Correlational research explores the interrelationships among variables of interest without any active intervention by the researcher. Historical research is designed to establish facts and relationships concerning past events. Evaluation research tests how well a program, practice, or policy is working. In experimental research, an investigator controls the study variable and randomly assigns subjects to different conditions to test the variable.

The nurse researcher is developing a research proposal and is in the process of selecting an instrument to measure anxiety. The nurse is in which part of the research process? Analyzing the data Designing the study Conducting the study Identifying the problem

Designing the study During study design, the researcher selects instruments to measure variables. Identifying the problem comes first in the research process, after which the researcher will design the study. Once the study has been designed, the researcher will conduct the study, and then analyze the data collected.

CHAPTER 25 The nurse must teach discharge instructions to a postsurgical patient. Which learning principles should the nurse use to effectively educate the patient? Select all that apply. Determine the extent to which the patient can perform skills. Assess the patient's physical condition before teaching. Refrain from asking the patient about cultural and spiritual influences about illness. If the patient is willing, involve the family member of the patient while teaching. Teach the patient in a location where he or she can easily interact with all the visitors.

Determine the extent to which the patient can perform skills. Assess the patient's physical condition before teaching. If the patient is willing, involve the family member of the patient while teaching. Determine the extent to which the patient can perform skills so the patient can easily perform the tasks given. Physical conditions such as body temperature, pain, and fatigue can interfere with the ability to maintain attention. Therefore, physical examination is necessary. If the patient desires, involving a family member can help speed recovery. The patient should be asked about his or her cultural and spiritual beliefs regarding the illness, because these influences might affect the learning process. The environment should be conducive to teaching. A quiet place away from distractions is also necessary.

The nurse is studying the process of nursing research. Which research should the nurse classify as qualitative research? Effectiveness of aspirin to reduce fever in patients with viral infections Effectiveness of psychological counseling on the perception of stress in patients with chronic illness Effectiveness of relaxation techniques in decreasing pain severity in cancer patients Effectiveness of loop diuretics in increasing urine output in patients with chronic renal failure

Effectiveness of psychological counseling on the perception of stress in patients with chronic illness The effectiveness of psychological counseling on the perception of stress in patients with chronic illness is the outcome variable. This variable cannot be measured; thus the study is a qualitative study. In the statement regarding the effectiveness of aspirin to reduce fever in patients with viral infections, fever is the main outcome variable. Changes in temperature can be measured; thus this study is an example of quantitative research. In the statement regarding the effectiveness of relaxation techniques in decreasing pain severity in cancer patients, pain severity is the main outcome variable. Changes in pain severity can be measured using the visual analogue scale; thus this study is an example of quantitative research. In the statement regarding the effectiveness of loop diuretics in increasing urine output in patients with chronic renal failure, urine output is the main outcome variable. The change in urine output can be measured; thus this study is an example of quantitative research.

The nurse designs and conducts an informational health campaign and then measures the outcomes of the campaign. Which type of research practice did the nurse perform? Evaluation Descriptive Exploratory Experimental

Evaluation Evaluation research tests how well a program, practice, or policy is working. The nurse is conducting an informational health campaign and measuring the outcomes of the campaign, which indicates that the nurse is engaged in evaluation. Descriptive research measures the characteristics of persons, situations, or groups and the frequency with which certain events or characteristics occur. Exploratory research is designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationships among phenomena. In experimental research, the investigator controls the study variable and randomly assigns subjects to different conditions to test the variable.

A group of nurses implemented a well-designed health care program focusing on the importance of immunization across many regions in the state of California. These nurses are conducting research to determine the outcome of the program in terms of the number of children receiving vaccinations. Which type of research is this? Exploratory research Experimental research Evaluation research Descriptive research

Evaluation research Evaluation research helps to test how well a program, practice, or policy is working. The research is conducted to determine or evaluate the effectiveness of the immunization program. An exploratory study is the initial study designed to develop or refine the dimensions of a nursing phenomenon, or to develop or refine a hypothesis about the relationships among different variables. This type of study does not evaluate the effectiveness of a program or event. An experimental study is a study in which the investigator controls the study variable and randomly assigns subjects to different conditions to test the variable. The evaluation research does not involve the study of variables. Descriptive research is a type of study that measures characteristics of persons or situations, and the frequency with which certain events or characteristics occur. This is not the case with evaluation research.

The nurse assesses the following risk factors for coronary artery disease (CAD) in a male patient. Which factors are classified as genetic or physiological? Select all that apply. Sedentary lifestyle Father died from CAD at age 50 History of hypertension Diet high in sodium Elevated cholesterol level Age of 44 years

Father died from CAD at age 50 History of hypertension Elevated cholesterol level Genetic risk factors are related to heredity and the genetic predisposition to an illness; physiological factors involve the physical functioning of the body. Certain physical conditions such as being pregnant or overweight place increased stress on physiological systems (e.g., the circulatory system), increasing susceptibility to illness in these areas. A person with a family history of coronary artery disease is at risk for developing the disease later in life because of a hereditary and genetic predisposition to the disease. Age, diet and lifestyle are not genetic or physiological risk factors.

The nurse researcher decides to complete a study to evaluate how Florence Nightingale improved patient outcomes in the Crimean War. This is an example of which type of research? Historical Evaluation Exploratory Experimental

Historical Historical studies establish facts concerning past events. Evaluation research tests how well a program, practice, or policy is working. Exploratory research is designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationship among phenomena. Experimental research involves studies in which the researcher controls the study variable and randomly assigns subjects to different conditions to test the variable.

The nurse is developing a PICOT question that addresses the effectiveness of hot fomentation in comparison with nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve dysmenorrheal pain. Which is the intervention of interest in this research question? NSAID drugs Hot fomentation Dysmenorrheal pain Women with dysmenorrhea

Hot fomentation The intervention of interest (I) in PICOT tells whether the intervention is worthwhile to use. In the research question, the nurse is comparing the effectiveness of hot fomentation (intervention of interest) with that of nonsteroidal anti-inflammatory drugs (NSAIDs) (conventional treatment versus comparison of interest). Dysmenorrheal pain is the outcome of interest (O). Women with dysmenorrhea are the patient population of interest (P).

While developing a research proposal, the nurse is in the process of devising research questions and a hypothesis. Which describes this part of the research process? Analyzing the data Designing the study Conducting the study Identifying the problem

Identifying the problem In this situation, the nurse is identifying the problem. During this first step, the nurse devises research questions and a hypothesis.. While analysing the data, the nurse interprets results, including conclusions and limitations. While designing a study protocol, the nurse selects instrumentation, questionnaires, physiological measures, interviews, and treatments. While conducting the study, the nurse obtains the necessary approvals and continually assesses the study methodology.

When recruiting subjects to participate in a study about the effects of an exercise program on balance, the researcher provides full and complete information about the purpose of the study and gives the subjects the choice to participate or not participate in the study. Of what is this an example? Bias Anonymity Confidentiality Informed consent

Informed consent The process of informed consent includes providing research subjects full disclosure about the study and the opportunity to participate or not to participate in the study. Bias is opinion by a researcher that will influence the results of research. Confidentiality guarantees that any information a subject provides will not be reported in any manner that identifies the subject and will not be accessible to people outside the research team. Anonymity guarantees that any information a subject provides will not be reported in any manner than identifies the subject and will not be accessible by anyone, including the research team.

The nurse understands that using a PICOT format for clinical questions helps in refining the search for evidence. Which are the best reasons to follow the PICOT format? Select all that apply. It helps to ask a more focused question. It is necessary to follow the sequence of PICOT. It prevents wandering when searching for evidence. It allows the researcher to ask questions that are focused on theory. It helps to identify knowledge gaps within a clinical situation.

It helps to ask a more focused question. It prevents wandering when searching for evidence. It helps to identify knowledge gaps within a clinical situation. The PICOT (Patient, Intervention, Comparison, Outcome, Time) format is used when asking a clinical question and looking for related evidence. The PICOT format helps to refine the focus of the question by dividing the question into different components of PICOT. The evidence can be searched through key words of a PICOT question, which helps to refine the search and to identify gaps in the clinical situation in terms of missing evidence. It is not necessary to follow the sequence of PICOT; the components can be used in any order. The PICOT format allows the nurse to ask questions that are focused on intervention, rather than theory.

The nurse understands the evidence-based articles and is critiquing the available evidence. Which characteristic feature should the nurse look for in a well-written literature review? It mentions the purpose of the article. It includes a short summary that contains brief information about the study. It explains a new therapy or new technology. It includes an argument about what led the author to conduct a study or report on a clinical topic.

It includes an argument about what led the author to conduct a study or report on a clinical topic. A well-written literature review offers an argument about what led the author to conduct a study or report on a clinical topic. The literature review also provides a detailed background of the level of science or clinical information that exists about the research study. An abstract is a short summary that contains brief information about the study. An introduction contains more information about the purpose of the article. A manuscript narrative provides information regarding new therapy or new technology.

The nurse working in an orthopedic center finds that most of the patients coming to the clinic have mechanical low-back aches. Which is the best reference in order to develop a good plan of care for these patients? Psychology and related health care disciplines (PsycINFO) Cochrane Database National Guidelines Clearinghouse (NGC) Cumulative Index of Nursing and Allied Health Literature (CINAHL)

National Guidelines Clearinghouse (NGC) The National Guidelines Clearinghouse (NGC) contains clinical guidelines and care plans for a specific set of clinical circumstances involving a specific patient population. Therefore, it helps in guiding nursing actions for specific disease conditions. PsycINFO provides research study results for psychiatry-related disorders. The Cochrane Database of Systematic Reviews provides high-quality evidence. It includes the full texts of systematic reviews. However, it does not provide guidelines and care plans for implementation in practice. The Cumulative Index of Nursing and Allied Health Literature (CINAHL) is a comprehensive database helpful in providing scientific knowledge in healthcare. It does not provide detailed care plans for practice.

A group of nurses on the research council of a local hospital are measuring nursing-sensitive outcomes. Which is a nursing-sensitive outcome that the nurses should consider measuring? Incidence of asthma among children of parents who smoke Frequency of episodes of low blood sugar in children at a local school Number of patients who fall and experience subsequent injury on the evening shift Number of sexually active adolescent girls who attend the community-based clinic for birth control

Number of patients who fall and experience subsequent injury on the evening shift Nursing-sensitive outcomes are outcomes that are directly related to nursing care. The number of patients who fall and experience injury on the evening shift can be directly correlated to nursing care, and can be measured in accordance to the measures taken by nursing staff. The incidence of asthma among children of parents who smoke, frequency of low blood sugar in children at a local school, and number of sexually active adolescent girls who attend the community clinic for birth control are not directly related to nursing care.

The nursing student has posed a PICOT clinical question for a research study. The question that has been posed is, "How do patients with cervical cancer rate their quality of life?" Which PICOT elements does this question contain? Select all that apply. Patient population of interest Intervention of interest Comparison of interest Outcome Time

Patient population of interest Outcome Using the PICOT format helps to ask a focused clinical question. P stands for population of interest, I stands for intervention of interest, C stands for comparison of interest, O stands for outcome, and T stands for time. Patients with cervical cancer represent the population of interest, and rating the quality of life represents the outcome. The question does not contain the other three elements: intervention of interest, comparison of interest, and time.

The nurse who works in a newborn nursery asks, "I wonder if the moms who breastfeed their babies would be able to breastfeed more successfully if we played peaceful music while they were breastfeeding." In this example of a PICOT question, which represents "I"? Breastfeeding moms Infants Peaceful music The nursery

Peaceful music The intervention (I) in this PICOT question is playing peaceful music. Breastfeeding moms, infants, and the nursery are not interventions; however, the mothers and infants are related to the population of interest (P) P=patient population of interest I= intervention of interest C=comparison of interest O=outcome T=time

The nurse is researching articles for a research study. Why would the nurse prefer gathering evidence from peer-reviewed articles? Choose the best answer. The articles are reviewed by a group of statistical analysts. The articles are reviewed by a group of nurse researchers. The articles are reviewed by experts in the subject matter of the article. The articles are reviewed by a group of advanced practice nurses.

Peer-reviewed articles are reviewed by experts in the subject matter of the article. Statistical analysts would be one part of the group reviewing the study. The experts of the subject matter vary from study to study and would be multidisciplinary; they are not limited to nurse researchers or advanced practice nurses.

A group of nurses are studying the research on nursing-sensitive outcomes. Which outcomes are nursing sensitive? Select all that apply. Prevalence of restraint use Prevalence of pressure ulcers Effectiveness of acetaminophen Patient falls with injury Prevalence of heart failure

Prevalence of restraint use Prevalence of pressure ulcers Patient falls with injury The prevalence of restraint use, prevalence of pressure ulcers, and falls of patients are outcomes dependent chiefly on the quality of nursing care. The effectiveness of acetaminophen and the prevalence of heart failure are not dependent on nursing care. They are not included in the list of nursing-sensitive outcomes.

Which database offers free access to journal articles? AHRQ CINAHL EMBASE PubMed

PubMed PubMed offers free access to journal articles. The Agency for Healthcare Research and Quality (AHRQ) includes clinical guidelines and evidence summaries. The Cumulative Index of Nursing and Allied Health Literature (CINAHL) includes studies in nursing, allied health, and biomedicine. The EMBASE database includes biomedical and pharmaceutical studies.

A group of staff educators are reading a research study together at a journal club meeting. While reviewing the study, one nurse states that the study evaluates whether newly graduated nurses progress through orientation more effectively when they participate in patient simulation exercises. Which part of the research process is reflected in this nurse's statement? Introduction Purpose statement Methods Results

Purpose Statement The purpose statement includes research questions or hypotheses—predictions made about the relationship or difference among study variables (concepts, characteristics, or traits that vary within or among subjects). The introduction lays the basics of the questions the researcher is asking and lays the groundwork of the study. Methods describe the steps taken to gather knowledge and test the variables. Results describe the findings of the research.

The nurse researcher interviews parents of children who have diabetes and asks them to describe how they deal with their child's illness. The analysis of the interviews yields common themes and stories describing the parents' coping strategies. This is an example of which type of study? Historical Qualitative Correlational Experimental

Qualitative The data in this study were collected during interviews; information from the interviews was used to describe common themes and experiences of the parents. These are characteristics of qualitative research. Historical research establish facts and relationships concerning past events. Correlational research explores the interrelationships among variables of interest without any active intervention by the researcher. In experimental research, the investigator controls the study variable and randomly assigns subjects to different conditions to test the variable.

Which type of research design would be helpful to determine the percentage of women who are diagnosed with an acute myocardial infarction between the ages of 40 and 60 years? Survey Qualitative research Quantitative research Evaluation research

Quantitative research Quantitative research involves analysis of numbers, such as the percentage of women diagnosed with acute myocardial infarction and what age groups the women belong to. The survey design examines opinions, attributes, behaviors, or characteristics of a population. Qualitative research describes information in a nonnumeric form. Evaluation research determines how well a program, practice, or policy is working.

The nurse researcher conducts a study that randomly assigns 100 patients who smoke and attend a wellness clinic into two groups. One group receives the standard smoking cessation handouts; the other group takes part in a new educational program that includes a smoking cessation support group. The nurse plans to compare the effectiveness of the standard treatment with the educational program. Which type of research study is this? Qualitative Descriptive Correlational Randomized controlled trial

Randomized controlled trial This is a randomized controlled trial because patients are randomly assigned into the control or treatment group. The researcher will measure the effectiveness of the standard treatment with the educational program, which is a quantitative measure, not qualitative. This research is also not descriptive, which measures people, situations, or groups and the frequency with which certain events or characteristics occur. Correlational research explores the interrelationships among variables of interest without any active intervention by the researcher.

A 50-year-old patient complains of hair loss. A scraping of the patient's scalp shows a candida infection. The hair loss decreased with the use of a medicated shampoo and herbal oil. The nurse has developed a PICOT question and starts to search for the evidence. The nurse has reviewed many books and searched for information on the Internet. The nurse also consulted other health care professionals and found that herbal oils have an antifungal medicinal value. Which should be the nurse do next? Select all that apply. Recommend a protocol if the evidence supports the use of herbal oil. Conduct a pilot study if the evidence is not strong enough to support the use of herbal oils. Keep all the data of the study confidential and share outcomes with staff who are affected by the results. Conduct the research study even if the PICOT question goes unanswered after the study. Avoid recommending any changes in the protocol, even if the study supports the use of herbal oil.

Recommend a protocol if the evidence supports the use of herbal oil. Conduct a pilot study if the evidence is not strong enough to support the use of herbal oils. Conduct the research study even if the PICOT question goes unanswered after the study. Once the nurse finds information supporting the use of herbal oils, the nurse should take steps to implement this change in practice and evaluate the outcomes. Following the evaluation, the nurse can recommend a related protocol. If the evidence is not strong enough, the nurse can conduct a pilot study to test the use of herbal oils in hair loss. If the PICOT question remains unanswered after evaluation, then a research study can be conducted. Following the outcome evaluation, the results should be shared with the staff to promote evidence-based practice. If the evaluation of the study shows that herbal oil is useful, then the nurse is allowed to recommend this change in protocol.

Which activity regarding the research process should the nurse conduct to determine what has already been studied about the research problem of interest? Construct a theoretical framework. Identify variables. Formulate a hypothesis. Review the literature.

Review the literature. A literature review provides a logical but abstract structure that suggests the relationship among the variables in a research study, allowing for the organization and explanation of all the information in the study. All available literature related to the nurse's research problem should be reviewed to provide a theoretical framework as a foundation for the research study. Variables are concepts in the study that are expected to change or differ from one person or time to another. A hypothesis is a prediction that should be based on previous research, so it is developed after conducting a review of the literature.

The nurse is conducting research on the effect of imagery on pain perception. Which actions should the nurse perform when searching the scientific databases for evidence? Select all that apply. Seek the assistance of a medical librarian. Enter and manipulate different key words. Be prepared for some confusion with the evidence obtained. Refer to agency policies and procedures manuals. Refer to existing clinical practice guidelines.

Seek the assistance of a medical librarian. Enter and manipulate different key words. Be prepared for some confusion with the evidence obtained. Scientific databases are appropriate for searching evidence on a research question. A medical librarian may help by suggesting the type of databases appropriate to the question and different key words for refining the search. Different combinations of key words should be checked to find studies relevant to the subject. If the key words do not match the words used in the research studies, the results of the search may cause some confusion. Agency policies and procedures manuals and clinical practice guidelines are good sources of information, but they do not help in searching scientific databases.

A group of nurses have implemented an evidence-based practice (EBP) change and have evaluated the effectiveness of the change. What is their next step? Conduct a literature review. Share the findings with others. Conduct a statistical analysis. Create a well-defined PICOT question.

Share the findings with others. After completing an evidence-based practice (EBP) project and evaluating its effectiveness, the next step is to communicate the results with others. Conducting a literature review and statistical analysis, and creating a well-defined PICOT question, come before evaluation and sharing findings.

Which statement shows the steps of the research process in the correct order? Review the literature, state the research problem, and develop a theoretical construct. Review the literature, state the research problem, and select the research strategy. Select the research strategy, collect data, and analyze data. State the research problem, review the literature, and clarify operational definitions.

State the research problem, review the literature, and clarify operational definitions. The first step of the research process is to state the research problem. The correct order of steps is to state the research problem, review the literature, develop a theoretical construct, identify variables, and then clarify operational definitions.

To which type of study should the nurse refer in order to find the strongest evidence of the effectiveness of a particular treatment? Case control studies Randomized control trials Descriptive studies Systematic reviews

Systematic reviews A systematic review is the highest level of evidence available. It summarizes what is currently known about a topic and reports if current evidence supports a change in practice or if further study is needed on that topic. Randomized controlled trials are the most precise form of experimental study and the gold standard for research. Case control studies and descriptive studies are much lower in the hierarchy of evidence.

The nurse is developing the protocol for a research study. The nurse is referencing various research articles to develop the procedures for the study. To which section of the research articles should the nurse refer? Abstract Introduction Methods Results

The nurse refers to the methods or design section of relevant research to develop methodologies for new research. The methods or design section of the research explains the process by which research is carried out. The abstract provides a brief overview of the entire research and does not specifically give detailed information about the procedures followed. The introduction states the purpose of the study and provides brief supporting evidence that explains the importance of the topic. This section does not provide detail about the procedures followed. The results section includes the statistical analysis that provides a detailed explanation of whether the research question was answered. This section does not give any information about the procedures followed by the researchers.

A 55-year-old patient is diagnosed with lung cancer and has a history of smoking. To find the association between smoking and lung cancer, the nurse decides to use a case-control study. Before proceeding to implementation, the nurse should obtain informed consent from the study subjects. Which are involved in informed consent? Select all that apply. The patient and a family member should sign the consent form. The patient should be capable of understanding the research procedure. Once the patient has signed the forms, the patient must participate until the end of the research. Informed consent ensures the patient that all the information of the study will be confidential. The patient has the right to refuse to participate at any point of time in the research.

The patient should be capable of understanding the research procedure. Informed consent ensures the patient that all the information of the study will be confidential. The patient has the right to refuse to participate at any point of time in the research. Informed consent means that the research subjects are given full and complete information about the study, including the purpose of the study, procedures, data collection, potential harm and benefits, and alternative methods of treatment. An informed consent implies that the information rendered by the patient will be kept confidential. The patient has the right to withdraw from the study at any point in time. If the patient is participating in the study, the family members are not required to sign the consent form. Signing a consent form does not mean that the patient has to participate until the end of the research. The patient can withdraw at any time.

Which topic is best suited for quantitative research? The perception of a patient diagnosed with cancer The patient's perception of the nurse's care in a palliative unit The perception of stress by family members of critically ill patients The percentage of cardiac illness in men between 40 and 60 years of age

The percentage of cardiac illness in men between 40 and 60 years of age Quantitative research involves analysis of numbers, such as percentages and ages. This type of research offers precise measurements and quantifications. Determining the percentage of cardiac illness in men between 40 and 60 years of age is an example of quantitative research. Qualitative research involves verbal analysis, and the information is obtained in a nonnumerical form. Determining the patient's perception of the nurse's care in a palliative unit or the perception of stress by family members of critically ill patients are examples of qualitative research.

The nursing student is learning about quantitative research. Which are examples of quantitative research? Select all that apply. Patient perceptions of nurses' care in a palliative unit Perception of stress by family members of critically ill patients The percentage of cardiac illness in men between 40 and 60 years of age The statistics of children between 5 and 10 years of age with poliomyelitis Factors that lead to an adolescent's decision to smoke cigarettes

The percentage of cardiac illness in men between 40 and 60 years of age The statistics of children between 5 and 10 years of age with poliomyelitis Factors that lead to an adolescent's decision to smoke cigarettes Quantitative research involves nursing phenomena that provide precise measurement and quantification. Studies focus on numerical data, statistical analysis, and use of controls to prevent bias. The studies to determine the percentage of cardiac illness and the statistics of children with poliomyelitis involve numerical data and statistical analysis. The study to determine the factors that lead to an adolescent's decision to smoke cigarettes involves use of controls. The study to determine perceptions of nurses' care in a palliative unit is a qualitative study as it involves factors that are difficult to measure in numerical value. The study to determine perception of stress by family members involves nonmeasurable factors.

The nurse is learning about the characteristics of different types of research studies. Which is the chief characteristic of a case control study? The study explains a phenomenon. The study is performed on two groups of subjects. The study groups are randomized. The study groups are biased.

The study is performed on two groups of subjects. A case control study is a nonexperimental study in which the researchers study the effects of the variables on a particular group of patients. In this type of study, researchers study one group of subjects with a certain condition (e.g., asthma) at the same time as another group of subjects who do not have the condition. A case control study determines whether there is an association between one or more predictor variables and the condition. A descriptive study explains a particular phenomenon. In a randomized controlled trial, the study groups are randomized. In controlled trials without randomization, the researchers have not randomized the groups.

A 55-year-old patient is diagnosed with lung cancer and has a history of smoking. To find the association between smoking and lung cancer, the nurse decides to use a case-control study. Which are the requirements of a case-control study? Select all that apply. Two groups are required. Hospital records are sufficient for evidence. One of the groups should have lung cancer. One of the groups should not have lung cancer. Two groups with different genders are required.

Two groups are required. One of the groups should have lung cancer. One of the groups should not have lung cancer. A case-control study requires two groups. One of the groups must have lung cancer, and the other should not have the disease. The hospital records are not sufficient for obtaining the evidence. It is not necessary that two groups should have different genders. Each group can have a mix of genders.

A research study is investigating the question, "What is the effect of the diagnosis of breast cancer on the roles of the family?" In this study the terms diagnosis of breast cancer and family roles are examples of what? Surveys The sample Variables Data collection points

Variables Variables are concepts, characteristics, or traits that vary within or among subjects. Surveys are a method of collecting data collection points, and the sample is the group of individuals surveyed for the information.

The nurse is helping a researcher conduct a randomized controlled trial (RCT). Which characteristic differentiates the RCT from other types of studies? Researchers will test a new drug with the usual standard of care. When completed, researchers will know if the intervention leads to better outcomes than the standard of care. Researchers will study two groups of subjects—one with the disease and another without the disease. When completed, researchers will determine if there is an association between one or more predictor variables and the condition.

When completed, researchers will know if the intervention leads to better outcomes than the standard of care. When a randomized controlled trial (RCT) is completed, the researcher will know if the intervention leads to better outcomes than the standard of care. In a case control study, the researchers determine if there is an association between a predictor variable and a condition. A case control study is one in which researchers study one group of subjects with a certain condition at the same time as another group of subjects who do not have the condition.

3. The first step in evidence-based practice is to ask a clinical question. In doing so, the nurse needs to realize that in researching interventions, the question a. Is more important than its format. b. Will lead you to hundreds of articles that must be read. c. May be easier if in PICO format. d. May be more useful the more general it is.

c. May be easier if in PICO format. The PICO format allows the nurse to ask questions that are intervention focused. Inappropriately formed questions will likely lead to irrelevant sources of information. It is not beneficial to read hundreds of articles. It is more beneficial to read the best four to six articles that specifically address the question. The more focused the question asked, the easier it will become to search for evidence in the scientific literature.

16. The hospital's quality improvement committee has identified a problem on one of the units. In using the PDSA method to help determine ways to deal with the issue, the committee decides to do a literature review. This is an example of quality improvement a. Combined with evidence-based practice. b. With inability to make the right decision. c. With delay in the action needed. d. With no designated method for dealing with issues.

a. Combined with evidence-based practice. Quality improvement combined with evidence-based practice is the foundation for excellent patient care and outcomes. Once a committee defines a problem, it applies a formal model for exploring and resolving quality concerns. One part of the PDSA cycle is the "Do" section, which requires the selection of an intervention on the basis of data reviewed. Therefore the committee is taking the right action and is not unduly delaying action; data must be obtained that are needed to make the right decision as part of the PDSA method, which is in place.

18. The hospital quality improvement committee has noted that the incidence of needlestick injuries on a particular unit has increased. When faced with issues, the committee applies the PDSA model, a formal model for exploring and resolving quality concerns. Because the committee is multidisciplinary in nature, and few members are nurses, it is imperative that the committee first a. Plan. b. Do. c. Study. d. Act.

a. Plan. "Plan" is the first step of the process; it involves a review of available data to understand existing practice conditions or problems to identify the need for change. "Do" involves selecting an intervention on the basis of the data reviewed and implementing the change. "Study" means to evaluate the results of the change. "Act" involves incorporating the change if it is successful.

8. In reviewing literature for an evidence-based practice study, the nurse realizes that the most reliable level of evidence is the a. Systematic review and meta-analysis. b. Randomized control trial (RCT). c. Case control study. d. Control trial without randomization.

a. Systematic review and meta-analysis. In a systematic review or meta-analysis, an independent researcher reviews all of the RCTs conducted on the same clinical question and reports whether the evidence is conclusive, or if further study is needed. A single RCT is not as conclusive as a review of several RCTs on the same question. Control trials without randomization may involve bias in how the study is conducted. Case control studies also have room for bias.

4. In collecting the best evidence, the gold standard for research is a. The randomized controlled trial (RCT). b. The peer-reviewed article. c. Qualitative research. d. The opinion of expert committees.

a. The randomized controlled trial (RCT). Individual RCTs are the gold standard for research. A peer-reviewed article means that a panel of experts has reviewed the article; this is not a research method. Qualitative research is valuable in identifying information about how patients cope with or manage various health problems and their perceptions of illness. It does not usually have the robustness of an RCT. Expert opinion is on the bottom of the hierarchical pyramid of evidence.

1. To provide patient care of the highest quality, nurses utilize an evidence-based practice approach because evidence-based practice is a.A guide for nurses in making clinical decisions. b.Based on the latest textbook information. c.Easily attained at the bedside. d.Always right for all situations.

a. A guide for nurses in making clinical decisions. Evidence-based practice (EBP) is a guide for nurses to structure how to make accurate, timely, and appropriate clinical decisions. A textbook relies on the scientific literature, which is often outdated by the time the book is published and is not the most reliable source for EBP. Unfortunately, most of the best information in evidence never reaches the bedside. EBP is not to be blindly applied without using good judgment and critical thinking skills. It is not appropriate for all settings.

7. The nurse is developing a PICO question related to whether her patient's blood pressure is more accurate while measuring with the patient's legs crossed versus with the patient's feet flat on the floor. With P being the population of interest, I the intervention of interest, C the comparison of interest, and O the outcome, the nurse determines that this is a. A true PICO question, because the outcome always comes before the intervention. b. A true PICO question regardless of placement of elements. c. Not a true PICO question, because the comparison comes after the intervention. d. Not a true PICO question, because the outcome comes after the population.

b. A true PICO question regardless of placement of elements. Note that a well-designed PICO question does not have to follow the sequence of P, I, C, and O. The aim is to ask a question that contains as many of the PICO elements as possible.

11. The hospital policy states that when starting an intravenous (IV) catheter, the nurse must first prepare the potential IV site with alcohol and dress it using a gauze dressing. The nurse has done a literature review and believes that evidence-based practice dictates the use of a transparent dressing to prevent catheter dislodgment. What should the nurse do? a. Begin to use transparent dressing instead of gauze dressings. b. Bring findings to the policy and procedure committee. c. Use transparent dressings on half of her IV starts and gauze on the other. d. Continue following hospital policy without saying anything. ANS: B

b. Bring findings to the policy and procedure committee. As a result of her finding, the nurse should meet with the policy and procedure committee to recommend routine use of transparent dressings. However, until the policy is changed, or the nurse receives approval to conduct a pilot study, the nurse is obligated to follow hospital procedure. If the nurse has information that can lead to better patient care, he or she has an obligation (moral and professional) to bring it to the attention of policy makers.

13. In conducting a research study, the researcher must guarantee that any information the subject provides will not be reported in any manner that identifies the subject and will not be accessible to people outside the research team. This concept is known as a. Anonymity. b. Confidentiality. c. Informed consent. d. The research process.

b. Confidentiality. Confidentiality guarantees that any information the subject provides will not be reported in any manner that identifies the subject and will not be accessible to people outside the research team. Anonymity occurs when even the researcher cannot link the subject to the data. Informed consent means that research subjects (1) are given full and complete information about the purpose of the study, procedures, data collection, potential harm and benefits, and alternative methods of treatment; (2) are capable of fully understanding the research; (3) have the power to voluntarily consent or decline participation; and (4) understand how confidentiality or anonymity is maintained. The research process is a broader concept that provides an orderly series of steps that allow the researcher to move from asking a question to finding the answer.

5. The nurse is writing a research article on a patient care topic. The nurse realizes that the section that will get the reader to read the article because of the value of the topic for the reader is the a. Abstract. b. Introduction. c. Literature review or background. d. Results.

b. Introduction. The introduction contains information about its purpose and the importance of the topic to the audience who reads the article. The abstract is a brief summary of the article. The literature review or background offers a detailed background of the level of science or clinical information that is available about the topic of the article. The results section is the summary section of the article.

15. When evaluating quality improvement (QI) programs in relation to evidence-based practice (EBP), it is easy to note that a. Both are designed to improve performance. b. When implementing EBP projects, it is important to review QI data. c. EBP is not at all related to QI. d. Evaluation of processes is the realm of performance improvement (PI), not QI.

b. When implementing EBP projects, it is important to review QI data. Evidence-based practice and quality improvement go hand in hand. When implementing an EBP project, it is important to review available QI data. Reliable QI data improve the relevance and scope of an EBP project. Performance improvement (PI) analyzes performance. QI analyzes processes.

12. The nurse is trying to identify common general themes relative to the effectiveness of cardiac rehabilitation for patients who have had heart attacks and have gone through cardiac rehabilitation programs. The nurse conducts interviews and focus groups. What type of research is the nurse conducting? a. Evaluation research b. Experimental research c. Qualitative research d. Nonexperimental research

c. Qualitative research Qualitative research involves using inductive reasoning to develop generalizations or theories from specific observations or interviews. Evaluation and experimental research are forms of quantitative research. Nonexperimental descriptive studies describe, explain, or predict phenomena such as factors that lead to an adolescent's decision to smoke cigarettes.

2. In caring for patients, it is important for the nurse to realize that evidence-based practice is a. The only valid source of knowledge that should be used. b. Secondary to traditional or standard care knowledge. c. Dependent on patient values and expectations. d. Not shown to provide better patient outcomes.

c. Dependent on patient values and expectations. Even when the best evidence available is used, application and outcomes will differ based on patient values, preferences, concerns, and/or expectations. Nurses often care for patients on the basis of tradition or convenience, or the standard, "It has always been done this way." Although these sources have value, it is important to learn to rely more on research evidence than on non-research evidence. Patients who receive care based on the most recent and best evidence experience 28% better outcomes.

6. The nurse is caring for a patient with chronic low back pain. In providing care for this patient, the nurse wonders whether the guidelines utilized for this type of pain are adequate. The nurse wants to determine the best evidence-based practice regarding these guidelines. What is the best database for the nurse to access? a. MEDLINE b. EMBASE c. PsycINFO d. AHRQ

d. AHRQ The Agency for Healthcare Research and Quality (AHRQ) includes clinical guidelines and evidence summaries. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health. EMBASE includes biomedical and pharmaceutical studies. PsycINFO deals with psychology and related health care disciplines.

14. The researcher is preparing to publish his study findings. In doing so, the researcher is aware of many ways that the study could have been done better, but that he did not have the ability to do. The researcher discloses these limitations in the manuscript, but they are most likely detected during which phase of the research process? a. Problem identification b. Study design c. Formulation of recommendations d. Analysis of data

d. Analysis of data During analysis of data, the researcher interprets the demographics of the study population, as well as results, including limitations. Problem identification involves identifying the area of interest and study variables, reviewing the literature, formulating the theoretical framework, and devising research questions. Study design involves selection of research methods. Formulation of recommendations involves determining the implications of the study for nursing.

17. The quality improvement committee has been alerted to an increased number of falls in the hospital. Most of these falls have occurred at night and have involved patients who were trying to crawl over bedrails. A literature review brought out that most falls occur because patients are trying to go to the bathroom. The committee created a practice change that bedrails should be left in the down position, and hourly nursing rounds should be conducted. What is the committee's next step? a. Evaluate the changes in 1 month. b. Wait a month before implementing the changes. c. Implement the changes as a pilot study. d. Communicate to staff the results of this inquiry.

d. Communicate to staff the results of this inquiry. Quality improvement combined with evidence-based practice is the foundation for excellent patient care and outcomes. Once a QI committee makes a practice change, it is important to communicate the results to staff. Practice changes will not likely last when QI committees fail to report findings and results of interventions. Once communicated, changes should be put in place as the committee deems reasonable (i.e., either fully or as a pilot study) and as soon as practical; this should be followed by re-evaluation.

10. The nurse has used her PICO 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 support staff than is available at this time. What is the nurse's best option? a. Drop the idea of making the change at this time. b. Insist that management hire the needed staff to facilitate the change. c. Seek employment in another institution that may have the staff needed. d. Conduct a pilot study to develop evidence to support the change.

d. Conduct a pilot study to develop evidence to support the change. When evidence is not strong enough to apply in practice, or if resources are limited, the next option is to conduct a pilot study to investigate the PICO question. Dropping the idea would be counterproductive; insisting that management hire staff could be seen as a mandate and could produce negative results. Seeking employment at another institution most likely would not be the answer because most institutions operate under similar established guidelines.

19. The quality improvement committee is examining an increase in medication errors on a particular unit. In conducting its analysis, what should be the committee's primary focus? a. Nurses who administer the medications b. Pharmacy that prepares the medications c. Secretaries who enter the orders d. None of the above

d. None of the above A well-organized QI program focuses on systems that significantly contribute to outcomes, not on individuals. Therefore, the entire process needs to be evaluated to determine effectiveness.

9. Qualitative nursing research is valuable in that it a. Excludes all bias. b. Uses randomization in structure. c. Determines associations between variables and conditions. d. Studies phenomena that are difficult to quantify.

d. Studies phenomena that are difficult to quantify. Qualitative nursing research is the study of phenomena that are difficult to quantify or categorize, such as patients' perceptions of illness. No study can totally exclude bias. However, randomization, such as that used in randomized control studies, helps. Qualitative nursing research does not usually randomize its subjects. Control studies determine whether there is an association between one or more predictor variables and the condition.