NUR 228 Exam 3 Podcast & Interactive Module Q's
The main difference between direct and indirect lobbying is:
direct lobbying involves direct contact with the elected official.
The purpose of evidence-based practice is to:
establish best practice guidelines for various clinical problems.
A nurse uses data from a nursing research study regarding nasogastric tube care when caring for her patient. This nurse has demonstrated the use of:
evidence-based practice.
The scientific method and nursing research process are composed of many steps. The first step in the research process is:
focusing on the clinical problem area.
A nurse shares a nursing research article with her peers during a monthly staff meeting. The nurse outlines the steps taken in the research process and how the findings apply to the nursing care they provide. The nurse has contributed to nursing research by:
using relevant research.
The IOM has proposed that what percentage of nurses should have their baccalaureate degree by the year 2020?
0.8
Since the 1960s, which degree has been promoted as the entry level for professional nursing in the United States?
Baccalaureate degree
A registered nurse has asked a certified nursing assistant (CNA) to discontinue a Foley catheter. Before delegating this task, the RN should have evaluated the CNA's:
Competence.
The new nurse manager suggests changing to recorded report. Physicians, nurses, and other members of the team will all be impacted by this change. The nurse manager should use which technique to obtain input from all parties?
Collaborating
A medical nursing unit in a large metropolitan hospital is participating in a double-blind randomized clinical trial. What might the role of the RN be in this clinical trial?
Collecting data
The nurse manager knows to use which technique when a nurse complains of being bullied by a coworker?
Conflict resolution
The identification of an independent and a dependent variable is a characteristic of which step of the scientific/nursing research process?
Defining variables
The use of informed consent and protecting the patient from harm are characteristics of what step in the scientific/nursing research process?
Ensuring an ethical process
Which of these is not a challenge technology has created in health care?
Fewer health care professionals
What is the first step in the research process?
Focus on the clinical problem area
Which factor leads the nurse to take the first step in identifying possible research questions?
Focusing on a clinical problem area
In START triage, tag colors include which of the following? (Select all that apply.)
Green = Minor (those who can walk), Red = Immediate (critical), Black = Expectant (those without respirations)
Nurses are required to protect patients' private health information. Alex considered this when advocating for her patient. What federal law governs patient health information privacy?
HIPAA (Health Insurance Portability and Accountability Act)
Which should not appear on an accountability checklist?
Hours worked
Nurses play a key role in which activity? (Select all that apply.)
Instances in which patients are being denied access to essential care, Instances in which patients seem to be short-changed by policies and actions directed primarily at cost containment, Reimbursement to the employing agency from managed care and other third-party payers
This week's episode of "A Year in the Life" follows Amy's continuing work on her nursing research topic of pain medication options for patients with opioid addiction. Which of the following best describes Amy's current stage regarding her proposed research idea?
Integrate the best evidence with feedback from clinical experts.
How did Alex Wubbels advocate for her patient's rights when the police wanted to take blood from a patient who was under Alex's care?
She did not allow a procedure to be performed on the patient without the patient's informed consent.
What does the acronym START stand for?
Simple triage and rapid treatment
Which of the following best describes the nurse's role in patient advocacy?
Supporting patient's rights and desire for care
A nurse is asking a patient to sign an informed consent form. Which of the following does informed consent require? (Select all that apply.)
That the patient has had other treatment options explained to him or her, That the patient consents to having the procedure performed, That the patient agrees to the procedure without coercion, That the patient is competent, That the patient understands the treatment/test and its potential adverse effects
Which groups set professional standards for nursing practice? (Select all that apply.)
The National Council of State Boards of Nursing, American Nurses Association
Which statement is the best description of a nurse being a patient advocate?
The nurse makes sure the patient's wishes are observed at all times, regardless of anyone else's wishes.
A nurse has questions regarding diabetic foot care. The nurse conducts a search and identifies a lack of research on diabetic foot care. The nurse has contributed to nursing research by:
identifying a gap in nursing research theory.
An example of how technology has positively influenced the nursing profession includes:
importing patient data into the electronic medical record using a handheld device.
Common barriers to using EBP and research in nursing include:
lack of education on how to read and critique research.
A nurse manager tasks an RN with updating their unit-specific nursing policies and procedures. The manager states that the policies must be updated through an evidence-based practice process. The RN understands that she will need to:
perform a literature review to identify current evidence-based practice guidelines.
To stay aware of current issues affecting nursing practice and health care delivery, a nurse could use a variety of resources that may include:
television, radio, newspapers, and journals.
Proponents of evidence-based practice integration believe that systematic review of all research on specific health topics leads to:
the best form of evidence for clinical practice.
Based on the talk show podcast, Maria did not think that an Institutional Review Board (IRB) was necessary for a publishable project. Which of the following best describes an IRB and its purpose?
A group that meets regularly to verify that the proposed study meets scientific standards.
Which type of evidence is the most rigorous?
A single, randomized clinical trial
When utilizing a nursing evidence-based research project, the acronym PICOT is recommended. What does PICOT stand for?
Patient population, Intervention, Comparison, Outcome, and Time frame
Technology has directly improved which of the following in health care recently? Select all that apply.
Access to health care, Training, Access to information
Kathy is an RN on an oncology unit. She actively listens to her patients' complaints and discusses them with her head nurse. She is also involved with her unit nursing council. Kathy is displaying what nursing characteristic?
Advocacy
When the nurse manager sends a memo to the staff letting them know a neutral third party will be present to listen to staffing concerns, she is demonstrating which communication principle?
Intention
Sue is an RN on a busy medical floor. Lately at work, Sue has been unable to spend the amount of time she would like to with her patients. She feels rushed and limited in how long she can spend in the patient's room. She feels upset and is frustrated. This is an example of what kind of conflict?
Intrapersonal
A nurse who is individually consuming research to improve her evidence-based practice would participate in which activities? Select all that apply.
Join a journal club, Practice using scholarly language, Search journal articles and literature
Anita has been an operating room nurse for nearly 15 years. She is always up for learning new things but finds reviewing research to be intimidating, and that it is often hard to implement changes and apply new knowledge. Which of the following act as barriers to learning? Select all that apply.
Lack of training in research or evidence-based practice, Lack of authority to make changes in practice, Lack of organizational support
Influencing others by holding key positions and impacting policy change is which stage of political activism?
Leading the way
To successfully implement EBP into nursing practice, what key stakeholders must be on board with the change? Select all that apply.
The health care organization, The individual health team members
The nurse's preceptor says, "When I painted the heels of a patient with betadine, the wound healed. I don't know about all this evidence-based practice - I know what works." The nurse knows which of the following is true of this statement?
The nurse will look for more evidence to support the intervention and ask for patient preferences.
A research nurse knows part of her job is protecting a patient's rights. Which of the following constitute the patient's rights? Select all that apply.
The right to refuse to participate without jeopardizing the care he or she will receive, The right to be protected from harm, The right to consent to participate in a study without coercion, The right to confidentiality
Why would a registered nurse opt to not delegate a task to an LPN or CNA?
There is a high potential for harm and quick independent thinking is needed.
In the analyzing data step of the research process, when would statistical analysis be required?
When inferring some characteristics about a population
On which ethnicity were clinical trials for most medications (including cardiovascular medications) performed?
Whites
A nurse is a member of the research council at her hospital. Which type of research engagement is this?
Working on a team to review research to improve practice
A critical component for effective conflict resolution is:
communication.
Which actions are suggested strategies for implementing evidence-based practice (EBP)? Select all that apply.
Assembling a cross-disciplinary committee to refine research-based policies and procedures., A chief nursing officer meeting with the hospital administration team to help them understand EBP and the benefits it offers., Updating clients and/or their families about current research studies they may qualify to take part in.
Accountability is often confused with which terms?
Autonomy and authority
A nurse on a medical-surgical floor volunteers to join a unit committee focused on nursing practice changes for patients with congestive heart failure. The nurse believes changes need to occur and wants to assist in making the changes. This is an example of which political activism stage?
Buying in
What is the first stage of becoming involved in political activism?
Buying in
Both nursing students who were featured in this week's talk show podcast took their nursing research into the community setting. How did Kevin act as a public health nurse with his work in the Philippines?
By helping to promote and protect the health of the people of the Philippines
What is the initiating event that starts the evidence-based practice process?
Clinically relevant question
A nurse is trying to convince a hospital administrator that they should be encouraging the use of evidence-based practice. Which characteristics could the nurse cite as a benefit? Select all that apply.
Control of health care costs, Provision of highest quality patient care, Increased patient satisfaction
Barriers to nursing research include lack of time, poor attitudes among practicing nurses, comfort with the status quo, and lack of education to properly critique research studies. Which approach can improve the utilization of nursing research on a unit? (Select all that apply.)
Create a journal club for the unit., Create an interdisciplinary team to do patient rounds., Create a shared governance model.
Nurses and physicians are expected to select health care interventions that are supported by research and other credible forms of evidence. They may also be expected to provide evidence to demonstrate that the care they deliver is not only clinically effective but also cost-effective and satisfying to patients. This best describes which concepts?
Evidence-based practice
True or false: Avoiding or withdrawing yourself from conflict is never a good way to cope with conflict.
FALSE
True or false: Ideally, technology should replace the human element of health care in every way possible to remove the possibility of human error.
FALSE
True or false: Intrapersonal conflict is a conflict between you and another individual.
FALSE
True or false: Only nurses who work in hospitals that conduct research can contribute to research.
FALSE
True or false: Perceived conflict is emotionalized and involves things like hostility, fear, mistrust, and anger.
FALSE
In regards to the changing of colostomy pouches, a nurse has noticed that patients on the unit who use a specific product do better with wound healing than those who do not. She is curious about why this is. Which step in the research process does this represent?
Focusing on a clinical problem area
Which of the following can influence the way that patients metabolize drugs? (Select all that apply.)
Genetics, Ethnicity
As a disaster response nurse, you encounter a 38-year-old female with a head laceration at the site of a train crash. She walks up to you. Her respirations are 24, capillary refill is 2 seconds and mental status is intact. Using START triage, how would you triage this victim?
Green
A preterm labor patient is being transferred to a regional medical center because her newborn will require NICU services. The nurse must print off the patient's electronic health record for the referral hospital. The patient must sign a consent for release of medical information prior to printing the EHR. This must occur because of:
Health Information Portability and Accountability Act (HIPAA)
The most rigorous level of nursing research is:
Level 1: Systematic review of randomized or nonrandomized clinical trials
Which factors represent challenges to impacting public policy, as discussed in this module? Select all that apply.
Limited time and money, Workforce shortage, Cost of care, Number of nurses
In this week's episode of "A Year in the Life," Jolene recommends that Amy narrow her topic of interest before doing a literature search. Why is this important?
Narrowing a subject of interest helps the researcher do a timely literature search that keeps the focus of the study on topic.
In this week's episode of "A Year in the Life," Amy is planning to attend the nursing EBP committee. What is the issue that she wants to research?
Opioid addiction and pain management
Integration of EBP research into clinical practice will be accepted more readily if organizations take which actions? Select all that apply.
Provide health care teams with time to implement EBP, Display commitment to developing EBP care pathways, Provide necessary resources for implementing EBP
After a nursing research project is completed, what should the nurse do next?
Publish the results to increase the literature base.
What type of nursing research would be best used to examine compliance with hand washing?
Quantitative
As a disaster response nurse near the site of a car bombing, you encounter a 25-year-old male who is unable to walk. He is breathing, and his respirations are 35. Using START triage, how would you triage this victim?
Red
Enzymes produced from which cytochrome affect drug metabolism?
P450
Which of the following support the need for evidence-based practice? Select all that apply.
Patient satisfaction, Clinical experience, Logical reasoning
As a result of the human genome project, health care professionals have learned that individuals differ significantly in the way they metabolize drugs. Why is recognition of this fact particularly important with patients who are poor metabolizers?
Patients may be administered too small a dose.
An adult victim at an accident scene is not breathing. When performing START triage, which action would you take?
Position airway
In this week's Finger on the Pulse talk show podcast, Judy presented her senior-level course change project. Which systems-model prevention strategy did Judy implement with the resident assistants?
Primary prevention strategies
Tracy is an RN in the emergency room. She asks the certified nursing assistant (CNA) to obtain a set of vital signs on her patient. The CNA replies, "You need to do that yourself, I have better things to do than do all your work." What type of relationship training could prevent this situation?
Professional partnerships
When assembling a scientific study for research, in which step do researchers examine previous studies?
Reviewing the literature
A nurse has requested that a CNA take out an intravenous (IV) catheter from a patient, Mr. Thomas, because he is being discharged. When the CNA walks into the room, the patient is still hooked up to a bag of normal saline (NS) running at 100 mL/h. The removal of the IV is within the scope of practice, and the CNA proceeds to remove the IV. Which of the following five rights of delegation is missing? Select all that apply.
Right direction/communication, Right supervision/evaluation
In the previous situation, which of the Five Rights of Delegation was not properly met?
Right supervision/evaluation
An accountability checklist asks questions regarding the nurse's accountability to what facets? (Select all that apply.)
Self, Institution, Client
Which model is defined by the following statement? Nurses assume responsibility and accountability for developing unit-based and institution-wide procedures for clinical practice and quality improvement.
Shared governance
Why is it important for nurses to be familiar with the steps of the research process?
So they can critique research studies effectively
The effective nurse leader knows to focus on which of the following to prevent conflict in the workplace?
Stress relief
A certified nursing assistant (CNA) is asked to walk a patient after abdominal surgery for a total of three times this shift. It is within the scope of practice for the CNA to ambulate the patient. However, the patient was not walked at all that day and, later that night, has a hard time breathing. True or false: The nurse is held accountable in this situation.
TRUE
True or False: Lobbying involves visiting or writing politicians and other people involved in politics in order to influence future policies and decisions.
TRUE
True or false: A registered nurse can be held accountable for tasks delegated to certified nursing assistants and licensed practical nurses.
TRUE
True or false: Easier access to confidential information is both an advantage and a challenge of technology in health care.
TRUE
True or false: Evidence-based practice (EBP) is defined as practice based on the best available evidence that also incorporates patient values and preferences along with clinician judgment and expertise.
TRUE
True or false: Evidence-based practice use includes all interprofessional team members, not just nurses.
TRUE
True or false: Nurses have the ability to formulate hypotheses in their daily nursing practice.
TRUE
True or false: The ultimate goal of research is to develop, refine, and expand knowledge.
TRUE
True or false: The use of text messaging, pagers, and cellphones in the health care setting has allowed for better rest and less disruption of the client.
TRUE
True or false: While evidence-based practice improves the patient experience and outcomes, it also benefits the nurses involved by improving their self-confidence and enhancing job satisfaction.
TRUE
Technological changes that influence nursing practice and health care include which of the following? Select all that apply.
Tailoring treatment plans for malignant tumors from genetic-testing results, Use of robots to deliver meal trays, make rounds, and take vital signs
Managed care, government health care plans, and private health insurance companies engage in which cost containment methods? (Select all that apply.)
They control health care costs., They monitor access to services., They strive to eliminate redundancy., They look for ways to reduce overuse of services.
Which of the following is true about START triage?
This technique is commonly used in the United States but is also used worldwide.
What purpose in a research study does the initial review of the literature hold for the reviewer? Select all that apply.
To help the researcher develop a strong knowledge base, To refine the research question being asked, To find out what related studies have been conducted
Which characteristics assist nurses in being able to influence and recommend changes to policies that benefit others? Select all that apply.
Understanding of health-related research, Assessment skills, Communication skills
A nursing student who is currently completing a clinical rotation on the medical-surgical unit has been reading research articles on medical management of myocardial infarction patients. The student is not sure whether she should share this information with the nurse on the unit, who seems to be effectively managing her patient assignment. Does the nurse have to incorporate research findings into practice?
Yes.
An alarm is sounding in a patient's ICU room. The nurse enters the room, silences the alarm, and reviews the monitor data. The nurse then leaves the room. This is an example of:
treating the monitor and not the patient.