Taylor Practice Questions - Nursing Theory and Evidence Based Practice
A nurse develops the following foreground question using the PICO format in preparation for a research study: "In overweight clients, how do chromium supplements compared to no supplements help with weight loss?" Which part of the question reflects the intervention?
Chromium supplements
Nurses in an ICU noticed that their clients required fewer interventions for pain when the ICU was quiet. They then asked a researcher to design a study about the effects of noise on the pain levels of hospitalized clients. How does this demonstrate the ultimate goal of expanding the nursing body of knowledge?
Nursing research helps improve ways to promote and maintain health. RATIONALE: Nursing research expands knowledge to learn improved ways to promote and maintain health. The other answers are incorrect because they are not the primary purpose of nursing research.
The focus of nursing is always on which of the four common concepts in nursing theory?
Person RATIONALE: All of these concepts are important in nursing theory; however, the focus of nursing is on the person (client).
A nurse has developed a plan of care for an adult client. What nursing function is important when using a nursing diagnosis to guide the care of this client?
Prioritize the nursing diagnoses. RATIONALE: After performing a nursing assessment, data should be analyzed and compiled into actual and potential health problems and documented as a nursing diagnosis. It is the nurse's responsibility to prioritize the nursing diagnoses, thereby prioritizing the care of the client. Resolved nursing diagnoses should be deleted from the plan of care as soon as they are resolved and replaced with new ones when appropriate. Nursing diagnoses should be written in a nonjudgmental way and in legally advisable terms. The plan of care is individualized for each client and therefore the client should be aware of what is included.
What type of of research study would a hospital conduct to explore client' and families' perceptions of receiving care?
Qualitative RATIONALE: Quantitative researchers tend to use deductive reasoning, logic, and measurable attributes of human experience, whereas qualitative researchers tend to use dynamic, individual aspects of the human experience in a holistic approach. Ordinal and interval refer to types of variables. Qualitative research is considered to be scientific even though it is not experimental.
A nurse is reviewing a qualitative research study. Which aspects of this type of study would the nurse need to keep in mind? SATA
Reality is not viewed as a fixed entity. Control or manipulation is rarely used. Intuition is used to analysis. RATIONALE: Qualitative research involves seeing reality not as a fixed entity but as existing in a context with the researcher rarely controlling or manipulating any aspect of the people/environment under study. Subjective interactions are viewed as the primary way to access understanding of the phenomena and intuition is used to analysis. Objectivity and control of biases are aspects of quantitative research.
If a nurse describes a study of people and the nursing profession including studies of education, policy development, ethics, and nursing history, then what is the nurse defining?
nursing research RATIONALE: Nursing research is a study of people and the nursing profession. Adaptation, nursing, and Maslow's theory may provide a theoretical foundation for the study, but the study itself is nursing research.
When the nurse researcher informs the participant that the participant's identity will not be linked with the information that is collected, the researcher is ensuring the participant's:
Confidentiality RATIONALE: Confidentiality ensures that the subjects' identities will not be linked with the information they provide and will not be publicly divulged. Not linking the subject's identity to the data collected does not ensure the participant;s anonymity (the researcher knows the participant's identity), protection from harm, or ability to withdraw.
Identifying the kind and amount of nursing services required is a possible solution for:
inadequate staffing RATIONALE: A possible solution for inadequate staffing is to identify the kind and amount of nursing services required. Using a team conference to develop a consistent plan of care is a possible solution for the client who refused to cooperate with the therapeutic regimen. Educating the client to become an assertive health care consumer is a possible solution for the client who quietly accepts whatever care is delivered or not delivered. A possible solution for the nurse who is a candidate for burnout is to learn to give quality care during the designated work period.
What are the primary purposes for conducting research in nursing? SATA
- provide a resource for evaluating care - provide a basis for best practice guidelines - develop new ways to improve assessment and diagnostic skills RATIONALE: The nursing profession uses research findings to develop innovative methods to sharpen assessment and diagnostic skills; establish future standards for developing patient goals, patient outcomes, and nursing interventions in the planning stage; and provide the latest knowledge to enhance nursing practice. Reviews of clinical research also provide a basis for best practice guidelines and serve as another excellent resource for nurses in evaluating care. Primary purposes of nursing research do not include decreasing the number of illnesses in the population (which is more the goal of medical research) or to improve pass rates on the NCLEX.
A nurse is preparing to conduct a research study and uses the PICO format to develop the foreground question which is: "In adults, does reducing salt intake, compared to no change in salt intake, lower blood pressure?" the nurse identifies the P as:
Adults
Which types of knowledge are subjective? SATA
Authoritative knowledge Traditional Knowledge RATIONALE: Traditional and authoritative knowledge are practical but may by subjective. Scientific knowledge, the scientific method, and evidence based practice are all rooted in research and are unlikely to be subjective.
An abstract idea or object that relates to other abstract ideas or objects is which?
Concept
Self-evaluation is a method that nurses use to promote their own development, and to grow in confidence in their nursing roles. This process is referred to as:
Reflective practice
Which group of nurses would be least likely involved in direct research? SATA
Novice nurses Student nurses RATIONALE: Direct research, except in the role of data collection or administration of medications and treatments as a protocol in a research project, usually does not involve student nurses and novice nurses. Master's prepared nurses such as clinical nurse specialists and nurse practitioners, as well as nurses at the PhD level, can be involved in direct research.
When a researcher begins to form plans for a research project, the researcher must decide on the method for conducting the research. The nurse researcher that plans to emphasize collection of narrative data and the analyses would select which of the following methods of research?
Qualitative research RATIONALE: Qualitative research utilizes words or narrative for data, rather than numbers. Quantitative research utilizes numerical values and statistical analysis of data. Basic research is utilized for its application in clinical practice. The stem of the question did not provide information as to the application of the study.
The type of intervention that the nurse performs when he or she observes the spouse of a postoperative client performing the client's dressing change is described as
Supervisory RATIONALE: The term "supervisory intervention" is applied in the context of overseeing a client's overall care.
Which statement best explains the importance of theoretic frameworks?
Theoretic frameworks advance nursing knowledge and practice. RATIONALE: Theoretic frameworks are important to the advancement of nursing knowledge and professional practice. The other statements are correct but do not communicate what is most important about theoretic frameworks.
A nursing theorist examines a hospital environment by studying each ward and how it works individually, and then relates this information to the hospital as a whole working entity. This is an example of the use of which theory?
General Systems Theory RATIONALE: General systems theory is an example of an interdisciplinary base for a nursing theory. This theory describes how to break whole things into parts and then to learn how the parts work together in "systems". It emphasizes relationships between the whole and the parts and describes how parts function and behave. Another example of an interdisciplinary base for nursing theory is the adaptation theory. Adaptation theory defines adaptation as the adjustment of living matter to other living things and to environmental conditions. A third disciplinary base for nursing theory is developmental theory. Developmental theory outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death. Erikson's theory of psychosocial development is one type of developmental theory.
Which is true of concepts?
Concepts describe objects, properties, and events and the relationships among them. RATIONALE: Concepts describe objects, properties, and events and the relationships among them. Theories are derived through deductive and inductive reasoning and provide a mechanism by which knowledge can be tested, and nursing theory differentiates nursing from other disciplines.
A nurse providing care has a personal philosophy that nursing interventions should be instituted for clients when the clients demonstrate ineffective adaptive responses. This nurse's philosophy is based on the theory of:
Sister Callista Roy RATIONALE: Sister Callista Roy is a nursing theorist whose work focused on the central theme that humans are biopsychosocial beings existing within an environment. Needs are created within interrelated adaptive modes: physiologic self-concept, role function, and interdependence. When individuals demonstrate ineffective adaptive responses, nursing interventions are required. Madeline Leininger is a nursing theorist whose work focused on caring as the central theme of nursing care, nursing knowledge, and nursing practice. The theory, when applied to clinical practice, provides the foundation of transcultural nursing care. Caring improves human conditions and life processes. Imogene M King is a nursing theorist whose work focused on the central theme that the client is a personal system within a social system; the nurse and the client experience each other and the situation, act and react, and transact. This theory is exhibited in clinical practice: nursing is a process of human interactions, as nurses and clients communicate to mutually set goals, and explore and agree on the means to reach those goals. Jean Watson is a nursing theorist who is known for her focus on caring. The central theme of her work is that nursing is concerned with promoting and restoring health, preventing illness, and caring for the sick. Caring is universal and is practiced through interpersonal relationships.
Which are examples of ways that a nurse can use theories to guide client care? SATA
Collect client data. Organize client information. Classify client data. Analyze client situations. RATIONALE: Assignments on a clinical unit are made by using acuity systems or delegation rather than being based in nursing theory. The other choices are all examples of ways that theory can guide client care.
Who is considered to be the first nursing researcher?
Florence Nightingale RATIONALE: Nursing research has been an integral part of the profession since Florence Nightingale documented the care of soldiers in the Crimean War. Although the others listed were important in the history of nursing, Florence Nightingale is considered to be the first nursing researcher.
Which theory describes how humans adjust to life with other living things and with the environment?
Adaptation theory RATIONALE: The adaptation theory describes the adjustment of living things to other living things and the environment. The systems theory describes how parts interact together. The nursing theory describes, explains, predicts, and controls outcomes in nursing practice. The developmental theory describes the maturation of humans through stages.
A community health nurse has been visiting a diabetic client whose morning fasting glucose levels are constantly elevated. Upon further assessment, the nurse determines that the client's spouse does not understand how to prepare meals following the prescribed diabetic diet. Using Dorothea Orem's Self-Care theory, how can the nurse help meet the needs of this client?
Arrange an evaluation appointment with a dietician. RATIONALE: According to Dorothea Orem's theory, the role of the nurse is to facilitate self-care to sustain life and health, to recover from disease or injury, or to cope with its effects. Arranging an evaluation appointment with a dietician facilitates self-care because the nurse is providing a service that assists the client and spouse to progressively maximize their self-care potential. People learn behaviors that they perform on their won behalf to maintain life, health and well being. The other options are providing care for the client, not facilitating self-care.
A nurse subscribes to the Basic Needs theory. Which action by the nurse exemplifies this theory?
Assisting the client to the bedside commode RATIONALE: The Basic Needs theory subscribes to the concept that a nurse assists in performing activities that the client would perform if the client could. Therefore, assisting the client to the bedside commode is an example of an action that supports Basic Needs theory. The other actions do not support this theory.
The American Nurses Association's Commission on Nursing Education developed guidelines for the investigative function of nurses at different educational levels. Which of the following is a guideline for a nurse with an associate's degree?
Assists in collection of data within an established, structured format. RATIONALE: The nurse with an associate degree assists in collection of data within an established, structured format. The nurse with a bachelor's degree reads, interprets, and evaluates research for applicability to nursing practice, identifies nursing problems that need to be investigated, and participates in implementation of scientific studies. The nurse with a master's degree in nursing analyzes and reformulates nursing practice problems so that scientific knowledge and scientific method can be used to find solutions.
A client reports weakness following administration of insulin. The nurse decides to assess the client's blood sugar and prepare a snack in case the blood sugar is low. What action has the nurse implemented?
Clinical reasoning RATIONALE: Clinical reasoning is the process of making a nursing judgement that will provide safe and quality care.
A group of objects with relationships is which?
Concept RATIONALE: A concept is a group of abstract ideas or objects and their relationships to one another. Theory is a group of concepts and the relationships among them. Deductive reasoning provides a basis for theory development, as one studies a general idea to more specific properties. Inductive reasoning is derived from consideration of specific properties to make conclusions about a general idea.
A nursing theory differs from a theoretical framework in which way?
Concepts and propositions are more specific. RATIONALE: The concepts and propositions of a theory are more specific than those of a theoretical framework. The other statements are not necessarily true of a theory.
A nurse researcher develops a foreground question in preparation for conducting a research study. The question is: "In clients with intravenous catheters, how does replacing administration sets every 72 hours (h) compared with other frequent intervals (24h, 48h, 96h) decrease infection rates?" Applying the PICO framework, which part of the statement reflects the O?
Decrease infection rates RATIONALE: The O of PICO indicates the outcome, which in this instance is "decrease infection rates". The P refers to patients, who in this case have intravenous catheters; I refers to intervention, which in this care is replacing the administration set every 72 hours; C refers to comparison or control group, which in this case is those who have the administration set replaced at other frequencies.
The process of considering an idea as a whole and then dividing it into smaller, more specific ideas is which?
Deductive reasoning RATIONALE: Deductive reasoning involves looking at an idea as a whole and then considering more specific ideas. Theory is a group of concepts and the relationships among them. Concepts are abstract ideas or objects and their relationships to one another. Inductive reasoning is derived from consideration of specific properties to conclusions about a general idea.
Which is a focus of medical research rather than nursing research?
Drug metabolism RATIONALE: Drug metabolism is an example of a focus of medical research. Nursing research is defined as a systematic inquiry into the problems encountered in nursing practice and into the modalities of client care such as health appraisal, prevention of trauma, promotion of recovery, and coordination of health care.
The nurse is preparing to submit a research project to the institutional review board (IRB). The nurse understands that which is the purpose of the IRB?
Ensure the ethical treatment of all participants. RATIONALE: Research involving human subjects needs approval by institutional review boards before implementation. The primary role of such boards is to ensure that the rights of participants are protected and ethical standards are maintained with research subjects. The IRB does not determine costs, validity, or whether the project will be published.
A nurse who works in a pediatric practice assesses the developmental level of children of various ages to determine their psychosocial development. These assessments are based on the work of:
Erikson RATIONALE: Erik Erikson based his theory of psychosocial development on the process of socialization, emphasizing how individuals learn to interact with the world. Erikson recognized the role of social, biological, and environmental factors in development, and defined specific tasks or conflicts that people accomplish or overcome during what he defined as the eight stages of life, based on chronologic age. Abraham Maslow developed his theory of human needs in terms of physical and psychosocial needs considered essential to human life, rather than by chronologic age as Erikson did. Maslow defined five levels of need in a hierarchy, with different needs existing simultaneously. Jean Watson is a nursing theorist who is known for her focus on caring. The central theme of her work is that nursing is concerned with promoting and restoring health, preventing illness, and caring for the sick. Caring is universal and is practiced through interpersonal relationships. Martha Rogers is a nursing theorist who is known for her theory of the individual client being central to the discipline of nursing. Nursing interventions are directed toward repatterning human environment fields or assisting in mobilizing inner resources.
When looking at a model for evidence-based practice, what is the final step of the process?
Evaluating practice change RATIONALE: The fifth and final step in the process of implementing evidence-based practice is to evaluate and critically appraise the change in practice. Formulating a clinical question and searching and appraising the literature precede this step.
Who is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment?
Florence Nightingale RATIONALE: Florence Nightingale conceptualized the nurse's role as manipulating the environment to facilitate and encourage the reparative process. This would be accomplished by attending to ventilation, warmth, light, diet, cleanliness, and noise. Sister Callista Roy, CSJ is an American nun, nursing theorist, professor and author. She is known for creating the adaptation model of nursing. Dorothea Orem was a nursing theorist and creator of the self-care deficit nursing theory, also known as the Orem model of nursing. Lydia Hall was a pioneer in nursing autonomy and nurse-driven care.
One of the primary reasons for conducting nursing research is to:
Generate knowledge to guide practice. RATIONALE: One of the major reasons for conducting nursing research is to generate knowledge to guide practice. The other answers pertain to other aspects of nursing practice but not to nursing research.
A well-constructed problem statement formulated at the beginning of a nursing research study should:
Indicate the population. RATIONALE: The problem statement should be clear and unambiguous, express a relationship between two or more variables, identify the population to be studied, and encourage empiric testing. It need not incorporate nursing theory, include references or identify the benefits of the study.
The nurse enters the room of the client diagnosed with a cerebral hemorrhage and immediately states "This client is getting worse". This is an example of the experienced nurse using:
Intuitive problem identification RATIONALE: Experienced nurses are able to make clinical decisions based on intuition, or an "inner prompting or hunch" that can lead to early and life-saving interventions. Intuitive problem solving is based on a background of experience, knowledge, and skill. Acute observation ability is using skills to determine the extent of the issue using observation. Logical fallacies (illogical thinking) are used to describe faults in logic that result in false conclusions. Assumption is a thing that is accepted as true or as certain to happen, without proof.
A nurse is reviewing nursing theory for usefulness in a home healthcare setting. Which is the appropriate application of Dorothea Orem's self-care model in a home healthcare setting?
Match the client's self-care needs with appropriate supportive interventions. RATIONALE: According to Orem's self-care model, a nurse assists clients with self-care to improve or maintain health, as well as to progressively maximize self-care potential. Helping a client find appropriate support at home demonstrates this theory. The other options do not demonstrate this model.
What is the central theme of Florence Nightingale's nursing theory?
Meeting the personal needs of the client within the environment. RATIONALE: Florence Nightingale believed in meeting the personal needs of the client within the environment. Hildegard Peplau believed nursing is a therapeutic, interpersonal, and goal-oriented process. Nursing is an art is the theory of Ernestine Wiedenbach, while Betty Neuman's nursing theory states that humans are in a constant relationship with stressors in the environment.
A nurse is planning to conduct a nursing research study and is seeking federal funding. Which institution would be most helpful for the nurse to contact regarding acquiring funding?
National Institute of Nursing Research RATIONALE: The nurse would most likely contact the National Institute of Nursing Research (NINR), which was established under the National Institutes of Health in response to a 1983 study by the Institute of Medicine. The institute's purpose was to place nursing securely in the sphere of scientific investigation and to support research and training in client care, health promotion, and disease prevention, as well as the mitigation of effects of acute and chronic disabilities. The NINR has continued to fund and support nursing research and is instrumental in the support and dissemination of seminal work in nursing. The ANA Cabinet of Nursing Research was responsible for establishing priorities for nursing research.
What theory describes, explains, predicts, and controls outcomes in nursing practice?
Nursing Theory RATIONALE: Nursing theory describes, explains, predicts, and controls outcomes in nursing practice. Systems theory describes how parts interact together. Adaptation theory describes adjustment of living things to other living things and the environment. Developmental theory describes maturation of humans through stages.
What is the best explanation for the way evidence-based practice (EBP) has changed the way nursing care is delivered?
Nursing care now uses EBP as a means of ensuring quality care. RATIONALE: The facilitation of EBP involves identifying and evaluating current literature and research, as well as incorporating the findings into client care as a means of ensuring quality care. The other answers are incorrect; they were used even before EBP became a major force in the delivery of nursing care.
A nurse is developing a foreground question for nursing research using the PICO model. Which component would be represented by the statement "a 45-year-old male with coronary heart disease and atrial fibrillation"?
P RATIONALE: When using PICO, the P stands for the patient or problem and its delineation. The I signifies the intervention considered; C denotes comparison if appropriate, or it may be optional, and O represents the outcome of interest or relevant outcomes.
The Joint Commission is conducting an accreditation visit at a hospital. What is the focus of the evaluation being conducted?
Quality Assurance RATIONALE: Accreditation by the Joint Commission evaluates quality assurance. Quality assurance is an externally driven process, demonstrating nursing excellence by meeting professional standards of care. Quality improvement is an internally driven, continuous process focusing on the processes of client care. Peer review is a process whereby individual nurses improve their professional performance through the evaluation of one staff member by another staff member on the same level of the hierarchy. Magnet status is awarded by the American Nurses Credentialing Center, recognizing health care organizations for their excellence in nursing.
Which is the best example of evidence-based nursing practice?
Recommending ginger to alleviate nausea and vomiting in obstetric patients based on a literature review. RATIONALE: Identifying a client problem (nausea and vomiting), performing a literature review to learn about solutions to this problem that have been studied (use of ginger), and applying the information gained to client in one's practice (recommending ginger to obstetrical clients with nausea and vomiting) are a great example of evidence-based nursing practice. Basing interventions on personal experience, personal observation, and person success in treating clients, despite research findings to the contrary, are not good examples of evidence-based practice. Evidence from a single article in a nursing journal for use of an intervention with a single client who may or may not be a part of the population studied is not the best example of evidence-based nursing practice.
Which statement is true of the nursing process?
Scientific problem solving can occur within the nursing process. RATIONALE: Problem solving and the nursing process are not competing or mutually exclusive processes. Rather, both scientific problem solving, trial-and-error, and intuition may take place within the nursing process. One of the strengths of the nursing process is that it is applicable to all nursing areas from medical surgical to community health settings.
Personal characteristics demonstrate that one has developed critical thinking. Characteristics of critical thinking include:
Self-aware, honest, persistent, and authentic RATIONALE: The characteristics of critical thinking include: self-aware, genuine/authentic, effective communicator, curious/inquisitive, confident/resilient, honest, creative, proactive, persistent, and improvement oriented.
The nurse is caring for a pediatric client with respiratory distress. Upon assessment the client has increased respiration's and work of breathing. Breath sounds are adventitious and the client has thick yellow/green drainage coming from the nose. Based on these findings, the nurse determines that this client has an ineffective airway clearance related to copious amounts of think secretions and proceeds to perform nasopharyngeal suctioning to relieve some of the secretions. If the nurse were documenting the evaluation of this intervention, what would be documented?
The amount and type of drainage suctioned from the nares, and the client's response. RATIONALE: The evaluation phase is the phase of the nursing process in which the client's response to the plan of care is analyzed and decisions are made to continue, revise, or terminate the plan of care. The amount and type of drainage and the client's response to the nasopharyngeal suctioning is the evaluation and should be documented. The client's symptoms are documented as part of the assessment. Ineffective airway clearance is documented as the nursing diagnosis. Nasopharyngeal suctioning is documented as the intervention.
A nurse is discussing dietary issues with a Latino client in the clinic. The client states "My grandmother always told me that I needed to include beans in my diet so that my muscles would grow". The information that the client is expressing is known as what?
Traditional knowledge RATIONALE: Traditional knowledge is known as knowledge that is passed down from one generation to the next. A grandmother passing information is an example of traditional knowledge. Authoritative knowledge is information that is gleaned from an expert based on their perceived experience. Scientific is knowledge derived though the scientific method. Philosophy is the study of wisdom and one's perceptions of life.
What nursing activity forms the bridge between theory and practice?
evidence-based research RATIONALE: Evidence-based research is translational research that forms the bridge between theory and practice. Theoretical writing focuses on theory. Client-focused care and case management are focused on practice.
A conceptual framework is defined as
a set of concepts and propositions RATIONALE: A conceptual framework or model is defined as a set of concepts and the propositions that integrate them into a meaningful configuration. A conceptual framework is not an explanation of nursing and nursing practice, a set of phenomena and related abstractions, or a foundation for nursing skills and care.
What is meant by intellectual and affective activities in which individuals engage to explore their experiences in order to lead to new meanings and appreciations?
reflection RATIONALE: Reflection is defined as those intellectual and affective activities in which individuals engage to explore their experiences in order to lead to new understandings and appreciations.
Evidence-based care emphasizes decision making based on the best available evidence and:
use of outcome studies to guide decisions. RATIONALE: Evidence-based care emphasizes decision making based on the best available evidence and the use of outcome studies to guide decisions. The other answers do not represent the primary emphasis of evidence-based care but represent other approaches (authoritative knowledge, traditional medical model, and economic concerns)
