HLT 2000 Exam 4

- Chapter 10: The Science of Nursing and Evidence-Based Practice

The discovery of oxygen would be called pure science because this information?

 Was obtained for the sake of obtaining new knowledge of the world

o What is meant by the term evidence-based practice?

 Applying research findings; patient care data, preferences, and values; and

nursing expertise to nursing practice

o To build the body of knowledge of nursing, a problem amenable to study should

be?

 Based on published research findings and fit logically with what is already

known

o Which of the following is not a necessary step in the research process?

 Review of best practice guidelines

o Which of the following are the three most common sources of research questions?

 Clinical problem, replication of prior research, testing nursing theory

o Which of the following is an example of a research question based on a clinical

problem?

 Relationship between hours of bright light and irritability of preterm

infants

o A nursing manager wants the unit staff to become more involved in research. The

staff nurses say they are not qualified to conduct research. Which response by the

manager is the best?

 You need a basic understanding of the research process because you

should be good consumers of research

o An intensive care unit nurse notices that patients seem to have more normal vital

signs when they are being visited by their family members, especially when the

visitors seem to be more caring. However, the hospital has strict visiting hours of

10 minutes every other hour. What would be the most appropriate research

question to ask at this time?

 Do ICU patients have vital signs in normal range more frequently when

they are being visited by family members?

o Which research design has the goal of determining a cause-and-effect

relationship?

 Experimental design

o Which research design would be used to determine the relationship between self-

concept, physical fitness, and health habits in school-aged children?

 Nonexperimental design

o Which research design should be used to determine whether there is a difference

in the effectiveness of two preoperative preparation methods on length of stay?

 Experimental Design

o For data collection to be valid, what must occur?

 The tool must measure what it is supposed to measure

o A data collection protocol calls for a questionnaire to be administered to patients

having knee replacement surgery after the third physical therapy appointment.

Errors can be introduced into the study by

 Giving the questionnaire to all participants when they arrive for their

appointment

o Which of the following must be included in the informed consent in research?

 Participants must be informed of risks associated with participation

o What body has been established to protect participants of research?

 Institutional Review Board

o What is the current name of the agency that serves as an important source of

funding for nursing research?

 National Institute of Nursing Research

o Translational research/science will do which of the following?

 Take laboratory findings for development for use with patients at the

bedside

 Use clinical research findings to ask new questions for research in the

laboratory

o Quantitative research methods may be somewhat less useful in nursing because of

which of the following?

 Many phenomena of interest to nurses are not amenable to study in tightly

to statements that can be tested

 The complexity of human beings makes it difficult to break problems in

controlled circumstances

 Patients perceptions of experiences may have significant effects on their

health behaviors

o Evidence based nursing practice involves which of the following

 The use of the best evidence available supporting the interventions

 The expertise of the professional nurse

 The preference of the individual patients and their families

o A nurse wants to examine the accuracy of child and parent perceptions of asthma

symptoms and their decision making based on their understanding of the

symptoms. What specific factors would identify participants?

 Children 5 to 18 years of age

 Mother of the children

o Dissemination of findings may involve which of the following activities

 Manuscript reviewed by peers

 Oral presentation of finding at annual conference of the society of

pediatric nurses

 Poster presentation at regional conference of Sigma Theta Tau

International

 Publication of findings in Western Journal of Nursing Research

- Chapter 11: Developing Nursing Judgement through Critical Thinking

o Critical thinking is developed to improve

 Patient outcome

o How is the nursing process defined?

 A conceptual framework that enables the student or practicing nurse to

think systematically and process pertinent information about the patient

 Combines the art and science of nursing

o How is a nursing diagnosis defined?

 A clinical judgment about individual, family, or community responses to

actual or potential health problems or life processes which provide the

basis for selection of nursing interventions to achieve outcomes for which

the nurse has accountability (NANDA-1)

o Until what year was diagnosis considered within the scope of practice of

physicians only?

 1970s

o True or False: Nursing diagnosis is meant to be a substitute for medical diagnosis

 False: Not meant to be substitute

o What is medical diagnosis?

 Focus on what is wrong with patients in terms of disease process

 Platform for which nurses’ diagnoses are developed

o What is Nursing Diagnosis?

 Identifies problems the patient is experiencing as result of disease

 Address problems nurse can treat within their scope of practice

o What are the six components of nursing diagnosis?

 Label

 Definition

 Related factors

 Defining characteristics

 Desired outcomes/evaluation criteria

 Actions/interventions

o What is the definition of label as a component of the nursing diagnosis?

 Concise term or phrase that names the diagnosis

o What is the definition of definition as a component of the nursing diagnosis?

 Term or phrase that clearly delineates meaning and helps differentiate

from similar diagnoses

o What is the definition of related factors as a component of nursing diagnosis?

 Factors that precede are associated with, or related to diagnosis

o What is the definition of defining characteristics as a component of nursing

diagnosis?

 Subjective and objective findings

o What is the definition of desired outcome/evaluation criteria as a component of

nursing diagnosis?

 What the patient and you set as goals for care

o What is the definition of actions/interventions as a component of nursing

diagnosis?

 What the patient and you will do to reach goals

o True or False: All nursing diagnoses must be supported by data

 True

o What is nursing process?

 Series of organized steps, purpose of which is to impose some discipline

and critical thinking on the provision of excellent care

o True or False: Nursing process is always linear

 False

o What is the first phase of nursing process?

 Assessment

o What information do you gather during assessment/phase one?

 Info about patient, family, community

 Subjective, objective data

 Physiologic, psychological, sociocultural, developmental, spiritual, and

environmental information should be gathered

o What is subjective data?

 Symptoms

 Describe their needs, feelings and perception of the problem

 Only source of info is the patient

o What is objective data?

 Signs

 Data that is collected through observation, examination, or consultation

with other health care providers

 These data assessments are measurable (vital signs)

o What is the primary means of collecting subjective and objective data?

 Patient interview

o What is phase two of the nursing process?

 Analysis and identification of the process

o What happens during phase two of the nursing process?

 Data must first be validated and compared with norms

 Problems are then characterized into nursing diagnosis

o What is phase three of nursing process?

 Planning

o What happens during phase three?

 Identification of patient goals and how to reach them

 Goals should be agreed on by patients and nurse

 Goals give the patient, family, significant others and the nurse direction

and make them active partners

o ________ is an important consideration in setting patient goals and selecting

interventions

 Cultural congruency

o What are independent interventions?

 Requires no supervision

 Are within nursing scope practice

 Nurses have knowledge and skills to carry out the action safely

o What are dependent interventions?

 Require instructions, written prescriptions, or supervision of another

health professional with prescriptive authority

 Actions can’t be done without orders

o What is phase four of nursing process?

 Implementation of planned interventions

o What happens during phase four?

 Nurse is continually assessing the patient, noting response to nursing

interventions, and modifying the care plan or adding nursing diagnoses as

needed

o What is phase five of the nursing process?

 Evaluation

o What happens during the fifth phase?

 Nurse examines whether the problem is resolved, in the process of being

resolved, or unresolved

 Best nursing care plan is one that is evaluated frequently and changed in

response to the patient’s condition

o What is the best means of developing clinical judgment?

 Extensive patient contact

o When developing sound clinical judgement you must:

 Recall facts

 Recognize patterns in patient behavior

 Put facts and observations together to form a meaningful whole

 Acting on resulting information in an appropriate way

 Knowing limitations of your expertise

- Nursing Diagnosis and Critical Thinking

o The nurse has just been assigned to the clinical care of a newly admitted patient.

To know how to best care the patient, the nurse uses the nursing process. Which

step of the nursing process would the nurse do first?

 Assessment

o Which is the most important reason for a nurse to be a critical thinker?

 Nurses care for clients with multiple health problems

o What do critical thinking and the nursing process have in common?

 They are both thinking methods used to solve a problem

o Which differentiates a nursing diagnosis from a medical diagnosis?

 A clients response to a health problem

o The nurse is conducting an interview. Which of these statements is true regarding

open-ended questions?

 They allow for self-expression

 They build and enhance rapport

 They are used when narrative information is needed

o Which statement about the nursing process is correct?

 It is a problem-solving method to guide nursing activities

o Which aspects of healthcare are affected by a clients culture?

 How the client views healthcare

 How the client views illness

 How the client will pay for healthcare services

 The types of treatment a client will accept

o Put the following patient situations in order according to level of priority

 A teenager who was stung by a bee during a soccer match is having

trouble breathing

 An older adult with a urinary tract infection is also showing signs of

confusion and agitation

 A patient newly diagnosed with type two diabetes mellitus does not know

how to check his own