Chapter 5: Evidence-Based Practice Nursing School Test Banks

Potter & Perry: Fundamentals of Nursing, 7th Edition

Test Bank

MULTIPLE CHOICE

1. Which of the following research approaches is an example of an exploratory type of research?

1.

Establishing facts and relationships of past events

2.

Testing how well a program, practice, or policy is working

3.

Refining a hypothesis on the relationships among phenomena

4.

Portraying the characteristics of persons, situations, or groups

ANS: 3

An example of an exploratory type of research is to develop or refine a hypothesis about the relationships among phenomena.

An example of a historical type of research is to establish facts and relationships concerning past events.

An example of an evaluation type of research is to test how well a program, practice, or policy is working.

An example of a descriptive type of research is to accurately portray characteristics of persons, situations, or groups and the frequency with which certain events or characteristics occur.

PTS: 1 DIF: A REF: 62 OBJ: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

2. The Health Information Portability and Accountability Act (HIPAA), implemented in 2003, may influence nursing research in the area of:

1.

The cost of the study

2.

Where the study may be published

3.

What type of study may be conducted

4.

How the data will be obtained and protected

ANS: 4

HIPAA regulations identify how protected health information of potential research subjects is to be managed. The researcher must be able to ensure that the data will be protected and used only by the researcher.

HIPAA regulations should not influence the area of cost in nursing research.

The focus of HIPAA regulations is not on where a study may be published.

HIPAA regulations should not influence the type of study conducted.

PTS: 1 DIF: A OBJ: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

3. The expected research role for the baccalaureate-prepared nurse is to:

1.

Assume the role of a clinical expert

2.

Acquire funding for research projects

3.

Identify clinical nursing problems in practice

4.

Develop methods of inquiry relevant to nursing

ANS: 3

Nurses with a baccalaureate degree are prepared to read research critically and use existing standards to determine the readiness of the findings for clinical practice. They also participate in research activities through identification of clinical problems in nursing practice.

Nurses with a masters degree assume the role of clinical expert and are able to create a climate in which research-based change can be implemented into practice.

Doctorally-prepared nurses are responsible for acquiring funding for research from public and private sources.

Doctorally-prepared nurses are prepared to design studies independently including the development of methods of inquiry relevant to nursing.

PTS: 1 DIF: A REF: 55 OBJ: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

4. When a nurse researcher distributes an explanatory information sheet to subjects solicited for participation in her study, which of the following ethical principles that guide research is this researcher using?

1.

Informed consent

2.

Freedom from harm

3.

Protection of subjects

4.

Confidentiality of subjects

ANS: 1

As a component of informed consent, research subjects are given full and complete information about the purpose of the study, procedures, data collection, potential harm and benefits, and alternative methods of treatment.

Research aspects such as minimizing the risk to participants, allowing reasonable risk to participants in relation to anticipated benefits, and monitoring the research to ensure the safety of participants follow the ethical standard of freedom from harm.

In the case of research, institutions have Health Information Portability and Accountability Act (HIPAA) regulations that identify how protected health information of research subjects is to be managed. The nurse researcher who follows HIPAA guidelines is following the principle of protection of subjects.

Confidentiality guarantees that any information provided by the subject will not be reported in any manner that identifies the subject and will not be made accessible to people outside the research team. Describing how confidentiality is maintained is a component of informed consent.

PTS: 1 DIF: A REF: 63 OBJ: Comprehension

TOP: Nursing Process: Planning

MSC: NCLEX test plan designation: Safe, Effective Care Environment

5. The nurse takes on ethical responsibilities when conducting research with human subjects. Which of the following violates an ethical responsibility associated with informed consent?

1.

Adhering to verbal and written agreements

2.

Using data obtained before the initiation of the study

3.

Explaining the possibility of unknown risks when appropriate

4.

Providing alternatives, including the right of refusal and standard practices

ANS: 2

Using data obtained before the initiation of the study would be a breach of privacy because the participant has not yet given informed consent for use of those data.

Adhering to verbal and written agreements is central to informed consent and the implementation of ethical research.

One component of informed consent is the inclusion of informing the research subject of the potential harm and benefits. This would include the risks to the subject (including financial risks) and the potential for no benefit.

Within the consent document, the researcher must outline alternative methods of treatment and alternatives to participation, including the right to withdraw from the study at any given time.

PTS: 1 DIF: A REF: 63 OBJ: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

6. Nurses need to become familiar with the elements of a research publication. A brief explanation of the type of measurement to be used is found in which section of a study?

1.

Results

2.

Methods

3.

Conclusion

4.

Introduction

ANS: 2

The methods section of a study includes the description of the sample (what or who was studied), type of data collected, and the device or instrument used to measure empirical information.

The results section contains a description of the results obtained in the study, including appropriate statistical tests used to analyze the data.

The conclusion consists of the author summarizing implications that can be drawn from the study.

The introduction section presents the purpose, a summary of literature used to formulate the study, and the hypothesis tested or the research questions posed.

PTS: 1 DIF: A REF: 59 OBJ: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

7. After identifying the problem, the next step in the research process is to:

1.

Select the population

2.

Review the literature

3.

Obtain approval to conduct the study

4.

Identify the instrument to use for data analysis

ANS: 2

After identifying the problem, the next step in the research process is to review the literature to determine what is known about the problem.

Following identification of the problem and review of the literature, the researcher will design the study protocol. Selecting the population is a component of this phase of the research process.

Obtaining necessary approvals is part of conducting the study, which follows the design phase in the research process.

Identifying the instrument to use for data analysis occurs during the process of designing the study protocol. This step would occur during the study design phase of the research process after problem identification and literature review have taken place.

PTS: 1 DIF: A REF: 58 OBJ: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

8. A sample of orthopedic clients varies greatly in their requests for postsurgical analgesics. Which type of nursing research would best examine a prospective group of clients in determining what factors affect their alterations in comfort?

1.

Historical research

2.

Evaluation research

3.

Correlational research

4.

Experimental research

ANS: 3

Correlational research explores the interrelationships among variables of interest (such as factors affecting client comfort) without any active intervention by the researcher.

Historical research is designed to establish facts and relationships concerning past events. It would not use prospective groups of clients.

Evaluation research tests how well a program, practice, or policy is working.

In experimental research, the investigator controls the study variable and randomly assigns subjects to different conditions.

PTS: 1 DIF: A REF: 62 OBJ: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

9. Which of the following research topics best lends itself to the experimental research process method?

1.

The effects of therapeutic touch on a geriatric client diagnosed with Alzheimers disease

2.

Prioritizing three nursing diagnoses for a newly admitted client with diabetes mellitus

3.

Employing humor as an intervention with clients who are recovering from orthopedic surgery

4.

Determining the blood pressure patterns of a client who recently experienced a cerebrovascular accident (i.e., stroke)

ANS: 3

In experimental research, the investigator controls the study variable (use of humor) and randomly assigns subjects to different conditions (those who receive humor as an intervention, and those who do not).

The effect of therapeutic touch on a geriatric client with Alzheimers disease lends itself to the nursing process as a nursing intervention to perhaps assist a client in meeting a goal of preventing social isolation. To use the experimental research process, there would have to be other clients involved (i.e., a group of clients with Alzheimers disease who receive therapeutic touch, and a group of clients with Alzheimers disease who do not receive therapeutic touch) to determine whether or not therapeutic touch had any effect.

Prioritizing nursing diagnoses for client care is an example of using the nursing process.

Determining the blood pressure patterns of a client who recently had a cerebrovascular accident is a part of the assessment phase of the nursing process. In contrast to an experimental research study, no variable is being controlled by the nurse.

PTS: 1 DIF: A REF: 62 OBJ: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

10. The nurse is looking at different strategies for learning and incorporating new information into practice. A strategy that uses problem-solving is demonstrated by:

1.

Repeatedly practicing vital signs until competence is achieved

2.

Seeking information from the nurse manager on the clients status

3.

Reviewing Maslows hierarchy either in a textbook or on the internet

4.

Trying different types of colostomy dressings for maximum therapeutic effect

ANS: 4

Trying various ways of resolving clients health care needs or evaluating health care products, as in trying different types of colostomy dressings for maximum effect, is an example of the problem-solving strategy for knowledge acquisition.

Practicing skills is an example of gaining experience to increase ones knowledge.

Information-seeking is a strategy used to obtain knowledge from experts in a particular field.

Reviewing Maslows hierarchy in a reference textbook or on the internet is another example of acquiring knowledge through information-seeking.

PTS: 1 DIF: A REF: 55 OBJ: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

11. A nurse researcher has completed a study involving the use of intravenous analgesics for postsurgical discomfort. The description of the 16 clients used for the study would best be written in which part of the research report?

1.

Results section

2.

Methods section

3.

Discussion section

4.

Introduction section

ANS: 2

A description of the clients used is found in the methods section of the research study.

The results section contains a description of the results obtained in the study, including appropriate statistical tests used to analyze the data.

The discussion section presents the authors interpretation of the results, including conclusions and implications that can be drawn from the study.

The introductory section presents the purpose of the study, a summary of literature, and the hypotheses tested or questions posed.

PTS: 1 DIF: A REF: 59 OBJ: Knowledge

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

12. A nurse reads about a case study involving the potential positive effects of the early stimulation of posthead-injury clients. Which of the following questions should be a priority consideration before use of the research results?

1.

What was the cost of the study?

2.

Were ethical principles maintained?

3.

Were the results of this study published in other journals?

4.

Are the clients in the study similar to clients I work with?

ANS: 4

Determination of whether the subjects and environment in the study are similar to the clients for whom the nurse provides care in the particular practice setting is necessary before research can be considered for use in practice.

Although cost may be a consideration in determining the feasibility of applying research findings, it is not the priority consideration for research utilization. The research findings would first have to be applicable to the practice setting and client population.

Even though research may indicate ethical principles were maintained, it does not necessarily mean that it is feasible to apply the findings in practice. For example, cost issues may limit the use of research findings.

The number of journals that published the research results of the study should not be the priority consideration in implementation of its findings. To judge the scientific worth of the study; however, it is important to examine the amount of supportive evidence provided by other scientific studies that have obtained similar results.

PTS: 1 DIF: C REF: 59 OBJ: Analysis

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

13. An example of a predictive type of question that a nurse might use for research is which of the following?

1.

What creates an increase in stress levels?

2.

How often does the stress reaction occur?

3.

What does guided imagery mean to clients?

4.

If guided imagery is used, will stress levels be reduced?

ANS: 4

Questioning whether stress will be reduced is an example of a predictive type of question because it connects stress reduction with the use of guided imagery.

Asking what increases stress explores factors that impact a phenomenon. It is not a predictive type of question.

Asking how often stress increases does not predict any outcome, but rather focuses on frequency of a response, which could be used in data collection.

Asking what guided imagery means does not predict any type of outcome, but rather explores meaning in order to gain understanding.

PTS: 1 DIF: A REF: 55 OBJ: Comprehension

TOP: Nursing Process: Assessment

MSC: NCLEX test plan designation: Safe, Effective Care Environment

14. A nurse routinely uses therapeutic touch when caring for postoperative clients with incisional pain. Occasionally a client will show reluctance when the intervention is offered. The nurses best response in such a situation is to:

1.

Research for alternative interventions that will be better received by the client

2.

Suggest that the client allow the intervention just once before making a final decision

3.

Respect the clients wishes and rely on pain medication to help with managing the pain

4.

Inform the client that the intervention has been found to be effective during several research projects

ANS: 1

Evidence-based practice is a problem-solving approach to clinical practice that integrates the conscientious use of best evidence in combination with a clinicians expertise and client preferences and values in making decisions about client care. If the client is not receptive to an intervention, the best nursing response is to search for an alternative evidence-based therapy that the client will accept.

Suggesting the client allow intervention once before making a decision may be considered as long as there is no pressure placed on the client to accept the intervention, but it is not the best option provided because there is no guarantee that the client will be receptive to the intervention, and the problem regarding incisional pain would then go unaddressed.

While requesting the clients wishes is not inappropriate, it does not address the issue of best evidence-based practice and so is not the best option available.

Informing the client that intervention has been effective in research may be considered as long as there is no pressure placed on the client to accept the intervention, but it is not the best option provided because there is no guarantee that the client will be receptive to the intervention, and the problem regarding incisional pain would then go unaddressed.

PTS: 1 DIF: C REF: 55 OBJ: Analysis

TOP: Nursing Process: Planning

MSC: NCLEX test plan designation: Safe, Effective Care Environment/Physiological Integrity

15. The dressing covering the pressure ulcer on a clients heel frequently becomes loosened and requires repeated reinforcement. The nurse asks, What can be done to improve the adhering properties of this type of dressing? The nurse has just formulated a:

1.

PICO-formatted question

2.

Research question (hypothesis)

3.

Problem-focused triggered question

4.

Knowledge-focused triggered question

ANS: 3

A problem-focused trigger question is one you face while caring for a client or a trend you see on a nursing unit. For example, while caring for an unconscious client, you think, What is the best solution to use when giving mouth care to this client?

The more focused a question you ask, the easier it will be to search for evidence in the scientific literature. PICO is a formatting process used when searching the literature for information on a specific topic.

Hypotheses are predictions made about the relationship or difference between study variables (a concept, characteristic, or trait that varies within subjects).

A knowledge-focused trigger is a question regarding new information available on a topic. For example, What is the current evidence to improve pain management in clients with migraine headaches?

PTS: 1 DIF: A REF: 55 OBJ: Comprehension

TOP: Nursing Process: Planning

MSC: NCLEX test plan designation: Safe, Effective Care Environment

Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

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