Ch. 2 Evidence Based Practice Flashcards
A student nurse asks an experienced nurse why it is necessary to change the patient’s bed every day. The nurse answers: “I guess we have just always done it that way.” This answer is an example of what type of knowledge?
A) Instinctive knowledge
B) Scientific knowledge
C) Authoritative knowledge
D) Traditional knowledge
d.
Traditional knowledge is the part of nursing practice passed down from generation to generation, often without research data to support it. Scientific knowledge is that knowledge obtained through the scientific method (implying thorough research). Authoritative knowledge comes from an expert and is accepted as truth based on the person’s perceived expertise. Instinct is not a source of knowledge.
A nurse is using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model PET as a clinical decision-making tool when delivering care to patients. Which steps reflect the intended use of this tool? Select all that apply.
A) A nurse recruits an interprofessional team to develop and refine an EBP question.
B) A nurse draws from personal experiences of being a patient to establish a therapeutic relationship with a patient.
C) A nurse searches the Internet to find the latest treatments for type 2 diabetes.
D) A nurse uses spiritual training to draw strength when counseling a patient who is in hospice for an inoperable brain tumor.
D) A nurse questions the protocol for assessing postoperative patients in the ICU.
E) A nursing student studies anatomy and physiology of the body systems to understand the disease states of assigned patients.
a, c, e.
The JHNEBP model is a powerful problem-solving approach to clinical decision making, and is accompanied by user-friendly tools to guide individual or group use. It is designed specifically to meet the needs of the practicing nurse and uses a three-step process called PET: practice question, evidence, and translation. The goal of the model is to ensure that the latest research findings and best practices are quickly and appropriately incorporated into patient care. Steps in PET include, but are not limited to, recruiting an interprofessional team, developing and refining the EBP question, and conducting internal and external searches for evidence.
A nurse is using general systems theory to describe the role of nursing to provide health promotion and patient teaching. Which statements reflect key points of this theory? Select all that apply.
A) A system is a set of individual elements that rarely interact with each other.
B) The whole system is always greater than the sum of its parts.
C) Boundaries separate systems from each other and their environments.
D) A change in one subsystem will not affect other subsystems.
E) To survive, open systems maintain balance through feedback.
F) A closed system allows input from or output to the environment.
b, c, e.
According to general systems theory, a system is a set of interacting elements contributing to the overall goal of the system. The whole system is always greater than its parts. Boundaries separate systems from each other and their environments. Systems are hierarchical in nature and are composed of interrelated subsystems that work together in such a way that a change in one element could affect other subsystems, as well as the whole. To survive, open systems maintain balance through feedback. An open system allows energy, matter, and information to move freely between systems and boundaries, whereas a closed system does not allow input from or output to the environment.
A charge nurse meets with staff to outline a plan to provide transcultural nursing care for patients in their health care facility. Which theorist promoted this type of caring as the central theme of nursing care, knowledge, and practice?
A) Madeline Leininger
B) Jean Watson
C) Dorothy E. Johnson
D) Betty Newman
a.
Madeline Leininger’s theory provides the foundations of transcultural nursing care by making caring the central theme of nursing. Jean Watson stated that nursing is concerned with promoting and restoring health, preventing illness, and caring for the sick. The central theme of Dorothy E. Johnson’s theory is that problems arise because of disturbances in the system or subsystem or functioning below optimal level. Betty Newman proposed that humans are in constant relationship with stressors in the environment and the major concern for nursing is keeping the patient system stable through accurate assessment of these stressors.
A student nurse interacting with patients on a cardiac unit recognizes the four concepts in nursing theory that determine nursing practice. Of these four, which is most important?
A) Person
B) Environment
C) Health
D) Nursing
a.
Of the four concepts, the most important is the person. The focus of nursing, regardless of definition or theory, is the person.
A nurse manager schedules a clinic for the staff to address common nursing interventions used in the facility and to explore how they can be performed more efficiently and effectively. The nurse manager’s actions to change clinical practice are an example of a situation described by which nursing theory?
A) Prescriptive theory
B) Descriptive theory
C) Developmental theory
D) General systems theory
a.
Prescriptive theories address nursing interventions and are designed to control, promote, and change clinical nursing practice. Descriptive theories describe a phenomenon, an event, a situation, or a relationship. Developmental theory outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death. General systems theory describes how to break whole things into parts and then to learn how the parts work together in “systems.”
When conducting quantitative research, the researcher collects information to support a hypothesis. This information would be identified as:
A) The subject
B) Variables
C) Data
E) The instrument
c.
Data refer to information that the researcher collects from subjects in the study (expressed in numbers). A variable is something that varies and has different values that can be measured. Instruments are devices used to collect and record the data, such as rating scales, pencil-and-paper tests, and biologic measurements.
A nurse is conducting quantitative research to examine the effects of following nursing protocols in the emergency department (ED) on patient outcomes. This is also known as what type of research?
A) Descriptive
B) Correlational
C) Quasi-experimental
D) Experimental
c.
Quasi-experimental research is often conducted in clinical settings to examine the effects of nursing interventions on patient outcomes. Descriptive research is often used to generate new knowledge about topics with little or no prior research. Correlational research examines the type and degree of relationships between two or more variables. Experimental research examines cause-and-effect relationships between variables under highly controlled conditions.
A nurse studies the culture of Native Alaskans to determine how their diet affects their overall state of health. Which method of qualitative research is the nurse using?
A) Historical
B) Ethnography
C) Grounded theory
D) Phenomenology
b.
Ethnographic research was developed by the discipline of anthropology and is used to examine issues of culture of interest to nursing. Historical research examines events of the past to increase understanding of the nursing profession today. The basis of grounded theory methodology is the discovery of how people describe their own reality and how their beliefs are related to their actions in a social scene. The purpose of phenomenology (both a philosophy and a research method) is to describe experiences as they are lived by the subjects being studied.
A nurse is formulating a clinical question in PICOT format. What does the letter P represent?
A) Comparison to another similar protocol
B) Clearly defined, focused literature review of procedures
C) Specific identification of the purpose of the study
D) Explicit descriptions of the population of interest
d.
The P in the PICOT format represents an explicit description of the patient population of interest. I represents the intervention, C represents the comparison, O stands for the outcome, and T stands for the time.
