End of Chapter Review Questions for Exam 3

Question 1

A nurse researcher interviews parents of children who have diabetes and asks them to describe how they deal with their child’s illness. The analysis of the interviews yields common themes and stories describing the parents’ coping strategies. This is an example of which type of study?

Historical
Qualitative
Correlational
Experimental

Answer 1

Qualitative
The data in this study were collected during interviews; information from the interviews was used to describe common themes and experiences of the parents. These are characteristics of qualitative research.

Question 2

A nurse who works in a newborn nursery asks, “I wonder if the moms who breastfeed their babies would be able to breastfeed more successfully if we played peaceful music while they were breastfeeding.” In this example of a PICOT question, the I is:

Breastfeeding moms.
Infants.
Peaceful music.
The nursery.

Answer 2

Peaceful music

The Intervention in this PICOT question is playing peaceful music.

Question 3

A nurse researcher conducts a study that randomly assigns 100 patients who smoke and attend a wellness clinic into two groups. One group receives the standard smoking cessation handouts; the other group takes part in a new educational program that includes a smoking cessation support group. The nurse plans to compare the effectiveness of the standard treatment with the educational program. What type of a research study is this?

Qualitative
Descriptive
Correlational
Randomized controlled trial

Answer 3

Randomized controlled trial

This is a randomized controlled trial because patients are randomly assigned into the control or treatment group.

Question 4

A group of nurses have implemented an evidence-based practice (EBP) change and have evaluated the effectiveness of the change. Their next step is to:

Conduct a literature review.
Share the findings with others.
Conduct a statistical analysis.
Create a well-defined PICOT question.

Answer 4

Share the findings with others.
After completing an EBP project and evaluating its effectiveness, it is important to communicate the results with others.

Question 5

When recruiting subjects to participate in a study about the effects of an exercise program on balance, the researcher provides full and complete information about the purpose of the study and gives the subjects the choice to participate or not participate in the study. This is an example of:

Bias.
Anonymity.
Confidentiality.
Informed consent.

Answer 5

Informed consentThe process of informed consent includes providing research subjects full disclosure about the study and provides the subject the opportunity to participate or not to participate in the study.The process of informed consent includes providing research subjects full disclosure about the study and provides the subject the opportunity to participate or not to participate in the study.

Question 6

Nurses on a pediatric nursing unit are discussing ways to improve patient care. One nurse asks a colleague, “I wonder how best to measure pain in a child who has sickle cell disease?” This question is an example of a/an:

Hypothesis.
PICOT question.
Problem-focused trigger.
Knowledge-focused trigger.

Answer 6

Knowledge-focused trigger.

Knowledge-focused triggers are questions about information available on a specific topic.

Question 7

The nurses on a medical unit have seen an increase in the number of pressure ulcers that develop in their patients. They decide to initiate a quality improvement project using the PDSA model. Which of the following is an example of “Do” from that model?

Implement the new skin care protocol on all medicine units.
Review the data collected on patients cared for using the protocol.
Review the QI reports on the six patients who developed ulcers over the last 3 months.
Based on findings from patients who developed ulcers, implement an evidence-based skin care protocol.

Answer 7

Implement the new skin care protocol on all medicine units.

In the Do step, the nurse selects an intervention and implements it.

Question 8

A nurse researcher decides to complete a study to evaluate how Florence Nightingale improved patient outcomes in the Crimean War. This is an example of what type of research?

Historical
Evaluation
Exploratory
Experimental

Answer 8

Historical

Historical studies establish facts concerning past events

Question 9

A group of nurses on the research council of a local hospital are measuring nursing-sensitive outcomes. Which of the following is a nursing-sensitive outcome that the nurses need to consider measuring?

Incidence of asthma among children of parents who smoke
Frequency of low blood sugar episodes in children at a local school
Number of patients who fall and experience subsequent injury on the evening shift
Number of sexually active adolescent girls who attend the community-based clinic for birth control

Answer 9

Number of patients who fall and experience subsequent injury on the evening shift
Nursing-sensitive outcomes are outcomes that are sensitive to nursing care.

Question 10

A group of staff nurses notice an increased incidence of medication errors on their unit. After further investigation it is determined that the nurses are not consistently identifying the patient correctly. A change is needed quickly. What type of quality improvement method would be most appropriate?

PDSA
Six Sigma
Rapid-improvement event
A randomized controlled trial

Answer 10

Rapid-improvement event
Rapid-improvement events are appropriate to use when a serious problem that affects patient outcomes exists and needs to be resolved quickly.

Question 11

A nurse is providing care to a patient who is experiencing major abdominal trauma following a car accident. The patient is losing blood quickly and needs a blood transfusion. The nurse finds out that the patient is a Jehovah’s Witness and cannot have blood transfusions because of religious beliefs. He or she notifies the patient’s health care provider and receives an order to give the patient an alternative to blood products. This is an example of:

A quality improvement study.
An evidence-based practice change.
A time when calling the hospital’s ethics committee is essential.
Considering the patient’s preferences and values while providing care.

Answer 11

Considering the patient’s preferences and values while providing care.
Providing evidence-based practice requires that you take the patient’s values and beliefs into consideration while providing care.

Question 12

A group of staff educators are reading a research study together at a journal club meeting. While reviewing the study, one of the nurses states that it evaluates if newly graduated nurses progress through orientation more effectively when they participate in patient simulation exercises. Which part of the research process is reflected in this nurse’s statement?

Introduction
Purpose statement
Methods
Results

Answer 12

Purpose statement
The purpose statement includes research questions or hypotheses—predictions made about the relationship or difference between study variables (concepts, characteristics, or traits that vary within or among subjects).

Question 13

A research study is investigating the following research question: What is the effect of the diagnosis of breast cancer on the roles of the family? In this study “the diagnosis of breast cancer” and “family roles” are examples of:

Surveys
The sample
Variables
Data collection points

Answer 13

Variables

Variables are concepts, characteristics, or traits that vary within or among subjects.

Question 14

A nurse researcher is developing a research proposal and is in the process of selecting an instrument to measure anxiety. In which part of the research process is this nurse?

Analyzing the data
Designing the study
Conducting the study
Identifying the problem

Answer 14

Designing the study

During study design the researcher selects instruments to measure variables.

Question 15

If an infectious disease can be transmitted directly from one person to another, it is a:

Susceptible host.
Communicable disease.
Port of entry to a host.
Port of exit from the reservoir.

Answer 15

Communicable disease
When an infectious disease can be transmitted directly from one person to another, it is termed a communicable disease. No vector is necessary for transmission.

Question 16

Which is the most likely means of transmitting infection between patients?

Exposure to another patient’s cough
Sharing equipment among patients
Disposing of soiled linen in a shared linen bag
Contact with a health care worker’s hands

Answer 16

Contact with a health care worker’s hands Contact with a health care worker’s hands
Hands become contaminated through contact with the patient and the environment and serve as an effective vector of transmission.

Question 17

Identify the interval when a patient progresses from nonspecific signs to manifesting signs and symptoms specific to a type of infection.

Illness stage
Convalescence
Prodromal stage
Incubation period

Answer 17

Prodromal stage

The prodromal stage is the interval between entrance of a pathogen into the body and appearance of first symptoms.

Question 18

Which of the following is the most effective way to break the chain of infection?

Hand hygiene
Wearing gloves
Placing patients in isolation
Providing private rooms for patients

Answer 18

Hand hygiene
Hands become contaminated through contact with the patient’s environment. Clean hands interrupt the transmission of microorganisms.

Question 19

A family member is providing care to a loved one who has an infected leg wound. What would you instruct the family member to do after providing care and handling contaminated equipment or organic material?

Wear gloves before eating or handling food.
Place any soiled materials into a bag and double bag it.
Have the family member check with the doctor about need for immunization.
Perform hand hygiene after care and/or handling contaminated equipment or material.

Answer 19

Perform hand hygiene after care and/or handling contaminated equipment or material.
Clean hands interrupt the transmission of microorganisms from family members.

Question 20

A patient is isolated for pulmonary tuberculosis. The nurse notes that the patient seems to be angry, but he knows that this is a normal response to isolation. Which is the best intervention?

Provide a dark, quiet room to calm the patient.
Reduce the level of precautions to keep the patient from becoming angry.
Explain the reasons for isolation procedures and provide meaningful stimulation.
Limit family and other caregiver visits to reduce the risk of spreading the infection.

Answer 20

Explain the reasons for isolation procedures and provide meaningful stimulation.
Patients on isolation precautions may interpret the needed restrictions as a sign of rejection by the health care worker

Question 21

The nurse wears a gown when:

The patient’s hygiene is poor.
The nurse is assisting with medication administration.
The patient has acquired immunodeficiency syndrome (AIDS) or hepatitis.
Blood or body fluids may get on the nurse’s clothing from a task that he or she plans to perform.

Answer 21

Blood or body fluids may get on the nurse’s clothing from a task that he or she plans to perform.
The gown serves as a barrier between the patient’s blood and/or body fluid and potential contact with the caregiver’s skin.

Question 22

The nurse has redressed a patient’s wound and now plans to administer a medication to the patient. Which is the correct infection control procedure?

Leave the gloves on to administer the medication.
Remove gloves and administer the medication.
Remove gloves and perform hand hygiene before administering the medication.
Leave the medication on the bedside table to avoid having to remove gloves before leaving the patient’s room.

Answer 22

Remove gloves and perform hand hygiene before administering the medication.
Gloves need to be changed, and hand hygiene performed to prevent transfer of microorganisms from one source (wound) to another (nurse’s hands).

Question 23

When a nurse is performing surgical hand asepsis, the nurse must keep hands:

Below elbows.
Above elbows.
At a 45-degree angle.
In a comfortable position.

Answer 23

Above elbows.

Keeping hands above the elbows when performing a surgical scrub prevents contaminated water from contact with hands.

Question 24

What is the best method to sterilize a straight urinary catheter and suction tube in the home setting?

Use an autoclave.
Use boiling water.
Use ethylene oxide gas.
Use chemicals for disinfection.

Answer 24

Use boiling water.

The best sterilizer in a home setting is boiling water.

Question 25

A patient has an indwelling urinary catheter. Why does an indwelling urinary catheter present a risk for urinary tract infection?

It keeps an incontinent patient’s skin dry.
It can get caught in the linens or equipment.
It obstructs the normal flushing action of urine flow.
It allows the patient to remain hydrated without having to urinate.

Answer 25

It obstructs the normal flushing action of urine flow.
The presence of a catheter in the urethra breaches the natural defenses of the body. Reflux of microorganisms up the catheter lumen from the drainage bag or backflow of urine in the tubing increases the risk of infection

Question 26

Put the following steps for removal of protective barriers after leaving an isolation room in order:

Untie top, then bottom mask strings and remove from face.
Untie waist and neck strings of gown. Allow gown to fall from shoulders and discard. Remove gown, rolling it onto itself without touching the contaminated side.
Remove gloves.
Remove eyewear or goggles.
Perform hand hygiene.

Answer 26

Remove gloves
Remove eyewear or goggles
untie top, then bottom mask strings and remove from face
untie waist and neck strings of gown. allow fown to fall from shoulders and discard. Remove gown, rolling it onto itself without touching the contaminated sides
perform hand hygiene

Question 27

Your ungloved hands come in contact with the drainage from your patient’s wound. What is the correct method to clean your hands?

Wash them with soap and water.
Use an alcohol-based hand cleaner.
Rinse them and use the alcohol-based hand cleaner.
Wipe them with a paper towel.

Answer 27

Wash them with soap and water.

Physically removing wound drainage is most effectively accomplished by washing with soap and water.

Question 28

A patient’s surgical wound has become swollen, red, and tender. You note that the patient has a new fever and leukocytosis. What is the best immediate intervention?

Notify the health care provider and use surgical technique to change the dressing.
Reassure the patient and recheck the wound later.
Notify the health care provider and support the patient’s fluid and nutritional needs.
Alert the patient and caregivers to the presence of an infection to ensure care after discharge.

Answer 28

Notify the health care provider and support the patient’s fluid and nutritional needs.
Early intervention can reduce the risk of sepsis caused by the progression of the infection. Fever depletes body fluid stores, resulting in an increased risk of dehydration, and providing proper nutrition promotes healing.

Question 29

While preparing to do a sterile dressing change, a nurse accidentally sneezes over the sterile field that is on the over-the-bed table. Which of the following principles of surgical asepsis, if any, has the nurse violated?

When a sterile field comes in contact with a wet surface, the sterile field is contaminated by capillary action.
Fluid flows in the direction of gravity.
A sterile field becomes contaminated by prolonged exposure to air.
None of the principles were violated.

Answer 29

A sterile field becomes contaminated by prolonged exposure to air.
Avoid activities that create air currents, such as sneezing. When you sneeze, microorganisms travel through the air by droplets, contaminating the sterile field.

Question 30

A 6-month-old child from Guatemala was adopted by an American family in Indiana. The child’s socialization into the American midwestern culture is best described as:

Assimilation.
Acculturation.
Biculturalism.
Enculturation.

Answer 30

Enculturation.

Socialization into one’s primary culture as a child is known as enculturation.

Question 31

A 46-year-old woman from Bosnia came to the United States 6 years ago. Although she did not celebrate Christmas when she lived in Bosnia, she celebrates Christmas with her family now. This woman has experienced assimilation into the culture of the United States because she:

Chose to be bicultural.
Adapted to and adopted the American culture.
Had an extremely negative experience with the American culture.
Gave up part of her ethnic identity in favor of the American culture.

Answer 31

Adapted to and adopted the American culture.

Assimilation results when an individual gradually adopts and incorporates the characteristics of the dominant culture.

Question 32

To enhance their cultural awareness, nursing students need to make an in-depth self-examination of their own:

Motivation and commitment to caring.
Social, cultural, and biophysical factors.
Engagement in cross-cultural interactions.
Background, recognizing her biases and prejudices.

Answer 32

Background, recognizing her biases and prejudices
Cultural awareness is an in-depth self-examination of one’s own background, recognizing biases and prejudices and assumptions about other people.

Question 33

Which of the following is required in the delivery of culturally congruent care?

Learning about vast cultures
Motivation and commitment to caring
Influencing treatment and care of patients
Acquiring specific knowledge, skills, and attitudes

Answer 33

Acquiring specific knowledge, skills, and attitudes

Specific knowledge, skills, and attitudes are required in the delivery of culturally congruent care.

Question 34

A registered nurse is admitting a patient of French heritage to the hospital. Which question asked by the nurse indicates that the nurse is stereotyping the patient?

“What are your dietary preferences?”
“What time do you typically go to bed?”
“Do you bathe and use deodorant more than one time a week?”
“Do you have any health issues that we should know about?”

Answer 34

“Do you bathe and use deodorant more than one time a week?”

Nurses need to avoid stereotypes or unwarranted generalizations about any particular group that prevents further assessment of the individual’s unique characteristics.

Question 35

When action is taken on one’s prejudices:

Discrimination occurs.
Delivery of culturally congruent care is ensured.
Effective intercultural communication develops.
Sufficient comparative knowledge of diverse groups is obtained.

Answer 35

Discrimination occurs
Prejudices associate negative permanent characteristics with people who are different from the valued group. When a person acts on these prejudices, discrimination occurs.

Question 36

A nursing student is doing a community health rotation in an inner-city public health department. The student investigates sociodemographic and health data of the people served by the health department, and detects disparities in health outcomes between the rich and poor. This is an example of a(n):

Illness attributed to natural and biological forces.
Creation of the student’s interpretation and descriptions of the data.
Influence of socioeconomic factors in morbidity and mortality.
Combination of naturalistic, religious, and supernatural modalities.

Answer 36

Influence of socioeconomic factors in morbidity and mortality.
Health disparity populations are populations that have a significant increased incidence or prevalence of disease or that have increased morbidity, mortality, or survival rates compared to the health status of the general population.

Question 37

Culture strongly influences pain expression and need for pain medication. However, cultural pain is:

Not expressed verbally or physically.
Expressed only to others from a similar culture.
Usually more intense than physical pain.
Suffered by a patient whose valued way of life is disregarded by practitioners.

Answer 37

suffered by a patient whose valued way of life is disregarded by practitioners.
Patients suffer cultural pain when health care providers disregard values or cultural beliefs.

Question 38

Which of the following best represents the dominant values in American society on individual autonomy and self-determination?

Physician orders
Advance directive
Durable power of attorney
Court-appointed guardian

Answer 38

Advance directive
Informed consent and advance directives protect the right of the individual to know and make decisions ensuring continuity of individual autonomy and self-determination.

Question 39

The nurse at an outpatient clinic asks a patient who is Chinese American with newly diagnosed hypertension if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head. What should the nurse do next?

Ask the patient how much salt he is consuming each day
Discuss the health implications of sodium and hypertension
Remind the patient that many foods such as soy sauce contain “hidden” sodium
Suggest some low-sodium dietary alternatives

Answer 39

Ask the patient how much salt he is consuming each day
In an Asian culture spoken messages often have little to do with their meanings. It is important for the nurse to clarify how much salt the patient is consuming in his diet.

Question 40

A female Jamaican immigrant has been late to her last two clinic visits, which in turn had to be rescheduled. The best action that the nurse could take to prevent the patient from being late to her next appointment is:

Give her a copy of the city bus schedule.
Call her the day before her appointment as a reminder to be on time.
Explore what has prevented her from being at the clinic in time for her appointment.
Refer her to a clinic that is closer to her home.

Answer 40

Explore what has prevented her from being at the clinic in time for her appointment.
Present-time orientation is in conflict with the dominant organizational norm in health care that emphasizes punctuality and adherence to appointments. Nurses need to expect conflicts and make adjustments when caring for ethnic groups.

Question 41

A nursing student is taking postoperative vital signs in the postanesthesia care unit. She knows that some ethnic groups are more prone to genetic disorders. Which of the following patients is most at risk for developing malignant hypertension?

Ashkenazi Jew
Chinese American
African American
Filipino

Answer 41

African American

Certain genetic disorders are linked with specific ethnic groups such as malignant hypertension among African Americans.

Question 42

A community health nurse is making a healthy baby visit to a new mother who recently emigrated to the United States from Ghana. When discussing contraceptives with the new mom, the mother states that she won’t have to worry about getting pregnant for the time being. The nurse understands that the mom most likely made this statement because:

She won’t resume sexual relations until her baby is weaned.
She is taking the medroxyprogesterone (Depo-Provera) shot.
Her husband was recently deployed to Afghanistan.
She has access to free condoms from the clinic.

Answer 42

She won’t resume sexual relations until her baby is weaned.
In some African cultures such as in Ghana and Sierra Leone some women will not resume sexual relations with their husbands until the baby is weaned.

Question 43

During their clinical post-conference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that her patient was homeless. This is an example of caring for a patient from a different:

Ethnicity.
Culture.
Heritage.
Religion.

Answer 43

Culture.
Culture is the context in which groups of people interpret and define their experiences relevant to life transitions. This includes events such as birth, illness, and dying. It is the system of meanings by which people make sense of their experiences.

Question 44

When interviewing a Native American patient on admission to the hospital emergency department, which questions are appropriate for the nurse to ask? (Select all that apply.)

Do you use any folk remedies?
Do you have a family physician?
Do you use a Shaman?
Does your family have a history of alcohol abuse?

Answer 44

Do you have a family physician?
Do you use a Shaman?
Do you use any folk remedies?