Med Surge Exam 1 Flashcards
Which trait is being used by the nurse who says, “I don’t know, but I’ll find out?” Intellectual humility Intellectual courage Intellectual empathy Fair-mindedness
Correct Answer: 1
intellectual humility
Nursing diagnosis or medical diagnosis? Pneumonia Pain Asthma Ineffective airway clearance Anxiety
Pneumonia - Medical Pain - Nursing Asthma - Medical Ineffective airway clearance - Nursing Anxiety - Both
Order the steps in the nursing process. Implement interventions Evaluate outcomes Develop nursing diagnosis Plan care Collect data
Collect data (1) Develop nursing diagnosis (2) Plan care (3) Implement interventions (4) Evaluate outcomes (5)
Identify the questions in the WHAT’S UP? guide.
- W
- H
- A
- T
- S
- U
- P
- Where is it?
- How does it feel?
- Aggravating and alleviating factors?
- Timing?
- Severity?
- Useful other data?
- Patient’s perception of the problem
Nursing Diagnosis
Problem
Etiology
Signs and symptoms
Why Use E B P?
Gold standard of health care
Nurses can give best care possible
E B P Decision Making is defined by
Evaluation of quality Applicability of existing research Patient preferences Costs Clinical expertise Clinical setting
EBP
evidenced based practice
Which of these factors are considered when deciding which evidence to use? Select all that apply. Quality Applicability Nurse convenience Cost Clinical expertise Clinical setting
Correct Answer: 1, 2, 4, 5, 6
Six Steps of E B P: “A S K M M E!”
Step 1
Step 1: Ask the burning question
“Why do we do it that way?”
“How could we do that better?”
Levels of Evidence Quality
One
Two
Three
Four
Level One
Strongest evidence
Systematic reviews of randomized controlled trials
True experimental studies: Factors that could falsely change results controlled as possible
Level One Sources
Joanna Briggs Institute’s Evidence-Based Resources and Cochrane Reviews
Level Two
At least one well-designed randomized controlled trial
Level Three
Evidence obtained from quasi-experimental research studies
Factors that could falsely change the results are not controlled
Less predictive of effectiveness
Level Four
Expert opinion
Weakest level of evidence
Independent nursing interventions does not require
hcp order.
It is under supervision of registered nurse (R N)
the nurse requests the competency evaluated nursing assistant to help the patient with oral care. Which of the following methods requested by the nurse would be most appropriate to achieve evidence-based care?
- instruct the competency evaluated nursing assistant to have the patient rinse the mouth with water after dinner.
- Instruct her to give oral care using oral swabs to clean the teeth and mouth.
- ask her to instruct the patient to use a mouthwash rinse for the oral care.
- explain that oral care is best done by brushing the teeth and tongue with a toothbrush and toothpaste.
4.explain that oral care is best done by brushing the teeth and tongue with a toothbrush and toothpaste.
The nurse is contributing to the plan of care for a patient. In considering appropriate care, the nurse bases the care on which of the following to provide excellent care?
- content taught throughout a nursing educational program
- orientation to the health care agency for new employees
- A nurse’s personal judgment of what is best for each patient.
- Evidence that is evaluated for the health care agency and each patient
- evidence that is evaluated for the health care agency and each patient
A policy and procedure committee is reviewing evidence for a new policy. When considering the evidence, which of the following sources would generally be safest for a health care agency to implement ?
- Joanna Briggs Institute evidence -based resource .
- One randomized controlled trial.
- Four quasi-experimental studies that show similar results.
- The opinion of a national nursing expert on the subject.
1.Joanna Briggs Institute evidence -based resource .
The nurse reads about a research study that affects nursing care and could lead to decreased wound infections. Which of the following actions should the nurse take regarding the information in the study?
- put the information into practice while performing wound care.
- Discuss the research with a trusted coworker, and if the coworker agrees, put the information into practice at work.
- Present the proposed practice change to the policy and procedure committee for evaluation and possible adoption
- Do a journal search to look for similar studies, and if three similar studies are found , incorporate the information into practice.
3.Present the proposed practice change to the policy and procedure committee for evaluation and possible adoption.
A policy and procedure committee is revising the nursing intervention of insertion of a urinary catheter. Where should the committee begin looking for evidence to write an effective policy and procedure on this intervention?
- In current nursing skills textbook’s
- In nursing articles written by national nursing experts based on opinion
- In research articles, preferably systemic reviews of randomized controlled trials
- In the policies and procedures of other nursing facilities
- In research articles, preferably systemic reviews of randomized controlled trials
Nonmaleficence
the obligation to “do no harm”
fidelity
obligation to be faithful to commitments made
beneficence
actions taken will benefit a person
Utilitarianism
utilitarian theory states that actions are judged “right” or “wrong” based purely on their consequences