Evidence-Based Practice and Nursing Research, Exams of Nursing

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Exam Questions And Answers

Evidence-based practice (EBP) - correct answer ✅Integration of the best available evidence, combined with clinical expertise, enabling health practitioners of all varieties to address health care questions with an evaluative and qualitative approach Evidence-based practice (EBP) - correct answer ✅Reflects clinical expertise that is integrated with the best scientific evidence, patient values and preferences, and clinical circumstances Five fundamental steps : Evidence-Based Practice - correct answer ✅Step 1: Construct a relevant, answerable question from an identified clinical concern. Step 2: Search the literature for the best external evidence that addresses the clinical concern. Step 3: Critically appraise the evidence for validity and applicability. Step 4: Apply the evidence to your clinical concern. Step 5: Evaluate your performance

Exam Questions And Answers

PICO- Organizes the elements that guide the clinical question - correct answer ✅P: Patient or problem I: Intervention C: Comparison O: Outcome Foreground - correct answer ✅Example: In children with acute otitis media, should watchful waiting be considered instead of treatment with antibiotics? Is this a background or foreground question? Level 1 evidence represents the most valid reports addressing patient- oriented outcomes. - correct answer ✅A level 1 ranking also indicates that specific quality criteria were met based on the study type In this question the beta blockers are the comparison with ACE inhibitors. ACE inhibitors comprise the intervention. Improve ejection fraction is the outcome. Patients with congestive heart failure are the patient and problem. PICO is an acronym used to describe a format of the four elements required to formulate a good clinical question (P, patient or problem; I, intervention; C, comparison; O, outcomes). - correct answer ✅A nurse is using the PICO criteria to write a research question. In the research

Exam Questions And Answers

question "In patients with congestive heart failure, will ACE inhibitors compared with beta blockers improve ejection fraction?" which section is the comparison? A. ACE inhibitors B. Improve ejection fraction C. Beta blockers D. Patients with congestive heart failure Quality assurance (QA) or performance improvement (PI) studies - correct answer ✅-Use data to determine whether patient outcome criteria are being met, charting is complete, or procedures are being done per protocol. -The result of these studies is to assist the staff in achieving consistently excellent quality care. Experimental design - correct answer ✅controls the independent variables and randomly assigns the subjects to study groups Quasi-experimental design - correct answer ✅researcher does not attempt to randomize the subjects but does attempt to show a relationship between the dependent and independent variables- does not allow for complete control over the variance

Exam Questions And Answers

Quantitative study - correct answer ✅Asks the question WHO, WHAT, WHY, WHERE, WHEN, or HOW; describes the relationship among variables Qualitative study - correct answer ✅Attempts to clarify underlying assumptions that are vague or unclear by ASKING what the PERCEPTIONS, BELIEFS, or TENETS are within a particular setting Research Process: Reliability - correct answer ✅measures the device or technique, or the instrument, used to collect data by asking how trustworthy it is at gathering the intended data Research Process: Validity - correct answer ✅measures the degree to which an instrument is measuring what it is supposed to measure Direct research utilization - correct answer ✅Actually changes a practice habit or includes a new intervention in practice Indirect research utilization - correct answer ✅Enhances knowledge base Persuasive research utilization - correct answer ✅Advocates for a practice change

Exam Questions And Answers

Heparin Injection site - correct answer ✅Administer subcutaneously or intravenously. If administered subcutaneous, administer in abdomen only avoiding umbilical- area at least 2 inches or 5cm. Pinch the area of skin and give directly in the center of skin fold Ventrogluteal - correct answer ✅-Safe for adults and children -Use landmarks to identify injection site- Anterior superior iliac spine and iliac crest** Administering Intramuscular Injections - correct answer ✅-Requires a longer and larger-gauge needle -Administer at 90 degree angle

• Use Z-track method** -Injection sites: Ventrogluteal Vastus lateralis Deltoid

Exam Questions And Answers

Z-track method - correct answer ✅a technique for pulling the skin during an injection, is recommended for IM injections TB Intradermal Evaluation - correct answer ✅-Inspect bleb. Option: Use skin pencil and draw circle around perimeter of injection site. Read TB test at 48 to 72 hours -look for induration (hard, dense, raised area) of skin around injection site of: 15 mm or more in patients with no known risk factors for tuberculosis. -10 mm or more in patients who are recent immigrants; injection drug users; residents and employees of high-risk settings; patients with certain chronic illnesses; children less than 4 years of age; and infants, children, and adolescents exposed to high-risk adults. -5 mm or more in patients who are human immunodeficiency virus (HIV) positive, have fibrotic changes on chest x-ray film consistent with previous tuberculosis infection, have had organ transplants, or are immunosuppressed Deductive reasoning - correct answer ✅-Process of going from broad information to specific details or from general to specific

Exam Questions And Answers

-Taking general assessment data, drawing conclusions, identifying problems or needs, and formulating a plan of care -Example: nursing process because it involves taking data and deducing a plan of care Critical thinking - correct answer ✅-Purposeful and rational -Sets out to accomplish a specified goal -Purposeful, goal-directed process of inquiry that uses available facts, principles, theories, and abstractions to analyze, make inferences, solve problems, or arrive at decisions Reasoned thought - correct answer ✅Discriminating, prudent, and does not allow emotion, feelings, or prejudices to skew decisions Clinical judgment - correct answer ✅-Perceptive understanding of a situation based on knowledge, empirical data (data that can be observed or experienced), theory, and scientific inquiry -Decides whether to proceed with or revise a course of action

Exam Questions And Answers

Critical thought - correct answer ✅-Experience, knowledge, and skills required in order to think critically -Disciplined, rational, and self-directed activity that uses standards and criteria Diagnostic thinking - correct answer ✅-Flexible and embraces complexity -Based in the scientific process, but uses both analytical and intuitive cognitive processes Characteristics: -Ability to grasp and analyze the -complexity of any given situation -Use of all data at hand to make both inferences and deductions Cultivated thinking - correct answer ✅-Engaging in critical thought -Thought that is organized, enlightened, and educated -Does not assume that all pertinent information has been gathered yet

Exam Questions And Answers

-Seeks the latest and best information available to make the most appropriate decisions -An RN who continues to update data and stay well informed will best meet patients' needs. Inductive reasoning - correct answer ✅-This occurs when a patient presents with symptoms or problems the nurse has seen before. -From the assessment data gathered, the nurse makes inferences (conclusions or assumptions), asks further questions, and makes decisions. -It goes from specifics to generalities and infers the likely outcomes based on supporting data. Curiosity - correct answer ✅-Desire to understand what something is or how it works, to be compelled to explore beyond what is immediately obvious- Always asks- why? -May also imply skepticism, or the need to challenge beliefs in search of other possible conclusions or truths

Exam Questions And Answers

Curiosity - correct answer ✅-Relentless pursuit of truth -To retain an open mind, to look freshly at the world (and our patients), and to practice discovery every day -Does not prejudge Reflection - correct answer ✅-Looking back and reconsidering ideas, thoughts, beliefs, and actions -Helps the nurse improve practice through careful self-critique of prior scenarios Creativity - correct answer ✅-Ability to be innovative, resourceful, and inventive -Recognizes patterns that are present but understands that outcomes are often uncertain until tested Intuitive thought - correct answer ✅-Involves one's sixth sense, instincts, or insight

Exam Questions And Answers

-Intuition implies perceptiveness, the ability to see or sense subtle patterns or characteristics -Can be referred to as "gut feeling" A. Ammonia - correct answer ✅Potential Causes: Urinary tract infection, renal failure What Odor? A. Ammonia B. Feces C. Fetid, sweet Odor D. Foul-smelling stools in infant E. Stale Urine E. Musty Odor - correct answer ✅Potential Cause(s): Infection inside cast What Odor? A. Ammonia B. Feces C. Fetid, sweet Odor

Exam Questions And Answers

D. Sweet, fruity ketones E. Musty Odor C. Foul-smelling stools in infant - correct answer ✅Potential Cause(s): Malabsorption syndrome What Odor? A. Ammonia B. Feces C. Foul-smelling stools in infant D. Sweet, fruity ketones E. Musty Odor B. Fetid, sweet odor - correct answer ✅Potential Cause(s): Infection of bronchial tree What Odor? A. Ammonia B. Fetid, sweet odor C. Body Odor D. Sweet, fruity ketones E. Musty Odor

Exam Questions And Answers

C. Sweet, heavy, thick odor - correct answer ✅Potential Cause(s): Pseudomonas (bacterial Infection) What Odor? A. Ammonia B. Fetid, sweet odor C. Sweet, heavy, thick odor D. Sweet, fruity ketones E. Musty Odor D. Stale Urine - correct answer ✅Potential Cause(s): Uremic Acidosis What Odor? A. Ammonia B. Fetid, sweet odor C. Sweet, heavy, thick odor D. Stale Urine E. Musty Odor D. Sweet, fruity ketones - correct answer ✅Potential Cause(s): Diabetic Acidosis

Exam Questions And Answers

What Odor? A. Ammonia B. Fetid, sweet odor C. Sweet, heavy, thick odor D. Sweet, fruity ketones E. Musty Odor Crackles - correct answer ✅- Most common in dependent lobes: right and left lung bases -Random, sudden reinflation of groups of alveoli; also related to increase in fluid in small airways Rhonchi - correct answer ✅-Heard primarily over trachea and bronchi; if loud enough, can be heard over most lung fields -Fluid or mucus in larger airways, causing turbulence; muscular spasm Wheezes - correct answer ✅-Heard over all lung fields but are more distinct over posterior lung fields

Exam Questions And Answers

-High-velocity airflow through severely narrowed or obstructed bronchus Pleural friction rub - correct answer ✅-Heard over anterior lateral lung field (if patient is sitting upright) -Inflamed pleura, parietal pleura rubbing against visceral pleura Root Cause Analysis (RCA) - correct answer ✅-process of responding to sentinel events to discover the causes and develop an effective plan for preventing future events. SPLATT - correct answer ✅S-ymptoms at time of fall P-revious fall L-ocation of fall A-ctivity at time of fall T-ime of fall T-rauma after fall Acceptable Range: Temperature - correct answer ✅Acceptable Range: 36-38° C (96.8-100.4° F)

Exam Questions And Answers

Oral/tympanic: 37.0° C (98.6° F) Rectal: 37.5° C (99.5° F) Axillary: 36.5° C (97.7° F) Acceptable Range: Pulse - correct answer ✅Acceptable Range: Adult: 60-100 beats/min, strong and regular Acceptable Range: Respirations - correct answer ✅Acceptable Range: Adult: 12-20 breaths/min, deep and regular Acceptable Range: Blood pressure - correct answer ✅Acceptable Range: Systolic: <120 mm Hg Diastolic: <80 mm Hg Pulse pressure: 30-50 mm Hg Acceptable Range: Pulse oximetry - correct answer ✅Acceptable Range:

Exam Questions And Answers

Normal SpO2: 95%-100% Apnea - correct answer ✅Respirations cease for several seconds. Persistent cessation results in respiratory arrest. Biot's respiration - correct answer ✅Respirations are ABNORMALLY SHALLOW for two to three breaths, followed by IRREGULAR period of APNEA. Bradypnea - correct answer ✅Rate of breathing is regular but abnormally slow (<12 breaths/min). Cheyne-Stokes respiration - correct answer ✅-Respiratory rate and depth are irregular, characterized by alternating periods of apnea and hyperventilation. -Respiratory cycle begins with slow, shallow breaths that gradually increase to abnormal rate and depth. -The pattern reverses; breathing slows and becomes shallow, concluding in apnea before respiration resumes.

Exam Questions And Answers

Hyperpnea - correct answer ✅Respirations are increased in depth; occurs normally during exercise. Hyperventilation - correct answer ✅Rate and depth of respirations increase. Hypocarbia may occur. Hypoventilation - correct answer ✅Respiratory rate is abnormally low, and depth of ventilation may be depressed. Hypercarbia may occur. Kussmaul's respiration - correct answer ✅Respirations are abnormally deep but regular. Tachypnea - correct answer ✅Rate of breathing is regular but abnormally rapid (>20 breaths/min). C. Common Law - correct answer ✅-Also called case law -Law that has arisen from judicial decisions; "judge-made" decisions A. Administrative Law B. Statutory Law C. Common Law

Exam Questions And Answers

A. Administrative Law - correct answer ✅-Controls the administrative operations of government A. Administrative Law B. Statutory Law C. Common Law B. Statutory Law - correct answer ✅-Constitutional law -Enacted law - For example, NURSE PRACTICE ACT A. Administrative Law B. Statutory Law C. Common Law civil and criminal penalties - correct answer ✅Health Insurance Portability and Accountability Act of 1996 (HIPAA) Failure to follow this act ___________ and __________ penalties Patient rights - correct answer ✅-Right to be treated with dignity and respect, privacy, decision-making, confidentiality, access to health records, and the right to refuse treatment

Exam Questions And Answers

Assault - correct answer ✅-deliberate threat to physically harm another True - correct answer ✅True or False? -the two conditions must be met for ASSAULT are:

1. the offender must have the ability to commit a battery
2. the person must be aware of the immediate threat and must be fearful of it Battery - correct answer ✅-actual and intentional act of touching another without the person's consent False imprisonment - correct answer ✅Verbally or physically forcing an individual to stay in a place against his or her wishes and is an INTENTIONAL TORT. Negligence - correct answer ✅Failure to use such care as a reasonable prudent and careful person would use under similar circumstances Professional negligence (also called medical malpractice or professional malpractice) - correct answer ✅Omission or commission of an act that departs from the standard of care that a reasonably prudent person would do in the same or similar circumstances

Exam Questions And Answers

Example: -commission of an act: the administration of too much oxygen -Omission of an act: failure to administer oxygen Malpractice - correct answer ✅improper or unethical conduct or unreasonable lack of skill by a holder of a professional or official position (TJC 2011) Accountability - correct answer ✅Willingness to assume responsibility and accept the consequences for your actions Tort - correct answer ✅-Legal wrong committed against a person or property; a violation of civil law Intentional Tort - correct answer ✅-Assault and battery -False imprisonment -Fraud -Invasion of privacy -Slander and defamation Examples of Intentional or Unintentional Torts?

Exam Questions And Answers

Unintentional Tort - correct answer ✅-Professional negligence Example of Intentional or Unintentional Torts? Four elements of Malpractice that must be present for a person to recover damages - correct answer ✅1. Duty to care: obligation exists to conform to a recognized standard of care

2. Breach of duty: must be a failure to adhere to an obligation and a deviation from a recognized standard of care
3. Injury: actual damages have occurred
4. Causation: injury was foreseeable, caused by a breach of duty, and the conduct was the cause of the injury Ethics - correct answer ✅-Branch of philosophy that offers a way of examining moral life -Studies how we make decisions regarding right and wrong Bioethics - correct answer ✅Applies ethical theories and principles to moral issues and problems in the practice of medicine

Exam Questions And Answers

Morals - correct answer ✅-What we believe to be right and wrong -Often based on religious beliefs, culture, social influences, and life experiences Values - correct answer ✅-Enduring beliefs or ideals -Largely shaped by one's culture -Can have values conflict Moral development - correct answer ✅How an individual learns to handle moral or ethical dilemmas Autonomy - correct answer ✅-Freedom to choose and make one's own decisions -Self-determination Veracity - correct answer ✅- is the principle of truth-telling and not intentionally deceiving or misleading patients Fidelity - correct answer ✅-Practicing faithfully within the legal boundaries -Keeping promises

Exam Questions And Answers

Beneficence - correct answer ✅-Emphasizes preventing or removing harm or promoting/doing good

• it is stated in terms of POSITIVE OUTCOMES -Most critical ethical principle in health care EXAMPLE: following the nursing process to develop a plan of care agreed upon by the nurse and patient Nonmaleficence - correct answer ✅- refers to doing no harm and is stated in terms of NEGATIVE OUTCOMES -Example: the nurse intentionally administer a lethal dose of a medication to a patient or the doctor who fails to rescue or respond to a deteriorating patient condition Confidentiality - correct answer ✅- a legal and ethical term, refers to protection of private health information gathered during the provision of health care services -Right to privacy

Exam Questions And Answers

Justice - correct answer ✅-is concerned with the concept of FAIRNESS: the quality of being just or fair, conforming to truth, or treating like cases similarly. Ethical Dilemmas - correct answer ✅Exist when a conflict arises among health care professionals, patients, families, and health care organizations Moral courage - correct answer ✅Deciding on a right course of action regardless of the possible consequences Moral distress - correct answer ✅Situations in which an individual knows the right action to take, but feels powerless to take that action Deontology - correct answer ✅Ethical theories: Action should be judged based on the MOTIVE or INTENT behind the actions and DOES NOT rely on outcomes. Utilitarianism - correct answer ✅Ethical theories: Action should be JUDGED on whether it produces the GREATEST GOOD and does RELY on outcomes.