Making A Difference With Nursing Research 1st Edition By Young – Test Bank

Langford Making a Difference with Nursing Research, 1/E
Chapter 10

Question 1

Type: MCSA

The nurse is aware of a number of patients who develop post-operative abdominal wound infections. What can the nurse do first with this information?

1. Identify this as a clinical problem.
2. List strategies to treat the post-operative infections.
3. Search for literature that identifies the frequency of post-operative infections.
4. Review evidence-based guidelines to combat post-operative infections.

Correct Answer: 1

Rationale 1: A clinical problem is a patient care situation in nursing practice that requires a solution. The nurse has identified a patient care problem with post-operative wound infections. This is the first step in the process. (See page 217)

Rationale 2: The nurse would not be able to list strategies to treat the post-operative infections until much later in the process. (See page 217)

Rationale 3: Searching for literature would be done after the clinical problem is identified. (See page 217)

Rationale 4: Reviewing evidence-based guidelines to combat post-operative infections would be done much later in the process. (See page 217)

Global Rationale:

Cognitive Level: Applying

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 1

Question 2

Type: MCSA

The nurse has written the following problem statement: “In adult patients who experience aphasia after having a stroke, what is the effect of using a flip chart with pictures instead of an erasable white board in the room on the patients’ ability to communicate care needs?” When using the PICOT format, what has the nurse identified as the comparison intervention?

1. Patients recovering from a stroke
2. Communicate care needs
3. Flip chart with pictures
4. Erasable white board

Correct Answer: 4

Rationale 1: When using the PICOT format “patients recovering from a stroke” is the population. (See page 217)

Rationale 2: When using the PICOT format “communicates care needs” is the outcome. (See page 217)

Rationale 3: When using the PICOT format “flip chart with pictures” is the proposed intervention. (See page 217)

Rationale 4: When using the PICOT format “erasable white board” is the comparison intervention. (See page 217)

Global Rationale:

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 1

Question 3

Type: MCSA

The nurse wants to analyze the effects of early ambulation instead of 24 hours of bed rest after surgery on the return of bowel sounds in patients recovering from spinal surgery. If using the PICOT format, what is the nurse proposing as the intervention in this statement?

1. Early ambulation
2. 24 hours of bed rest
3. Return of bowel sounds
4. Patients with spinal surgery

Correct Answer: 1

Rationale 1: If using the PICOT format “early ambulation” is the proposed intervention. (See page 217)

Rationale 2: If using the PICOT format“24 hours of bed rest” is the comparison intervention. (See page 217)

Rationale 3: If using the PICOT format “return of bowel sounds” is the outcome. (See page 217)

Rationale 4: If using the PICOT format “patients with spinal surgery” is the population. (See page 217)

Global Rationale:

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 1

Question 4

Type: MCSA

The nurse is planning to search the literature for help with the clinical problem of infiltrated intravenous sites associated with needleless intravenous systems. What would the nurse identify as a key concept for this problem?

1. Intravenous infusion fluids
2. Intravenous site infiltrations
3. Infiltration of needleless intravenous systems
4. Treatment of infiltrations caused by needleless intravenous systems

Correct Answer: 3

Rationale 1: Intravenous infusion fluids would not help with the clinical problem of infiltrated intravenous sites associated with needleless intravenous systems. (See page 218)

Rationale 2: Intravenous site infiltrations would be too broad of a concept since information about all intravenous site infiltrations would be provided. (See page 218)

Rationale 3: Infiltration of needleless intravenous systems would be the best key concept for the nurse to use since this is the identified problem. (See page 218)

Rationale 4: Treatment of infiltrations caused by needleless intravenous systems does not address the problem of infiltrated intravenous sites. This key concept would not provide information about the problem but rather about the treatment. (See page 218)

Global Rationale:

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 2

Question 5

Type: MCSA

A search for literature to address the clinical problem of bruising after providing a Z-track injection is being planned. Which key words would provide the most applicable results?

1. Bruising or injection
2. Bruising and injections
3. Bruising or Z-track injection
4. Bruising and Z-track injection

Correct Answer: 4

Rationale 1: The key terms “bruising or injection” will provide information about either of the two terms. This will not provide the most applicable results. (See page 219)

Rationale 2: The key terms “bruising and injections” will provide information about both of the two terms, but the terms are not narrow enough. The search results may be overwhelming in volume. (See page 219)

Rationale 3: The key terms “bruising or Z-track injection” will provide information about either of the two terms. This will not provide the most applicable results. (See page 219)

Rationale 4: The key terms “bruising and Z-track injection” will provide information about both of the two terms. This will provide the most applicable results. (See page 219)

Global Rationale:

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 2

Question 6

Type: MCSA

A literature search on the impact of using a bedside incentive spirometer after surgery to prevent hospital-acquired pneumonia in the patient recovering from orthopedic surgery resulted in 150 articles. What will the nurse do first after receiving the list?

1. Read the abstracts of each article for applicability.
2. Read the titles of each article for applicability.
3. Read the references at the end of each article.
4. Read the complete articles for applicability.

Correct Answer: 2

Rationale 1: Reading the abstracts of each article will occur after the titles are reviewed. The nurse might be spending time reading articles that are not appropriate for the patient problem being studied. (See page 220)

Rationale 2: The nurse will read the titles of each article for applicability. This is the first step when determining if an article is appropriate for the patient problem being studied. (See page 220)

Rationale 3: The reference lists at the end of the articles are an important source of information; however, the nurse will not perform this action first. This will come later in the process when examining the literature. (See page 220)

Rationale 4: Reading the complete articles for applicability may or may not be done. The nurse will need to first review the titles for applicability and then follow a decision-making process to select articles that are appropriate for the patient problem being studied. (See page 220)

Global Rationale:

Cognitive Level: Applying

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 2

Question 7

Type: MCSA

The nurse is planning to appraise the evidence collected about a patient care problem. Why would the nurse review clinical practice guidelines first?

1. Clinical guidelines are written in narrative format.
2. Clinical guidelines are the strongest level of clinical evidence.
3. Clinical guidelines provide information about patient experiences.
4. Clinical guidelines provide evidence about non-experimental studies.

Correct Answer: 2

Rationale 1: Clinical guidelines may be written in narrative format; however, this is not the reason why the nurse would review them first. (See page 222)

Rationale 2: Clinical guidelines provide the strongest level of clinical evidence. This is why the nurse would review them first. (See page 222)

Rationale 3: Clinical guidelines provide information about quantitative research studies, which are experimental and provide statistical analysis. Information about patient experiences would be a part of qualitative research studies. This is not the reason why the nurse would review them first. (See page 222)

Rationale 4: Clinical guidelines provide information about quantitative research studies, which are experimental. This is not the reason why the nurse would review them first. (See page 222)

Global Rationale:

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 3

Question 8

Type: MCSA

The nurse is planning to appraise the evidence for a clinical problem and wants to focus on Level 2 evidence. What will the nurse review for this level of evidence?

1. Systematic literature reviews
2. Qualitative research studies
3. Expert opinion reports
4. Clinical guidelines

Correct Answer: 1

Rationale 1: Systematic literature reviews are included as Level 2 evidence. (See page 225)

Rationale 2: Qualitative research studies are a part of Level 5 evidence. (See page 225)

Rationale 3: Expert opinion reports are a part of Level 6 evidence. (See page 225)

Rationale 4: Clinical guidelines are a part of Level 1 evidence. (See page 225)

Global Rationale:

Cognitive Level: Applying

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 3

Question 9

Type: MCSA

The nurse wants to review literature on non-experimental studies to address a patient care problem. On which level of evidence is the nurse going to focus this review?

1. Level 1
2. Level 2
3. Level 3
4. Level 4

Correct Answer: 4

Rationale 1: Level 1 evidence is the strongest evidence and includes clinical guidelines. (See page 228)

Rationale 2: Level 2 evidence includes systematic literature reviews about experiments conducted on the patient care problem. (See page 228)

Rationale 3: Level 3 evidence is single experimentally designed research studies. (See page 228)

Rationale 4: Level 4 evidence is systematic reviews of non-experimental studies. (See page 228)

Global Rationale:

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 3

Question 10

Type: MCMA

The nurse is ensuring that research articles for a patient problem are Level 5 evidence. What will the nurse focus on when reviewing these articles?

Standard Text: Select all that apply.

1. Qualitative study
2. Use of questionnaires
3. Single non-experiment study
4. Use of interviews or observation
5. Random assignment of control groups

Correct Answer: 1,2,3,4

Rationale 1: Level 5 evidence includes qualitative studies. (See page 228)

Rationale 2: Since Level 5 studies are qualitative, questionnaires might be used to collect self-reported data. (See page 228)

Rationale 3: Level 5 evidence includes single non-experimental studies. (See page 228)

Rationale 4: Since Level 5 studies are qualitative, interviews and observation will be used to collect data. (See page 228)

Rationale 5: Randomly assigning control groups is a characteristic of quantitative research or experimental studies. (See page 228)

Global Rationale:

Cognitive Level: Applying

Client Need:

Client Need Sub:

Nursing/Integrated Concepts:

Learning Outcome: 3