Medica Surgical Nursing Preparation For Practice 2nd Edition By Osborn – Test Bank
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Sample
Test
Osborn, Medical-Surgical Nursing,
2e
Chapter 03
Question 1
Type: MCSA
A nurse notices a particular nursing intervention is not
successful in helping patients achieve their health care goals and decides to
study the issue. What should the nurse do first?
1. Identify
the problem.
2. Design
the sampling plan.
3. Conduct
a literature review.
4. Conduct
a pilot study.
Correct Answer: 1
Rationale 1: The first step in any
research process is to identify a researchable problem, which is a situation in
need of a solution, alteration, or improvement. It is an area of concern for a
particular population that requires investigation and it is derived from a topical
area.
Rationale 2: Designing a sample plan is
part of the research design and occurs later in the research process.
Rationale 3: Conducting a literature
review occurs after the study question has been defined.
Rationale 4: A pilot study is done after
the research is designed.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Planning
Learning Outcome: 3-2
Question 2
Type: MCSA
A qualitative research study has concluded and the nurse
researcher is currently watching the study participants to make sure that the
research findings can be observed in their routine lives. The nurse is
conducting which type of basic research?
1. Ethnography
2. Experimental
research
3. Phenomenology
4. Grounded
theory
Correct Answer: 4
Rationale 1: Ethnography focuses on the
culture of a group.
Rationale 2: Experimental research is a
type of quantitative research.
Rationale 3: Phenomenology describes the
meaning of a lived experience through the perspective of the participant.
Rationale 4: Grounded theory refers to
the idea that conclusions of a qualitative study are grounded in data and based
on direct and careful observations of everyday life within the group studied.
By observing the study participants, the nurse is following a grounded theory
research design.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3-1
Question 3
Type: MCSA
The nurse asks a patient if he has used a newly developed
exercise to relieve the arthritis pain in his shoulders. The nurse is most
likely employing which concept?
1. Applied
research
2. Basic
research
3. Critical
thinking
4. Discharge
planning
Correct Answer: 1
Rationale 1: Applied research focuses on
finding solutions to existing problems. Practicing nurses are most likely to be
involved in applied research.
Rationale 2: Basic research is
undertaken to extend the knowledge base in a discipline or to formulate or
refine a theory.
Rationale 3: Critical thinking is a
process to determine the best interventions when planning care and may be based
on experience, knowledge, or research.
Rationale 4: Discharge planning is an
activity, started upon admission, to determine the patient’s needs once
discharged from a health care facility.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Evaluation
Learning Outcome: 3-1
Question 4
Type: MCMA
The nurse is analyzing a phenomenological research study. Which
data would the nurse evaluate as matching this study design?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.
Standard Text: Select all that apply.
1. Waiting
to have a procedure done is more stressful than the actual procedure.
2. A
patient’s blood pressure is 150/90 after ambulating 10 feet.
3. A
patient’s urine output after ingesting 240 mL of water is 100 mL.
4. Ten
mothers in the same housing community desire a centrally located day care
facility.
5. Breast
cancer survivors are more likely than others to participate in efforts to raise
money for breast cancer research.
Correct Answer: 1,5
Rationale 1: Phenomenology describes the
meaning of a lived experience through the perspective of the participant. This
statement exemplifies the meaning of a lived experience through the perspective
of the participant.
Rationale 2: This is an example of
objective data that is more likely to be collected during a quantitative
research study.
Rationale 3: This is an example of
objective data that is more likely to be collected during a quantitative
research study.
Rationale 4: This is an example of
ethnography, which focuses on the culture of a group of people with an effort
to understand their worldview.
Rationale 5: Phenomenology describes the
meaning of a lived experience through the perspective of the participant. These
patients have lived the experience of surviving breast cancer.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Evaluation
Learning Outcome: 3-6
Question 5
Type: MCSA
The nurse, working with patients in an orthopedic surgical unit,
wants to study the impact of assistive devices on progressive ambulation. What
would be an example of a research problem for this study?
1. Do
post–hip replacement patients ambulate faster with one crutch or two?
2. How
does learning postsurgical exercises before the hip replacement impact the
patient’s use of assistive devices?
3. Will
post–hip replacement patients recover from surgery faster if ambulated the day
after surgery?
4. Will
post–hip replacement surgery patients be discharged using a cane for
ambulation?
Correct Answer: 1
Rationale 1: The research problem is a
small, specific piece of a phenomenon to be studied. The question that best
supports the nurse’s focus would be whether post–hip replacement patients
ambulate faster with one crutch or two.
Rationale 2: This question focuses on
assistive devices, not on progressive ambulation.
Rationale 3: This question does not
specifically address the use of assistive devices.
Rationale 4: This question is about
discharge rather than about the impact of assistive devices on progressive
ambulation.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Planning
Learning Outcome: 3-2
Question 6
Type: MCSA
Even though the nurses in a patient care area have been asked to
collect data while conducting patient care, several nurses do the data
collection only if time is available. Which research problem criteria does the
inconsistent collection of data exemplify?
1. Feasible
to address
2. Researchable
3. Of
interest to the researcher
4. Significant
to nursing
Correct Answer: 1
Rationale 1: Feasible to address means
there is the cooperation of others and time to complete the research. The
nurses collect the data only if there is time.
Rationale 2: The inconsistent data
collection is not directly related to whether the study question is
researchable.
Rationale 3: The researcher’s interest
in the study question does not change the inconsistency in data collection.
Rationale 4: The inconsistent data
collection is not as relevant to the significance to nursing as it is to
another option.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Assessment
Learning Outcome: 3-2
Question 7
Type: MCSA
A nurse is going to determine the best design to use for a
research project. Which action would the nurse perform to guide this choice?
1. Collect
data.
2. Do a
review of the literature.
3. Write
an overview of the conceptual framework.
4. Identify
themes and categories.
Correct Answer: 3
Rationale 1: Data collection is done
after the research design is determined.
Rationale 2: A review of the literature
will help with the identification of research problems.
Rationale 3: The third major step in the
research process is selecting the type of research that will answer the
question and the concomitant research design. It is helpful to begin the design
section by writing an overview in which the theoretical or conceptual framework
is stated if one is used.
Rationale 4: Themes and categories are
identified when analyzing the data.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Planning
Learning Outcome: 3-2
Question 8
Type: MCSA
A patient has not responded to an intervention with the desired
outcome. Which nursing action is the best example of using evidence-based
practice to solve this problem?
1. Apply
the intervention again.
2. Find
a research study about the intervention and apply the study’s finding.
3. Evaluate
what went wrong with the intervention.
4. Find
research, quality improvement study outcomes, and information from experts to
change the intervention.
Correct Answer: 4
Rationale 1: The nurse should not apply
the intervention again as it is not producing the desired outcome.
Rationale 2: Finding a research study
about the intervention and applying the findings would be research utilization.
Research utilization is part of evidence-based practice but is not the most
complete option.
Rationale 3: The nurse should have
evaluated what happened before deciding the intervention was not working.
Rationale 4: Evidence-based practice
stresses the use of research findings, quality improvement data, and the
consensus of experts to substantiate practice.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Planning
Learning Outcome: 3-3
Question 9
Type: MCSA
The nurses have been instructed on the use of an evidence-based
practice (EBP) method to monitor patients; however, several nurses continue to
conduct patient monitoring using the previous method. What can the nurse
manager do to increase the use of the evidence-based practice method?
1. Assign
the nurses not using the new method to participate in gathering data for a
research study.
2. Review
the evidence-based material again with those nurses who are not using the new
method.
3. Remind
the nurses that performance evaluations are tied to the use of evidence-based
practice.
4. Determine
that either method would be appropriate for the nurses to use.
Correct Answer: 2
Rationale 1: This action may be viewed
as punitive and does not support the use of EBP in the current patient unit.
Rationale 2: Strategies to promote the
use of evidence-based practice include continuing education and in-service
programs on EBP.
Rationale 3: Even if this is true, using
performance evaluations as leverage to make nurses use evidence-based practice
may be seen as coercive. If this reminder is seen as a threat, nurses are not
likely to think positively about using EBP in the future.
Rationale 4: This action would not
support the evidence-based practice approach and should not be used.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Planning
Learning Outcome: 3-3
Question 10
Type: MCSA
A patient refuses to participate in a research study for an
experimental medication. By accepting the patient’s decision, the nurse is
exercising which ethical principle?
1. Respect
for persons
2. Justice
3. Informed
consent
4. Beneficence
Correct Answer: 1
Rationale 1: Inherent in the principle
of respect for persons are the concepts of autonomy, dignity, uniqueness,
freedom, and choice. This principle forms the foundation of participants’
rights to informed consent, privacy, and confidentiality, and involves
respecting people’s autonomy or right to choose freely for themselves.
Rationale 2: The principle of justice
means that people are treated fairly.
Rationale 3: The patient refused to
participate, so informed consent was not obtained.
Rationale 4: In regard to ethical
research, the principle of beneficence means the duty to promote or do good in
addition to doing no harm.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Assessment
Learning Outcome: 3-4
Question 11
Type: MCSA
A patient with severe hypertension, chosen to receive an
experimental medication that has shown a dramatic efficacy in lowering blood
pressure, has been told that his participation in the study is no longer
needed. The patient is upset because he wanted to try the medication to control
his blood pressure. What should the nurse do to support this patient?
1. Tell
the patient that he can participate some other time.
2. Explain
to the patient that experimental medications rarely produce the desired
results.
3. Help
the patient understand that his participation “wasn’t meant to be.”
4. Talk
with the researchers about the patient’s right to receive the medication.
Correct Answer: 4
Rationale 1: The nurse should not make
false promises.
Rationale 2: The nurse should not make
questionable statements to invalidate the patient’s wish to try a medication
with potential benefits.
Rationale 3: Stating that his participation
“wasn’t meant to be” is dismissive of the patient’s wish to try a medication
with potential benefits.
Rationale 4: The principle of justice
requires that people be treated fairly. This includes the patient’s right to
receive research treatments.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3-4
Question 12
Type: MCSA
The nurse wants to study outpatient medical records to determine
a specific pattern of care. Which part of HIPAA should this nurse initially
consult to guide the study?
1. Disclosing
data
2. Creating
data
3. Destroying
data
4. Accessing
data
Correct Answer: 4
Rationale 1: The nurse will consider the
laws regarding disclosure of data later in the research process.
Rationale 2: Data may be created over
the course of conducting research, but the question refers to accessing data to
begin research.
Rationale 3: The HIPAA law does not
provide information on the destroying of data.
Rationale 4: It is the covered
organization’s obligation not to disclose information improperly when a
researcher seeks data that includes private health information. The nurse’s
initial concern should regard how to access data without violating HIPAA laws.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Planning
Learning Outcome: 3-5
Question 13
Type: MCSA
While conducting a research study, the researcher creates a
table of new health data based on patient responses. Which action by the
researcher is correct?
1. Asking
the patients’ nurses if the data appears to be correct and then document it was
validated
2. Validating
the data with laboratory results in the patients’ medical records that are not
part of the study
3. Gaining
permission from the patients to use the data and discussing who will receive it
4. Sharing
the data with the patients’ health care providers to improve care
Correct Answer: 3
Rationale 1: The researcher should not
discuss the data with the patients’ nurses. To do so would violate HIPAA
regulations.
Rationale 2: The researcher should not
review the patients’ medical records without the patients’ permission to do so.
Rationale 3: The HIPAA privacy
regulation impacts nursing research in three ways: data access, data creation,
and data disclosure. Within data creation, any protected health information
obtained is covered by HIPAA and the research is bound by HIPAA regulations.
The researcher must obtain permission from the patient to use the data,
including who is going to receive it.
Rationale 4: The researcher should not
discuss the data with the patients’ health care providers.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3-5
Question 14
Type: MCSA
The nurse is implementing stage 2 of a critique of a
quantitative research study. In this stage, the nurse will perform which
action?
1. Study
the findings.
2. Summarize
the quality of the study.
3. Review
the purpose of the research.
4. Focus
on the conduct of the research.
Correct Answer: 4
Rationale 1: In stage 3, the findings
are studied.
Rationale 2: Stage 4 includes a summary
of the quality of the study.
Rationale 3: Stage 1 focuses on
reviewing the purpose of the research.
Rationale 4: Stage 2 focuses on the
conduct of the research. This refers to studying the manner in which the
research was conducted and includes determining if the methodology was applied
correctly.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3-6
Question 15
Type: MCMA
While critiquing a quantitative research study, the nurse is
curious about the sample size. Which question is appropriate?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.
Standard Text: Select all that apply.
1. Does
the study describe the population about whom results will be generalized?
2. Are
inclusion and exclusion criteria identified?
3. Is
the sample size appropriate to meet assumptions of the statistical tests?
4. How
are the rights of the participants protected?
5. Is
the sample representative of the population?
Correct Answer: 1,2,3,5
Rationale 1: The sample size may make it
impossible to generalize findings.
Rationale 2: The sample size may be
limited or unlimited due to inadequate inclusion or exclusion criteria.
Rationale 3: The sample size should
support the statistical tests used in the study.
Rationale 4: The protection of
participants’ rights is part of the critical appraisal of the conduct of the
research and does not pertain to sample size.
Rationale 5: The sample size will, in
part, depend on the population size.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Evaluation
Learning Outcome: 3-6
Question 16
Type: MCSA
The nurse, critiquing a quantitative research study, is
particularly interested in information obtained in stage 3 of the critique.
This information would most likely include which information?
1. How
the findings of the study are related to the theoretical framework
2. Whether
the study can be replicated
3. The
major strengths of the study
4. How
ethical issues were handled
Correct Answer: 1
Rationale 1: Stage 3 of a quantitative
research critique focuses on findings, discussion, implications, and
conclusions and how the findings match the theoretical framework.
Rationale 2: Whether the study was
described in sufficient detail to allow replication is reviewed in stage 4 of
this process.
Rationale 3: The major strengths of the
study are reviewed in stage 4 of this process.
Rationale 4: How ethical issues were
handled is critiqued in stage 2 of the process.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3-6
Question 17
Type: MCMA
Hospital management has developed an initiative for the use of
evidence-based practice in all hospital departments. Which statements would the
nurse educator use in educative sessions with nurses?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.
Standard Text: Select all that apply.
1. “The
interventions nurses have traditionally used will form the foundation for our
practice.”
2. “We
will be reviewing all our standards and protocols in light of associated
research.”
3. “Your
clinical expertise will be valuable as we develop evidence-based practice in
our units.”
4. “Evidence-based
practice is focused on the conservation of resources.”
5. “You
will be asked to question your practice.”
Correct Answer: 2,3,5
Rationale 1: Interventions based on
tradition may not be valid when evaluated from an evidence-based practice
viewpoint.
Rationale 2: Research utilization is one
of the methods of discovering best practice.
Rationale 3: Clinical expertise is part
of evidence-based practice.
Rationale 4: Evidence-based practice is
focused on the delivery of optimal care and does consider available resources.
It is not, however, designed with a focus on the conservation of resources. The
focus is patient care.
Rationale 5: The nurse is required to
question aspects of personal practice and whether these practices are truly
based on evidence.
Global Rationale:
Cognitive Level: Analyzing
Client Need: Safe Effective Care
Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3-3
Question 18
Type: MCMA
Which study titles would alert the members of an institutional
review board (IRB) that the study sample may include vulnerable subjects?
Note: Credit will be given only if all correct choices and no
incorrect choices are selected.
Standard Text: Select all that apply.
1. Identification
of Coping Patterns Among Pregnant Wives of Soldiers Involved in Combat
2. Development
of Cancer in Persons Exposed to Passive Tobacco Smoke
3. Interventions
to Delay Development of Alzheimer Disease in Persons with Down Syndrome
4. Weight
Gain in Students during the First Two Semesters of Nursing School
5. Interventions
to Decrease Feelings of Breathlessness in Terminally Ill Subjects
Correct Answer: 1,3,4,5
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