Test Bank of Evidence Based Practice in Nursing & Healthcare A Guide to Best Practice 2nd Edition By Bernadette Mazurek Melnyk

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Evidence Based Practice in Nursing & Healthcare A Guide to Best Practice 2nd Edition By Bernadette Mazurek Melnyk

Chapter 6- Critically Appraising Qualitative Evidence for Clinical Decision Making

 

1. A qualitative research study would be considered to be level one evidence in a nurse’s attempt to answer which of the following clinical questions?
A) “What is the meaning of hope among patients undergoing treatment with burn injuries?”
B) “What factors contribute to diabetic patients’ decisions to infrequently monitor their blood glucose levels?”
C) “How does an exercise program compared with dietary control affect weight loss in obese patients?”
D) “How does partial assistance with feeding compared with total assistance affect the nutritional outcomes of stroke patients younger than 70?”

 

 

2. A nurse has recognized a need to understand the ways in which women with fibromyalgia adjust their lifestyles to accommodate the effects of their diagnosis. Which of the following domains of research is most likely to provide evidence for the nurse?
A) Randomized controlled trials
B) Qualitative studies
C) Case control studies
D) Cohort studies

 

 

3. A nurse is searching for evidence in an effort to answer a series of clinical questions related to childhood asthma. In which of the following areas is qualitative research likely to be most valuable?
A) Identifying if nebulized delivery of bronchodilators is superior to the use of metered-dose inhalers
B) Identifying which environmental exposures are most closely linked to the incidence of bronchospasm
C) Identifying how a family’s accessibility to primary care affects the course of a child’s asthma
D) Identifying values that determine children’s choices of where and when to use their metered-dose inhalers

 

 

4. A nurse is seeking to understand the processes of adjustment and coping that parents go through in the year after giving birth to a child with a neural tube defect. Which of the following qualitative traditions is most likely to inform the nurse?
A) Ethnography
B) Phenomenology
C) Grounded theory
D) Hermeneutics

 

 

5. A nurse researcher is conducting a phenomenological study among men who have been diagnosed with prostate cancer. Which of the following focuses is most indicative of the nurse’s chosen methodology?
A) Identifying what support programs best meet men’s emotional needs following diagnosis
B) Identifying the role that culture plays in men’s sense-making of their diagnoses
C) Identifying the process that men go through as they suspect, receive, and then live with their diagnoses
D) Identifying and examining the meanings of the lived experiences that the men associate with their diagnoses

 

 

6. In the course of gathering and analyzing data for a qualitative study that examines the effect that a child’s chronic illness has on his or her siblings, a nurse has produced fieldnotes. What is the purpose of the nurse’s fieldnotes?
A) Making a record of the nurse’s observations and interactions that occur during data gathering
B) Producing a written record through which other researchers may follow the research process
C) Recording the analytic conclusions of the data
D) Relating the changes in the phenomenon that occur over time

 

 

7. While conducting a qualitative research study on patients’ responses to having a colostomy, the nurse is at the stage of doing content analysis. What activities characterize this component of the qualitative research process?
A) Identifying practical applications of the research findings
B) Reflecting on the nurse’s own response to the informants’ experiences
C) Breaking down data and reconstituting them in some other form
D) Gathering data from participants in the form of interviews and focus groups

 

 

8. A nurse is writing a research proposal for a grounded theory study that will address the experiences and transitions of women in the months following spontaneous abortion. Which of the following guidelines should the nurse follow when choosing a sampling strategy?
A) Random sampling should be the nurse’s goal with participant self-selection if this is not practicable.
B) The nurse should identify a minimum of 10 informants or 15 informants if purposeful sampling is utilized.
C) The nurse should have a sample small enough to allow depth of inquiry but large enough to include a variety of voices.
D) The nurse should seek as large a sample as possible in order to facilitate thick description and the validity of findings.

 

 

9. Which of the following facts about a qualitative study addresses the meanings of a support group for adults with type 1 diabetes that may present a potential flaw?
A) The researcher provides original insights into the etiology of diabetes.
B) The researcher has type 1 diabetes.
C) The researcher was an open attendee of the support group meetings.
D) The researcher did not do random sampling.

 

 

10. A researcher has developed and administered a survey that addresses patients’ reactions and responses to being diagnosed with nosocomial (hospital-acquired) infections while inpatients. The researcher has subsequently completed and submitted a manuscript that proposes a theory around the patients’ perceptions of infection control in the hospital setting. The researcher’s actions most clearly represent a potential deficit in which of the following criteria?
A) Veracity
B) Individuality
C) Transferability
D) Credibility

 

 

11. A careful reading of a qualitative research study has revealed a potential lack of confirmability. Which of the following observations may have led the reader to this conclusion?
A) The findings appear to be true only among the specific participants in the study.
B) The links between the findings and the data are not evident.
C) The sample consisted of only 8 participants.
D) The researcher makes no mention of producing fieldnotes.

 

 

12. The findings of a widely-disseminated qualitative study that addresses the meaning of smoking to teenage cigarette smokers has resulted in significant changes to many of the antismoking strategies undertaken by school nurses. The study has most clearly demonstrated which of the following qualities?
A) Ontological authenticity
B) Credibility
C) Catalytic authenticity
D) Confirmability

 

 

13. An oncology nurse has been exposed to numerous qualitative studies addressing the experience and meaning of cancer diagnosis and is now preparing to conduct a metasynthesis of the subject. Which of the following principles should the nurse include in the methodology of this new study?
A) Reanalyzing the raw data from the studies selected for inclusion
B) Performing a thematic analysis of the themes and category titles of the chosen studies
C) Forming a liaison with the authors of the original studies
D) Performing statistical analysis of the combined findings of the chosen studies

 

 

14. Though rooted in the voices of the 16 men who were interviewed for the study, the findings of a qualitative study into the health practices of male prison inmates is thought to be true for many members of the larger prison population. This fact about the study most clearly demonstrates
A) Transferability
B) Confirmability
C) Dependability
D) Credibility

 

 

15. Use of which of the following data-gathering techniques is most likely to represent a potential flaw in the design of a qualitative study?
A) Participant observation
B) Unstructured interviews
C) Focus groups
D) Online surveys

 

 

 

Answer Key

 

1. A
2. B
3. D
4. C
5. D
6. A
7. C
8. C
9. A
10. D
11. B
12. C
13. C
14. A
15. D

 

Chapter 7- Patient Concerns, Choices, and Clinical Judgment in Evidence-Based Practice

1. Which of the following activities most clearly indicates that a nurse is engaging in self-improving practice?
A) The nurse reflects on practice in an effort to identify potential mistakes.
B) The nurse seeks input from more experienced colleagues.
C) The nurse attempts to get to know patients on a personal level.
D) The nurse has participated in a research study being conducted on the hospital unit.

 

 

2. A nurse has recently marked 10 years of practice on a medical unit. Which of the following aspects of “experience” is most likely to result in improved practice on the part of a nurse?
A) Increased years of practice in a consistent clinical environment
B) Exposure to more patient interactions and conduction of more interventions
C) Examination of interactions and events in the clinical context
D) Engagement with a greater variety of patients and patient populations

 

 

3. Which of the following aspects of care on a postsurgical unit is the clearest example of phronesis?
A) “The patient will dangle at the bedside q4h on postoperative day 1.”
B) “The patient will demonstrate independent ambulation prior to discharge.”
C) “The patient will perform leg exercises and deep breathing and coughing exercises twice on the day of surgery.”
D) “The patient will transition from dangling to assisted standing for the first time following surgery with the assistance of the physical therapist.”

 

 

4. Which of the following activities by the nurse most directly fosters phronesis in the care of geriatric patients in a long-term care setting?
A) The nurse consistently seeks out and attends continuing education offerings.
B) The nurse stays abreast of current research in geriatric nursing.
C) The nurse has organized a pilot study on falls prevention in the care facility.
D) The nurse makes an effort to get know residents’ individual needs, concerns, and goals.

 

 

5. How should a nurse best understand the concept of clinical expertise?
A) Clinical expertise is even more valuable than research evidence.
B) Clinical expertise is enhanced by holistically knowing patients as individuals.
C) Clinical expertise is demonstrated by the formalized knowledge of nursing practice.
D) Clinical expertise is central to good nursing practice, superseded only by the importance of published articles.

 

 

6. A nurse is providing care for a 3-year-old girl who has been admitted to the pediatric intensive care unit with a suspected brain injury following a choking episode. Which of the following aspects of the nurse’s care best demonstrates clinical expertise?
A) The nurse has previously cared for a patient in similar circumstances.
B) The nurse has a sound and current knowledge base around respiratory and neurological pathophysiology.
C) The nurse recognizes that there are numerous patient and family variables at play.
D) The nurse demonstrates empathy when caring for the patient.

 

 

7. A qualitative study addresses the cues that nurses perceive when they sense a patient’s condition is worsening. The study data are based on narratives from several nurses who provide care in high acuity settings. Narratives are most likely to make which of the following contributions to the study?
A) Insights into the nuances of nurses’ understandings of complex situations
B) Indications of the depth of participants’ knowledge bases
C) Insights into the nurses’ abilities to implement evidence-based practice
D) Indications of the depth of clinical expertise that exists among the sample

 

 

8. Which of the following clinical questions is most likely to be informed by the use of nurses’ narratives?
A) How do 8-hour nursing shifts compare with 12-hour shifts to affect patient safety in an emergency department setting?
B) What meaning do nurses assign to conflicts they have with patients and the families of patients?
C) What factors contribute to nurses’ decisions to administer as-needed analgesia?
D) How does a mentorship program compare with traditional orientation of new staff in affecting retention among new nursing graduates?

 

 

9. Which of the following statements provides the clearest rationale for the use of narratives in understanding nursing knowledge and clinical expertise?
A) The acuity of patients on admission to a hospital is higher than in previous decades and continues to increase.
B) The ability of  nurses to provide adequate care with ever-increasing patient loads is poorly understood.
C) As life expectancy increases, more patients are living with chronic conditions whose symptoms often overlap.
D) The trajectory of illness and the human experience of it can be complex and highly individualized.

 

 

10. Nurse L provides care on a busy medical unit of an inner-city hospital. Which of the nurse’s actions best exemplifies clinical grasp?
A) Nurse L is committed to reading and integrating the most recent, published evidence.
B) Nurse L is able to identify subtle changes in patient condition that are often not obvious to other clinicians.
C) Nurse L has responded appropriately to patients in cardiac or respiratory arrest.
D) Nurse L makes a concerted effort to get to know patients’ families.

 

 

11. A nurse paged the attending physician because a postmastectomy patient became somewhat agitated and tachypneic in recent hours. Despite other nurses’ assertions that the patient was simply experiencing some anxiety, the nurse suspected a more serious etiology. The physician prescribed a single dose of a benzodiazepine, which was largely ineffective. Due to the nurse’s persistence, diagnostics were performed, leading to a diagnosis of pulmonary embolism. Which of the following did the nurse exhibit?
A) Evidence-based practice
B) Clinical grasp
C) Patient-centered care
D) Best practice

 

 

12. Nurse M makes a conscious effort to think beyond the rigidly-defined signs and symptoms of illnesses and recognizes that context has a highly significant impact on illness situations. This thinking facilitates which of the following?
A) Engaging in detective work
B) Phronesis
C) Making qualitative distinctions
D) Techne

 

 

13. A nurse who provides care on a geriatric subacute medicine unit is aware that elderly patients often exhibit signs and symptoms of infection that are very different from those of younger patients. This knowledge is an example of
A) recognizing changing clinical relevance.
B) engaging in detective work.
C) making qualitative distinctions.
D) developing clinical knowledge about specific patient populations.

 

 

14. While helping a colleague reposition a patient who is in moderate respiratory distress, the nurse has a sense that it would be appropriate to ensure the bag-valve mask (Ambu bag) is readily accessible and to confirm the patient’s code status. Which of the following qualities does this exemplify?
A) Engaging in detective work
B) Evidence-based practice
C) Future think
D) Phronesis

 

 

15. Knowing that the patient was admitted with a diagnosis of sepsis, the nurse has limited the most recent bedside assessment to an oral temperature followed by a review of the patient’s white cell count. This limited-scope assessment will most directly affect the nurse’s ability to
A) engage in experiential learning.
B) see the unexpected.
C) individualize care.
D) provide empathy.

 

 

 

Answer Key

 

1. A
2. C
3. B
4. D
5. B
6. C
7. A
8. B
9. D
10. B
11. B
12. C
13. D
14. C
15. B