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A nurse is using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model PET as a clinical decision-making tool when delivering care to patients. Which steps reflect the intended use of this tool? Select all that apply.
- A. Recruiting an interprofessional team to develop and refine an EBP question
- B. Drawing from personal experiences of being a patient to establish a therapeutic relationship with a patient
- C. Conducting a search of electronic databases for current treatments for type 2 diabetes
- D. Drawing on their spiritual training when counseling a patient in hospice care at end of life
- E. Questioning the protocol for assessing postoperative patients returning to the ICU
- F. Studying pathophysiology to understand the disease states of assigned patients
Correct Answer: A,C,E
Rationale: The JHNEBP model is a powerful problem-solving approach to clinical decision making, which uses a three-step process called PET: practice question, evidence, and translation. The goal of the model is to ensure that the latest research findings and best practices are quickly incorporated into patient care. Steps in PET include, but are not limited to, recruiting an interprofessional team, developing and refining the EBP question, and conducting internal and external searches for evidence.
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Nursing students have been assigned to discuss a section of a research article examining 24-hour visitation for patients in the intensive care unit (ICU). What topic will the student assigned to the applicability section plan to discuss?
- A. Description of the tool that was used to gather the data
- B. How the results could be used in the student's practice
- C. Statistical methods used to determine the results
- D. Whether informed consent was obtained from the participants
Correct Answer: B
Rationale: Applicability refers to how study results could be used in practice. Method includes the design and data analysis. Informed consent affirms the patient's right to agree to participate in a study without coercion, to refuse to participate without jeopardizing their care, the right to confidentiality, the right to be protected from harm, and the ability to withdraw from the study at any time.
A nurse is using general systems theory to assist a family of four develop healthier food choices. What statement best reflects a key point of this theory?
- A. Food choices made by the parents will influence choices made by the children.
- B. The children should avoid giving feedback on the family food choices.
- C. Boundaries are closed between family members and their environments.
- D. A change in one family member's behavior rarely affects other members.
Correct Answer: A
Rationale: General systems theory defines a system as a set of interacting elements contributing to the overall goal of the system. A change in one element could affect other subsystems, as well as the whole. To survive, open systems maintain balance through feedback, in this case, family members. An open system allows energy, matter, and information to move freely between systems and boundaries, such as with members of the health care team, whereas a closed system does not allow input from or output.
A nurse is conducting qualitative research to study the culture of Native Alaskans and how their diet affects their overall state of health. Which method of research is the nurse using?
- A. Historical
- B. Ethnography
- C. Grounded theory
- D. Phenomenology
Correct Answer: B
Rationale: Ethnographic research was developed by the discipline of anthropology and is used to examine issues of culture of interest to nurses. Historical research examines events of the past to increase understanding of the nursing profession today. The basis of grounded theory methodology is the discovery of how people describe their own reality and how their beliefs are related to their actions in a social scene. The purpose of phenomenology (both a philosophy and a research method) is to describe experiences as they are lived by the subjects being studied.
A Alexandrovich, A. B. (2016). An evidence-based approach to addressing healthcare issues of the LGBTQ community. The Journal for Nurse Practitioners, 12(9), 607-613.
Correct Answer: C
Rationale: Federal regulations require that institutions receiving federal funding or conducting studies of drugs or medical devices regulated by the Food and Drug Administration establish institutional review boards (IRBs). The IRBs review studies conducted in the institution to determine the risk status of the studies and to ensure that ethical principles are followed. While organizations may have internal procedures for conducting research, such as including surgeons, the director of nursing, the pharmacy director, and staff, these are not government mandates. The type of study, such as randomized-controlled study, will be determined by the nurse in collaboration with the prescriber and approval of the IRB.
A nurse conducting quantitative research hypothesizes that adolescents with anorexia nervosa who participate in outpatient therapy report less depression than those receiving inpatient treatment. What information does the nurse collect to support the hypothesis?
- A. Subjects' demographics
- B. Variables
- C. Data
- D. Instruments
Correct Answer: C
Rationale: Data refer to information that the researcher collects from subjects in the study, generally expressed in words, numbers, graphs, and charts. A variable is something (such as conditions, equipment, interventions) that varies and has different values (outcomes) that can be measured. Instruments are devices used to collect and record the data, such as rating scales, pencil-and-paper tests, and biologic measurements.