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A nurse says, 'When I was in school, I learned to call upset patients by name to get their attention; however, I read a descriptive research study that says that this approach does not work. I plan to stop calling patients by name.' Which statement is the best appraisal of this nurse's comment?
- A. One descriptive research study rarely provides enough evidence to change practice.
- B. Staff nurses apply new research findings only with the help from clinical nurse specialists.
- C. New research findings should be incorporated into clinical algorithms before using them in practice.
- D. The nurse misinterpreted the results of the study. Classic tenets of practice do not change.
Correct Answer: A
Rationale: Descriptive research findings provide evidence for practice but must be viewed in relation to other studies before practice changes. One study is not enough. Descriptive studies are low on the hierarchy of evidence. Clinical algorithms use flowcharts to manage problems and do not specify one response to a clinical problem. Classic tenets of practice should change as research findings provide evidence for change.
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A nurse consistently strives to demonstrate caring behaviors during interactions with patients. Which reaction reported by a patient indicates this nurse is most effective?
- A. Feeling less distrustful of others
- B. Sensing a connection with others
- C. Experiencing only minimal uneasiness about the future
- D. Being somewhat encouraged with efforts to improve
Correct Answer: B
Rationale: A patient is likely to respond most to caring with a sense of connectedness with others. The absence of caring can make patients feel some degree of distrustful, disconnection, unease, and discouragement.
A bill introduced in Congress would reduce funding for the care of people diagnosed with mental illnesses. A group of nurses write letters to their elected representatives in opposition to the legislation. Which role have the nurses fulfilled?
- A. Advocacy
- B. Attending
- C. Recovery
- D. Evidence-based practice
Correct Answer: A
Rationale: An advocate defends or asserts another's cause, particularly when the other person lacks the ability to do that for him or herself. Examples of individual advocacy include helping patients understand their rights or make decisions. On a community scale, advocacy includes political activity, public speaking, and publication in the interest of improving the individuals with mental illness; the letter-writing campaign advocates for that cause on behalf of patients who are unable to articulate their own needs.
A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Which statement is an example of 'attending'?
- A. We all have stress in life. Being in a psychiatric hospital is not the end of the world.
- B. Tell me why you felt you had to be hospitalized to receive treatment for your depression.
- C. You will feel better after we get some antidepressant medication started for you.
- D. I'd like to sit with you for a while, so you may feel more comfortable talking with me.
Correct Answer: D
Rationale: Attending is a technique that demonstrates the nurse's commitment to the relationship and reduces feelings of isolation. This technique shows respect for the patient and demonstrates caring. Generalizations, probing, and false reassurances are nontherapeutic.
An experienced nurse says to a new graduate, 'When you've practiced as long as I have, you will instantly know how to take care of psychotic patients.' What is the new graduate's best analysis of this comment?
- A. The experienced nurse may have lost sight of patients' individuality, which may compromise the integrity of practice.
- B. New research findings must be continually integrated into a nurse's practice to provide the most effective care.
- C. Experience provides mental health nurses with the tools and skills needed for effective professional practice.
- D. Experienced psychiatric nurses have learned the best ways to care for psychotic patients through trial and error.
- E. Effective psychiatric nurses should be continually guided by an intuitive sense of patients' needs.
Correct Answer: A,B
Rationale: Evidence-based practice involves using research findings to provide the most effective nursing care. Evidence is continually emerging; therefore, nurses cannot rely solely on experience. The effective nurse also maintains respect for each patient as an individual. Overgeneralization compromises that perspective. Intuition and trial and error are unsystematic approaches to care.
An informal group of patients discuss their perceptions of nursing care. Which comment best indicates a patient's perception that his or her nurse is caring?
- A. My nurse always asks me which type of juice I want to help me swallow my medication.
- B. My nurse explained my treatment plan to me and asked for my ideas about how to make it better.
- C. My nurse told me that if I take all the medicines the doctor prescribes, I will get discharged soon.
- D. My nurse spends time listening to me talk about my problems. That helps me feel like I'm not alone.
Correct Answer: D
Rationale: Caring evidences empathic understanding as well as competency. It helps change pain and suffering into a shared experience, creating a human connection that alleviates feelings of isolation. The incorrect options give examples of statements that demonstrate advocacy or giving advice.