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A nursing student questions the primary nurse about instilling air into a nasogastric tube to confirm placement, when they learned that x-ray validation of the tube's tip in the stomach reflects best practice. The student is validating safe nursing practice with which type of knowledge?
- A. Instinctive knowledge
- B. Scientific knowledge
- C. Authoritative knowledge
- D. Traditional knowledge
Correct Answer: B
Rationale: Scientific knowledge is obtained through the scientific method or research; this leads to evidence-based practice. Instinct, such as 'I feel this is correct,' is not a source of knowledge. Traditional knowledge is the part of nursing practice passed down from generation to generation, often without research data to support it. Examples include daily bathing and changing bed linens each day. Authoritative knowledge comes from an expert and is accepted as truth based on the person's perceived expertise.
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After their clinical experience, nursing students are given a reflective assignment to discuss the concepts in nursing theory that influence and determine nursing practice. What part of this theory is most important when delivering thoughtful care?
- A. Environment
- B. Health
- C. Nursing
- D. Person
Correct Answer: D
Rationale: Of the four concepts, the most important is the person. The focus of nursing, regardless of definition or theory, is the person.
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 quantitative research to examine which of two types of silicone foam sacral dressings best prevent pressure injuries in bedridden patients. What type of research is the nurse conducting?
- A. Descriptive
- B. Correlational
- C. Quasi-experimental
- D. Experimental
Correct Answer: C
Rationale: Quasi-experimental research is often conducted in clinical settings to examine the effects of nursing interventions on patient outcomes. Descriptive research is often used to generate new knowledge about topics with little or no prior research. Correlational research examines the type and degree of relationships between two or more variables. Experimental research examines cause-and-effect relationships between variables under highly controlled conditions.
A nurse is formulating a clinical question using the PICOT format. The nurse begins with determining the 'P,' which focuses on which element?
- A. Comparison to another similar protocol
- B. Clearly defined, focused literature review of procedures
- C. Specific identification of the purpose of the study
- D. Explicit descriptions of the population of interest
Correct Answer: D
Rationale: The P in the PICOT format represents an explicit description of the patient population of interest. I represents the intervention, C represents the comparison, O stands for the outcome, and T stands for the time.
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.