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A patient shows the nurse an article from the Internet about a health problem. Which characteristic of the website's address most alerts the nurse that the site may have biased and prejudiced information?
- A. Address ends in '.org.'
- B. Address ends in '.com.'
- C. Address ends in '.gov.'
- D. Address ends in '.net.'
Correct Answer: B
Rationale: Financial influences on a site are a clue that the information may be biased. '.com' at the end of the address indicates that the site is a commercial one. '.gov' indicates that the site is maintained by a government entity. '.org' indicates that the site is nonproprietary; the site may or may not have reliable information, but it does not profit from its activities. '.net' can have multiple meanings.
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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.
A patient who immigrated to the United States from Honduras was diagnosed with schizophrenia. The patient took an antipsychotic medication for 3 weeks but showed no improvement. Which resource should the treatment team consult for information on more effective medications for this patient?
- A. Clinical algorithm
- B. Clinical pathway
- C. Clinical practice guideline
- D. International Statistical Classification of Diseases and Related Health Problems (ICD)
Correct Answer: A
Rationale: A clinical algorithm is a guideline that describes diagnostic and/or treatment approaches drawn from large databases of information. These guidelines help the treatment team make decisions cognizant of an individual patient's needs, such as ethnic origin, age, or gender. A clinical pathway is a map of interventions and treatments related to a specific disorder. Clinical practice guidelines summarize best practices about specific health problems. The ICD classifies diseases.
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.
A team of nurses wants to integrate evidence-based practice into a facility's clinical pathways. Which step should the team implement first?
- A. Acquire findings from published literature.
- B. Apply the research findings to clinical practice.
- C. Assess the outcomes of using new research findings.
- D. Ask questions to identify clinical problems that should be changed.
Correct Answer: D
Rationale: Integrating evidence-based practice is a multistep process rather than a single change event. The first step is to identify clinical problems that should be changed. Each step must proceed in order when integrated into a clinical environment.
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.