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A school health nurse plans to use evidence-based practice (EBP) to guide the development of health education programs most likely to increase retention of learning in elementary schoolchildren. Which of the following would be the best way to use EBP in this situation?
- A. Ask other school health nurses what they included in their own education programs.
- B. Compare and contrast randomized controlled trials related to learning in elementary schoolchildren.
- C. Develop a series of games to accompany the programs developed to promote health.
- D. Seek out and examine health education programs for elementary schoolchildren on the Internet.
Correct Answer: B
Rationale: The correct answer is B because comparing and contrasting randomized controlled trials related to learning in elementary schoolchildren is the best way to use evidence-based practice (EBP). This method involves systematically reviewing existing research studies to determine the most effective health education programs. Randomized controlled trials are considered the gold standard in research, providing the highest level of evidence. By analyzing these trials, the nurse can identify interventions that have been proven to be successful in increasing retention of learning in elementary schoolchildren.
Choice A is incorrect because relying solely on anecdotal evidence from other school health nurses does not constitute evidence-based practice. Choice C is incorrect as developing games may be a creative approach, but it does not ensure the effectiveness of the health education programs. Choice D is also incorrect as the internet may not always provide reliable or evidence-based information.
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Public health nursing is distinguished from other specialties by adherence to eightprinciples. Which are domains of public health nursing practice? (Select all that apply.)
- A. Intuitive assessment skills
- B. Community organization skills
- C. Communication skills
- D. Cultural competency skills
Correct Answer: B
Rationale: The correct answer is B: Community organization skills. Public health nursing involves working with communities to promote health and prevent diseases. Community organization skills are essential for collaborating with community members, organizations, and stakeholders to develop and implement effective health programs.
A: Intuitive assessment skills - While assessment skills are important in public health nursing, they are not necessarily intuitive. Public health nurses rely on evidence-based assessments rather than intuition.
C: Communication skills - Communication skills are crucial in public health nursing, but they are not specific to this specialty. Most nursing specialties require strong communication skills.
D: Cultural competency skills - While cultural competency is important, it is not a domain specific to public health nursing. Cultural competency is relevant in all areas of nursing practice.
Demographic characteristics indicate that people in developed countries are living longer, healthier lives, yet tremendous health and social disparities exist. Which describes social determinants of health?
- A. What society does collectively to ensure the conditions exist in which people can be healthy
- B. Social conditions in which people live and work
- C. Context of preventing disease and disability and promoting and protecting the health of the entire community
- D. Comprehensive management of health information and its secure exchange between consumers, providers, government and quality entities, and insurers
Correct Answer: A
Rationale: The correct answer is A because it accurately defines social determinants of health as what society collectively does to create conditions for health. It emphasizes the importance of societal actions in promoting health outcomes for individuals. Choice B refers to social conditions but does not explicitly mention the collective responsibility of society. Choice C focuses on community health but does not encompass the broader societal role. Choice D is about health information management, not social determinants. Choices E, F, and G are not provided, so they are irrelevant. In summary, A is correct as it highlights the societal efforts in creating a healthy environment, while the other choices are incorrect as they do not fully capture the concept of social determinants of health.
A nurse in a surgical clinic is providing teaching to a client who is scheduled for a modified radical mastectomy. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will complete my arm exercises four times a day
- B. Using data from the main health care institutions in the community to determine needed health services
- C. Ensure timely and effective medical intervention and treatment for community members
- D. Giving some of their own surplus clothes to those who can use them
Correct Answer: A
Rationale: The correct answer is A: "I will complete my arm exercises four times a day." This indicates an understanding of the teaching because after a modified radical mastectomy, it's important to perform arm exercises to prevent lymphedema and improve range of motion. Completing exercises four times a day shows commitment to the prescribed regimen.
Choices B, C, and D are incorrect as they do not pertain to the client's post-operative care after a modified radical mastectomy. B focuses on data collection for health services, C relates to community medical interventions, and D is about charitable donations, none of which are relevant to the client's self-care instructions.
While conducting a literature review for an evidence-based project, the nurse recognizes that which type of study represents the lowest level of evidence?
- A. Case reports
- B. Cohort studies
- C. Randomized control trials
- D. Cross-sectional studies
Correct Answer: A
Rationale: The correct answer is A: Case reports. Case reports represent the lowest level of evidence because they are anecdotal, describing observations of individual cases without control groups or systematic data collection. They lack generalizability and are subject to bias. Cohort studies (B), randomized control trials (C), and cross-sectional studies (D) are higher levels of evidence with more rigorous study designs and stronger ability to establish causation and relationships between variables. Cohort studies follow a group over time, RCTs involve random allocation of participants into groups, and cross-sectional studies provide a snapshot of a population at a specific point in time.
A nurse is familiar with evidence-based practice (EBP) and wants to implement it into the care of clients. Which of the following would present the biggest challenge?
- A. Assessing one's current practice and accessing evidence-based resources
- B. Convincing administration that EBP is beneficial
- C. Distinguishing EBP from practice based on old standards
- D. Showing clients that EBP will improve their health outcomes
Correct Answer: D
Rationale: The correct answer is D because showing clients that EBP will improve their health outcomes presents the biggest challenge. This is because clients may be resistant to change or skeptical about new approaches. It requires effective communication and education to convince clients of the benefits of EBP. Assessing current practice (A) and accessing resources, convincing administration (B), and distinguishing EBP from old standards (C) are challenges that can be addressed through education and training. In contrast, clients' attitudes and beliefs are harder to change, making option D the most challenging aspect of implementing EBP.