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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.
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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.
Which patient statements identify qualities of nursing practice with high therapeutic value? 'My nurse:
- A. The nurses talk in language I can understand.
- B. The nursing staff helps me keep track of my medications.
- C. My nurse is willing to go to social activities with me.
- D. The staff lets me do whatever I choose without interfering.
- E. My nurses look at me as a whole person with different needs.
Correct Answer: A,B,E
Rationale: Each correct answer demonstrates caring is an example of appropriate nursing foci: communicating at a level understandable to the patient, using holistic principles to guide care, and providing medication supervision. The incorrect options suggest a laissez-faire attitude on the part of the nurse when the nurse should instead provide thoughtful feedback and help patients test alternative solutions or violate boundaries.
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.
A patient is hospitalized for depression and suicidal ideation after their spouse asks for a divorce. Select the nurse's most caring comment.
- A. Let's discuss healthy means of coping when you have suicidal feelings.
- B. I understand why you're so depressed. When I got divorced, I was devastated too.
- C. You should forget about your marriage and move on with your life.
- D. How did you get so depressed that hospitalization was necessary?
Correct Answer: A
Rationale: The nurse's communication should evidence caring and a commitment to work with the patient. This commitment lets the patient know the nurse will help. Probing and advice are not helpful for therapeutic interventions.
Which research evidence would most influence a group of nurses to change their practice?
- A. Expert committee report of recommendations for practice
- B. Systematic review of randomized controlled trials
- C. Nonexperimental descriptive study
- D. Critical pathway
Correct Answer: B
Rationale: Research findings are graded using a hierarchy of evidence. A systematic review of randomized controlled trials is level A and provides the strongest evidence for changing practice. Expert committee recommendations and descriptive studies lend less powerful and influential evidence. A critical pathway is not evidence; it incorporates research findings after they have been analyzed.