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The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate?
- A. Strong evidence from unbiased observational studies
- B. Evidence from randomized clinical trials showed inconsistent results
- C. Consistent evidence from well-performed randomized clinical trials
- D. Evidence for at least one critical outcome from randomized clinical trials had serious flaws
Correct Answer: B
Rationale: Evidence from randomized clinical trials with important limitations indicates that the evidence is of moderate quality. Strong evidence from unbiased observational studies and consistent evidence from well-performed randomized clinical trials indicates high quality. Evidence for at least one critical outcome from randomized clinical trials that has serious flaws indicates low quality.
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The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?
- A. Limit explanation of procedures because the child is preschool aged.
- B. Ask that all family members leave the room when performing procedures.
- C. Allow the child to choose the type of juice to drink with the administration of oral medications.
- D. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective.
Correct Answer: C
Rationale: The overriding goal in providing atraumatic care is first, do no harm. Allowing the child a choice of juice to drink when taking oral medications provides the child with a sense of control. The preschool child should be prepared before procedures, so limiting explanations of procedures would increase anxiety. The family should be allowed to stay with the child during procedures, minimizing stress. Lidocaine/prilocaine (EMLA) cream is a topical local anesthetic. The nurse should plan to use the prescribed cream in time for morning laboratory draws to minimize pain.
The nurse is aware that which age group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking?
- A. Preschool
- B. Young school age
- C. Middle school age
- D. Adolescent
Correct Answer: A
Rationale: Preschool children have the cognitive characteristic of magical and egocentric thinking, meaning they are unable to comprehend danger to self or others. Young and middle school-aged children have transitional cognitive processes, and they may attempt dangerous acts without detailed planning but recognize danger to themselves or others. Adolescents have formal operational cognitive processes and are preoccupied with abstract thinking.
An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions?
- A. Justice
- B. Autonomy
- C. Beneficence
- D. Nonmaleficence
Correct Answer: B
Rationale: Autonomy is the patients right to be self-governing. The adolescent is trying to be autonomous, so the nurse is supporting this value. Justice is the concept of fairness. Beneficence is the obligation to promote the patients well-being. Nonmaleficence is the obligation to minimize or prevent harm.
The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching?
- A. Childhood obesity is the most common nutritional problem among children.
- B. Immunization rates are the same among children of different races and ethnicity.
- C. Dental caries is not a problem commonly seen in children since the introduction of fluoridated water.
- D. Mental health problems are typically not seen in school-age children but may be diagnosed in adolescents.
Correct Answer: A
Rationale: When teaching parents of school-age children about childhood health problems, the nurse should include information about childhood obesity because it is the most common problem among children and is associated with type 2 diabetes. Teaching parents about ways to prevent obesity is important to include. Immunization rates differ depending on the childs race and ethnicity; dental caries continues to be a common chronic disease in childhood; and mental health problems are seen in children as young as school age, not just in adolescents.
The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?
- A. Purposeful and goal directed
- B. A simple developmental process
- C. Based on deliberate and irrational thought
- D. Assists individuals in guessing what is most appropriate
Correct Answer: A
Rationale: Clinical reasoning is a complex developmental process based on rational and deliberate thought. When thinking is clear, precise, accurate, relevant, consistent, and fair, a logical connection develops between the elements of thought and the problem at hand.