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When using the Five Steps of the Evidence-Informed Practice (EIP) Process, in which order should the nurse construct a clinical question?
- A. Comparison of interest
- B. Population of interest
- C. Outcome of interest
- D. Intervention of interest
- E. Timeframe
Correct Answer: A,B,C,D,E
Rationale: The order of the nurse's statements follows the PICOT format, which includes Population, Intervention, Comparison, Outcome, and Timeframe, in that order.
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Which of the following is an example of a correctly written nursing diagnosis statement?
- A. Altered tissue perfusion related to heart failure
- B. Risk for impaired tissue integrity related to sacral redness
- C. Ineffective coping related to insufficient sense of control
- D. Altered urinary elimination related to urinary tract infection
Correct Answer: C
Rationale: This diagnosis statement includes a NANDA nursing diagnosis and an etiology that describes a patient's response to a health problem that can be treated by nursing. The use of a medical diagnosis (as in the responses beginning 'Altered tissue perfusion' and 'Altered urinary elimination') is not appropriate. The response beginning 'Risk for impaired tissue integrity' uses the defining characteristics as the etiology.
When caring for patients using evidence-informed practice, which of the following does the nurse use?
- A. Clinical judgment based on experience
- B. Evidence from a clinical research study
- C. The best available evidence to guide clinical expertise
- D. Evaluation of data showing that the patient outcomes are met
Correct Answer: C
Rationale: Evidence-informed nursing practice is a continuous interactive process involving the explicit, conscientious, and judicious consideration of the best available evidence to provide care. Four primary elements are: (a) clinical state, setting, and circumstances; (b) patient preferences and actions; (c) best research evidence, and (d) health care resources. Clinical judgment based on the nurse's clinical experience is part of EIP, but clinical decision making also should incorporate current research and research-based guidelines. Evidence from one clinical research study does not provide an adequate substantiation for interventions. Evaluation of patient outcomes is important, but interventions should be based on research from randomized control studies with a large number of subjects.
The nurse is caring for a patient with a new diagnosis of pneumonia and explains to the patient that together they will plan the patient's care and set goals for discharge. The patient asks: 'How is that different from what the doctor does?' Which response by the nurse is most appropriate?
- A. The role of the nurse is to administer medications and other treatments prescribed by your doctor.
- B. The nurse's job is to help the doctor by collecting data and communicating when there are problems.
- C. Nurses perform many of the procedures done by physicians, but nurses are here in the hospital for a longer time than doctors.
- D. In addition to caring for you while you are sick, the nurses will assist you to develop an individualized plan to maintain your health.
Correct Answer: D
Rationale: This response is consistent with the Canadian Nurses Association (CNA) definition of nursing. Registered nurses are self-regulated health care professionals who work autonomously and in collaboration with others. RNs enable individuals, families, groups, communities and populations to achieve their optimal level of health. RNs coordinate health care, deliver direct services, and support patients in their self-care decisions and actions in situations of health, illness, injury, and disability in all stages of life. The other responses describe some of the dependent and collaborative functions of the nursing role but do not accurately describe the nurse's role in the health care system.
Which of the following best explains the nurse's primary use of the nursing process when providing care to patients?
- A. To explain nursing interventions to other health care professionals
- B. As a problem-solving tool to identify and treat patients' health care needs
- C. As a scientific-based process of diagnosing the patient's health care problems
- D. To establish nursing theory that incorporates the biopsychosocial nature of humans
Correct Answer: B
Rationale: The nursing process is an assertive problem-solving approach to the identification and treatment of patients' problems. Diagnosis is only one phase of the nursing process. The primary use of the nursing process is in patient care, not to establish nursing theory or explain nursing interventions to other health care professionals.
Which of the following would the nurse perform during the assessment phase of the nursing process?
- A. Obtains data with which to diagnose patient problems.
- B. Uses patient data to develop priority nursing diagnoses.
- C. Teaches interventions to relieve patient health problems.
- D. Assists the patient to identify realistic outcomes to health problems.
Correct Answer: A
Rationale: During the assessment phase, the nurse gathers information about the patient. The other responses are examples of the intervention, diagnosis, and planning phases of the nursing process.