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.
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A nurse manager wants to facilitate incorporation of evidence-based practice (EBP) in the clinical setting. Which of the following would be the best strategy to accomplish this goal?
- A. Eliminate all protocols and standards that are not evidence base
- C. Encourage group reflection on the ideals and expectations of nursing car
Correct Answer: C
Rationale: The correct answer is C: Encourage group reflection on the ideals and expectations of nursing care. This strategy promotes a collaborative approach to understanding and implementing EBP. Group reflection fosters critical thinking, stimulates discussion, and encourages shared decision-making, leading to a deeper understanding and acceptance of EBP within the team. It also promotes a culture of continuous learning and improvement.
Eliminating all protocols not evidence-based (option A) may hinder current practice and create resistance. Without alternatives listed for other choices, it is challenging to provide detailed explanations for their incorrectness.
Select the great public health achievements in the United States in the 20th century. (Select all that apply.)
- A. Elimination of common infectious diseases
- B. Recognition of tobacco as a health hazard
- C. Fluoridation of drinking water
- D. Healthier mothers and babies
Correct Answer: A
Rationale: The correct answer is A: Elimination of common infectious diseases. This achievement significantly improved public health by decreasing morbidity and mortality rates. It was made possible through advancements in vaccination programs, sanitation practices, and public health education. This achievement led to the eradication of diseases like smallpox and the near-elimination of diseases like polio. The other choices are incorrect because although they are also important public health achievements, they do not have the same widespread impact as the elimination of common infectious diseases. Recognizing tobacco as a health hazard (B) led to public health campaigns and regulations but did not have the same broad-reaching impact. Fluoridation of drinking water (C) improved dental health but did not have the same magnitude of impact on overall public health. Healthier mothers and babies (D) is crucial but does not encompass the scope of achievement represented by the elimination of common infectious diseases.
Which action by the nurse is an example of engaging in environmental justice?
- A. Using the environment to assist in client recovery
- B. Encouraging communities to engage in composting
- C. Eliminating lead-based paint in public housing
- D. Educating the community on proper disposal of hazardous materials
Correct Answer: C
Rationale: The correct answer is C: Eliminating lead-based paint in public housing. This action exemplifies environmental justice as it aims to address a specific environmental hazard that disproportionately affects marginalized communities living in public housing. By removing lead-based paint, the nurse is advocating for a safe and healthy living environment for all individuals, regardless of their socioeconomic status. This action promotes fairness and equality in environmental protection. In contrast, choices A, B, and D focus on general environmental initiatives that may not directly target environmental injustices or disparities. Therefore, choice C is the most effective in addressing environmental justice concerns.
A nurse implements an education program that incorporates computer games to reinforce learning for a group of older adults. Although the research demonstrates evidence of improved retention of this information, the nurse experiences exactly the opposite with this group. Which of the following is the most likely cause of such poor outcomes?
- A. Failure to consider client and setting differences
- B. Inadequate incorporation of evidence into practice
- C. Inferior quality of the available research evidence
- D. Lack of skills when evaluating the evidence
Correct Answer: A
Rationale: The correct answer is A: Failure to consider client and setting differences. Older adults may have different learning styles, preferences, and abilities compared to other age groups. The nurse may have overlooked these factors when implementing the computer games, resulting in poor outcomes. This highlights the importance of tailoring educational programs to fit the specific needs of the target audience.
Explanation for incorrect choices:
B: Inadequate incorporation of evidence into practice - This choice suggests a lack of proper implementation of research evidence, which is not directly related to the poor outcomes observed in this scenario.
C: Inferior quality of the available research evidence - The quality of the research evidence does not necessarily explain why the nurse did not achieve the desired outcomes.
D: Lack of skills when evaluating the evidence - While important, the lack of skills in evaluating evidence does not directly address the issue of poor outcomes with older adults in this context.
A community health nurse is developing a plan to improve the community's environmental health. Which of the following actions should the nurse take first?
- A. Encourage community involvement in environmental improvement.
- B. Establish a timeframe for environmental improvements.
- C. Request funding from community organizations.
- D. Collect information about the community's environmental status.
Correct Answer: D
Rationale: The correct answer is D - Collect information about the community's environmental status. This is the first step because it allows the nurse to assess the current environmental health issues in the community. By gathering data, the nurse can identify specific problems and prioritize interventions based on evidence. This information will guide the development of an effective plan tailored to address the community's specific needs.
Choice A is incorrect because community involvement should come after assessing the environmental status. Choice B is incorrect as setting a timeframe is premature without understanding the extent of the issues. Choice C is incorrect as funding should be sought once the plan is developed.
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