Medical Surgical Nursing 2E Osborn Test bank

Medical Surgical Nursing  2E Osborn  Test bank
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Osborn, Medical-Surgical Nursing, 2e
Chapter 03
Question 1
Type: MCSA
A nurse notices a particular nursing intervention is not successful in helping patients achieve their health care goals and decides to study the issue. What should the nurse do first?
1. Identify the problem.
2. Design the sampling plan.
3. Conduct a literature review.
4. Conduct a pilot study.
Correct Answer: 1
Rationale 1: The first step in any research process is to identify a researchable problem, which is a situation in need of a solution, alteration, or improvement. It is an area of concern for a particular population that requires investigation and it is derived from a topical area.
Rationale 2: Designing a sample plan is part of the research design and occurs later in the research process.
Rationale 3: Conducting a literature review occurs after the study question has been defined.
Rationale 4: A pilot study is done after the research is designed.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3-2

Question 2
Type: MCSA
A qualitative research study has concluded and the nurse researcher is currently watching the study participants to make sure that the research findings can be observed in their routine lives. The nurse is conducting which type of basic research?
1. Ethnography
2. Experimental research
3. Phenomenology
4. Grounded theory
Correct Answer: 4
Rationale 1: Ethnography focuses on the culture of a group.
Rationale 2: Experimental research is a type of quantitative research.
Rationale 3: Phenomenology describes the meaning of a lived experience through the perspective of the participant.
Rationale 4: Grounded theory refers to the idea that conclusions of a qualitative study are grounded in data and based on direct and careful observations of everyday life within the group studied. By observing the study participants, the nurse is following a grounded theory research design.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3-1

Question 3
Type: MCSA
The nurse asks a patient if he has used a newly developed exercise to relieve the arthritis pain in his shoulders. The nurse is most likely employing which concept?
1. Applied research
2. Basic research
3. Critical thinking
4. Discharge planning
Correct Answer: 1
Rationale 1: Applied research focuses on finding solutions to existing problems. Practicing nurses are most likely to be involved in applied research.
Rationale 2: Basic research is undertaken to extend the knowledge base in a discipline or to formulate or refine a theory.
Rationale 3: Critical thinking is a process to determine the best interventions when planning care and may be based on experience, knowledge, or research.
Rationale 4: Discharge planning is an activity, started upon admission, to determine the patients needs once discharged from a health care facility.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 3-1

Question 4
Type: MCMA
The nurse is analyzing a phenomenological research study. Which data would the nurse evaluate as matching this study design?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Waiting to have a procedure done is more stressful than the actual procedure.
2. A patients blood pressure is 150/90 after ambulating 10 feet.
3. A patients urine output after ingesting 240 mL of water is 100 mL.
4. Ten mothers in the same housing community desire a centrally located day care facility.
5. Breast cancer survivors are more likely than others to participate in efforts to raise money for breast cancer research.
Correct Answer: 1,5
Rationale 1: Phenomenology describes the meaning of a lived experience through the perspective of the participant. This statement exemplifies the meaning of a lived experience through the perspective of the participant.
Rationale 2: This is an example of objective data that is more likely to be collected during a quantitative research study.
Rationale 3: This is an example of objective data that is more likely to be collected during a quantitative research study.
Rationale 4: This is an example of ethnography, which focuses on the culture of a group of people with an effort to understand their worldview.
Rationale 5: Phenomenology describes the meaning of a lived experience through the perspective of the participant. These patients have lived the experience of surviving breast cancer.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 3-6

Question 5
Type: MCSA
The nurse, working with patients in an orthopedic surgical unit, wants to study the impact of assistive devices on progressive ambulation. What would be an example of a research problem for this study?
1. Do posthip replacement patients ambulate faster with one crutch or two?
2. How does learning postsurgical exercises before the hip replacement impact the patients use of assistive devices?
3. Will posthip replacement patients recover from surgery faster if ambulated the day after surgery?
4. Will posthip replacement surgery patients be discharged using a cane for ambulation?
Correct Answer: 1
Rationale 1: The research problem is a small, specific piece of a phenomenon to be studied. The question that best supports the nurses focus would be whether posthip replacement patients ambulate faster with one crutch or two.
Rationale 2: This question focuses on assistive devices, not on progressive ambulation.
Rationale 3: This question does not specifically address the use of assistive devices.
Rationale 4: This question is about discharge rather than about the impact of assistive devices on progressive ambulation.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3-2

Question 6
Type: MCSA
Even though the nurses in a patient care area have been asked to collect data while conducting patient care, several nurses do the data collection only if time is available. Which research problem criteria does the inconsistent collection of data exemplify?
1. Feasible to address
2. Researchable
3. Of interest to the researcher
4. Significant to nursing
Correct Answer: 1
Rationale 1: Feasible to address means there is the cooperation of others and time to complete the research. The nurses collect the data only if there is time.
Rationale 2: The inconsistent data collection is not directly related to whether the study question is researchable.
Rationale 3: The researchers interest in the study question does not change the inconsistency in data collection.
Rationale 4: The inconsistent data collection is not as relevant to the significance to nursing as it is to another option.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3-2

Question 7
Type: MCSA
A nurse is going to determine the best design to use for a research project. Which action would the nurse perform to guide this choice?
1. Collect data.
2. Do a review of the literature.
3. Write an overview of the conceptual framework.
4. Identify themes and categories.
Correct Answer: 3
Rationale 1: Data collection is done after the research design is determined.
Rationale 2: A review of the literature will help with the identification of research problems.
Rationale 3: The third major step in the research process is selecting the type of research that will answer the question and the concomitant research design. It is helpful to begin the design section by writing an overview in which the theoretical or conceptual framework is stated if one is used.
Rationale 4: Themes and categories are identified when analyzing the data.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3-2

Question 8
Type: MCSA
A patient has not responded to an intervention with the desired outcome. Which nursing action is the best example of using evidence-based practice to solve this problem?
1. Apply the intervention again.
2. Find a research study about the intervention and apply the studys finding.
3. Evaluate what went wrong with the intervention.
4. Find research, quality improvement study outcomes, and information from experts to change the intervention.
Correct Answer: 4
Rationale 1: The nurse should not apply the intervention again as it is not producing the desired outcome.
Rationale 2: Finding a research study about the intervention and applying the findings would be research utilization. Research utilization is part of evidence-based practice but is not the most complete option.
Rationale 3: The nurse should have evaluated what happened before deciding the intervention was not working.
Rationale 4: Evidence-based practice stresses the use of research findings, quality improvement data, and the consensus of experts to substantiate practice.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3-3

Question 9
Type: MCSA
The nurses have been instructed on the use of an evidence-based practice (EBP) method to monitor patients; however, several nurses continue to conduct patient monitoring using the previous method. What can the nurse manager do to increase the use of the evidence-based practice method?
1. Assign the nurses not using the new method to participate in gathering data for a research study.
2. Review the evidence-based material again with those nurses who are not using the new method.
3. Remind the nurses that performance evaluations are tied to the use of evidence-based practice.
4. Determine that either method would be appropriate for the nurses to use.
Correct Answer: 2
Rationale 1: This action may be viewed as punitive and does not support the use of EBP in the current patient unit.
Rationale 2: Strategies to promote the use of evidence-based practice include continuing education and in-service programs on EBP.
Rationale 3: Even if this is true, using performance evaluations as leverage to make nurses use evidence-based practice may be seen as coercive. If this reminder is seen as a threat, nurses are not likely to think positively about using EBP in the future.
Rationale 4: This action would not support the evidence-based practice approach and should not be used.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3-3

Question 10
Type: MCSA
A patient refuses to participate in a research study for an experimental medication. By accepting the patients decision, the nurse is exercising which ethical principle?
1. Respect for persons
2. Justice
3. Informed consent
4. Beneficence
Correct Answer: 1
Rationale 1: Inherent in the principle of respect for persons are the concepts of autonomy, dignity, uniqueness, freedom, and choice. This principle forms the foundation of participants rights to informed consent, privacy, and confidentiality, and involves respecting peoples autonomy or right to choose freely for themselves.
Rationale 2: The principle of justice means that people are treated fairly.
Rationale 3: The patient refused to participate, so informed consent was not obtained.
Rationale 4: In regard to ethical research, the principle of beneficence means the duty to promote or do good in addition to doing no harm.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 3-4

Question 11
Type: MCSA
A patient with severe hypertension, chosen to receive an experimental medication that has shown a dramatic efficacy in lowering blood pressure, has been told that his participation in the study is no longer needed. The patient is upset because he wanted to try the medication to control his blood pressure. What should the nurse do to support this patient?
1. Tell the patient that he can participate some other time.
2. Explain to the patient that experimental medications rarely produce the desired results.
3. Help the patient understand that his participation wasnt meant to be.
4. Talk with the researchers about the patients right to receive the medication.
Correct Answer: 4
Rationale 1: The nurse should not make false promises.
Rationale 2: The nurse should not make questionable statements to invalidate the patients wish to try a medication with potential benefits.
Rationale 3: Stating that his participation wasnt meant to be is dismissive of the patients wish to try a medication with potential benefits.
Rationale 4: The principle of justice requires that people be treated fairly. This includes the patients right to receive research treatments.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3-4

Question 12
Type: MCSA
The nurse wants to study outpatient medical records to determine a specific pattern of care. Which part of HIPAA should this nurse initially consult to guide the study?
1. Disclosing data
2. Creating data
3. Destroying data
4. Accessing data
Correct Answer: 4
Rationale 1: The nurse will consider the laws regarding disclosure of data later in the research process.
Rationale 2: Data may be created over the course of conducting research, but the question refers to accessing data to begin research.
Rationale 3: The HIPAA law does not provide information on the destroying of data.
Rationale 4: It is the covered organizations obligation not to disclose information improperly when a researcher seeks data that includes private health information. The nurses initial concern should regard how to access data without violating HIPAA laws.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 3-5

Question 13
Type: MCSA
While conducting a research study, the researcher creates a table of new health data based on patient responses. Which action by the researcher is correct?
1. Asking the patients nurses if the data appears to be correct and then document it was validated
2. Validating the data with laboratory results in the patients medical records that are not part of the study
3. Gaining permission from the patients to use the data and discussing who will receive it
4. Sharing the data with the patients health care providers to improve care
Correct Answer: 3
Rationale 1: The researcher should not discuss the data with the patients nurses. To do so would violate HIPAA regulations.
Rationale 2: The researcher should not review the patients medical records without the patients permission to do so.
Rationale 3: The HIPAA privacy regulation impacts nursing research in three ways: data access, data creation, and data disclosure. Within data creation, any protected health information obtained is covered by HIPAA and the research is bound by HIPAA regulations. The researcher must obtain permission from the patient to use the data, including who is going to receive it.
Rationale 4: The researcher should not discuss the data with the patients health care providers.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3-5

Question 14
Type: MCSA
The nurse is implementing stage 2 of a critique of a quantitative research study. In this stage, the nurse will perform which action?
1. Study the findings.
2. Summarize the quality of the study.
3. Review the purpose of the research.
4. Focus on the conduct of the research.
Correct Answer: 4
Rationale 1: In stage 3, the findings are studied.
Rationale 2: Stage 4 includes a summary of the quality of the study.
Rationale 3: Stage 1 focuses on reviewing the purpose of the research.
Rationale 4: Stage 2 focuses on the conduct of the research. This refers to studying the manner in which the research was conducted and includes determining if the methodology was applied correctly.
Global Rationale:

Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3-6

Question 15
Type: MCMA
While critiquing a quantitative research study, the nurse is curious about the sample size. Which question is appropriate?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Does the study describe the population about whom results will be generalized?
2. Are inclusion and exclusion criteria identified?
3. Is the sample size appropriate to meet assumptions of the statistical tests?
4. How are the rights of the participants protected?
5. Is the sample representative of the population?
Correct Answer: 1,2,3,5
Rationale 1: The sample size may make it impossible to generalize findings.
Rationale 2: The sample size may be limited or unlimited due to inadequate inclusion or exclusion criteria.
Rationale 3: The sample size should support the statistical tests used in the study.
Rationale 4: The protection of participants rights is part of the critical appraisal of the conduct of the research and does not pertain to sample size.
Rationale 5: The sample size will, in part, depend on the population size.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 3-6

Question 16
Type: MCSA
The nurse, critiquing a quantitative research study, is particularly interested in information obtained in stage 3 of the critique. This information would most likely include which information?
1. How the findings of the study are related to the theoretical framework
2. Whether the study can be replicated
3. The major strengths of the study
4. How ethical issues were handled
Correct Answer: 1
Rationale 1: Stage 3 of a quantitative research critique focuses on findings, discussion, implications, and conclusions and how the findings match the theoretical framework.
Rationale 2: Whether the study was described in sufficient detail to allow replication is reviewed in stage 4 of this process.
Rationale 3: The major strengths of the study are reviewed in stage 4 of this process.
Rationale 4: How ethical issues were handled is critiqued in stage 2 of the process.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3-6

Question 17
Type: MCMA
Hospital management has developed an initiative for the use of evidence-based practice in all hospital departments. Which statements would the nurse educator use in educative sessions with nurses?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The interventions nurses have traditionally used will form the foundation for our practice.
2. We will be reviewing all our standards and protocols in light of associated research.
3. Your clinical expertise will be valuable as we develop evidence-based practice in our units.
4. Evidence-based practice is focused on the conservation of resources.
5. You will be asked to question your practice.
Correct Answer: 2,3,5
Rationale 1: Interventions based on tradition may not be valid when evaluated from an evidence-based practice viewpoint.
Rationale 2: Research utilization is one of the methods of discovering best practice.
Rationale 3: Clinical expertise is part of evidence-based practice.
Rationale 4: Evidence-based practice is focused on the delivery of optimal care and does consider available resources. It is not, however, designed with a focus on the conservation of resources. The focus is patient care.
Rationale 5: The nurse is required to question aspects of personal practice and whether these practices are truly based on evidence.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3-3

Question 18
Type: MCMA
Which study titles would alert the members of an institutional review board (IRB) that the study sample may include vulnerable subjects?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Identification of Coping Patterns Among Pregnant Wives of Soldiers Involved in Combat
2. Development of Cancer in Persons Exposed to Passive Tobacco Smoke
3. Interventions to Delay Development of Alzheimer Disease in Persons with Down Syndrome
4. Weight Gain in Students during the First Two Semesters of Nursing School
5. Interventions to Decrease Feelings of Breathlessness in Terminally Ill Subjects
Correct Answer: 1,3,4,5
Rationale 1: The vulnerable population identified in this title is pregnant women. Pregnant women are vulnerable because of potential risks to the fetus.
Rationale 2: This title does not specifically identify a vulnerable population.
Rationale 3: Cognitively impaired persons, in this case persons with Down syndrome, are considered a vulnerable population because they cannot legally or ethically provide informed consent.
Rationale 4: Students are considered a vulnerable population as they may believe participation in a study is linked to grades.
Rationale 5: Terminally ill subjects are considered vulnerable. The risk/benefit ratio and comfort must be considered.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 3-4

Question 19
Type: MCMA
A nurse is conducting research regarding the social habits of teenagers. A 14-year-old is being considered as a study participant. How should the nurse manage the issue of informed consent?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Have the 14-year-old give the legal informed consent.
2. Explain the study to the 14-year-old.
3. Have the childs parent sign the legal informed consent form.
4. Obtain written consent from the 14-year-old.
5. Sign the legal written consent for the 14-year-old, noting that the child indicated desire to participate in the study.
Correct Answer: 2,3,4
Rationale 1: A 14-year-old is not legally or ethically competent to give informed consent.
Rationale 2: The child should be given all the same information that would be given to an adult.
Rationale 3: The childs parent is legally responsible for the childs welfare and should be the individual who signs the informed consent paperwork.
Rationale 4: Even though legal informed consent cannot be obtained from the child, the researcher should obtain a written consent of participation from the child.
Rationale 5: The researcher should not sign the consent form for anyone.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3-4

Question 20
Type: MCMA
A nurse who is reading a research report has questions about the studys internal validity. Which questions might this nurse be considering?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Was there bias in the random selection of study subjects?
2. Was the research setting adequately controlled?
3. Do all of the items being measured focus on the same trait?
4. Did the independent variable occur before the dependent variable?
5. Why was the sample size at the end of the study so much smaller than the sample size at the beginning of the study?
Correct Answer: 1,4,5
Rationale 1: A bias in the random selection of study subjects comprises a selection threat to internal validity.
Rationale 2: A lack of controlled research settings is a threat to external validity.
Rationale 3: Sampling of items that do not focus on the same trait is a measurement error. Measurement errors are a threat to internal consistency.
Rationale 4: Questions about the temporal sequence of independent and dependent variables result in a threat to internal validity.
Rationale 5: Attrition from the original study group can be expected but should be explained. If there is no logical explanation, a threat to internal validity exists.
Global Rationale:

Cognitive Level: Analyzing
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 3-6

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