NUR 115 EXAM #3 QUESTIONS AND ANSWERS
A nursing student is taking care of a patient with possible appendicitis and is curious
about the best method of diagnosing this disorder. What does the nursing student have
to consider in formulating a question using the PICO format (patient, population, or
problem; intervention; comparison intervention; outcomes) to determine evidence-based
practice (EBP)?
a. Problem: Appendicitis; interventions: Ultrasound versus computed tomography (CT)
scan; outcome: Diagnosis of appendicitis
b. Problem: Pain; interventions: Hydromorphone versus morphine; outcome: Pain free
c. Problem: Fever; interventions: Cooling measures versus antipyretics; outcome:
Normal temperature
d. Problem: Appendicitis; interventions: Complete blood count versus chemistry panel
tests; outcome: Painless - Answers - A
The PICO format asks for the patient's problem, the two possible interventions for
comparison (i.e., diagnostics), and the desired outcome from the interventions.
The nurse decides to access a systematic review database to determine EBP related to
the patient's treatment plan for a diagnosis of otitis media (i.e., ear infection). What
database can provide that type of resource?
a. Cumulative Index of Nursing and Allied Health Literature (CINAHL)
b. Cochrane
c. PubMed
d. MD Consult - Answers - B
The Cochrane database provides systematic reviews of the literature. CINAHL and
PubMed provide primary research articles, and MD Consult provides background
information.
The nurse researcher provides participants with informed consent so that what ethical
principle is upheld?
a. Respect for persons
b. Beneficence
c. Justice
d. Ethics - Answers - A
Informed consent abides by the principle of respect for persons. The beneficence
principle reminds researchers to minimize harm and maximize benefits. The principle of
justice requires researchers to treat people fairly and to design research to select
subjects equitably and avoid exploitation of vulnerable populations. Ethics is a general
concept, not a specific principle.
,The nurse feels that the results of a recent literature search and analysis about
handwashing should be implemented in the entire hospital system. With whom would
the nurse be required to collaborate?
a. Colleagues caring for patients in her unit
b. Colleagues in the community
c. Administrators at the hospital
d. Others in her department - Answers - C
Implementation would require collaboration with hospital administrators to influence the
larger practice environment of the entire hospital. Collaboration with colleagues in the
community would have no effect on the hospital system. Collaboration with the
department or colleagues in the unit would not allow for hospital-wide implementation.
Knowledge gained from research in the 1970s about placing infants on their backs to
prevent sudden infant death syndrome (SIDS) was not recommended to parents until
the 1990s. This is an example of what barrier to EBP?
a. Proliferation of research
b. Implementation delay
c. Information needs not being met
d. Lack of readily available resources - Answers - B
There is an implementation delay of approximately 17 years from clinical research to
integration into practice. Proliferation of research is the large amount of research that is
conducted. Lack of resources refers to a reduced number of databases that provide the
information being sought, and information needs not being met refer to the inability to
readily find the answers to questions.
A patient is on the way to the hospital in an ambulance and is asked to participate in a
research protocol for a new treatment for myocardial infarction. What is this an example
of? (Select all that apply.)
a. Standard practice
b. An ethical dilemma
c. A violation of informed consent
d. A patient who is in a vulnerable population category
e. Compliance with important ethical issues of justice and autonomy - Answers - C, D
Because the patient does not have time to consider the option, this is a violation of
informed consent. Because the patient is in an emergency situation, the patient is in a
vulnerable population category. It is neither standard practice nor an ethical dilemma,
because research protocols clearly indicate when a person is to be approached for
participation in research studies. Asking a patient to participate in research in an
emergency situation is a violation of the ethical issues of justice and autonomy.
Patients are participating in a study to identify genetic disorders. About which potential
concerns should the nurse researcher be aware? (Select all that apply.)
a. Violation of confidentiality if a disorder is revealed
, b. Possible adverse consequences related to employment
c. Possible adverse consequences related to reputation
d. Possible adverse consequences to insurability
e. Inability to prevent the progression of genetic disorders - Answers - A, E
Potential concerns include violation of confidentiality and the inability to prevent
progression of genetic disorders. Employment, reputation, and insurability would not be
of concern as a result of participating in the study.
Which entities or documents specifically address the role of the nurse in research?
(Select all that apply.)
a. American Nurses Association (ANA) standards of practice
b. Institutional review board (IRB)
c. Hospital Magnet status
d. The Joint Commission (TJC)
e. MD Consult - Answers - A, C
The American Nurses Association (ANA) standards of professional performance
support the nurse's role in research, and hospital Magnet status includes the nurse
using evidence to improve quality of care. The Joint Commission (TJC) does not
address nursing research, institutional review boards approve all research involving
human subjects if it is funded by the federal government, and MD Consult is a
background resource for research. None of these three entities specifically address the
role of the nurse in research.
Which factors contribute to the nurse having difficulty keeping up with the latest
research findings? (Select all that apply.)
a. Implementation delays
b. Proliferation of research
c. Volume of health care literature
d. Hours spent in direct patient care
e. The need to read three articles every day of the week - Answers - B, C, D
The proliferation of research has led to huge volumes of literature, which would require
the nurse to read an unrealistic number of articles daily to remain current. Hours spent
in direct patient care make it nearly impossible to keep up with current practices.
Implementation delays affect the nurse's ability to put alternative interventions into
practice, rather than keep up with research.
After reading various research articles and reviews on a subject, the nurse designs a
practice change based on the literature. What stage of EBP is this?
a. Maintaining the change
b. Implementing the change
c. Evaluating and critically appraising
d. Synthesizing the evidence and developing a plan - Answers - D
A nursing student is taking care of a patient with possible appendicitis and is curious
about the best method of diagnosing this disorder. What does the nursing student have
to consider in formulating a question using the PICO format (patient, population, or
problem; intervention; comparison intervention; outcomes) to determine evidence-based
practice (EBP)?
a. Problem: Appendicitis; interventions: Ultrasound versus computed tomography (CT)
scan; outcome: Diagnosis of appendicitis
b. Problem: Pain; interventions: Hydromorphone versus morphine; outcome: Pain free
c. Problem: Fever; interventions: Cooling measures versus antipyretics; outcome:
Normal temperature
d. Problem: Appendicitis; interventions: Complete blood count versus chemistry panel
tests; outcome: Painless - Answers - A
The PICO format asks for the patient's problem, the two possible interventions for
comparison (i.e., diagnostics), and the desired outcome from the interventions.
The nurse decides to access a systematic review database to determine EBP related to
the patient's treatment plan for a diagnosis of otitis media (i.e., ear infection). What
database can provide that type of resource?
a. Cumulative Index of Nursing and Allied Health Literature (CINAHL)
b. Cochrane
c. PubMed
d. MD Consult - Answers - B
The Cochrane database provides systematic reviews of the literature. CINAHL and
PubMed provide primary research articles, and MD Consult provides background
information.
The nurse researcher provides participants with informed consent so that what ethical
principle is upheld?
a. Respect for persons
b. Beneficence
c. Justice
d. Ethics - Answers - A
Informed consent abides by the principle of respect for persons. The beneficence
principle reminds researchers to minimize harm and maximize benefits. The principle of
justice requires researchers to treat people fairly and to design research to select
subjects equitably and avoid exploitation of vulnerable populations. Ethics is a general
concept, not a specific principle.
,The nurse feels that the results of a recent literature search and analysis about
handwashing should be implemented in the entire hospital system. With whom would
the nurse be required to collaborate?
a. Colleagues caring for patients in her unit
b. Colleagues in the community
c. Administrators at the hospital
d. Others in her department - Answers - C
Implementation would require collaboration with hospital administrators to influence the
larger practice environment of the entire hospital. Collaboration with colleagues in the
community would have no effect on the hospital system. Collaboration with the
department or colleagues in the unit would not allow for hospital-wide implementation.
Knowledge gained from research in the 1970s about placing infants on their backs to
prevent sudden infant death syndrome (SIDS) was not recommended to parents until
the 1990s. This is an example of what barrier to EBP?
a. Proliferation of research
b. Implementation delay
c. Information needs not being met
d. Lack of readily available resources - Answers - B
There is an implementation delay of approximately 17 years from clinical research to
integration into practice. Proliferation of research is the large amount of research that is
conducted. Lack of resources refers to a reduced number of databases that provide the
information being sought, and information needs not being met refer to the inability to
readily find the answers to questions.
A patient is on the way to the hospital in an ambulance and is asked to participate in a
research protocol for a new treatment for myocardial infarction. What is this an example
of? (Select all that apply.)
a. Standard practice
b. An ethical dilemma
c. A violation of informed consent
d. A patient who is in a vulnerable population category
e. Compliance with important ethical issues of justice and autonomy - Answers - C, D
Because the patient does not have time to consider the option, this is a violation of
informed consent. Because the patient is in an emergency situation, the patient is in a
vulnerable population category. It is neither standard practice nor an ethical dilemma,
because research protocols clearly indicate when a person is to be approached for
participation in research studies. Asking a patient to participate in research in an
emergency situation is a violation of the ethical issues of justice and autonomy.
Patients are participating in a study to identify genetic disorders. About which potential
concerns should the nurse researcher be aware? (Select all that apply.)
a. Violation of confidentiality if a disorder is revealed
, b. Possible adverse consequences related to employment
c. Possible adverse consequences related to reputation
d. Possible adverse consequences to insurability
e. Inability to prevent the progression of genetic disorders - Answers - A, E
Potential concerns include violation of confidentiality and the inability to prevent
progression of genetic disorders. Employment, reputation, and insurability would not be
of concern as a result of participating in the study.
Which entities or documents specifically address the role of the nurse in research?
(Select all that apply.)
a. American Nurses Association (ANA) standards of practice
b. Institutional review board (IRB)
c. Hospital Magnet status
d. The Joint Commission (TJC)
e. MD Consult - Answers - A, C
The American Nurses Association (ANA) standards of professional performance
support the nurse's role in research, and hospital Magnet status includes the nurse
using evidence to improve quality of care. The Joint Commission (TJC) does not
address nursing research, institutional review boards approve all research involving
human subjects if it is funded by the federal government, and MD Consult is a
background resource for research. None of these three entities specifically address the
role of the nurse in research.
Which factors contribute to the nurse having difficulty keeping up with the latest
research findings? (Select all that apply.)
a. Implementation delays
b. Proliferation of research
c. Volume of health care literature
d. Hours spent in direct patient care
e. The need to read three articles every day of the week - Answers - B, C, D
The proliferation of research has led to huge volumes of literature, which would require
the nurse to read an unrealistic number of articles daily to remain current. Hours spent
in direct patient care make it nearly impossible to keep up with current practices.
Implementation delays affect the nurse's ability to put alternative interventions into
practice, rather than keep up with research.
After reading various research articles and reviews on a subject, the nurse designs a
practice change based on the literature. What stage of EBP is this?
a. Maintaining the change
b. Implementing the change
c. Evaluating and critically appraising
d. Synthesizing the evidence and developing a plan - Answers - D
