NR 324/ NR324 Exam 4 (NEW 2026/ 2027 Update) Adult Health I Guide | Q&A| Grade A| 100% Correct (Verified Solutions) -Chamberlain

NR 324/ NR324 Exam 4 (NEW 2026/ 2027 Update) Adult Health I Guide | Q&A| Grade A| 100% Correct (Verified Solutions) -Chamberlain Q. Which statement about qualitative research analysis is true? ANSWER Interpretation and analysis of qualitative data typically occur simultaneously Q. A nurse researcher studied lapses in medication compliance among schizophrenic patients living in the community. In his journal article, the researcher reported that he had worked in psychiatric nursing for 15 years and had a nephew who was schizophrenic. Which quality-enhancing strategy is the researcher using? ANSWER Researcher credibility Q. "Does stress during a woman's first trimester of a pregnancy affect the infant's birth weight?" This is a: ANSWER Research question Q. The electronic database that focuses on the nursing and allied health literature is: ANSWER CINAHL Q. In thinking about sampling for a qualitative study, a researcher might ask which question? ANSWER Who would be a rich information source for my study? Q. In which section would the following sentence most likely appear: "The study sample consisted of 135 mother-infant dyads from an inner-city neighborhood"? ANSWER Method section Q. A nurse researcher conducted an in-depth study of anxiety in mechanically ventilated hospital patients. The researcher coded data from interviews with 20 patients, and a co-investigator independently coded 8 of the 20 interview. The coding of the two researchers was then compared. Which quality-enhancement strategy was the researcher using? ANSWER Investigator Triangulation Q. A nurse researcher is studying how members of an immigrant community manage chronic health problems. The researcher spends 15 months in the field conducting interviews and making observations in the community. Which quality enhancement strategy is described in this study? ANSWER Prolonged engagement Q. The results section of a quantitative research article summarizes results of the: ANSWER Statistical analysis Q. Which is not a quality criterion in Lincoln and Guba's framework? ANSWER Objectivity Q. Which is a major challenge specific to longitudinal designs? ANSWER Attrition Q. Which is a significant challenge in qualitative analysis? ANSWER Reducing data for reporting purposes Q. A qualitative researcher is studying the experience of living with idiopathic pulmonary fibrosis (IPF). In this study, the experience of living with IPF would most likely be called the: ANSWER Phenomenon of Interest Q. A nurse researcher studied women's experience during the transition to menopause. Data were collected by interviewing 20 women in their 50s. The participants were also asked to maintain a daily diary for a month. Which form of triangulation was used in this study? ANSWER Method triangulation Q. For those interpreting statistical results, confidence intervals (CIs) provide which data? ANSWER The range of probable values within which the population value lies Q. Qualitative research, which term is most likely to be used to refer to issues focused on methodologic and interpretive quality? ANSWER Trustworthiness Q. Which procedure do grounded theory researchers use to develop and refine theoretically relevant categories? ANSWER Constant comparison Q. Which best characterizes meta-synthesis? ANSWER They involve interpretation as well as integration of previous findings Q. Which measure of central tendency is the most stable? ANSWER Mean Q. Which is a question that researchers may ask when deciding how to control confounding variables? ANSWER What factors, other than the independent variable, could affect the outcome? Q. Here are 5 values: 5, 6, 9, 10, 10. Which measure of central tendency for this distribution would have a value of 9? ANSWER Median Q. Which statement about coding qualitative data is true? ANSWER Coding schemes typically have major thematic categories and subcategories. Q. Which is the weakest form of sampling for quantitative studies? ANSWER Convenience sampling Q. Which statement about qualitative analysis is true? ANSWER There are no universally adopted rules for analyzing qualitative data Q. Several conceptual models and theories of nursing have been developed, and four concepts play key roles in most of them. Which is not a concept that is central to models of nursing? ANSWER Social support Q. Ethnographers strive to: ANSWER understand human cultures Q. In analyzing scores on an anxiety scale, a nurse researcher found the scores were distributed from 62 to 98 in the research sample. What is the range? ANSWER 36 Q. What is an important concept that links the credibility of research results to efforts at corroboration? ANSWER Replication Q. Confidence Intervals (CIs) address a key question relating to the appraisal of evidence for EBP. Which question do CIs address? ANSWER How precise if the estimate???? Q. Most definitions of evidence-based practice call for the integration of best research evidence with: ANSWER patient preferences and values Q. Which of the following is a barrier that qualitative researchers face in demonstrating the trustworthiness of their studies to readers? ANSWER Page limitations imposed by journals Q. Interpreting results involves several types of considerations. Which consideration is at issue when researchers ask the question, "How rigorous is the evidence about whether the results are correct?" ANSWER The credibility and accuracy of the results. Q. It is important that researchers design rigorous study methods to eliminate: ANSWER Biases Q. A researcher want to know how many people would have to receive a fall prevention intervention to prevent one fall. What index would the researcher compute? ANSWER Odds ratio Q. What is another name for a distribution that is described as a bell-shaped curve? ANSWER Normal Q. Several strategies can be used to enhance transferability in qualitative studies. Which is one of those strategies? ANSWER Thick description Q. In undertaking a risk/benefit assessment to ensure the ethical conduct of a study, the researchers might identify which as a potential benefit? ANSWER Knowledge gains that could benefit patients in the future. Q. A nurse researcher conducted a mixed method study about elders who delayed responding to symptoms of heart failure. One research question was "Among elderly patients with heart failure, what are the most frequently reported symptoms?" Which would be a particularly likely second researcher question in this mixed methods study? ANSWER "Why do elderly patients delay in responding to heart failure symptoms?" In a sample of 250 patient with cancer, the scores on a scale that measured resilience ranged from 10 to 70. There were two peaks in the distribution, at the scores of 25 and 55. What would this distribution be called? Bimodal Systematic reviews are the cornerstone of: Evidence Based Practice Which is the unit of analysis in a meta-analysis? A primary quantitative study Which is an important research precept? Correlation does not prove causation The first major step that a researcher must undertake in a qualitative analysis is which of the following? Developing a system for organizing and indexing the data Which statement about quality issues in qualitative research is true? One debate among qualitative researchers is whether there should be a generic set of quality standards or different standards for different traditions??? Which quality-enhancement strategy used primarily during data collection is somewhat controversial among qualitative researchers? Member checking A researcher administered a self-esteem scale to a sample of 200 children. The bulk of scores were at the upper end of the distribution. How would the frequency distribution for the scores be described Negatively skewed Which is the most likely frequency distribution for the variable height in a population of adults? Normally distributed Which adjective best captures a careful reader's mindset in scrutinizing the evidence in a research report? Demanding When a researcher reports that a result is statistically significant, what does it mean? The obtained result likely was not the result of chance. What limits the capacity of the scientific method to answer questions about human experiences and health outcomes? The difficulty of accurately measuring complex human characteristics. Which is a useful tool for understanding the precision of results? Confidence Intervals What is the most frequently occurring score in a distribution called? Mode Which statement about qualitative analysis is true? Themes may develop within categories of the coding scheme or may cut across categorized Consider the following hypothesis: The amount of daily daylight is unrelated to levels of depression in older adults. What type of hypothesis is this? Null hypothesis Descriptive phenomenology most fundamentally involves a search for: The essential nature of an experience Indications for NGT: Decompression Lavage Enteral feeding and medication admin Compression Decompression: Removal of gases or stomach contents to relieve distension, nausea, or vomiting after GU surgery, trauma, obstruction, or the absence of peristalsis Can be continuous or intermittent Small bore: More comfortable, more flexible tube Usually used for feeding What type of tube is usually used for decompression Large bore tubes - 12 Fr and above Lavage: Washing out of the stomach to treat active bleeding, ingestion of poison, or for gastric dilation Decompression tube types: Salem sump, Miller-Aboot, Levin Lavage tube types: Salem sump, Levin, Ewald Enteral feeding: Short term alternative to the oral route for administering nutritional supplements for patients with impaired swallowing Less than 4 weeks Tube types for enteral feeding: Duo, Dobhoff, Levin Compression: Using an internal balloon to apply pressure for preventing esophageal or GI hemorrhage Compression tube types: Senstaken-Blakemore Delegation of inserting NTG Nurses must insert, maintain, and assess the placement and function of NGT What can nurses delegate to UAP for NGT Measuring and recording drainage Providing oral and nasal care Assist with patient positioning and offering ice chips if allowed Correctly anchor the NG tube to the patient's gown after a bath or repositioning Ensuring the HOB remains greater than 30 degrees Ways to verify placement of NGT: Chest x ray is the best Air auscultation bolus Assess gastric contents and pH When must NGT placement be checked Every shift Before medication administration Before irrigation to maintain patency Would do so by gastric contents or air bolus check How often should NGT be rotated in patients nares Every 24 hrs to prevent skin breakdown Manifestations of tube dislocation/pulmonary aspiration: Gagging Coughing Choking Cyanosis Vomiting Sounds of fluid in lungs during chest auscultation Fever What should you do if tube dislocation or pulmonary aspiration is suspected Turn off feeding or stop medication administration, put the patient in high fowlers, suction, and be prepared for administration of O2, obtaining VS, and calling HCP G tube: Long term alternative to the oral route for administering nutritional supplements for patients with impaired swallowing Greater than 4 weeks PEG tube: G tube placed via endoscopy Can be placed during surgery J tube: Placed in the jejunum of the small intestine when a G tube can't be used Delegation of G tube: Nurse must verify placement, check residual, assess G tube insertion site, and initiate tube feedings What can be delegated to UAP for G tubes Measuring and recording intake or drainage Providing oral care Assisting with patient positioning and offering ice chips if allowed Providing site care around the G tube Ensuring the HOB remains above 30 degrees Administering tube feedings if certified When should placement of G tube be checked Every shift Before medication administration Before irrigation to maintain patency Before initiating a tube feeding Manifestations of G tube dislocation: Gagging, coughing, choking Abdominal pain Abdominal distension Delegation of skin care for G tube: Nurse must assess for skin breakdown but can delegate care to UAP How to perform G tube skin care: Use normal saline and cotton tip applicators and 4x4 drain sponges under the silicone petals to absorb drainage and prevent irritation Well healed site may be cleaned with soap and water an 4x4s may not be necessary How to check residual: May need to use clean cup if the amount is greater than 60 mL or one irrigation syringe Removed residual must be returned back to patient to avoid electrolyte disturbances Return gastric residual carefully - wrap the 3 way stopcock with a towel to prevent splashing and body fluid exposure What temp should enteral solutions be administered Room temp to avoid cramping How often must enteral tubing be changed Every 24 hours Why must you frequently assess that NGT/G tubing has not become disconnected There is no leurlock connection between tubing How must medications be administered via NGT or G tube All meds must be crushed, dissolved, or use liquid formula What type of medications should not be crushed Sustained release, chewable, long acting, or enteric coated tablets and capsules How to administer medications when NGT is being used for decompression: Stop suction prior to giving med Leave suction off for 1 hour to allow for absorption Resume suction Indications of NGT: Gastric decompression Gastric lavage Gastric compression Enteral feeding Medication admin Indications of G tube/PEG: Enteral feeding Medication admin Drainage Indications of J tube: Enteral feeding Medication admin Drainage Who inserts NGT Nurse Who inserts G tube/PEG HCP Who inserts J tube HCP What is the most uncomfortable of the tubes NGT Complications of NGT: Trauma to nose/mouth Tracheal intubation Easily dislodged Risk of sinusitis Complications of G tube/PEG: More invasive, requires sedation/anesthesia in endoscopy Percutaneous wound Skin breakdown or infection Complications of J tube: Same as G tube Duration of NGT: Short term Less than 4 weeks Duration of G tube: Long term Greater than 4 weeks Duration of J tube: Long term Greater than 4 weeks Nutrition of all tubes is either... Continuous or bolus Feeding complications of all tubes: Aspiration Regurgitation Regurgitation less likely with J tube How to aspirate stomach contents Use 60 mL syringe Return to patient once done to prevent electrolyte imbalances What is too much aspirate More than 200 mL Withhold medication and contact HCP What may high aspirate mean Delayed gastric emptying which contributes to gastric distension, esophageal reflux, and vomiting all of which place the patient at risk for aspiration How to auscultate air bubble Instill 30 mL of air into NG/PEG tube while listening to the gastric air bubble Should hear gurgling sound Explain how to administer crushed medications via tubes Crush medication and dissolve in 30 mL warm water - use a different cup for each medication Draw dissolved medication into 60 mL syringe Flush with 30 mL of warm water in between each medication Follow with a final flush of 30-60 mL warm water once all meds are administered What should you do when administering meds via tube if your patient is on fluid restriction Reduce amount of flush in between to 5 mL How should you administer meds via tube if patient is on continuous feeding Normally administer meds, stop tube feeding for 1 hour, and then restart What position should patients be in during feedings/med administration with a tube Fowlers How can you prevent a blocked NGT Prevention flush the tube with 30 mL of warm water every 4-6 hours and flush it well while administering meds Indications for temporary ostomies: Trauma, bowel rest, or a diversion to allow a pressure ulcer to heal Indications for permanent ostomies: Cancer, bowel infarction, permanent injury to the bowel or bladder What can be delegated regarding ostomies Pouching of an established ostomy can be delegated with nurse oversight Emptying a pouch can be delegated Pouching of a new ostomy can NOT be delegated How often should ostomy be checked On initial shift rounds and at least every 2-3 hours Indications for enemas: Constipation Relieve gaseous distension Bowel cleansing prior to a procedure or surgery Medication admin How do enemas treat constipation Promotes defecation by stimulating peristalsis The volume of fluid breaks up the fecal mass, stretches the rectal wall, and initiates the defecation reflex Can enemas be delegated Not if it is a medicated enema Prior to delegation the nurse must assess for patient positioning, comfort, and vital sings Tap water enema: Hypotonic - exerts an osmotic pressure lower than fluid in the interstitial spaces Normal saline enema: Physiologically the safest form as it reduces the risk of electrolyte imbalances Volume infused stimulates peristalsis Only form used for infants Hypertonic enema: Exert osmotic pressure that pulls fluids out of interstitial spaces Colon fills with fluid and distension promotes defecation Soapsuds: Add soapsuds to tap water or saline Creates intestinal irritation and promotes peristalsis How long should patient retain oil retention enemas At least 30 minutes But as long as possible Carminative enemas: Used to expel intestinal gas Involves instilling a large volume of fluid in small increments, 100-200 mL at a time, turning the patient from side to side, and lowering the container to allow the solution back into the container Medicated enemas: Contain a medication used to improve a clinical need Kayexalate and neomycin Kayexalate: Used to treat dangerously high potassium levels Neomycin: Antibiotic used to reduce bacteria before bowel surgery Enema contraindications: Increased ICP Glaucoma Recent rectal or prostate surgery High enemas: Cleanse the entire colon and require the patient to turn from their left side, to their back, and to their right side to help fluid reach the large intestine Low enemas: Cleanse the rectum and sigmoid colon High vs low enema: Refers to the height from which the fluid is delivered What position should patients always be in for enemas Left sims position What should you do if patient complains of abdominal cramping with enemas Slow or stop enema Restart slowly if pain or cramping subsides What may rigid or distended abdomen with enema indicate Bowel perforation Stop the enema and notify HCP What is the only enema that should be given to infants and children Normal saline What are instances in which you would need to call the HCP Client has a change in condition Any interventions Also at your discretion What should be included in introduction Name, unit, facility What should be included in situation State client who you are calling about and room number State problem you are calling about What should be included in background State admission diagnosis and date of admission State any pertinent medical history A brief synopsis of the treatment to date What should be included in assessment Most current VS Any relevant changes from prior assessment Relevant lab values, or changes in lab values Relevant trends of abnormal clinical data Patient response to interventions/actions already tried Central vascular/venous access device: Allows for convenient IV therapy Patients who require blood transfusion: Surgery Trauma Any type of hemorrhage Cancer patients Sickle cell patients Why do cancer patients need blood transfusions Chemo destroys RBCs Word 'central' refers to... Location of the catheter tip, not the insertion site How often do chemo patients need blood transfusions/platelet transfusions Blood every 120 days Platelet every 10 days Most common type of blood to give: Packed RBC Central lines can be inserted through... Peripheral arm veins or a central vein Veins that can be accessed for CVADs: Internal jugular, external jugular, subclavian, superior vena cava How is giving platelets vs RBC different Infuse platelets a lot faster Indications for blood transfusion: To increase circulating volume after surgery, trauma, or hemorrhage To increase the number of circulating RBCs and maintain levels of hgb in patients with severe anemia To provide selected components as replacement therapy Amount of whole blood given: 525 mL/unit Basic indications for whole blood: Treat hemorrhage for greater than 25% blood loss Amount of packed RBC given: 340 mL/unit