Fundamentals of Nursing 4th Edition By Delaune – Ladner-Test Bank

 

 

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Sample Test

CHAPTER 3: RESEARCH AND EVIDENCE-BASED PRACTICE

 

MULTIPLE CHOICE

 

1.    The nurse is participating in research that involves the systematic collection of numerical information and the analysis of that information using statistical procedures. This type of research is known as:

a.	quantitative research.	c.	evaluative research.
b.	qualitative research.	d.	exploratory research.

 

 

ANS:  A

Quantitative research is the systematic collection of numerical information and the analysis of the information using statistical procedures. Qualitative research is the systematic collection and analysis of more subjective narrative materials using procedures in which there tends to be a minimum of researcher-imposed control. Evaluative research is the systematic investigation of how well a program, practice, or policy is working. Exploratory research is the preliminary investigation designed to develop or refine hypotheses or to test the data collection methods.

 

PTS:   1                    DIF:    Analysis         REF:   Framework| Types of Research Design

 

2.    The Quality Improvement Committee within a hospital is utilizing evaluative research to do which of the following?

a.	Investigate the possibility of undertaking a research study
b.	Compare an intervention with a group versus a control group
c.	Describe a situation, problem, or phenomenon in a community
d.	Measure the effectiveness of a program, practice, or policy

 

 

ANS:  D

Evaluative research measures the effectiveness of a program, practice, or policy. Describing a situation, problem, or phenomenon in a community is the definition of research. Investigating the possibility of undertaking a research study is the definition of exploratory research. Comparing an intervention with a group versus a control group is an activity within quantitative research.

 

PTS:   1                    DIF:    Application    REF:   Types of Research Design

 

3.    The nurse is assisting the nurse researcher with an experimental research project. This type of research:

a.	describes a situation, problem, or phenomenon in a community.
b.	measures the effectiveness of a program, practice, or policy.
c.	controls the independent variable and randomly assigns subjects to different conditions.
d.	investigates the possibility of undertaking a research study.

 

 

ANS:  C

Experimental research controls the independent variable and randomly assigns subjects to different conditions. Descriptive research describes a situation, problem, or phenomenon in a community. Evaluative research measures the effectiveness of a program, practice, or policy. Exploratory research investigates the possibility of undertaking a research study.

 

PTS:   1                    DIF:    Analysis         REF:   Types of Research Design

 

4.    The nurse is participating in a quantitative research study. Which of the following is a major characteristic of this type of research?

a.	Holistic design
b.	Deductive reasoning
c.	Complete and broad focus
d.	Analysis of words and individual interpretation

 

 

ANS:  B

One characteristic of quantitative research is  use of deductive reasoning. The other choices are characteristics of qualitative research.

 

PTS:   1                    DIF:    Analysis

REF:   Table 3-1 Major Characteristics: Quantitative and Qualitative Research

 

5.    The nurse is reading the hypothesis of a research study which is: To what extent does level of education predict compliance with the prescribed diet in clients with newly diagnosed type I diabetes? The dependent variable in this hypothesis would be:

a.	level of education.	c.	newly diagnosed.
b.	compliance with the prescribed diet.	d.	clients with type 1 diabetes.

 

 

ANS:  B

The dependent variable is the variable that is hypothesized to depend on or be caused by or predicted by the independent variable. Level of education is the independent variable. Newly diagnosed and clients with type 1 diabetes define the population being studied.

 

PTS:   1                    DIF:    Analysis         REF:   Framework

 

6.    The nurse is reviewing the outcome of a research study to help plan client care. The nurse is utilizing research according to Carper’s empirical pattern of knowing which is which of the following?

a.	Interprets, engages, and envisions clues to knowledge
b.	Encounters and focuses on self and others
c.	Extends knowledge of valuing, clarifying, and advocating
d.	Uses research to explain, describe, and predict

 

 

ANS:  D

According to Carper, there are four fundamental patterns of knowing. Within empirical, the nurse uses research to explain, describe, and predict. Within esthetics, the nurse uses research to interpret, engage, and envision clues to knowledge. Within personal, the nurse uses research to encounter and focus on self and others. And within ethical, the nurse uses research to extend knowledge of valuing, clarifying, and advocating.

 

PTS:   1                    DIF:    Analysis         REF:   Framework

 

7.    An adult is a subject in a nursing research study and asks to withdraw from the study. The appropriate response for the nurse researcher is to:

a.	allow the client to withdraw.
b.	encourage the client to remain in the study.
c.	cite the benefits of being a part of the research study.
d.	explain that the permission form they signed requires them to continue with the study.

 

 

ANS:  A

The client has the right to withdraw. The nurse needs to protect the client’s right to self-determination, and when functioning in the role of advocate, the nurse should allow the client to withdraw from the study. The other choices would not protect the client’s right to self-determination.

 

PTS:   1                    DIF:    Application    REF:   Protecting Human Rights in Research

 

8.    A nurse researcher has designed a study that requires the cooperation of staff nurses in a community health agency. One of the nurses is uncomfortable with the protocol and does not wish to participate in the study. How should this situation be handled?

a.	The nurse can be required to participate in the study as a condition of employment.
b.	The nurse should have his questions clarified regarding the protocol.
c.	The nurse can refuse to participate in the study.
d.	The nurse should resign from the agency.

 

 

ANS:  C

Staff nurses who are expected to participate in research must have an adequate understanding of the nature of the study. The staff nurse has the right to refuse to participate in the study. The nurse should not be required to participate in the study as a condition of employment nor should the nurse have his questions clarified regarding the protocol. The nurse does not need to resign from the agency.

 

PTS:   1                    DIF:    Application    REF:   Framework: Rights

 

9.    The nurse is planning a research study. The first step that this nurse will do in this process is:

a.	review relevant literature.
b.	create a statement of the research problem.
c.	select a research design.
d.	delineate the conceptual framework.

 

 

ANS:  B

The first step in the research process is to create the statement of the research problem. Reviewing relevant literature is the third step in the process. Selecting a research design is the seventh step in the process. Delineating the conceptual framework is the fourth step in the process.

 

PTS:   1                    DIF:    Application    REF:   Steps in the Research Process

 

10.  The nurse is studying the history of nursing research and learns that nursing research in the late 1950s and 1960s focused on:

a.	developing a scientific base for clinical practice.
b.	wellness, disease prevention, and health promotion.
c.	effective educational preparation of professional nurses.
d.	development of conceptual models and theories.

 

 

ANS:  C

Nursing research in the late 1950s and 1960s focused on the effective educational preparation of professional nurses. Research during the late 1960s and 1970s focused on the development of conceptual models and theories. The other choices do not have a specific date associated with their study.

 

PTS:   1                    DIF:    Analysis         REF:   Historical Development

 

11.  Within a research hypothesis, the nurse is identifying the independent variable. An independent variable is best defined as:

a.	the outcome variable of interest.
b.	an abstraction or mental representation inferred from situations, events, or behaviors.
c.	constructs that are knitted together in an orderly system to explain the way people function.
d.	the variable that is believed to cause or influence the dependent variable.

 

 

ANS:  D

The independent variable is the variable that is believed to cause or influence the dependent variable. The dependent variable is the outcome variable of interest. A construct is an abstraction or mental representation inferred from situations, events, or behaviors. A theory can be defined as constructs that are knitted together in an orderly system to explain the way people function.

 

PTS:   1                    DIF:    Application    REF:   Framework

 

12.  The nurse reads that The Association of Collegiate Schools of Nursing was organized in 1932 with the purpose of :

a.	assisting nursing schools in developing standardized curriculum.
b.	promoting the conduct of research to improve nursing education and practice.
c.	offering accreditation to university-based nursing programs.
d.	communicating nursing research and scholarly activity.

 

 

ANS:  B

The Association of Collegiate Schools of Nursing was organized in 1932 to promote the conduct of research to improve education and practice. The other choices do not describe the purpose of the Association of Collegiate Schools of Nursing and are incorrect.

 

PTS:   1                    DIF:    Analysis         REF:   Historical Development

 

13.  The nurse reads that The National Institute of Nursing Research was developed as a result of:

a.	federal studies that recommended nursing research be included in the mainstream of biomedical and behavioral sciences.
b.	the number of nursing research journals was increasing so much that there needed to be organization and centralization of research.
c.	the American Nurses Association established the need for further nursing research and dissemination of findings.
d.	the American Medical Association supported the nursing profession to perform their own clinical research.

 

 

ANS:  A

The National Institute of Nursing Research was developed as a result of federal studies that recommended nursing research be included in the mainstream of biomedical and behavioral science. The other choices are not reasons why The National Institute of Nursing Research was developed and are incorrect.

 

PTS:   1                    DIF:    Analysis         REF:   Historical Development

 

14.  The nurse is participating in a type of study that uses ideas that are analyzed as words. This type of research is:

a.	evaluative.	c.	qualitative.
b.	quantitative.	d.	experimental.

 

 

ANS:  C

In qualitative research, ideas are analyzed as individual words. In quantitative research, numbers are analyzed. Evaluative research investigates how well a program, practice, or policy is working. Experimental research is when the investigator manipulates the independent variable and randomly assigns subjects to different conditions.

 

PTS:   1                    DIF:    Analysis         REF:   Table 3-1| Types of Research Design

 

15.  The nurse is providing full disclosure to a client in order to obtain informed consent for a research study. Full disclosure is to include:

a.	informing the client of any possible risks and benefits.
b.	informing the client of what type of research design is being used.
c.	providing monetary reimbursement to the client for her time involved.
d.	having the client sign a disclaimer for any harm that may occur due to the study.

 

 

ANS:  A

Full disclosure means that complete information is provided to potential research subjects regarding the nature of the study, the client’s right to refuse to participate, and the likely risks and benefits that could occur. The other choices are not included in full disclosure and are incorrect.

 

PTS:   1                    DIF:    Application    REF:   Framework: Rights

 

16.  The nurse is reviewing the strategy for testing a hypothesis of a research project. This step of the research process is termed the:

a.	theoretical framework.	c.	operational definition.
b.	research design.	d.	abstract.

 

 

ANS:  B

The research design is when the hypothesis is tested. Theoretical framework is a part of the introduction of the scientific problem. Abstract is a summary statement that identifies the purpose, methodology, findings, and conclusions of a research study. Operational definition is not a part of the research process.

 

PTS:   1                    DIF:    Analysis         REF:   Abstract Contents| Framework

 

17.  The nurse is reviewing a proposal for a research study in efforts to identify the underlying theory. In nursing research, a theory:

a.	determines the type of research design that will be used.
b.	identifies an abstraction or mental representation of behaviors or events.
c.	explains the way in which people function or react.
d.	involves the systematic collection of data.

 

 

ANS:  C

In a theory, a set of concepts and propositions are placed in an order that explains the way people function or react. The purpose of the study is used to determine the type of research design that will be used. A construct identifies an abstraction or mental representation of behaviors or events. The systematic collection of data is done during the data collection phase of the research study.

 

PTS:   1                    DIF:    Application    REF:   Framework

 

18.  The nurse reads the tentative prediction of the relationship between two or more variables being studied in a research project. This tentative relationship is considered as being the:

a.	theoretical framework.	c.	qualitative analysis
b.	construct.	d.	hypothesis.

 

 

ANS:  D

The hypothesis is the statement of an asserted relationship between two or more variables. The theoretical framework is the theory that supports the research project. Construct is an abstraction or mental representation inferred from situations, events, or behaviors. Qualitative analysis is done after the data is collected and involves four distinct processes.

 

PTS:   1                    DIF:    Application    REF:   Framework

 

19.  A type of study where the researcher manipulates a treatment or intervention, but the researcher is unable to randomize subjects into groups or lacks a control group is a(n):

a.	evaluative study.	c.	descriptive study.
b.	quasi-experimental study.	d.	experimental study.

 

 

ANS:  B

A quasi-experimental study is one in which the subjects cannot be randomly assigned to treatment conditions even though the researcher can manipulate the independent variable. An evaluative study is the systematic investigation of how well a program, practice, or policy is working. A descriptive study is an investigation of the portrayal of the characteristics of persons, groups, or situations and the frequency with which certain phenomena occur. An experimental study is one in which the investigator controls the independent variable and randomly assigns subjects to different conditions.

 

PTS:   1                    DIF:    Analysis         REF:   Types of Research Design

 

20.  The nurse is considering a career as a nurse researcher. A nurse researcher is a nurse scientist who:

a.	has a minimum of a bachelor’s degree in nursing and acts as a client advocate in research studies.
b.	translates, applies, and evaluates new knowledge provided by research.
c.	is educated at the doctoral level with experience in the process of scientific inquiry.
d.	participates on research teams to plan, apply, and collect data.

 

 

ANS:  C

A nurse researcher is a nurse scientist who has also been educated at the doctoral level to conduct research. The other choices do not describe the characteristics of a nurse researcher and are incorrect. The other choices describe the characteristics of a nurse who might be selected to participate with a nurse researcher in a study project.

 

PTS:   1                    DIF:    Analysis         REF:   Framework: Roles

 

21.  The nurse is participating on a committee whose purpose is to plan the implementation of research findings to enhance client care. The committee is going to use symbolic research utilization which includes:

a.	using evidence to change the minds of other people, especially decision makers.
b.	using symbolic language to provide analogies to better explain research to practitioners.
c.	the direct, explicit application of knowledge gained from research to change practice.
d.	using research findings to enhance one’s own understanding of a problem or issue.

 

 

ANS:  A

Research utilization occurs at three levels. At the symbolic level, evidence is used to change the minds of other people, usually decision makers. At the instrumental level, research is the direct, explicit application of knowledge gained from research to change practice. At the conceptual level, research findings are used to enhance one’s understanding of a problem or issue in nursing. The use of symbolic language to provide analogies to better explain research to practitioners is not a type of research utilization.

 

PTS:   1                    DIF:    Application    REF:   Research Utilization

 

22.  The nurse is reading the final report from the Western Interstate Commission for Higher Education (WICHE) for Nursing Research Development study regarding nursing research utilization. This study found that:

a.	nursing research was on the rise with many valuable studies being conducted related to practice.
b.	there were a limited number of scientifically sound, reliable nursing studies with clearly identified implications for nursing care.
c.	practicing nurses demonstrated a major lack of understanding of how to utilize nursing research.
d.	there was little support in health care institutions for conducting nursing research to support practice.

 

 

ANS:  B

The final report from the WICHE project indicated that the project was successful in increasing research utilization; however, there were a limited number of scientifically sound, reliable nursing studies with clearly identified implications for nursing care. The other choices were not findings from the WICHE project and are incorrect.

 

PTS:   1                    DIF:    Application    REF:   Research Utilization

 

23.  The nurse is having difficulty changing an element of client care according to the findings from a research study. According to Polit, Beck, and Hungler, barriers to research utilization in nursing practice include:

a.	practicing nurses do not care about evidence-based practice.
b.	nursing administrators do not promote evidence-based practice.
c.	changing practice to reflect current research findings is too costly.
d.	many practicing nurses have limited educational preparation with limited exposure to research and utilization.

 

 

ANS:  D

Polit, Beck, and Hungler identified four barriers to utilizing nursing research. For practicing nurses, there is limited educational preparation with limited exposure to research and utilization. The other choices were not identified as barriers to research utilization by Polit, Beck, and Hungler and are incorrect.

 

PTS:   1                    DIF:    Application    REF:   Barriers to Utilizing Nursing Research

 

24.  The nurse is assisting in the process of acquiring subjects and collecting the information necessary to address the proposed research question. This step of the research process is:

a.	nonexperimental research.	c.	data collection.
b.	developing the research design.	d.	sampling.

 

 

ANS:  C

Data collection is when the subjects are acquired and information is collected to address the proposed research question. Nonexperimental research is not a type of research design nor a step in the research process and is incorrect. Developing the research design is done before collecting data. Sampling is done before collecting the data.

 

PTS:   1                    DIF:    Application    REF:   Steps in the Research Process

 

25.  The nurse is reading a research article that addresses the research of someone else. This type of research is considered as being:

a.	historical research.	c.	evaluative research.
b.	a primary source.	d.	a secondary source.

 

 

ANS:  D

A secondary source is when the author of a research study addresses the research of someone else. A primary source is when an article is written by one or more of the main researchers. Historical research is the systematic investigation of a past event using relevant sources to describe or explain the event. Evaluative research is the systematic investigation of how well a program, practice, or policy is working.

 

PTS:   1                    DIF:    Application    REF:   Types of Research Design| Nursing Students

 

26.  The nurse is implementing evidenced-based practice in the care of a client. Which of the following will the nurse include when utilizing evidenced-based practice?

a.	Discover the client’s preferences
b.	Determine the least expensive care providers to provide care to the client
c.	Identify generic drugs that can be used
d.	Limit contact with the client

 

 

ANS:  A

In evidenced-based practice the nurse integrates research findings with clinical experience, the client’s preferences, and available resources in planning and implementing cost-effective, individualized nursing care. Selecting the least expensive care providers and limiting contact with the client are not steps to implementing evidenced-based practice. The nurse can identify generic drugs; however, it is up to the client’s physician if these drugs can be prescribed for the client.

 

PTS:   1                    DIF:    Application    REF:   Evidenced-Based Practice

 

27.  The nurse is utilizing a best practice approach when providing care to a client. This approach is considered as being:

a.	evidenced-based practice.
b.	an approach that produces the best client outcome.
c.	the least time consuming.
d.	the best approach based upon research.

 

 

ANS:  B

A best practice is not necessarily evidenced-based. Best practices are ideas and strategies that work to produce positive client outcomes or reduce costs. Evidence-based practice is using the best evidence available to guide clinical decision making. Best practices are not necessarily less time consuming. The best approach based upon research describes evidence-based practice and not best practice.

 

PTS:   1                    DIF:    Application    REF:   Evidenced-Based Practice

 

28.  The nurse is providing client care with the use of a critical pathway. This client care tool is considered:

a.	evidenced-based practice.
b.	best practice.
c.	the result of a study of client outcomes.
d.	better than an individualized client care plan.

 

 

ANS:  C

Critical pathways are not necessarily evidenced-based practice. Critical pathways were created out of studies done on client outcomes. Evidenced-based practice is using the best evidence available to guide clinical decision making. Best practice are ideas and strategies that work to produce positive client outcomes or reduce costs. There is no evidence to suggest that critical pathways are better than an individualized client care plan.

 

PTS:   1                    DIF:    Application    REF:   Evidenced-Based Practice

 

29.  The nurse is writing an evidence report regarding one aspect of client care. When writing the summary statement, the nurse should include a:

a.	review of the various published research.
b.	ranking of the strength and quality of the study results.
c.	practice-focused guideline.
d.	description of what the evidence reports.

 

 

ANS:  D

The summary statement of the evidence report is a description of what the evidence reports. The analysis portion of the evidence report is a review of the various published research. The evidence portion of the evidence report includes a ranking of the strength and quality of the study results. The recommendations portion of the evidence report include a practice-focused guidelines.

 

PTS:   1                    DIF:    Application    REF:   Evidence Reports

 

30.  The nurse is participating in a research study with the intention of replicating findings from a previous study. The purpose of this new research study is to:

a.	utilize the remainder of the dollars left in the research budget.
b.	practice collecting data.
c.	create a stronger scientific knowledge base for which to support evidenced-based practice.
d.	have something for the clients to do while in the hospital receiving care.

 

 

ANS:  C

One trend in health care that has an impact on evidenced-based practice is the creation of a stronger scientific knowledge base. One way to create this stronger base is to replicate the findings from previous studies. The other choices are not correct and would not support the creation of a stronger scientific knowledge base nor support the creation of evidenced-based practice.

 

PTS:   1                    DIF:    Application    REF:   Trends in Research and Evidenced-Based Practice

 

 

CHAPTER 4: HEALTH CARE DELIVERY, QUALITY, AND THE CONTINUUM OF CARE

 

MULTIPLE CHOICE

 

1.    The nurse is working in a tertiary care environment. The purpose of tertiary care is to:

a.	restore a client to the state that existed before the development of an illness.
b.	treat an acute illness.
c.	promote wellness.
d.	prevent illness or disability.

 

 

ANS:  A

The purpose of tertiary care is to restore a client to the state that existed before the development of an illness. Promoting wellness and preventing illness or disability are purposes of primary care. Treating an acute illness is the purpose of secondary care.

 

PTS:   1                    DIF:    Application    REF:   Continuum of Care

 

2.    Which nurse is performing primary health care? The nurse who is:

a.	providing direct care.
b.	teaching a client who has had a stroke how to perform range of motion exercises.
c.	working at a mammography clinic.
d.	working in a smoking cessation program.

 

 

ANS:  D

Services provided in primary health care include smoking cessation, immunizations, teaching, and promoting safe environments. Services provided in secondary health care include working at a mammography clinic and providing direct care. Services provided in tertiary health care include teaching a client who has had a stroke how to perform range of motion exercises.

 

PTS:   1                    DIF:    Application    REF:   Table 4-5 Types of Health Care Services

 

3.    A client has a managed care health plan. The rationale for managed care is to:

a.	limit the amount of care a client receives for any one illness.
b.	give clients preventive services delivered by a primary care provider.
c.	allow clients a wider range of practitioners.
d.	improve client access to medical specialists.

 

 

ANS:  B

The rationale for managed care is to give consumers preventive health services delivered by a primary care provider. The other choices do not describe the rationale for managed care and are incorrect.

 

PTS:   1                    DIF:    Analysis         REF:   Managed Care

 

4.    A client tells the nurse that when he receives health care through an independent practice. Which of the following is a characteristic of independent practice?

a.	Capitated rates	c.	Limited access to specialists
b.	Single point of entry	d.	Fee-for-service

 

 

ANS:  D

One characteristic of an independent practice is fee-for-service. The other choices are characteristics of a health maintenance organization.

 

PTS:   1                    DIF:    Application

REF:   Table 4-4 Independent Practice and Managed Care Options