Medical-Surgical Nursing Making Connections to Practice 1st edition Hoffman, Sullivan Test Bank

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Medical-Surgical Nursing: Making Connections to Practice 1st edition Hoffman, Sullivan Test Bank

Chapter 1: Foundations for Medical-Surgical Nursing

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. The medical-surgical nurse identifies a clinical practice issue and wants to determine if there is sufficient evidence to support a change in practice. Which type of study provides the strongest evidence to support a
practice change?
1) Randomized control study
2) Quasi-experimental study
3) Case-control study
4) Cohort study

____ 2. The medical-surgical unit recently implemented a patient-centered care model. Which action implemented by
the nurse supports this model?
1) Evaluating care
2) Assessing needs
3) Diagnosing problems
4) Providing compassion

____ 3. Which action should the nurse implement when providing patient care in order to support The Joint
Commission’s (TJC) National Patient Safety Goals (NPSG)?
1) Silencing a cardiorespiratory monitor
2) Identifying each patient using one source
3) Determining patient safety issues upon admission
4) Decreasing the amount of pain medication administered

____ 4. Which interprofessional role does the nurse often assume when providing patient care in an acute care
setting?
1) Social worker
2) Client advocate
3) Care coordinator
4) Massage therapist

____ 5. The medical-surgical nurse wants to determine if a policy change is needed for an identified clinical problem.
Which is the first action the nurse should implement?
1) Developing a question
2) Disseminating the findings
3) Conducting a review of the literature
4) Evaluating outcomes of practice change

____ 6. The nurse is evaluating the level of evidence found during a recent review of the literature. Which evidence
carries the lowest level of support for a practice change?
1) Level IV
2) Level V
3) Level VI
4) Level VII

____ 7. The nurse is reviewing evidence from a quasi-experimental research study. Which level of evidence should
the nurse identify for this research study?
1) Level ITestBankWorld.org
2) Level II
3) Level III
4) Level IV

____ 8. Which level of evidence should the nurse identify when reviewing evidence from a single descriptive research
study?
1) Level IV
2) Level V
3) Level VI
4) Level VII

____ 9. Which statement should the nurse make when communicating the “S” in the SBAR approach for effective
communication?
1) “The patient presented to the emergency department at 0200 with lower left abdominal
pain.”
2) “The patient rated the pain upon admission as a 9 on a 10-point numeric scale.”
3) “The patient has no significant issues in the medical history.”
4) “The patient was given a prescribed opioid analgesic at 0300.”
____ 10. The staff nurse is communicating with the change nurse about the change of status of the patient. The nurse
would begin her communication with which statement if correctly using the SBAR format?
1) “The patient’s heartrate is 110.”
2) “I think this patient needs to be transferred to the critical care unit.”
3) “The patient is a 68-year-old male patient admitted last night.”
4) “The patient is complaining of chest pain.”
____ 11. Which nursing action exemplifies the Quality and Safety Education for Nursing (QSEN) competency of
safety?
1) Advocating for a patient who is experiencing pain
2) Considering the patient’s culture when planning care
3) Evaluating patient learning style prior to implementing discharge instructions
4) Assessing the right drug prior to administering a prescribed patient medication
____ 12. Which type of nursing is the root of all other nursing practice areas?
1) Pediatric nursing
2) Geriatric nursing
3) Medical-surgical nursing
4) Mental health-psychiatric nursing
____ 13. Which did the Nursing Executive Center of The Advisory Board identify as an academic-practice gap for new
graduate nurses?
1) Patient advocacy
2) Patient education
3) Disease pathophysiology
4) Therapeutic communication
____ 14. Which statement regarding the use of the nursing process in clinical practice is accurate?
1) “The nursing process is closely related to clinical decision-making.”
2) “The nursing process is used by all members of the interprofessional team to plan care.”
3) “The nursing process has 4 basic steps: assessment, planning, implementation,
evaluation.”
4) “The nursing process is being replaced by the implementation of evidence-based practice.”TestBankWorld.org
____ 15. Which is the basis of nursing care practices and protocols?
1) Assessment
2) Evaluation
3) Diagnosis
4) Research
____ 16. Which is a common theme regarding patient dissatisfaction related to care provided in the hospital setting?
1) Space in hospital rooms
2) Medications received to treat pain
3) Time spent with the health-care team
4) Poor quality food received from dietary
____ 17. The nurse manager is preparing a medical-surgical unit for The Joint Commission (TJC) visit With the nurse
manager presenting staff education focusing on TJC benchmarks, which of the following topics would be
most appropriate?
1) Implementation of evidence-based practice
2) Implementation of patient-centered care
3) Implementation of medical asepsis practices
4) Implementation of interprofessional care
____ 18. Which aspect of patient-centered care should the nurse manager evaluate prior to The Joint Commission site
visit for accreditation?
1) Visitation rights
2) Education level of staff
3) Fall prevention protocol
4) Infection control practices
____ 19. The medical-surgical nurse is providing patient care. Which circumstance would necessitate the nurse
verifying the patient’s identification using at least two sources?
1) Prior to delivering a meal tray
2) Prior to passive range of motion
3) Prior to medication administration
4) Prior to documenting in the medical record
____ 20. The nurse is providing care to several patients on a medical-surgical unit. Which situation would necessitate
the nurse to use SBAR during the hand-off process?
1) Wound care
2) Discharge to home
3) Transfer to radiology
4) Medication education
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 21. The staff nurse is teaching a group of student nurses the situations that necessitate hand-off communication.
Which student responses indicate the need for further education related to this procedure? Select all that
apply.
1) “A hand-off is required prior to administering a medication.”
2) “A hand-off is required during change of shift.”
3) “A hand-off is required for a patient is transferred to the surgical suite.”TestBankWorld.org
4) “A hand-off is required whenever the nurse receives a new patient assignment.”
5) “A hand-off is required prior to family visitation.”
____ 22. Which actions by the nurse enhance patient safety during medication administration? Select all that apply.
1) Answering the call bell while transporting medications for a different patient
2) Identifying the patient using two sources prior to administering the medication
3) Holding a medication if the patient’s diagnosis does not support its use
4) Administering the medication two hours after the scheduled time
5) Having another nurse verify the prescribed dose of insulin the patient is to receive
____ 23. The medical-surgical nurse assumes care for a patient who is receiving continuous cardiopulmonary
monitoring. Which actions by the nurse enhance safety for this patient? Select all that apply.
1) Silencing the alarm during family visitation
2) Assessing the alarm parameters at the start of the shift
3) Responding to the alarm in a timely fashion
4) Decreasing the alarm volume to enhance restful sleep
5) Adjusting alarm parameters based on specified practitioner prescription
____ 24. The nurse is planning an interprofessional care conference for a patient who is approaching discharge from
the hospital. Which members of the interprofessional team should the nurse invite to attend? Select all that
apply.
1) Physician
2) Pharmacist
3) Unit secretary
4) Social worker
5) Home care aide
____ 25. The nurse manager wants to designate a member of the nursing team as the care coordinator for a patient who
will require significant care during the hospitalization. Which skills should this nurse possess in order to
assume this role? Select all that apply.
1) Effective clinical reasoning
2) Effective communication skills
3) Effective infection control procedures
4) Effective documentation
5) Effective intravenous skillsTestBankWorld.org
Chapter 1: Foundations for Medical-Surgical Nursing
Answer Section
MULTIPLE CHOICE
1. ANS: 1
Chapter number and title: 1, Foundations for Medical Surgical Practice
Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical
nursing
Chapter page reference: 003-004
Heading: Evidence-Based Nursing Care
Integrated Processes: Nursing Process: Planning
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Easy
Feedback
1 Systematic reviews of randomized control studies (Level I) are the highest level of
evidence because they include data from selected studies that randomly assigned
participants to control and experimental groups. The lower the numerical rating of the
level of evidence indicates the highest level of evidence; therefore, this type of study
provides the strongest evidence to support a practice change.
2 Quasi-experimental studies are considered Level III; therefore, this study does not
provide the strongest evidence to support a practice change.
3 Case-control studies are considered Level IV; therefore, this study does not provide the
strongest evidence to support a practice change.
4 Cohort studies are considered Level IV; therefore, this study does not provide the
strongest evidence to support a practice change.
PTS: 1 CON: Evidence-Based Practice
2. ANS: 4
Chapter number and title: 1, Foundations of Medical-Surgical Practice
Chapter learning objective: Explaining the importance of patient-centered care in the management of
medical-surgical patients
Chapter page reference: 004-005
Heading: Patient-Centered Care in the Medical-Surgical Setting
Integrated Processes: Caring
Client Need: Psychosocial Integrity
Cognitive level: Application [Applying]
Concept: Nursing Roles
Difficulty: Moderate
Feedback
1 Evaluation is a step in the nursing process; however, this is not an action that supports
the patient-centered care model.
2 Assessment is a step in the nursing process; however, this is not an action that supports
the patient-centered care model.TestBankWorld.org
3 Diagnosis is a step in the nursing process; however, this is not an action that supports
the patient-centered care model.
4 Compassion is a competency closely associated with patient-centered care; therefore,
this action supports the patient-centered model of care.
PTS: 1 CON: Nursing Roles
3. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Discussing implications to medical-surgical nurses of Quality and Safety
Education for Nurses (QSEN) competencies
Chapter page reference: 005-006
Heading: Patient Safety Outcomes
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Application [Applying]
Concept: Safety
Difficulty: Moderate
Feedback
1 Safely using alarms is a NPSG identified by TJC. Silencing a cardiorespiratory monitor
is not nursing action that supports this NPSG.
2 Patient identification using two separate resources is a NPSG identified by TJC.
Identifying a patient using only one source does not support this NPSG.
3 Identification of patient safety risks is a NPSG identified by the TJC. Determining
patient safety issues upon admission supports this NPSG.
4 Safe use of medication is a NPSG identified by the TJC. Decreasing the amount of pain
medication administered does not support this NPSG.
PTS: 1 CON: Safety
4. ANS: 3
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Describing the role and competencies of medical-surgical nursing
Chapter page reference: 006-007
Heading: Interprofessional Collaboration and Communication
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Nursing Roles
Difficulty: Easy
Feedback
1 The nurse does not often assume the interprofessional role of social worker when
providing patient care in an acute care setting.
2 The nurse does not often assume the interprofessional role of client advocate role when
providing patient care in an acute care setting.
3 The nurse often assumes the interprofessional role of care coordinator when providing
patient care in an acute care setting.
4 The nurse does not often assume the interprofessional role of massage therapist when
providing patient care in an acute care setting.TestBankWorld.org
PTS: 1 CON: Nursing Roles
5. ANS: 1
Chapter number and title: 1, Foundations of Medical-Surgical Practice
Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical
nursing
Chapter page reference: 003
Heading: Box 1.3 Steps of Evidence-Based Practice
Integrated Processes: Nursing Process: Implementation
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Analysis [Analyzing]
Concept: Evidence-Based Practice
Difficulty: Difficult
Feedback
1 The first step of evidence-based practice is to develop a question based on the clinical
issue.
2 The last step of evidence-based practice is to disseminate findings.
3 The second step of evidence-based practice is to conduct a review of the literature, or
current evidence, available.
4 The fifth step of evidence-based practice is to evaluate the outcomes associated with the
practice change.
PTS: 1 CON: Evidence-Based Practice
6. ANS: 4
Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice
Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical
nursing
Chapter page reference: 004
Heading: Box 1.4 Evaluating Levels of Evidence
Integrated Processes: Nursing Process: Planning
Client Need: Safe and Effective Care Environment/Management of Care
Cognitive level: Comprehension [Understanding]
Concept: Evidence-Based Practice
Difficulty: Easy
Feedback
1 The lower the numeric value of the evidence the greater the support for a change in
practice. Level IV evidence does not carry the lowest level of support for a practice
change.
2 The lower the numeric value of the evidence the greater the support for a change in
practice. Level V evidence does not carry the lowest level of support for a practice
change.
3 The lower the numeric value of the evidence the greater the support for a change in
practice. Level VI evidence does not carry the lowest level of support for a practice
change.
4 The lower the numeric value of the evidence the greater the support for a change in
practice. Level VII evidence carries the lowest level of support for a practice change.

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Medical-Surgical Nursing: Making Connections to Practice 1st edition Hoffman, Sullivan Test Bank

Chapter 1: Foundations for Medical-Surgical Nursing

Multiple Choice Identify the choice that best completes the statement or answers the question.

____ 1. The medical-surgical nurse identifies a clinical practice issue and wants to determine if there is sufficient evidence to support a change in practice. Which type of study provides the strongest evidence to support a practice change? 1) Randomized control study 2) Quasi-experimental study 3) Case-control study 4) Cohort study

____ 2. The medical-surgical unit recently implemented a patient-centered care model. Which action implemented by the nurse supports this model? 1) Evaluating care 2) Assessing needs 3) Diagnosing problems 4) Providing compassion

____ 3. Which action should the nurse implement when providing patient care in order to support The Joint Commission’s (TJC) National Patient Safety Goals (NPSG)? 1) Silencing a cardiorespiratory monitor 2) Identifying each patient using one source 3) Determining patient safety issues upon admission 4) Decreasing the amount of pain medication administered

____ 4. Which interprofessional role does the nurse often assume when providing patient care in an acute care setting? 1) Social worker 2) Client advocate 3) Care coordinator 4) Massage therapist

____ 5. The medical-surgical nurse wants to determine if a policy change is needed for an identified clinical problem. Which is the first action the nurse should implement? 1) Developing a question 2) Disseminating the findings 3) Conducting a review of the literature 4) Evaluating outcomes of practice change

____ 6. The nurse is evaluating the level of evidence found during a recent review of the literature. Which evidence carries the lowest level of support for a practice change? 1) Level IV 2) Level V 3) Level VI 4) Level VII

____ 7. The nurse is reviewing evidence from a quasi-experimental research study. Which level of evidence should the nurse identify for this research study? 1) Level ITestBankWorld.org 2) Level II 3) Level III 4) Level IV

____ 8. Which level of evidence should the nurse identify when reviewing evidence from a single descriptive research study? 1) Level IV 2) Level V 3) Level VI 4) Level VII

____ 9. Which statement should the nurse make when communicating the “S” in the SBAR approach for effective communication? 1) “The patient presented to the emergency department at 0200 with lower left abdominal pain.” 2) “The patient rated the pain upon admission as a 9 on a 10-point numeric scale.” 3) “The patient has no significant issues in the medical history.” 4) “The patient was given a prescribed opioid analgesic at 0300.” ____ 10. The staff nurse is communicating with the change nurse about the change of status of the patient. The nurse would begin her communication with which statement if correctly using the SBAR format? 1) “The patient’s heartrate is 110.” 2) “I think this patient needs to be transferred to the critical care unit.” 3) “The patient is a 68-year-old male patient admitted last night.” 4) “The patient is complaining of chest pain.” ____ 11. Which nursing action exemplifies the Quality and Safety Education for Nursing (QSEN) competency of safety? 1) Advocating for a patient who is experiencing pain 2) Considering the patient’s culture when planning care 3) Evaluating patient learning style prior to implementing discharge instructions 4) Assessing the right drug prior to administering a prescribed patient medication ____ 12. Which type of nursing is the root of all other nursing practice areas? 1) Pediatric nursing 2) Geriatric nursing 3) Medical-surgical nursing 4) Mental health-psychiatric nursing ____ 13. Which did the Nursing Executive Center of The Advisory Board identify as an academic-practice gap for new graduate nurses? 1) Patient advocacy 2) Patient education 3) Disease pathophysiology 4) Therapeutic communication ____ 14. Which statement regarding the use of the nursing process in clinical practice is accurate? 1) “The nursing process is closely related to clinical decision-making.” 2) “The nursing process is used by all members of the interprofessional team to plan care.” 3) “The nursing process has 4 basic steps: assessment, planning, implementation, evaluation.” 4) “The nursing process is being replaced by the implementation of evidence-based practice.”TestBankWorld.org ____ 15. Which is the basis of nursing care practices and protocols? 1) Assessment 2) Evaluation 3) Diagnosis 4) Research ____ 16. Which is a common theme regarding patient dissatisfaction related to care provided in the hospital setting? 1) Space in hospital rooms 2) Medications received to treat pain 3) Time spent with the health-care team 4) Poor quality food received from dietary ____ 17. The nurse manager is preparing a medical-surgical unit for The Joint Commission (TJC) visit With the nurse manager presenting staff education focusing on TJC benchmarks, which of the following topics would be most appropriate? 1) Implementation of evidence-based practice 2) Implementation of patient-centered care 3) Implementation of medical asepsis practices 4) Implementation of interprofessional care ____ 18. Which aspect of patient-centered care should the nurse manager evaluate prior to The Joint Commission site visit for accreditation? 1) Visitation rights 2) Education level of staff 3) Fall prevention protocol 4) Infection control practices ____ 19. The medical-surgical nurse is providing patient care. Which circumstance would necessitate the nurse verifying the patient’s identification using at least two sources? 1) Prior to delivering a meal tray 2) Prior to passive range of motion 3) Prior to medication administration 4) Prior to documenting in the medical record ____ 20. The nurse is providing care to several patients on a medical-surgical unit. Which situation would necessitate the nurse to use SBAR during the hand-off process? 1) Wound care 2) Discharge to home 3) Transfer to radiology 4) Medication education Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 21. The staff nurse is teaching a group of student nurses the situations that necessitate hand-off communication. Which student responses indicate the need for further education related to this procedure? Select all that apply. 1) “A hand-off is required prior to administering a medication.” 2) “A hand-off is required during change of shift.” 3) “A hand-off is required for a patient is transferred to the surgical suite.”TestBankWorld.org 4) “A hand-off is required whenever the nurse receives a new patient assignment.” 5) “A hand-off is required prior to family visitation.” ____ 22. Which actions by the nurse enhance patient safety during medication administration? Select all that apply. 1) Answering the call bell while transporting medications for a different patient 2) Identifying the patient using two sources prior to administering the medication 3) Holding a medication if the patient’s diagnosis does not support its use 4) Administering the medication two hours after the scheduled time 5) Having another nurse verify the prescribed dose of insulin the patient is to receive ____ 23. The medical-surgical nurse assumes care for a patient who is receiving continuous cardiopulmonary monitoring. Which actions by the nurse enhance safety for this patient? Select all that apply. 1) Silencing the alarm during family visitation 2) Assessing the alarm parameters at the start of the shift 3) Responding to the alarm in a timely fashion 4) Decreasing the alarm volume to enhance restful sleep 5) Adjusting alarm parameters based on specified practitioner prescription ____ 24. The nurse is planning an interprofessional care conference for a patient who is approaching discharge from the hospital. Which members of the interprofessional team should the nurse invite to attend? Select all that apply. 1) Physician 2) Pharmacist 3) Unit secretary 4) Social worker 5) Home care aide ____ 25. The nurse manager wants to designate a member of the nursing team as the care coordinator for a patient who will require significant care during the hospitalization. Which skills should this nurse possess in order to assume this role? Select all that apply. 1) Effective clinical reasoning 2) Effective communication skills 3) Effective infection control procedures 4) Effective documentation 5) Effective intravenous skillsTestBankWorld.org Chapter 1: Foundations for Medical-Surgical Nursing Answer Section MULTIPLE CHOICE 1. ANS: 1 Chapter number and title: 1, Foundations for Medical Surgical Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 003-004 Heading: Evidence-Based Nursing Care Integrated Processes: Nursing Process: Planning Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Evidence-Based Practice Difficulty: Easy Feedback 1 Systematic reviews of randomized control studies (Level I) are the highest level of evidence because they include data from selected studies that randomly assigned participants to control and experimental groups. The lower the numerical rating of the level of evidence indicates the highest level of evidence; therefore, this type of study provides the strongest evidence to support a practice change. 2 Quasi-experimental studies are considered Level III; therefore, this study does not provide the strongest evidence to support a practice change. 3 Case-control studies are considered Level IV; therefore, this study does not provide the strongest evidence to support a practice change. 4 Cohort studies are considered Level IV; therefore, this study does not provide the strongest evidence to support a practice change. PTS: 1 CON: Evidence-Based Practice 2. ANS: 4 Chapter number and title: 1, Foundations of Medical-Surgical Practice Chapter learning objective: Explaining the importance of patient-centered care in the management of medical-surgical patients Chapter page reference: 004-005 Heading: Patient-Centered Care in the Medical-Surgical Setting Integrated Processes: Caring Client Need: Psychosocial Integrity Cognitive level: Application [Applying] Concept: Nursing Roles Difficulty: Moderate Feedback 1 Evaluation is a step in the nursing process; however, this is not an action that supports the patient-centered care model. 2 Assessment is a step in the nursing process; however, this is not an action that supports the patient-centered care model.TestBankWorld.org 3 Diagnosis is a step in the nursing process; however, this is not an action that supports the patient-centered care model. 4 Compassion is a competency closely associated with patient-centered care; therefore, this action supports the patient-centered model of care. PTS: 1 CON: Nursing Roles 3. ANS: 3 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Discussing implications to medical-surgical nurses of Quality and Safety Education for Nurses (QSEN) competencies Chapter page reference: 005-006 Heading: Patient Safety Outcomes Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Application [Applying] Concept: Safety Difficulty: Moderate Feedback 1 Safely using alarms is a NPSG identified by TJC. Silencing a cardiorespiratory monitor is not nursing action that supports this NPSG. 2 Patient identification using two separate resources is a NPSG identified by TJC. Identifying a patient using only one source does not support this NPSG. 3 Identification of patient safety risks is a NPSG identified by the TJC. Determining patient safety issues upon admission supports this NPSG. 4 Safe use of medication is a NPSG identified by the TJC. Decreasing the amount of pain medication administered does not support this NPSG. PTS: 1 CON: Safety 4. ANS: 3 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Describing the role and competencies of medical-surgical nursing Chapter page reference: 006-007 Heading: Interprofessional Collaboration and Communication Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Nursing Roles Difficulty: Easy Feedback 1 The nurse does not often assume the interprofessional role of social worker when providing patient care in an acute care setting. 2 The nurse does not often assume the interprofessional role of client advocate role when providing patient care in an acute care setting. 3 The nurse often assumes the interprofessional role of care coordinator when providing patient care in an acute care setting. 4 The nurse does not often assume the interprofessional role of massage therapist when providing patient care in an acute care setting.TestBankWorld.org PTS: 1 CON: Nursing Roles 5. ANS: 1 Chapter number and title: 1, Foundations of Medical-Surgical Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 003 Heading: Box 1.3 Steps of Evidence-Based Practice Integrated Processes: Nursing Process: Implementation Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Analysis [Analyzing] Concept: Evidence-Based Practice Difficulty: Difficult Feedback 1 The first step of evidence-based practice is to develop a question based on the clinical issue. 2 The last step of evidence-based practice is to disseminate findings. 3 The second step of evidence-based practice is to conduct a review of the literature, or current evidence, available. 4 The fifth step of evidence-based practice is to evaluate the outcomes associated with the practice change. PTS: 1 CON: Evidence-Based Practice 6. ANS: 4 Chapter number and title: 1, Foundations of Medical-Surgical Nursing Practice Chapter learning objective: Discussing the incorporation of evidence-based practices into medical-surgical nursing Chapter page reference: 004 Heading: Box 1.4 Evaluating Levels of Evidence Integrated Processes: Nursing Process: Planning Client Need: Safe and Effective Care Environment/Management of Care Cognitive level: Comprehension [Understanding] Concept: Evidence-Based Practice Difficulty: Easy Feedback 1 The lower the numeric value of the evidence the greater the support for a change in practice. Level IV evidence does not carry the lowest level of support for a practice change. 2 The lower the numeric value of the evidence the greater the support for a change in practice. Level V evidence does not carry the lowest level of support for a practice change. 3 The lower the numeric value of the evidence the greater the support for a change in practice. Level VI evidence does not carry the lowest level of support for a practice change. 4 The lower the numeric value of the evidence the greater the support for a change in practice. Level VII evidence carries the lowest level of support for a practice change.

Test Bank For Essentials of Psychiatric Mental Health Nursing 8th Morgan

Chapter 1: Mental Health and Mental Illness Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. A nurse is assessing a client who experiences occasional feelings of sadness because of the recent death of a beloved pet. The client’s appetite, sleep patterns, and daily routine have not changed. How would the nurse interpret the client’s behaviors? 1. The client’s behaviors demonstrate mental illness in the form of depression. 2. The client’s behaviors are inappropriate, which indicates the presence of mental illness. 3. The client’s behaviors are not congruent with cultural norms. 4. The client’s behaviors demonstrate no functional impairment, indicating no mental illness. ____ 2. At which point would the nurse determine that a client is at risk for developing a mental illness? 1. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria. 2. When maladaptive responses to stress are coupled with interference in daily functioning. 3. When a client communicates significant distress. 4. When a client uses defense mechanisms as ego protection. ____ 3. A client has been given a diagnosis of human immunodeficiency virus (HIV). Which statement made by the client does the nurse recognize as the bargaining stage of grief? 1. “I hate my partner for giving me this disease I will die from!” 2. “If I don’t do intravenous (IV) drugs anymore, God won’t let me die.” 3. “I am going to support groups and learn more about the disease.” 4. “Can you please re-draw the test results, I think they may be wrong?” ____ 4. A nurse notes that a client is extremely withdrawn, delusional, and emotionally exhausted. The nurse assesses the client’s anxiety as which level? 1. Mild anxiety 2. Moderate anxiety 3. Severe anxiety 4. Panic anxiety ____ 5. A psychiatric nurse intern states, “This client’s use of defense mechanisms should be eliminated.” Which is a correct evaluation of this nurse’s statement? 1. Defense mechanisms can be appropriate responses to stress and need not be eliminated. 2. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be eliminated. 3. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not completely eliminated. 4. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged. ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH MORGAN TEST BANK Copyright © 2020 F. A. Davis Company ____ 6. During an intake assessment, a nurse asks both physiological and psychosocial questions. The client angrily responds, “I’m here for my heart, not my head problems.” Which is the nurse’s best response? 1. “It is just a routine part of our assessment. All clients are asked these same questions.” 2. “Why are you concerned about these types of questions?” 3. “Psychological factors, like excessive stress, have been found to affect medical conditions.” 4. “We can skip these questions, if you like. It isn’t imperative that we complete this section.” ____ 7. A client who is being treated for chronic kidney disease complains to the health-care provider that he does not like the food available to him while hospitalized. The health-care provider insists that the client strictly adhere to the diet plan. What action can be expected is the client uses the defense mechanism of displacement? 1. The client assertively confronts the health-care provider. 2. The client insists on being discharged and goes for a long, brisk walk. 3. The client snaps at the nurse and criticizes the nursing care provided. 4. The client hides his anger by explaining the logical reasoning for the diet to his spouse. ____ 8. A fourth-grade boy teases and makes jokes about a cute girl in his class. A nurse would recognize this behavior as indicative of which defense mechanism? 1. Displacement 2. Projection 3. Reaction formation 4. Sublimation ____ 9. Which nursing statement regarding the concept of psychosis is most accurate? 1. Individuals experiencing psychoses are aware that their behaviors are maladaptive. 2. Individuals experiencing psychoses experience little distress. 3. Individuals experiencing psychoses are aware of experiencing psychological problems. 4. Individuals experiencing psychoses are based in reality. ____ 10. When under stress, a client routinely uses alcohol to excess. When the client’s husband finds her drunk, the husband yells at the client about her chronic alcohol abuse. Which action alerts the nurse to the client’s use of the defense mechanism of denial? 1. The client hides liquor bottles in a closet. 2. The client yells at her son for slouching in his chair. 3. The client burns dinner on purpose. 4. The client says to the spouse, “I don’t drink too much!” ____ 11. Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife would indicate to a nurse that the client is in the acceptance stage of grief? 1. “If only we could have tried again, things might have worked out.” 2. “I am so mad that the children and I had to put up with him as long as we did.” 3. “Yes, it was a difficult relationship, but I think I have learned from the ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH MORGAN TEST BANK WWW.NURSINGTB.COMN U R S I N G T B . C O M Copyright © 2020 F. A. Davis Company experience.” 4. “I have a difficult time getting out of bed most days.” ____ 12. According to Maslow’s hierarchy of needs, which client action would demonstrate the highest achievement in terms of mental health? 1. Maintaining a long-term, faithful, intimate relationship 2. Achieving a sense of self-confidence 3. Possessing a feeling of self-fulfillment and realizing full potential 4. Developing a sense of purpose and the ability to direct activities ____ 13. According to Maslow’s hierarchy of needs, which situation on an inpatient psychiatric unit would require priority intervention by a nurse? 1. A client rudely complaining about limited visiting hours 2. A client exhibiting aggressive behavior toward another client 3. A client stating that no one cares 4. A client verbalizing feelings of failure Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 14. Which describes a defense mechanism an individual may use to relieve anxiety in a stressful situation? (Select all that apply.) 1. Homework 2. Smoking 3. Itching 4. Nail biting 5. Sleeping ____ 15. The nurse is reviewing the DSM-5 definition of a mental health disorder and notes the definition includes a disturbance in which areas? (Select all that apply.) 1. Cognition 2. Physical 3. Emotional regulation 4. Behavior 5. Developmental Completion Complete each statement. 16. _______________________ is a diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness. 17. _______________________ is a subjective state of emotional, physical, and social responses to the loss of a valued entity. Other ESSENTIALS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH MORGAN TEST BANK Copyright © 2020 F. A. Davis Company 18. Place in order the Kübler Ross stages of grief from 1-5. (Enter the number of each step in the proper sequence, using comma and space format, such as: 1, 2, 3, 4.) 1. Bargaining 2. Denial 3. Acceptance 4. Depression 5. Anger

Test Bank for Psychiatric Mental Health Nursing, 8th Edition Wanda Mohr

Chapter 01- Introduction to Psychiatric-Mental Health Nursing

A nurse is giving a presentation about preventing mental illness to college freshmen. A student asks, “What does it mean to be mentally healthy?” Which of the following potential responses by the nurse is best?

A) “Mental health is difficult to define and depends on cultural norms.” B) “Mental health is marked by productivity, fulfilling relationships, and adaptability.” C) “Mental health is characterized by the absence of mental illness.” D) “Mental health is the performance of behavior that is accepted as normal.”

A 48-year-old independent, successful woman is recovering from a modified radical mastectomy. She states she was grateful that during the first few weeks after surgery her mother stayed with her and did “everything” for her. Which element of mental health does this reflect?

A) Reality orientation B) Mastery of the environment C) Self-governance D) Tolerance of the unknown

Why is the document Mental Health: A Report of the Surgeon General (1999) most significant?

A) Because it states clearly that there are effective treatments for mental illness B) Because it allocates research money to psychiatric facilities C) Because it sets new guidelines for use of restraints D) Because it establishes reimbursement guidelines for third-party payers

While a nurse is performing an admission assessment for a mental health client, the client states that all of his problems have been caused by his parents. The nurse knows that psychological factors that can influence mental health include which of the following?

A) Neuroanatomy B) Emotional developmental level C) Values and beliefs D) Religion

What is the primary purpose of the five-axis system used in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision(DSM-IV-TR)?

A) To separate the various mental disorders into five related categories B) To give a comprehensive picture of client functioning C) To improve prognostic ability D) To provide a decision-making algorithm for pharmacologic treatment

One limitation of the DSM relates to diagnostic labels given to children. The most problematic issue caused by applying adult categories to children is which of the following?

A) It prevents the proper treatment of childhood disorders. B) The criteria for diagnosis of a disorder are flexible for an adult, but not for children. C) Categories are based on manifestations of adult disorders, not research in children. D) The DSM was written before childhood psychological conditions were recognized.

Which of the following represents a problem complicating the treatment of people with mental illness?

A) Insurers' reimbursement decisions B) Increased responsibility for care by state mental hospitals C) Overuse of the well-coordinated mental health care system D) Lack of effective treatments

Julie, a 47-year-old woman, missed 1 week of work when she was hospitalized with bipolar disorder. She was placed on medication and was able to return to work. When asked about her absence, Julie informed coworkers that she was suffering from influenza. What is the most likely reason Julie lied about her illness?

A) This is a sign that the medication is not effectively treating her illness. B) Fear of rejection, isolation, and discrimination based on her mental health diagnosis

C) Due to workplace policies that encourage the firing of those with mental illnesses D) To avoid eliciting sympathy among her coworkers

A 22-year-old man with a history of a recent suicide attempt is being treated for depression. Prior to becoming depressed, the client attended a prestigious art school and enjoyed many social and leisure activities. Of the following long-term goals for this client, which is consistent with an overarching recovery goal for all clients with mental disorders?

A) The client will not injure himself. B) The client's symptoms will be reduced. C) The client will show interest in social and leisure activities. D) The client will resume pre-illness functioning.

Which of the following approaches to care best reflects cultural competence?

A) Always assign nurses of a specific ethnic background to clients with the same ethnic background. B) Learn the behaviors and values associated with people of specific ethnic backgrounds. C) Assess the culturally mediated beliefs of each client. D) Believe that people are more alike than they are different. Chapter 02- Neuroscience-Biology and Behavior

The basic units of structure and function in the nervous system are called which of the following?

A) Glial cells B) Neurons C) Axons D) Dendrites

The structure and function of a neuron form the basis for the overall function of the nervous system. What are the components of a neuron?

A) A glial cell, nucleus, organelles, dendrites, and axons B) A glial cell, nucleus, dendrites, and synapses C) A cell body, nucleus, organelles, dendrites, and axons D) A cell body, nucleus, axon, and synapses

A patient has researched the role of neurotransmitters in her mental illness. What is the role of neurotransmitters?

A) Excite the receptor cell located inside the synaptic cleft. B) Inhibit the receptor cell found inside of glial cells. C) Communicate information within the receptor cell. D) Communicate information from one cell or cell group to another.

Because neurotransmitters are responsible for immediately transmitting impulses between nerve cells, they are known as which of the following?

A) First messengers B) Second messengers C) Receptors D) Synapses

A nurse is caring for a patient who is addicted to alcohol and drugs and is discussing the pathway of the brain responsible for this behavior. The nurse should know that the pathway of the brain thought to be involved in pleasurable sensations and the euphoria resulting from use of drugs is called the:

A) Tuberinfundibular dopamine pathway B) Nigrostriatal dopamine pathway C) Mesocortical dopamine pathway D) Mesolimbic dopamine pathway

A client lives with acquired deficits in emotional control, memory, and learning. What part of this client's brain is most likely affected?

A) Basal ganglia B) Brainstem C) Limbic system D) Cerebellum

You are caring for a mental health client who has developed difficulty with balance and muscle tone after a car accident that involved a head injury. Based on this information, what area of the brain was most likely injured in the accident?

A) Diencephalon B) Brainstem C) Cerebellum D) Pons

A client who experiences dysfunction in the hypothalamus is most likely to have

A) Maintaining homeostasis B) Processing sensory input

C) Secreting melatonin D) Integrating motor activities

Sensory deprivation in infancy and childhood has adversely affected a boy's brain development. Which characteristic of the brain was most directly involved in this process?

A) Neuroplasticity B) Reactive plasticity C) Adaptive plasticity D) Synaptic plasticity

Rather than being 100%, concordance rates for schizophrenia in monozygotic twins are only 50%. Which of the following statements best explains this phenomenon?

A) Genetic predisposition to disease is frequently overstated. B) One twin is inherently more vulnerable in every case. C) Environmental experiences affect gene expression. D) The genetic pathway responsible for vulnerability is unrelated to being a twin. Chapter 03- Conceptual Frameworks and Theories

A psychiatric–mental health nurse is aware of the importance of theories in the development and delivery of care. Which of the following is the best definition of a theory?

A) A group of related concepts or ideas B) A person's or group's beliefs about how something happens or works C) A prediction about two or more concepts D) A researchable question related to health care

Which of the following explains why theories are important to psychiatric–mental health nursing?

A) Theories provide more treatment options for clients. B) Theories add professionalism to health care. C) Theories simplify treatment decisions for most clients. D) Theories lead to the expansion of knowledge.

A client has been told by a psychologist that memories in his unconscious are contributing to his depression. This reasoning implies that the psychologist ascribes to what theory?

A) Psychoanalytic theory B) Behavior theory C) Cognitive–behavioral theory

D) The humanistic perspective

A client's current plan of care includes interventions that are rooted in the concepts of reinforcement. Which theory of human behavior is being prioritized during this client's care?

A) Humanistic theory B) Sociocultural theory C) Behavioral theory D) Psychoanalytic theory

A client and her therapist have been discussing the notion that her psychopathology results from the blocking or distortion of personal growth, excessive stress, and unfavorable social conditions. This discussion is congruent with what theory?

A) Humanistic theory B) Interpersonal theory C) Biophysiological theory D) Sociocultural theory

During marital counseling, a man complains that his wife often “bombards” him with problems as soon as he settles down at home after work, which results in a prolonged argument. The wife admits that she does this but states she feels neglected and that her husband does not take the family problems seriously. She doesn't want her marriage to turn out like her parents' marriage. The wife admits that she sometimes provokes an argument in order to gain her husband's attention. How would a behaviorist most likely explain the wife's actions?

A) She has repressed painful memories about her emotionally distant father and is working out her anger at the parent in the marital relationship. B) Her thoughts about her parents' unhappy marriage are a justification for her behavior. C) She has an underlying anxiety disorder. D) The long argument in which she and her husband participate positively reinforces her behavior.

An adult man recalls that he was teased as a child about his inability to participate in sports. He began to avoid situations in which others might evaluate his behavior. He seeks treatment now because he is an accomplished musician but cannot perform for an audience. According to behavioral theory, his behavior is an example of which of the following concepts?

A) Discrimination B) Modeling C) Generalization D) Shaping

The nurse is working with a client who admits to having low self-esteem. The care team has determined that cognitive restructuring will likely enhance the client's self-esteem. Which of the following best describes the goals of this intervention?

A) Avoid negative self-talk B) Replace negative self-talk with positive statements C) Change distorted thinking and the subsequent behaviors D) Use adaptive defense mechanisms

A 55-year-old woman is being treated for narcissistic personality disorder. The therapist demonstrates caring and appropriate regard for the client. The therapist's behavior is an example of which concept of behavior theory?

A) Shaping B) Discrimination C) Modeling D) Conditioning

In a group therapy session, group members confront a 35-year-old woman about her abuse of prescription pain medications. The woman states that, because a physician has prescribed her medication, she is not a drug addict. The nurse identifies this as an example of which of the following defense mechanisms?

A) Regression B) Projection C) Denial D) Sublimation Chapter 04- Evidence-Based Practice

The nurse demonstrates a commitment to the health, safety, and welfare of people by providing evidence-based practice. What does the term “evidence-based practice” mean?

A) Care that integrates research and clinical expertise with the client's characteristics, culture, and preferences B) Care that bases decision making on established clinical protocols C) Care based on prior outcomes from the nurse's practice D) Care based on outcomes and research conducted by the practitioner

Many pseudoscientific practitioners function openly and market themselves as mainstream

“therapists.” Why does the public often respond favorably to unconventional therapies? A) Pseudoscientific therapies are frequently more effective than conventional therapies. B) Further advancements can be made in effective pseudoscientific treatments with continued practice. C) Malpractice is minimized because pseudoscientific treatments are not empirically supported.

D) Some clients and families are disenchanted with the outcomes of professionally approved treatments.

Nursing is both an art and a science. Which statement best represents how evidence-based practice encompasses these two aspects of nursing?

A) The art of nursing has been replaced by evidence-based practice. B) Multiple theoretical perspectives no longer guide evidence-based nursing care. C) The art of nursing is demonstrated through carrying out the science of nursing in a skillful, knowledgeable, intelligent, and ethical manner. D) The artful side of nursing is of less value to positive patient outcomes than is the science of nursing.

Evidence-based practice is based on the scientific method and empirical evidence. Which of the following is a principle of empirical evidence?

A) Scientific observations are subjective inferences made by the knowledgeable nurse researcher. B) Empirical studies may be designed to report the physical and mental effects of subjective experiences. C) Empirical evidence is not appropriate in the field of mental health because cognitions and emotions are subjective and unpredictable. D) Empirical knowledge is verifiable only with valid and reliable measurement instruments.

The nurse is part of team conducting a research study that involves controlled observations. Controlled observations involve which of the following activities?

A) Putting information together to form a new understanding B) Watching something carefully and noting events C) Testing a hypothesis or prediction D) Determining whether data are reliable and supportive

Two patients with schizophrenia have consented to be involved in clinical trials to determine the efficacy of a new antipsychotic medication. The researcher administers the new drug to one subject and a sugar pill to another subject. The patient who received the sugar pill received a treatment that is considered which of the following?

A) Sham treatment B) Unethical treatment C) Placebo D) Supplemental therapy

A research team has been formed to study a new medication and its effects on depression. The researcher wants to use a design where neither the clients nor the research staff will know who is receiving the medication or the placebo. What type of study is this group conducting?

A) An empirical study B) An evidence-based study C) A case-control study

D) A double-blind study

A researcher is determining whether data that were obtained in a psychiatric nursing study are reliable and whether the data support the study hypothesis. In what part of the scientific process is the researcher functioning?

A) Experimentation B) Analysis C) Synthesis D) Prediction

The nurse is working with a 42-year-old female patient who is mildly overweight. The patient expresses a desire to “tone up” before summer and is interested in trying an over-the-counter weight loss remedy. The nurse should perform health education related to what subject?

A) To be wary of any product that claims rapid or effortless results without exercise B) The relatively low risk of using natural remedies C) The small amount of active ingredient in most over-the-counter treatments D) To choose a product that reports data indicating a high degree of effectiveness

Many people get health care information from the Internet. Hence, evidence-based health care can be threatened by the proliferation of pseudoscientific information available to the public. Which measure is currently being taken to prevent the misinformation of the healthcare consumer?

A) Evidence-based knowledge is currently only disseminated in professional journals and publications. B) The Food and Drug Administration (FDA) has been denied the jurisdiction to prosecute unscrupulous internet marketers. C) Public education is being performed by the Federal Trade Commission (FTC) through a campaign called Operation Cure All. D) Websites publicizing misinformation on the Internet are being screened and blocked. Chapter 05- Legal and Ethical Aspects

A psychiatric–mental health nurse has been consistently aware of the need to adhere to standards of practice during interactions with clients and their families. What is a standard of nursing practice?

A) The body of text in the state nurse practice act B) A document outlining minimum expectations for safe nursing practice C) Unwritten but traditional practices that constitute safe nursing care

D) Part of the federal nurse practice act

Nursing students are reviewing the nurse practice act in the state where they reside. A state's nurse practice act has which of the following functions?

A) Makes recommendations for how nurses should practice B) Defines the scope and limit of nursing practice C) Defines specific situations that constitute malpractice D) Follows federal laws about nursing practice

Chapter 01: Using Evidence in Practice Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition MULTIPLE CHOICE

Evidence-based practice is a problem-solving approach to making decisions about patient care that is grounded in:

a.	the latest information found in textbooks.
b.	systematically conducted research studies.
c.	tradition in clinical practice.
d.	quality improvement and risk-management data.

ANS: B The best evidence comes from well-designed, systematically conducted research studies described in scientific journals. Portions of a textbook often become outdated by the time it is published. Many health care settings do not have a process to help staff adopt new evidence in practice, and nurses in practice settings lack easy access to risk-management data, relying instead on tradition or convenience. Some sources of evidence do not originate from research. These include quality improvement and risk-management data; infection control data; retrospective or concurrent chart reviews; and clinicians’ expertise. Although non–research-based evidence is often very valuable, it is important that you learn to rely more on research-based evidence. DIF: Cognitive Level: Comprehension REF: Text reference: p. 2 OBJ: Discuss the benefits of evidence-based practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe and Effective Care Environment (management of care)

When evidence-based practice is used, patient care will be:

a.	standardized for all.
b.	unhampered by patient culture.
c.	variable according to the situation.
d.	safe from the hazards of critical thinking.

ANS: C Using your clinical expertise and considering patients’ cultures, values, and preferences ensures that you will apply available evidence in practice ethically and appropriately. Even when you use the best evidence available, application and outcomes will differ; as a nurse, you will develop critical thinking skills to determine whether evidence is relevant and appropriate. DIF: Cognitive Level: Application REF: Text reference: p. 2 OBJ: Discuss the benefits of evidence-based practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment MSC: NCLEX: Safe and Effective Care Environment (management of care)

When a PICOT question is developed, the letter that corresponds with the usual standard of care is:

a.	P.
b.	I.
c.	C.
d.	O.

ANS: C C = Comparison of interest. What standard of care or current intervention do you usually use now in practice? P = Patient population of interest. Identify your patient by age, gender, ethnicity, disease, or health problem. I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and prognostic factor) do you think is worthwhile to use in practice? O = Outcome. What result (e.g., change in patient’s behavior, physical finding, and change in patient’s perception) do you wish to achieve or observe as the result of an intervention? DIF: Cognitive Level: Knowledge REF: Text reference: p. 3 OBJ: Develop a PICO question. TOP: PICO KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

A well-developed PICOT question helps the nurse:

a.	search for evidence.
b.	include all five elements of the sequence.
c.	find as many articles as possible in a literature search.
d.	accept standard clinical routines.

ANS: A The more focused a question that you ask is, the easier it is to search for evidence in the scientific literature. A well-designed PICOT question does not have to include all five elements, nor does it have to follow the PICOT sequence. Do not be satisfied with clinical routines. Always question and use critical thinking to consider better ways to provide patient care. DIF: Cognitive Level: Analysis REF: Text reference: p. 3 OBJ: Describe the six steps of evidence-based practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

The nurse is not sure that the procedure the patient requires is the best possible for the situation. Utilizing which of the following resources would be the quickest way to review research on the topic?

a.	CINAHL
b.	PubMed
c.	MEDLINE
d.	The Cochrane Database

ANS: D The Cochrane Community Database of Systematic Reviews is a valuable source of synthesized evidence (i.e., pre-appraised evidence). The Cochrane Database includes the full text of regularly updated systematic reviews and protocols for reviews currently happening. MEDLINE, CINAHL, and PubMed are among the most comprehensive databases and represent the scientific knowledge base of health care. DIF: Cognitive Level: Synthesis REF: Text reference: p. 4 OBJ: Describe the six steps of evidence-based practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

The nurse is getting ready to develop a plan of care for a patient who has a specific need. The best source for developing this plan of care would probably be:

a.	The Cochrane Database.
b.	MEDLINE.
c.	NGC.
d.	CINAHL.

ANS: C The National Guidelines Clearinghouse (NGC) is a database supported by the Agency for Healthcare Research and Quality (AHRQ). It contains clinical guidelines—systematically developed statements about a plan of care for a specific set of clinical circumstances involving a specific patient population. The NGC is a valuable source when you want to develop a plan of care for a patient. The Cochrane Community Database of Systematic Reviews, MEDLINE, and CINAHL are all valuable sources of synthesized evidence (i.e., pre-appraised evidence). DIF: Cognitive Level: Synthesis REF: Text reference: p. 4 OBJ: Describe the six steps of evidence-based practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

The nurse has done a literature search and found 25 possible articles on the topic that she is studying. To determine which of those 25 best fit her inquiry, the nurse first should look at:

a.	the abstracts.
b.	the literature reviews.
c.	the “Methods” sections.
d.	the narrative sections.

ANS: A An abstract is a brief summary of an article that quickly tells you whether the article is research based or clinically based. An abstract summarizes the purpose of the study or clinical query, the major themes or findings, and the implications for nursing practice. The literature review usually gives you a good idea of how past research led to the researcher’s question. The “Methods” or “Design” section explains how a research study is organized and conducted to answer the research question or to test the hypothesis. The narrative of a manuscript differs according to the type of evidence-based article—clinical or research. DIF: Cognitive Level: Application REF: Text reference: p. 7 OBJ: Discuss elements to review when critiquing the scientific literature. TOP: Randomized Controlled Trials KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

The nurse wants to determine the effects of cardiac rehabilitation program attendance on the level of postmyocardial depression for individuals who have had a myocardial infarction. The type of study that would best capture this information would be a:

a.	randomized controlled trial.
b.	qualitative study.
c.	case control study.
d.	descriptive study.

ANS: B Qualitative studies examine individuals’ experiences with health problems and the contexts in which these experiences occur. A qualitative study is best in this case of an individual nurse who wants to examine the effectiveness of a local program. Randomized controlled trials involve close monitoring of control groups and treatment groups to test an intervention against the usual standard of care. Case control studies typically compare one group of subjects with a certain condition against another group without the condition, to look for associations between the condition and predictor variables. Descriptive studies focus mainly on describing the concepts under study. DIF: Cognitive Level: Synthesis REF: Text reference: p. 6 OBJ: Discuss ways to apply evidence in nursing practice. TOP: Randomized Controlled Trials KEY: Nursing Process Step: Implementation MSC: NCLEX: Safe and Effective Care Environment (management of care)

Six months after an early mobility protocol was implemented, the incidence of deep vein thrombosis in patients was decreased. This is an example of what stage in the EBP process?

a.	Asking a clinical question
b.	Applying the evidence
c.	Evaluating the practice decision
d.	Communicating your results

ANS: C After implementing a practice change, your next step is to evaluate the effect. You do this by analyzing the outcomes data that you collected during the pilot project. Outcomes evaluation tells you whether your practice change improved conditions, created no change, or worsened conditions. DIF: Cognitive Level: Application REF: Text reference: p. 9 OBJ: Discuss ways to apply evidence in nursing practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Evaluation MSC: NCLEX: Safe and Effective Care Environment (safety and infection control) MULTIPLE RESPONSE

To use evidence-based practice appropriately, you need to collect the most relevant and best evidence and to critically appraise the evidence you gather. This process also includes: (Select all that apply.)

a.	asking a clinical question.
b.	applying the evidence.
c.	evaluating the practice decision.
d.	communicating your results.

ANS: A, B, C, D

Test Bank for Claytons Basic Pharmacology for Nurses 18th Edition by Willihnganz

Chapter 01: Drug Definitions, Standards, and Information Sources Willihnganz: Clayton’s Basic Pharmacology for Nurses, 18th Edition MULTIPLE CHOICE 1.What is the name under which a drug is listed by the US Food and Drug Administration (FDA)?

a.	Brand
b.	Nonproprietary
c.	Official
d.	Trademark

ANS: C The official name is the name under which a drug is listed by the FDA. The brand name, or trademark, is the name given to a drug by its manufacturer. The nonproprietary, or generic, name is provided by the United States Adopted Names Council DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1 NAT: NCLEX Client Needs Category: Safe, Effective Care Environment TOP: Nursing Process Step: Assessment CON: Patient Education

Which source contains information specific to nutritional supplements?

a.	USP Dictionary of USAN & International Drug Names
b.	Natural Medicines Comprehensive Database
c.	United States Pharmacopoeia/National Formulary (USP NF)
d.	Drug Interaction Facts

ANS: C United States Pharmacopoeia/National Formulary contains information specific to nutritional supplements. USP Dictionary of USAN & International Drug Names is a compilation of drug names, pronunciation guide, and possible future FDA approved drugs; it does not include nutritional supplements. Natural Medicines Comprehensive Database contains evidence-based information on herbal medicines and herbal combination products; it does not include information specific to nutritional supplements. Drug Interaction Facts contains comprehensive information on drug interaction facts; it does not include nutritional supplements. DIF: Cognitive Level: Knowledge REF: p. 2 | p. 3 OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Assessment CON: Nutrition | Patient Education 3.What is the most comprehensive reference available to research a drug interaction?

a.	Drug Facts and Comparisons
b.	Drug Interaction Facts
c.	Handbook on Injectable Drugs
d.	Martindale—The Complete Drug Reference

ANS: B First published in 1983, Drug Interaction Facts is the most comprehensive book available on drug interactions. In addition to monographs listing various aspects of drug interactions, this information is reviewed and updated by an internationally renowned group of physicians and pharmacists with clinical and scientific expertise. DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Assessment CON: Safety | Patient Education | Clinical Judgment 4.The physician has written an order for a drug with which the nurse is unfamiliar. Which section of the Physicians’ Desk Reference (PDR) is most helpful to get information about this drug?

a.	Manufacturer’s section
b.	Brand and Generic name section
c.	Product category section
d.	Product information section

ANS: B A physician’s order would include the brand and/or generic name of the drug. The alphabetic index in the PDR would make this section the most user-friendly. Based on a physician’s order, manufacturer’s information and classification information would not be known. The Manufacturer’s section is a roster of manufacturers. The product category section lists products subdivided by therapeutic classes, such as analgesics, laxatives, oxytocics, and antibiotics. The product information section contains reprints of the package inserts for the major products of manufacturers. DIF: Cognitive Level: Comprehension REF: p. 4 OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Planning CON: Safety | Patient Education | Clinical Judgment 5.Which online drug reference makes available to healthcare providers and the public a standard, comprehensive, up-to-date look up and downloadable resource about medicines?

a.	American Drug Index
b.	American Hospital Formulary
c.	DailyMed
d.	Physicians’ Desk Reference (PDR)

ANS: C DailyMed makes available to healthcare providers and the public a standard, comprehensive, up-to-date look up and downloadable resource about medicines. The American Drug Index is not appropriate for patient use. The American Hospital Formulary is not appropriate for patient use. The PDR is not appropriate for patient use. DIF: Cognitive Level: Knowledge REF: p. 3 | p. 5 OBJ: 4 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Implementation CON: Safety | Patient Education | Clinical Judgment 6.Which legislation authorizes the FDA to determine the safety of a drug before its marketing?

a.	Federal Food, Drug, and Cosmetic Act (1938)
b.	Durham Humphrey Amendment (1952)
c.	Controlled Substances Act (1970)
d.	Kefauver Harris Drug Amendment (1962)

ANS: A The Federal Food, Drug, and Cosmetic Act of 1938 authorized the FDA to determine the safety of all drugs before marketing. Later amendments and acts helped tighten FDA control and ensure drug safety. The Durham Humphrey Amendment defines the kinds of drugs that cannot be used safely without medical supervision and restricts their sale to prescription by a licensed practitioner. The Controlled Substances Act addresses only controlled substances and their categorization. The Kefauver Harris Drug Amendment ensures drug efficacy and greater drug safety. Drug manufacturers are required to prove to the FDA the effectiveness of their products before marketing them. DIF: Cognitive Level: Knowledge REF: p. 5 OBJ: 6 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Assessment CON: Safety | Patient Education | Evidence | Health Care Law 7.Meperidine (Demerol) is a narcotic with a high potential for physical and psychological dependency. Under which classification does this drug fall?

a.	I
b.	II
c.	III
d.	IV

ANS: B Meperidine (Demerol) is a Schedule II drug; it has a high potential for abuse and may lead to severe psychological and physical dependence. Schedule I drugs have high potential for abuse and no recognized medical use. Schedule III drugs have some potential for abuse. Use may lead to low to moderate physical dependence or high psychological dependence. Schedule IV drugs have low potential for abuse. Use may lead to limited physical or psychological dependence. DIF: Cognitive Level: Comprehension REF: p. 5 OBJ: 2 NAT: NCLEX Client Needs Category: Safe, Effective Care Environment TOP: Nursing Process Step: Assessment CON: Patient Education | Addiction | Pain 8:What would the FDA do to expedite drug development and approval for an outbreak of smallpox, for which there is no known treatment?

a.	List smallpox as a health orphan disease.
b.	Omit the preclinical research phase.
c.	Extend the clinical research phase.
d.	Fast track the investigational drug.

ANS: D

Test Bank Community Health Nursing in Canada, 3rd Edition by Marcia Stanhope

Chapter 01: Community Health Nursing

Stanhope: Community Health Nursing in Canada, 3rd Canadian Edition

MULTIPLE CHOICE

1. Which of the following best describes community health nursing?

a.	Giving care with a focus on the aggregate’s needs
b.	Giving care with a focus on the group’s needs
c.	Focusing on the health care of individual clients in the community
d.	Working with an approach of unique client care

ANS: C By definition, community health nursing is the health care of individual clients in the community. DIF: Cognitive Level: Knowledge/Remember REF: p. 3 OBJ: 1.6 TOP: Client Need: Safe and Effective Care Environment - Management of Care 2. Which of the following best describes primary health care?

a.	A comprehensive way to address issues of social justice
b.	Giving the care to manage acute or chronic conditions
c.	Giving direct care to ill individuals within their family setting
d.	Having the goal of health promotion and disease prevention

ANS: A By definition, primary health care is comprehensive and addresses issues of social justice and equity. Social justice in the context of health refers to ensuring fairness and equality in health services so that vulnerable individuals in society have easy access to health care. DIF: Cognitive Level: Knowledge/Remember REF: p. 10 OBJ: 1.4 TOP: Client Need: Health Promotion and Maintenance 3. The health of which of the following is the primary focus of public health nurses (PHNs)?

a.	Families
b.	Groups
c.	Individuals
d.	Populations

ANS: D PHNs use knowledge of nursing, social sciences, and public health sciences for the promotion and protection of health and for the prevention of disease among populations. DIF: Cognitive Level: Knowledge/Remember REF: p. 13, Table 1-4 | p. 20 OBJ: 1.5 TOP: Client Need: Health Promotion and Maintenance 4. Which change is the primary explanation for life expectancy increasing so notably since the early 1900s?

a.	An increase in findings from medical laboratory research
b.	Incredible advances in surgical techniques and procedures
c.	Improved sanitation and other public health activities
d.	Increased use of antibiotics to fight infections

ANS: C Improvement in control of infectious diseases through immunizations, sanitation, and other public health activities led to the increase in life expectancy since the early 1900s. DIF: Cognitive Level: Knowledge/Remember REF: pp. 12-13 OBJ: 1.5 TOP: Client Need: Health Promotion and Maintenance 5. Which community health nursing practice area receives funding from the private sector?

a.	Telenurses
b.	Corrections nurses
c.	Nurse entrepreneurs
d.	Street or outreach nurses

ANS: C The nurse entrepreneur receives private funding, whereas all of the other community health nurse (CHN) roles are with provincially or federally funded positions. DIF: Cognitive Level: Knowledge/Remember REF: p. 22, Table 1-4 Examples OBJ: 1.6 TOP: Client Need: Safe and Effective Care Environment - Management of Care 6. A PHN strives to prevent disease and disability, often in partnership with other community groups. Which statement is an appropriate summary of the PHN’s role?

a.	The PHN asks the political leaders what interventions should be chosen.
b.	The PHN assesses the community and decides on appropriate interventions.
c.	The PHN uses data from the main health care institutions in the community to determine needed health services.
d.	The PHN works with community members to carry out public health functions.

ANS: D It is crucial that the PHN work with members of the community to carry out core public health functions. DIF: Cognitive Level: Application/Apply REF: p. 13, How To box OBJ: 1.5 TOP: Client Need: Health Promotion and Maintenance 7. Which of the following is used as a measurement of population health?

a.	Health status indicators
b.	The levels of prevention
c.	The number of memberships at the local fitness centre
d.	Reported provincial alcohol and tobacco sales in any given month

ANS: A Population health refers to the health outcomes of a population as measured by determinants of health and health outcomes. DIF: Cognitive Level: Knowledge/Remember REF: p. 16 OBJ: 1.2 TOP: Client Need: Health Promotion and Maintenance 8. A registered nurse (RN), has just been employed as a CHN. Which question would be most relevant to her practice as she begins her position?

a.	“Which community groups are at greatest risk for problems?”
b.	“Which patients should I see first as I begin my day?”
c.	“With which physicians will I be collaborating most closely?”
d.	“Who is the nursing assistant to whom I can refer patients?”

ANS: A CHNs apply the nursing process to the entire community; asking which groups are at greatest risk reflects a community-oriented perspective. The other possible responses focus on particular individuals. DIF: Cognitive Level: Application/Apply REF: p. 15 OBJ: 1.6 TOP: Client Need: Health Promotion and Maintenance 9. The CHN working with women at the senior citizens’ centre reminds them that the only way the centre will be able to afford a driver and a van service for those who cannot drive themselves is to continue to write letters to their local city council representatives, requesting funding for such a service. What is the CHN doing?

a.	Ensuring that the women do not expect the CHN herself to do anything about their problem
b.	Demonstrating that she understands the women’s concerns and needs
c.	Expressing empathy, support, and concern
d.	Helping the women engage in political action locally

ANS: D CHNs have an imperative to work with the members of the community to carry out public health functions such as political action. DIF: Cognitive Level: Application/Apply REF: p. 13, How To box OBJ: 1.5 | 1.6 TOP: Client Need: Safe and Effective Care Environment - Management of Care 10. Which activity is an example of the “advocate” role of the CHN?

a.	Organizing home care support for a newly discharged older adult client
b.	Acting as a member of a community action group for provision of accessible transit choices
c.	Doing prenatal assessments
d.	Facilitating a self-help group for smoking cessation

ANS: B An advocate provides a voice to client concerns when acting as a member of a community action group for provision of accessible transit choices. DIF: Cognitive Level: Application/Apply REF: p. 19, Table 1-3 OBJ: 1.6 TOP: Client Need: Safe and Effective Care Environment - Management of Care 11. In which scenario is the PHN most comprehensively fulfilling collaborative practice responsibilities?

a.	The PHN meets with several groups about community recreation issues.
b.	The PHN spends the day attending meetings at various health agencies.
c.	The PHN talks to several people about their particular health concerns.
d.	The PHN watches television, including a telecast of a city council meeting on the local cable station.

ANS: B Any of these might represent a PHN communicating, cooperating, or collaborating with community residents or groups about health concerns. However, the PHN who spends the day attending meetings at various health agencies is most comprehensively fulfilling requirements effectively, since health is broader than recreation, individual concerns are not as important as aggregate priorities, and watching television is only one-way communication. DIF: Cognitive Level: Synthesis/Synthesize REF: pp. 15-16 OBJ: 1.5 TOP: Client Need: Safe and Effective Care Environment - Management of Care 12. A CHN often has to make resource allocation decisions. In such cases, which approach will most help the CHN to arrive at the decision?

a.	Choosing a moral or ethical principle
b.	Choosing the cheapest, most economical approach
c.	Choosing the most rational outcome
d.	Choosing the needs of the aggregate, rather than the needs of a few individuals

ANS: D Although all of the answers represent components of the CHN’s decision-making process, the predominant needs of the population outweigh the expressed needs of one person or a few people. DIF: Cognitive Level: Application/Apply REF: pp. 7-8 OBJ: 1.3 TOP: Client Need: Safe and Effective Care Environment - Management of Care 13. Which situation most closely represents the focus of public health nursing?

a.	Assessing the services and effectiveness of the school health clinic
b.	Caring for patients after their outpatient surgeries
c.	Giving care to schoolchildren at the school clinic and to the children’s families
d.	Treating paediatric patients at an outpatient clinic

ANS: A A public health or population-focused approach would consider the entire group of children receiving care, to see if services are effective in achieving the goal of improving the health of the school population. DIF: Cognitive Level: Application/Apply REF: p. 13, How To box OBJ: 1.5 TOP: Client Need: Health Promotion and Maintenance 14. Which public health service best represents primary prevention?

a.	Developing a health education program about the dangers of smoking
b.	Providing a diabetes clinic for adults in low-income neighbourhoods
c.	Providing an influenza vaccination program in a community retirement village
d.	Teaching school-aged children about the positive effects of exercise

ANS: C Although all the services listed are appropriate and valuable, providing influenza vaccines to healthy adults represents the primary level of health prevention. DIF: Cognitive Level: Application/Apply REF: p. 14 OBJ: 1.5 TOP: Client Need: Health Promotion and Maintenance 15. What term is used interchangeably with the term subpopulations?

a.	Groups
b.	Aggregates
c.	Clients
d.	Communities

ANS: B Generally, subpopulations are referred to as aggregates within the larger community population. DIF: Cognitive Level: Knowledge/Remember REF: p. 16 OBJ: 1.2 TOP: Client Need: Health Promotion and Maintenance

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Test Bank Community Health Nursing in Canada, 3rd Edition by Marcia Stanhope

Chapter 01: Community Health Nursing

Stanhope: Community Health Nursing in Canada, 3rd Canadian Edition

MULTIPLE CHOICE