Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A charge nurse is discussing evidence-based practice (EBP) with a newly licensed nurse.
Which of the following information should the nurse include when discussing the hierarchy of evidence?
A. One of the highest levels of evidence are randomized, controlled, double-blind studies.
One of the highest levels of evidence are randomized, controlled, double-blind studies. This is because these studies reduce the risk of bias and confounding factors by randomly assigning participants to intervention or control groups, blinding the participants and researchers to the group allocation, and using a placebo or standard treatment as a comparison.
B. Ideas, editorials, and opinions are highly valued in determining EBP.
Choice B is wrong because ideas, editorials, and opinions are considered low levels of evidence as they are based on personal views and not on rigorous research methods.
C. The purpose of the hierarchy of evidence is to help the nurse compare patient values with research findings.
Choice C is wrong because the purpose of the hierarchy of evidence is to help the nurse evaluate the quality and strength of the research findings, not to compare patient values with research findings. Patient values are important for evidence-based practice, but they are not part of the hierarchy of evidence.
D. All forms of evidence should be considered equally when.
Choice D is wrong because all forms of evidence should not be considered equally when determining evidence-based practice. The hierarchy of evidence ranks different types of research designs according to their validity and applicability, and the nurse should use the highest level of evidence available for their clinical question.
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Full Explanation
One of the highest levels of evidence are randomized, controlled, double-blind studies. This is because these studies reduce the risk of bias and confounding factors by randomly assigning participants to intervention or control groups, blinding the participants and researchers to the group allocation, and using a placebo or standard treatment as a comparison.
Choice B is wrong because ideas, editorials, and opinions are considered low levels of evidence as they are based on personal views and not on rigorous research methods.
Choice C is wrong because the purpose of the hierarchy of evidence is to help the nurse evaluate the quality and strength of the research findings, not to compare patient values with research findings.
Patient values are important for evidence-based practice, but they are not part of the hierarchy of evidence.
Choice D is wrong because all forms of evidence should not be considered equally when determining evidence-based practice. The hierarchy of evidence ranks different types of research designs according to their validity and applicability, and the nurse should use the highest level of evidence available for their clinical question.
Similar Questions
A home health nurse visits a client who has COPD and receives oxygen at 2 L/min via nasal cannula. The client reports difficulty breathing.
Which of the following actions is the nurse’s priority?
A. Call emergency services for the client.
Choice A is wrong because it does not address the immediate need of assessing the respiratory status and may cause unnecessary panic or delay in treatment.
B. Increase the oxygen flow to 3 L/min.
Choice B is wrong because it does not follow the guidelines for oxygen therapy for COPD, which require a prescription and monitoring of oxygen levels. Increasing the oxygen flow without assessing the oxygen level could cause oxygen toxicity or suppress the respiratory drive.
C. Have the client cough and expectorate secretions.
Choice C is wrong because it is not the most urgent action to take. Having the client cough and expectorate secretions may help clear the airway, but it may also increase the work of breathing and worsen hypoxia. Assessing the respiratory status should come first. Normal ranges for oxygen saturation are 95% to 100% for healthy individuals and 88% to 92% for most people with COPD. Normal ranges for blood gas tests vary depending on the laboratory, but generally, normal values for arterial blood gas are: pH 7.35 to 7.45, PaCO2 35 to 45 mm Hg, PaO2 80 to 100 mm Hg, HCO3 22 to 26 mEq/L.
D. Assess the client’s respiratory status.
This is the nurse’s priority because it will help determine the severity of the client’s difficulty breathing and guide the appropriate interventions. According to the Mayo Clinic, oxygen therapy for COPD is indicated when there is not enough oxygen in the blood, which can be measured by a pulse oximeter or a blood gas test. Increasing the oxygen flow without assessing the oxygen level could be harmful or ineffective. Having the client cough and expectorate secretions may help clear the airway, but it is not the first action to take. Calling emergency services may be necessary if the client’s condition is life threatening, but it should not be done before assessing the respiratory status.
Full Explanation
This is the nurse’s priority because it will help determine the severity of the client’s difficulty breathing and guide the appropriate interventions. According to the Mayo Clinic, oxygen therapy for COPD is indicated when there is not enough oxygen in the blood, which can be measured by a pulse oximeter or a blood gas test. Increasing the oxygen flow without assessing the oxygen level could be harmful or ineffective. Having the client cough and expectorate secretions may help clear the airway, but it is not the first action to take. Calling emergency services may be necessary if the client’s condition is life threatening, but it should not be done before assessing the respiratory status.
Choice A is wrong because it does not address the immediate need of assessing the respiratory status and may cause unnecessary panic or delay in treatment.
Choice B is wrong because it does not follow the guidelines for oxygen therapy for COPD, which require a prescription and monitoring of oxygen levels.
Increasing the oxygen flow without assessing the oxygen level could cause oxygen toxicity or suppress the respiratory drive.
Choice C is wrong because it is not the most urgent action to take.
Having the client cough and expectorate secretions may help clear the airway, but it may also increase the work of breathing and worsen hypoxia.
Assessing the respiratory status should come first.
Normal ranges for oxygen saturation are 95% to 100% for healthy individuals and 88% to 92% for most people with COPD. Normal ranges for blood gas tests vary depending on the laboratory, but generally, normal values for arterial blood gas are: pH 7.35 to 7.45, PaCO2 35 to 45 mm Hg, PaO2 80 to 100 mm Hg, HCO3 22 to 26 mEq/L.
A nurse is teaching about values to a newly licensed nurse.
Which of the following statements by the newly licensed nurse indicates an understanding?
A. “A nurse’s personal values are not considered when making ethical decisions.”
Choice A is wrong because “A nurse’s personal values are not considered when making ethical decisions.” This statement contradicts the ethical principle of integrity, which means that the nurse acts in accordance with their personal and professional values and standards.
B. “A nurse’s behaviors and actions are called values.”
Choice B is wrong because “A nurse’s behaviors and actions are called values.” This statement confuses values with morals, which are the judgments about behaviors and actions based on personal or societal beliefs.
C. “It is important that the nurse is aware of the client’s values.”
This statement indicates an understanding of the ethical principle of respect for autonomy, which means that the nurse respects the client’s right to make their own decisions about their care and respects their values and beliefs.
D. “Value clarification involves maintaining clinical competency.”.
Choice D is wrong because “Value clarification involves maintaining clinical competency.” This statement confuses value clarification with professionalism, which involves maintaining clinical competency, accountability, and responsibility. Value clarification is a process of self-exploration and reflection that helps the nurse identify their own values and understand how they affect their ethical decisions.
E. “Value clarification involves maintaining clinical competency.”.
Full Explanation
This statement indicates an understanding of the ethical principle of respect for autonomy, which means that the nurse respects the client’s right to make their own decisions about their care and respects their values and beliefs.
Choice A is wrong because “A nurse’s personal values are not considered when making ethical decisions.” This statement contradicts the ethical principle of integrity, which means that the nurse acts in accordance with their personal and professional values and standards.
Choice B is wrong because “A nurse’s behaviors and actions are called values.” This statement confuses values with morals, which are the judgments about behaviors and actions based on personal or societal beliefs.
Choice D is wrong because “Value clarification involves maintaining clinical competency.” This statement confuses value clarification with professionalism, which involves maintaining clinical competency, accountability, and responsibility. Value clarification is a process of self-exploration and reflection that helps the nurse identify their own values and understand how they affect their ethical decisions.
In individuals who have appendicitis, the pain will typically localize to McBurney’s point.
Which quadrant of the abdomen is McBurney’s point found?
A. Left lower quadrant.
Choice A is wrong because the left lower quadrant is where the sigmoid colon and part of the small intestine are located. These organs are not related to appendicitis.
B. Left upper quadrant.
Choice B is wrong because the left upper quadrant is where the stomach, spleen, and part of the pancreas are located. These organs are also not related to appendicitis.
C. Right upper quadrant.
Choice C is wrong because the right upper quadrant is where the liver, gallbladder, and part of the small intestine are located. These organs can cause pain in this area if they have problems, but not appendicitis.
D. Right lower quadrant.
McBurney’s point is located one-third of the distance from the right anterior superior iliac spine to the umbilicus. This is where the base of the appendix is attached to the cecum, which is part of the large intestine. When the appendix becomes inflamed or infected, it causes pain in this area.
Full Explanation
Choice A is wrong because the left lower quadrant is where the sigmoid colon and part of the small intestine are located.
These organs are not related to appendicitis.
Choice B is wrong because the left upper quadrant is where the stomach, spleen, and part of the pancreas are located.
These organs are also not related to appendicitis.
Choice C is wrong because the right upper quadrant is where the liver, gallbladder, and part of the small intestine are located. These organs can cause pain in this area if they have problems, but not appendicitis