Deck 4: Evidence-Based Practice and Ethics in Communitypublic Health

Question 1

A nursing instructor is preparing a teaching plan for a class comparing evidence-based practice and critical thinking. Which concept would the instructor include?

A) Evidence-based practice and critical thinking are polar opposites.
B) Problem clarification of central concepts is inherent to both.
C) Interpretation of accumulated evidence is unique to evidence-based practice.
D) Problem exploration is unique to critical thinking.

Answer 1

Problem clarification of central concepts is inherent to both.

Question 2

According to the Institute of Medicine's landmark report, the Future of Nursing, nurses should do what? Select all that apply.

A) Work independently from other health professionals to promote the profession of nursing.
B) Work collaboratively with other health professionals to promote health care.
C) Attempt to redesign health care.
D) Improve practices through evidence-based means.
E) Provide the Future of Nursing report that does not express the importance of evidence-based nursing.

Answer 2

Work collaboratively with other health professionals to promote health care.
Attempt to redesign health care.
Improve practices through evidence-based means.

Question 3

Multiple reports such as To Err Is Human: Building a Safer Health System (2000), Crossing the Quality Chasm: A New Health System for the 21st Century (2001), and Priority Areas for National Action: Transforming Health Care Quality (2003) have supported evidence-based practice in the past decade. Which statement best summarizes evidence-based nursing practice?

A) We must continue to cling to "the way we've always done it."
B) We have spent billions of dollars each year researching new treatments and have translated that knowledge into clinical practice.
C) We are not translating the knowledge that we are gaining into clinical practice.
D) We have continued to spend more than a trillion dollars a year providing care and do translate that capacity into improved clinical practice.

Answer 3

We are not translating the knowledge that we are gaining into clinical practice.

Question 4

Which statement about the steps of the EBP process is most accurate?

A) One of the last steps of the EBP process is to search for and collect the most relevant best evidence.
B) One of the earliest steps in the EBP process is to disseminate the outcomes of the EBP decision or change.
C) It is optional to integrate the best evidence with one's clinical expertise and patient preferences and values in making a practice decision or change.
D) The first step in the EBP process is to cultivate a spirit of inquiry.

Question 5

Which statement about cultivating a spirit of inquiry is most accurate?

A) It is not very important; research will be performed anyway.
B) In order for effective change to occur, current practices must be continually examined, questioned, and challenged.
C) It involves "asking the burning clinical question."
D) The agency does not have an important role in cultivating a spirit of inquiry.

Question 6

Which statements about the impact of research on community health nursing are true? Select all that apply.

A) It is important to conduct research to affect public policy.
B) Public policy will continue to have a negative effect on the community's health.
C) Research will affect the effectiveness of community health nursing practice.
D) Research will affect the status and influence of nursing as a profession.
E) The impact that research has on community health nursing is negligible.

Question 7

Application of nursing research results to community health nursing practice is essential. Which step must occur before results can be applied?

A) Be informed about research findings.
B) Demonstrate skill in examining research reports.
C) Assess abstracts of relevant research studies.
D) Check if the study was funded by a drug company.

Question 8

After teaching a class on values, which statement by the class indicates the need for additional teaching?

A) "Some values are descriptive, while others are evaluative."
B) "Keeping a promise is an example of a terminal value."
C) "Values persist, remaining relatively stable over time."
D) "Certain values have more importance than others."

Question 9

Which action would the community health nurse take first when making an ethical decision?

A) Engage in critical thinking.
B) Choose a value.
C) Identify isolated values.
D) Clarify one's values.

Question 10

After a class discussion on moral evaluations, which characteristic identified by the class would lead the instructor to determine that the discussion has been effective?

A) There is specificity that applies to an individual person.
B) A special place is given to a person's own welfare.
C) Other values cannot override the moral evaluation.
D) They relate to a matter of individual taste.

Question 11

A group of students are reviewing for an examination on values. Identification of which as an instrumental value indicates the need for continued study?

A) Spiritual salvation
B) Confidentiality
C) Honesty
D) Promise keeping

Question 12

A community health nurse obtains a client's informed consent for care demonstrating the understanding that this is derived from which value?

A) Self-interest
B) Well-being
C) Equity
D) Self-determination

Question 13

Which statement about basic values that guide decision-making in community health nursing is true?

A) Client empowerment means that the provider must use a paternalistic approach to health care.
B) Self-interest does not interfere with self-determination.
C) When matters of well-being are considered, the client's preferences and needs should not be considered.
D) Equity is not possible in times of limited resources.

Question 14

In which situations should self-determination be restricted? Select all that apply.

A) When some objectives of individuals are contrary to the public interest or the interests of others in society.
B) When a person's decision-making is so defective or mistaken that the decision fails to promote the person's own values or goals.
C) When it interferes with self-interest.
D) Self-determination and personal autonomy must never be restricted.
E) When self-determination deteriorates into self-interest and poses a major roadblock to equitable care.

Question 15

A community health nurse is applying the value of equity in decision-making with clients. Which statement best describes this value?

A) Forming, revising, and pursuing personal life plans
B) Promoting clients' health and a sense of well-being
C) Fulfilling one's desires over those of others
D) Treating similar cases in the same fair fashion

Question 16

When working with clients, a community health nurse promotes the clients' self-concept and health-promoting behaviors. The nurse is attempting to achieve which outcome?

A) A value system
B) Prescriptive-proscriptive beliefs
C) Individual autonomy
D) Values clarification

Question 17

A community health nurse discovers that a bill in the legislature would eliminate a state law that currently funds child health promotion services for low-income children. Which action at the primary level of prevention would be most appropriate?

A) Advocate for amendment to the passed law to allow some funding for children to remain.
B) Once the bill has been passed, seek private resources to support funding of health promotion services for low-income children.
C) Gather a group of health professionals to volunteer to provide the health promotion services eliminated by the passed bill.
D) Advocate through active lobbying against the bill and gather community support.

Question 18

After teaching a class on ethical principles, the instructor determines that the class needs additional instruction when they identify which as an ethical principle?

A) Respect
B) Autonomy
C) Morality
D) Justice

Question 19

A community health nurse is working to support programs to encourage preschool immunizations. The nurse is integrating which ethical principle in his or her practice?

A) Beneficence
B) Autonomy
C) Nonmaleficence
D) Justice

Question 20

A community health nurse working with a group of families who come to local community health care center tells them that she is going to be setting up child care so that the families can participate in the various classes being offered by the center. Three months have passed, and the nurse still has not instituted the child care program. The nurse has violated which ethical principle?

A) Veracity
B) Fidelity
C) Justice
D) Respect

Question 21

A public health nurse is faced with an ethical dilemma. Which question should the nurse consider first when deciding how to resolve the dilemma?

A) "What exactly is the ethical dilemma?"
B) "What are the alternative courses of action?"
C) "What are the consequences of each alternative courses of action?"
D) "How should this dilemma be solved?"

Question 22

A community health nurse is working with a grassroots lobbying group to bring equitable health care access to a rural farm migrant area. Which fundamental ethical principle is the nurse using to guide provisions of care for the migrant population?

A) Veracity
B) Fidelity
C) Justice
D) Respect

Question 23

A community health nurse is promoting legislation to protect the environment from industry pollutants. Which fundamental ethical principle is the nurse using to guide provisions of care for the population?

A) Veracity
B) Fidelity
C) Justice
D) Nonmaleficence

Question 24

A community health nurse is discussing the core functions of public health inquiry with a group of student nurses. Which statement made by a student nurse indicates the need for further discussion about the core functions?

A) "One of the core functions is being able to analyze alternative courses of action and their consequences."
B) "Identifying and clarifying ethical dilemmas is a core function of public health inquiry."
C) "One of the main functions of public health inquiry is being an active member of the community in order to understand the need first hand."
D) "Incorporating guiding principles and values is very important when trying to resolve the dilemma."

Question 25

A community health nurse is working with a group of parents concerned with drug use within the school system. The nurse is open to hear their concerns and values their input when working toward the development of meeting the needs of the group. Which fundamental ethical principle is the nurse using to guide decision-making in this situation?

A) Veracity
B) Fidelity
C) Justice
D) Respect

Question 26

A community health nurse is working with a community group to meet the various needs in the area. Which principle would the nurse apply when working with the community group?

A) Tenacity
B) Autonomy
C) Advocacy
D) Privacy

Question 27

A nurse is researching a type of research which is housed in the Cochrane Collaboration and summarizes a known problem or situation. Which type of evidence is it classified?

A) Systematic review
B) Scoping review
C) Meta-analysis
D) Evidence based

Question 28

A nurse is interviewing for a nursing job in a clinic. During the interview, the nurse manager asks the nurse to explain a situation using core nursing values. Which is an example of a nursing value?

A) A nurse counsels the family of a dying patient to withdrawal treatment.
B) A nurse commits to picking up another shift for another coworker.
C) A nurse completes a nursing assessment every 4 hours on the assigned patients.
D) A nurse assists the clinic staff to protect the clients in the building during a thunderstorm.

Question 29

There are basic protections for research participants when a nurse is conducting research. Which statements pertain to protecting patients in research? Select all that apply.

A) The research conducted should not inflect permanent or serious harm.
B) At any time, research must be stopped if there is evidence of harm.
C) A research participant may withdrawal from participation at any time.
D) There needs to be a direct benefit to the participants who participate.
E) Consents include full disclosure of the study and assurance of privacy.
F) Children sign their own consents.