Deck 2: Informatics and Evidence-Based Practice in Medical-Surgical Nursing

Question 1

The nurse is determining the best internal evidence to use when planning evidence-based interventions for a patient's care. What should the nurse take into consideration when making this determination?

A) Opinions of authorities and reports of expert committees
B) Systematic reviews of descriptive and qualitative studies
C) Systematic reviews or meta-analyses of randomized controlled trials
D) Comparison of patient assessment and evaluation with quality improvement and outcome evaluations

Answer 1

Comparison of patient assessment and evaluation with quality improvement and outcome evaluations

Question 2

The staff development trainer is preparing a seminar for experienced nurses on the computerized clinical documentation system. What should the trainer include in this presentation?

A) Strategies to locate information quickly
B) Tips on using the computers and software efficiently
C) Reasons the documentation system supports patient care
D) Approaches to identify relationships among data elements
E) Case studies to analyze data patterns to make clinical judgments

Answer 2

Approaches to identify relationships among data elements
Case studies to analyze data patterns to make clinical judgments

Question 3

The nurse reviews quality improvement results and outcomes evaluations before selecting evidence-based practice interventions for a patient's care. What information is the nurse using?

A) Issue of interest
B) Internal evidence
C) External evidence
D) Patient population

Answer 3

Internal evidence

Question 4

The nurse manager determines that a staff nurse planned quality care for an assigned patient. What did the manager observe to come to this conclusion?

A) Incorporation of patient preferences
B) Accurate calculation of intake and output
C) Delegation of tasks to unlicensed assistive personnel
D) Logging out of the computer system after documenting

Question 5

The nurse is a member of the quality improvement committee within a healthcare organization. What action indicates that the information from this committee is being used to support evidence-based practice?

A) Quality improvement indicators address the largest volume of patient safety hazards.
B) Outcomes from quality improvement studies supersede patient preferences and values.
C) Committee participants support the use of evidence-based practice when planning patient care.
D) Results from quality improvement studies are being used as internal evidence for interventions.

Question 6

The Board of Directors for a major healthcare organization asks the Department of Patient Care Services to implement evidence-based practice. What reasons did the board most likely use to make this recommendation?

A) Rising cost for healthcare
B) Requests by the nursing staff
C) Expectation to do the right thing
D) Reduced numbers of hospital inpatients
E) Desire to engage in quality improvement

Question 7

The manager is on a committee that is investigating the implementation of evidenced-based practice for the nursing staff. Which outcomes should the manager highlight as expected when this approach is implemented?

A) Reduces costs
B) Promotes the best patient outcomes
C) Encourages healthcare worker retention
D) Reduces the cost of healthcare worker salaries
E) Reduces care variations between geographic locations

Question 8

The nurse manager is explaining evidence-based practice (EBP) to the staff during a weekly meeting. Which statement should the manager use when explaining this approach to care?

A) "EBP expedites the assessment phase of the nursing process."
B) "EBP is a problem-solving approach to clinical practice questions."
C) "EBP is quicker than using the nursing process when providing patient care."
D) "EBP demonstrates an interest in furthering the development of nursing science."

Question 9

While documenting care provided to a patient in the home, the nurse encounters a problem with the electronic medical record. Which action indicates that the nurse was able to troubleshoot and address the problem?

A) Followed the steps in the technical difficulties guide and completed documentation
B) Closed the electronic medical record and documented care in a traditional hard-copy note
C) Telephoned the information technology department and reported a problem with the system
D) Used the patient's personal computer to access the electronic record to record documentation

Question 10

The nurse is implementing evidence-based practice when caring for a patient with a chronic illness. Which actions indicate that the nurse is implementing this approach appropriately?

A) Studies healthcare provider's written orders
B) Analyzes patient's requests for care approaches
C) Asks colleagues to identify best approaches to care
D) Plans intervention based upon researched information
E) Reviews findings from patient assessment and laboratory data

Question 11

The nurse is a member of a committee charged with selecting a computerized clinical information system for an organization. Which features should the nurse recommend be included in this system to support patient care needs?

A) Standards of care
B) Quality improvement tracking database
C) Conditions of participation for health plans
D) Patient care policies and procedure manual
E) Clinical competency information and schedule

Question 12

The nurse is identifying external evidence to be used when implementing evidence-based practice for a patient's care. What should the nurse use as external evidence?

A) Textbooks
B) Research studies
C) Standardized care plans
D) Patient teaching materials

Question 13

The nurse is concluding actions taken when using evidence-based practice approaches to plan a patient's care. What should the nurse do to ensure that the planned care is of the highest quality?

A) Incorporate patient preferences and values
B) Transcribe the plan of care into the Kardex
C) Ask the manager to review the final plan of care
D) Discuss the plan of care with the healthcare provider

Question 14

What should a nurse who is reviewing interventions for a patient's health problem keep in mind when selecting applicable interventions?

A) Length of stay
B) Medical diagnosis
C) Patient experience
D) Patient circumstances
E) Prescribed treatments

Question 15

A patient asks why the nurse is playing with an iPad in the midst of providing care. What should the nurse respond to this patient?

A) "I'm just typing in notes to remember what care I provided to you."
B) "This is just a way for nurses to communicate instead of calling out to each other."
C) "I just needed to check and make sure I did everything that you needed at this time."
D) "This is a part of the computer system that is used to confidentially document your care."

Question 16

After purchasing a personal computer for use at home, the nurse enrolls in classes at the local community college to learn more about using the device. Which building block of informatics competencies is this nurse demonstrating?

A) Computer literacy
B) Information literacy
C) Relationship analysis
D) Computer integration

Question 17

The manager is evaluating a beginning nurse's ability to use the computerized documentation system. Which observations indicate that the beginning nurse needs additional training on the computer?

A) Documented care for one patient in 20 minutes
B) Input patient safety data on the appropriate screen
C) Stated laboratory results not available when they were entered 4 hours earlier
D) Retrieved a recent peer-reviewed article supporting an aspect of one patient's care
E) Commented that a paper chart is the only legal and reliable form of documentation

Question 18

The computerized clinical documentation system installed in a healthcare organization has a feature that alerts staff to potential safety hazards. Which computer message should the nurse interpret as a safety warning when providing patient care?

A) Warning: Scan the bar code on the item before using for patient care
B) Warning: Click on automatic calculation before leaving the graphic sheet section
C) Warning: Leaving the computer unattended for 1 minute will result in data not being saved
D) Warning: Administering this medication exceeds the maximum safe amount of acetaminophen

Question 19

The nurse is planning to use evidence-based practice to plan a patient's care. What actions should the nurse include when using this approach?

A) Review internal evidence
B) Identify external evidence
C) Discuss patient preferences
D) Consider individual expertise
E) Analyze costs associated with care

Question 20

While participating in the electronic communication committee, the nurse makes a recommendation to alter one aspect of the system to support nursing documentation. Which informatics competency is this nurse practicing?

A) Implement policies relevant to best practice.
B) Analyze and interpret information as part of planning care.
C) Use informatics applications designed for nursing practice.
D) Demonstrate expertise as a content expert in system design.

Question 21

The nurse needs to access the Cumulative Index of Nursing and Allied Health Literature (CINAHL). Where should the nurse go to access this database?

A) Public library
B) Medical school library
C) Library within the hospital
D) Public school district library
E) Library at the local university

Question 22

The nurse is completing the evaluation phase of the nursing process. What actions should the nurse perform that would be comparable to using the research process?

A) Analyzing results
B) Reporting findings
C) Conducting analysis
D) Conducting literature review
E) Identifying a research question

Question 23

The manager is designing a presentation to introduce the nursing staff to the implementation of evidence-based practice. In which order should the manager explain the steps of this process? Standard Text: Click and drag the options below to move them up or down.

A) Evaluate the outcomes
B) Search the literature efficiently
C) Appraise the literature critically
D) Formulate a searchable question
E) Apply the result to clinical practice or patient
F) none of the above

Question 24

The nurse decides that a clinical guideline would be helpful when planning the care of a patient. What should the nurse do to obtain this guideline?

A) Access a nursing literature database
B) Search through a nursing procedure textbook
C) Telephone a clinical guidelines company for assistance
D) Conduct a computer search on a clinical guidelines website

Question 25

The nurse is analyzing outcomes at the conclusion of a quantitative research study. On which variable is the nurse focusing?

A) Dependent
B) Conceptual
C) Operational
D) Independent

Question 26

The nurse needs to locate external evidence to support evidence-based practice interventions for a patient's care. What action indicates that the nurse maximized the use of technology to locate this evidence?

A) The nurse focused the search on appropriate and applicable nursing diagnoses.
B) The nurse identified specific data points when searching a clinical guidelines website.
C) The nurse input medical subject heading terms when searching through a database.
D) The nurse emphasized the expected patient outcomes when searching through a database.

Question 27

The nurse is participating in the research process. Which actions indicate that the nurse successfully completed the identification of a research question?

A) The nurse analyzed results.
B) The nurse reported findings.
C) The nurse conducted a literature review.
D) The nurse utilized knowledge of nursing.
E) The nurse reflected on clinical experiences.

Question 28

The nurse is evaluating outcomes from evidence-based interventions provided to a patient with chronic obstructive lung disease. Which outcome indicates that a positive change occurred in this patient?

A) Patient set a date to quit smoking.
B) Patient uses emergency bronchodilator every 4 hours.
C) Patient states that antibiotics are to be taken until all symptoms subside.
D) Patient explains that adverse effects of prescribed medications are to be expected.

Question 29

The nurse is designing a study to determine why some patients with diabetes develop foot ulcers while others do not. When reviewing this research question, what should the nurse highlight as the sample population?

A) Patients with diabetes
B) Foot ulcer development
C) Patients with foot ulcers
D) Patients without foot ulcers

Question 30

The nurse is reviewing steps performed within the research process. Which actions indicate that the nurse worked through the step equivalent to the nursing diagnosis phase of the nursing process?

A) Analyzed results
B) Collected information
C) Chose an appropriate theory
D) Conducted a literature review
E) Identified a research question

Question 31

The nurse is evaluating the success of using evidence-based interventions for patient care. What should the nurse do to determine if these interventions were successful?

A) Analyze outcomes
B) Review plan of care
C) Strategize actions to delegate
D) Identify use of pain medication

Question 32

While preparing for a clinical conference the nurse accesses the computer for evidence-based practice information. What information indicates that the nurse used the National Guideline Clearinghouse?

A) Opinions of experts who have cared for patients with similar problems
B) Copies of clinical guidelines that address a patient's particular problems
C) Results of descriptive studies performed on patients with similar problems
D) Analyses of controlled trials conducted with patients having similar problems

Question 33

The nurse is having difficulty identifying keywords to use when searching a database for evidence-based practice interventions. What should the nurse use to help with the identification of keywords?

A) The nursing process
B) Terms from the PICOT question
C) Identified levels for external evidence
D) NANDA-approved nursing diagnoses phrases

Question 34

The nurse is conducting a qualitative research study. In which order should the nurse complete the steps of the research process? Standard Text: Click and drag the options below to move them up or down.

A) Develop overall approach
B) Identify problem of interest
C) Confirm and close the study
D) Develop emergent research design
E) Interpret data throughout the study
F) none of the above

Question 35

The nurse is implementing evidence-based practice when providing patient care. Which action indicates that the nurse implemented this process appropriately?

A) The nurse ended the process by formulating a searchable question.
B) The nurse formulated a searchable question before searching the literature.
C) The nurse applied the result to clinical practice before searching the literature.
D) The nurse evaluated the outcomes of applied evidence before appraising the literature.

Question 36

The nurse desires to obtain as much information about clinical guidelines as possible in preparation for an educational program on evidence-based practice. Which database should the nurse use to achieve this goal?

A) Cochrane Collaboration
B) National Guideline Clearinghouse
C) PubMed from the National Library of Medicine
D) Cumulative Index of Nursing and Allied Health Literature (CINAHL)

Question 37

The nurse is reviewing content from the PICOT question format to identify terms to search when accessing information from a database. Which content should the nurse use as keyword(s) for this search?

A) Outcome
B) Assessment
C) Patient home address
D) Patient discharge plan

Question 38

The nurse is comparing the nursing process with the research process. Which steps should the nurse identify as being similar?

A) Set goals
B) Analyze the data
C) Evaluate the results
D) Collect data for evidence
E) Determine nursing diagnoses

Question 39

The nurse is designing a quantitative research project where the data will be collected at one point in time. Which type of data collection process is the nurse planning to use?

A) Prospective
B) Longitudinal
C) Retrospective
D) Cross-sectional

Question 40

The nurse is writing a paper on a research project as part of a class assignment. What should the nurse do to obtain the most current information about the research topic?

A) Ask the librarian to identify journals appropriate for the research topic.
B) Discuss ideas and content with classmates for inclusion in the research project.
C) Access a database and search for information appropriate for the research topic.
D) Study the class research textbook for information that would apply to the research topic.

Question 41

The manager is concerned that a staff nurse is not appropriately implementing evidence-based practice with patient care. What did the manager observe to come to this conclusion?

A) Clinical expertise is included.
B) Patient situations are individualized.
C) Data is researched before implementing.
D) Interventions are applied to all patients assigned.

Question 42

The nurse is reviewing the Institute of Medicine's framework for healthcare that leads to practical improvements. Which qualities should the nurse identify as being supported by this framework?

A) Safety
B) Timeliness
C) Cost reduction
D) Patient-centeredness
E) Elimination of healthcare-associated infections

Question 43

The nurse learns that topical medication and heat have been used to treat stage 3 pressure ulcers. What should the nurse consider before implementing this treatment approach?

A) How long the heat should be applied to the area
B) If the patient can withstand the application of heat
C) What medication should be used in the wound bed
D) If the treatment approach is ethical and evidence-based

Question 44

Prior to implementing evidence-based interventions when providing patient care, the nurse reviews the actions for scientific value. What is the purpose of this nurse's action?

A) Maximizing the utilization of resources
B) Ensuring the actions are applied at the global level
C) Ensuring that activities are worth doing to be ethical
D) Guaranteeing that the patient will not have an untoward effect