Test Bank
Clinical Nursing Skills and Techniques 10th Edition
BY
Anne Griffin Perry, Patricia A. Potter
,TABLE OF CONTENT
Chapter 01: Using Evidence in Nursing Practice................................................................................................................3
Chapter 02: Communication and Collaboration ...............................................................................................................10
Chapter 03: Admitting, Transfer, and Discharge ..............................................................................................................21
Chapter 04: Documentation and Informatics ....................................................................................................................34
Chapter 05: Vital Signs .....................................................................................................................................................44
Chapter 06: Health Assessment ........................................................................................................................................66
Chapter 07: Specimen Collection .....................................................................................................................................89
Chapter 08: Diagnostic Procedures .................................................................................................................................113
Chapter 09: Medical Asepsis ..........................................................................................................................................129
Chapter 10: Sterile Technique ........................................................................................................................................145
Chapter 11: Safe Patient Handling and Mobility (SPHM) Perry et al.: ………………………………………………..154
Chapter 12: Exercise and Mobility .................................................................................................................................171
Chapter 13: Support Surfaces and Special Beds .............................................................................................................187
Chapter 14: Patient Safety ..............................................................................................................................................199
Chapter 15: Disaster Preparedness..................................................................................................................................214
Chapter 16: Pain Management ........................................................................................................................................227
Chapter 17: End-of-Life Care .........................................................................................................................................247
Chapter 18: Personal Hygiene and Bed Making .............................................................................................................261
Chapter 19: Care of theEye and Ear................................................................................................................................282
Chapter 20: Safe Medication Preparation .......................................................................................................................292
Chapter 21: Nonparenteral Medications .........................................................................................................................315
Chapter 22: Parenteral Medications ................................................................................................................................338
Chapter 23: Oxygen Therapy ..........................................................................................................................................359
Chapter 24: Performing Chest Physiotherapy .................................................................................................................372
Chapter 25: Airway Management ...................................................................................................................................383
Chapter 26: Cardiac Care ................................................................................................................................................404
Chapter 27: Closed Chest Drainage Systems ..................................................................................................................423
Chapter 28: Emergency Measures for Life Support .......................................................................................................441
Chapter 29: Intravenous and Vascular Access Therapy .................................................................................................458
Chapter 30: Blood Therapy .............................................................................................................................................483
Chapter 31: Oral Nutrition ..............................................................................................................................................495
Chapter 32: Enteral Nutrition..........................................................................................................................................502
Chapter 33: Parenteral Nutrition .....................................................................................................................................511
Chapter 34: Urinary Elimination ....................................................................................................................................517
Chapter 35: Bowel Elimination and Gastric Intubation ..................................................................................................525
Chapter 36: Ostomy Care................................................................................................................................................534
Chapter 37: Preoperative and Postoperative Care...........................................................................................................541
Chapter 38: Intraoperative Care ......................................................................................................................................548
Chapter 39: Wound Care and Irrigations ........................................................................................................................555
Chapter 40: Impaired Skin Integrity Prevention and Care ..............................................................................................565
Chapter 41: Dressings, Bandages, and Binders ..............................................................................................................573
Chapter 42: Home Care Safety .......................................................................................................................................583
Chapter 43: Home Care Teaching...................................................................................................................................590
,Chapter 01: Using Evidence in Nursing Practice
Perry et al.: Clinical Nursing Skills & Techniques, 10th Edition
1. 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 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)
2. 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 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)
3. When a PICOT question is developed, the letter that corresponds with the usual standard of
care is:
a. P.
b. I.
c.
, c. CHOICE BLANK
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 OBJ: Develop a PICO question.
TOP: PICO KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
4. 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: CognitiveLevel: Analysis 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)
5. 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 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)
,6. 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 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)
7. 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 bests 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
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)
8. The nurse wants to determine the effects of cardiac rehabilitation program attendance on the
level of post myocardial 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: CognitiveLevel: Synthesis
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)
9. 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: CognitiveLevel: Application
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
1. 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
EBP comprises six steps (Melnyk and Fineout-Overholt, 2010):
1. Ask a clinical question.
2. Search for the most relevant and best evidence that applies to the question.
3. Critically appraise the evidence you gather.
4. Apply or integrate evidence along with one‘s clinical expertise and patient preferences and
values in making a practice decision or change.
5. Evaluate the practice decision or change.
6. Communicate your results.
