Test Bank for Leading and Managing in Nursing, 8th Edition (Yoder-Wise, 2024) Chapter 1-25 | All Chapters
Test Bank - Leading and Managing in Nursing, 8th Edition by Patricia S. Yoder-Wise, Susan Sportsman, 2024 | Chapter 1-25 | All chapters
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Test Bank For Leading and Managing in Nursing, 8th Edition
by Patricia S. Yoder-Wise, Susan Sportsman Chapter 1-25 |
9780323792066 | All Chapters with Answers and Rationals
The chief nursing officer at a local hospital seeking Magnet® status creates staff development
classes concerning translation of research into practice (TRIP). What best describes TRIP?
a. Conducting an integrative review of the literature
b. Searching the literature for a systematic review
c. Providing the results of research studies to practitioners
d. Applying strategies that aid in adoption of research in practice - ANSWER: ANS: D
The science of how research is adopted is known as translation science, the science of
translating research into practice (TRIP). The primary aim of research utilization is to activate
the change process to move research findings into practice to improve patient outcomes.
The chief nursing officer at a local hospital seeking Magnet® status creates staff development
classes about incorporating evidence-based practice in nursing. What best describes
evidence-based practice?
a. Applying best research evidence to care of patients
b. Using research-based information to develop practice guidelines
c. Conducting a randomized control trial to determine effectiveness of handwashing
techniques
d. Developing standards for practice - ANSWER: ANS: A
Evidence-based medicine is derived from evidence-based medicine and involves integration
of the best research evidence with clinical expertise and the patient's unique values and
circumstances in making decisions about the care of individual patients. It is focused on
searching for, appraising, and synthesizing the best evidence to address a specific clinical
practice problem.
As a nurse manager, you trial a new pain scale on your unit that is supported by numerous
research studies. You compare the patient outcomes with the new scale against the existing
scale. Feedback from staff suggests that the new scale is too difficult for patients who have
limited language skills and who are already under duress to understand. The difficulty in
implementing the new scale refers to testing:
a. efficacy.
b. effectiveness.
c. practice failure.
d. comparative error. - ANSWER: ANS: B
Comparing the effectiveness of interventions can help to address the needs of clinicians in
determining best practices for their patients. Comparative effectiveness research (CER) is the
"generation and synthesis of evidence that compares the benefits and harms of alternative
methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the
delivery of care" (Institute of Medicine, 2009, p. 29). Efficacy is testing an intervention or
treatment in a traditional randomized clinical trial under carefully controlled conditions and is
used to determine whether an intervention or treatment works, whereas effectiveness is testing
whether the intervention or treatment works in the real world of practice.
The nurse manager wants to use evidence-based recommendations to prevent
ventilator-associated pneumonia. What is the critical first step to effectively gather evidence
for guiding practice?
a. Develop the clinical question.
b. Identify the databases to be used.
c. Appraise the evidence.
d. Integrate available evidence with unit expertise. - ANSWER: ANS: A
Identifying the question may be the most challenging part of the process. Once the clinical
,question has been identified, writing it down will help in moving on to the next step of
gathering evidence.
A strategic goal for nursing in the facility developed by the chief nursing officer is to
implement an evidence-based practice program. What is an appropriate strategy that can be
used by a nurse manager who is beginning to implement an evidence-based practice program
on the unit?
a. Conducting a review of adverse events and incident reports
b. Soliciting input from staff members
c. Reviewing specialty organization guidelines
d. Identifying patients with extended lengths of stay - ANSWER: ANS: B
Stakeholders need to be involved early, and staff members need to be involved when
initiatives involve direct patient care. Involvement assists in understanding issues and
concerns, motivations, and unmet needs.
The nurse manager of an ICU wants to implement the revised policy and procedure on central
line catheter care. What would be the most effective method of getting the staff nurses to
incorporate a new evidence-based practice into their care?
a. Conducting an interactive educational workshop
b. Distributing educational materials on clinical units
c. Sharing the results of a chart audit with staff
d. Providing staff with a short DVD on the topic - ANSWER: ANS: A
Suggestions for effective strategies that promote behavioral change in health professionals
include active involvement strategies such as face-to-face information sessions in small
groups and one-to-one interactions. Other approaches have mixed or few results.
Before implementation of the new policy and procedure on central line catheter care, the nurse
manager uses an appraisal system to evaluate the evidence. What is important in using an
appraisal system to evaluate the evidence gathered in preparation for development of a new
protocol?
a. Limiting the search to randomized clinical trials
b. Matching the appraisal tool to the type of evidence
c. Eliminating qualitative research studies
d. Using only preprocessed evidence - ANSWER: ANS: B
Appraisal tools are specific to the number of studies, as well as to the study design (type of
evidence), type of review, and strategy for determining the applicability of evidence to your
practice.
To help staff nurses adjust to using research in practice, what strategy would the nurse
manager use?
a. Attendance at a regional research conference
b. Formal classes in electronic search techniques
c. Establishing a journal club
d. Issuing reports on the adverse consequences of outdated practices - ANSWER: ANS: C
Journal clubs provide opportunities for engagement in reading research and considering how
it might be applied to clinical practice problems, which is considered very effective in
behavioral change.
What is a strategy that can be used by a small community hospital with limited resources to
develop an evidence-based nursing practice program?
a. Hiring a nurse researcher
b. Partnering with nurse researchers at a local university
c. Subscribing to journals devoted to evidence-based nursing
d. Including research competencies in managers' job descriptions - ANSWER: ANS: B
Partnering with nurse researchers assists in providing nurse researcher expertise and
leadership to organizations that do not have the size or the resources to hire nurse researchers.
,Tara, the unit manager, is explain to her colleague her recent project, which involves seeking
the most effective approaches to incontinence care, with the intention of adopting
evidence-supported approaches on her dementia care unit. Her colleague suggests that
translation of research into practice is:
a. less important than knowledge-generating research, which is required to advance
the nursing profession.
b. a priority of all healthcare practitioners to improve patient care.
c. characterized by lack of knowledge about how to use evidence to guide practice.
d. so difficult that it is useless to begin the query in the first place. - ANSWER: ANS: B
The National Institutes of Health identified translational research or getting research into the
hands of practitioners to improve patient care, as a priority.
After searching the literature, Tara, the unit manager develops a table that outlines the
findings of studies on management of incontinence. She then examines the studies in terms of
risk and whether the findings fit within her practice context and for her population of
moderately to severely cognitively impaired patients. This is which phase of a research
utilization model?
a. Preparatory
b. Validation
c. Evaluation
d. Application - ANSWER: ANS: C
The third phase, comparative evaluation and decision making, involves making a decision
about the applicability of the studies by synthesizing cumulative findings; evaluating the
degree and nature of other criteria, such as risk, feasibility, and readiness of the finding; and
making a recommendation about using the findings of the studies.
The clinical guidelines for management of incontinence developed by the Registered Nurses
Association of Ontario (RNAO):
a. reflect practice that is fiscally directed and sound.
b. articulate practice recommendations developed from synthesis and review of
evidence.
c. are intended to increase awareness of issues in incontinence management.
d. reflect a compilation of information from a variety and range of sources related to
incontinence. - ANSWER: ANS: B
The evidence-based practice (EBP) movement has grown exponentially with scientific
publications, establishment of collaboration centers, resources on the Web, and grants focused
specifically on translating of research into practice. A number of evidence-based nursing
centers have been established around the world. These centers have teams of researchers who
critically appraise evidence and then disseminate protocols for the use of evidence in practice.
In this example, clinical guidelines have been developed by a professional nursing
organization on the basis of best possible evidence on incontinence management. Although
issues may be raised in the recommendations, the purpose is to guide practice for the purposes
of better patient care.
Marie is a long-term staff nurse on the rehab floor. Her unit manager has been eager to adopt
evidence-based recommendations related to family-centered care on the unit. Marie's
response has been that she rarely has time to provide care to patients, let alone families, and
that there is no good reason to do anything different than what she is already doing. An
approach that may gain Marie's support of the idea is to:
a. invite Marie to review the studies for herself.
b. suggest that she does not need to provide family-centered care.
c. avoid discussion of the idea with her until she initiates it.
d. secure the support of her closest colleagues on the unit. - ANSWER: ANS: D
As a skeptic, Marie, who is a late majority adopter, needs pressure from colleagues to move
her toward support of the recommendations. The translation of research into practice requires
that nurse leaders and managers understand group dynamics, individual responses to
innovation and change (such as the response of late majority adopters), and the culture of their
, healthcare organization.
You are excited by evidence supporting the use of workstations on wheels (WOWs) at the
bedside to improve documentation and patient outcomes. You have disseminated the
information through discussions and e-mails and are now ready to begin the process of
considering implementation on the unit. To develop positive attitudes toward the use and
implementation of the technology, you would discuss your ideas with (Rogers' diffusion of
innovations theory):
a. Harvey, RN, a technology guru, who enthusiastically tries on all new software.
b. Berta, RN, who thoughtfully considers evidence and regularly uses it to try new
approaches in her practice.
c. Carol, LPN, who is positive about new ideas but looks to her friends for their ideas
about whether or not to try something new.
d. Ben, a 10-year veteran of the unit, who wonders why technology should be used at
all. He says that he will use it when there is no chance of security - ANSWER: ANS: B
Berta is the one with whom you should now have informed conversations, because she is an
early adopter who is respected for her thoughtful acquisition and critique of knowledge and
application of knowledge to practice. Berta, an early adopter (Rogers' characteristics of
innovation adopters), is more effective in this stage than Harvey, an innovator who may be
seen as open to all new ideas regardless of merit.
The implementation of saline flushes for capped angiocatheters across all areas of practice in
the facility is an example of:
a. how multilevel and interprofessional application of a procedure can slow adoption
of EBP.
b. how competition among disciplines can lead to negative patient outcomes.
c. the reluctance of hospital administrators to act on recommendations from EBP.
d. how a safe, well-known practice outweighs the benefits of adopting a newer
practice. - ANSWER: ANS: A
The translation of research into practice operates at four levels: The individual healthcare
professional, healthcare groups or teams, organizations, and the larger healthcare system or
environment. The adoption of saline flushes illustrates the challenges of communicating EBP
to other disciplines and organizations and of the involvement of different levels. This
particular innovation needed endorsement by nurses, physicians, and pharmacists, as well as
by administrators who needed evidence of lost savings to support adoption.
Which of the following would be most effective in implementing the findings of a new
clinical treatment for problems associated with bowel motility for the staff nurses?
a. Lecture by a nurse practitioner
b. Workshop for surgical nurses that involves discussion of case studies and
application of evidence
c. Discussion of the findings on the bulletin boards at the workstation
d. Education of unit opinion leaders regarding the evidence presented in the studies - ANSWER: ANS:
B
Current research suggests that translation of research into practice is best facilitated through
interactive learning such as workshops. Least effective strategies included didactic learning
and distribution of learning materials.
Which of the following is an effective approach in the appraisal of research studies?
a. Accept only studies that use a RCT design.
b. When ranking research studies, choose RCTs over qualitative studies.
c. Select only studies with a large sample size.
d. Evaluate the quality of the research against the standards for that type of research. - ANSWER:
ANS: D
While randomized controlled trials (RCTs) are generally considered the gold standard for
research, it is important to assess not only the method but also the quality of the study and its
applicability to the question that is being asked. The quality of all studies should be appraised
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