Category: Nursing

PARADIGMS AND METHODS FOR NURSING RESEARCH

A 
paradigm
 is a worldview, a general perspective on the complexities of the world. Paradigms for human inquiry are often characterized in terms of the ways in which they respond to basic philosophical questions, such as, What is the nature of reality? (ontologic) and What is the relationship between the inquirer and those being studied? (epistemologic).

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

Disciplined inquiry in nursing has been conducted mainly within two broad paradigms, 
positivism
 and 
constructivism
. This section describes these two paradigms and outlines the research methods associated with them. In later chapters, we describe the 
transformative paradigm
 that involves 
critical theory research
 (
Chapter 21
), and a 
pragmatism paradigm
 that involves 
mixed methods research
 (
Chapter 26
).

The Positivist Paradigm

The paradigm that dominated nursing research for decades is known as 
positivism
 (also called 
logical positivism
). Positivism is rooted in 19th century thought, guided by such philosophers as Mill, Newton, and Locke. Positivism reflects a broader cultural phenomenon that, in the humanities, is referred to as 
modernism
, which emphasizes the rational and the scientific. paradigms and methods for nursing research.

As shown in 
Table 1.2
, a fundamental assumption of positivists is that there is a reality 
out there
 that can be studied and known (an 
assumption
 is a basic principle that is believed to be true without proof or verification). Adherents of positivism assume that nature is basically ordered and regular and that reality exists independent of human observation. In other words, the world is assumed not to be merely a creation of the human mind. The related assumption of 
determinism
 refers to the positivists’ belief that phenomena are not haphazard but rather have antecedent causes. If a person has a cerebrovascular accident, the researcher in a positivist tradition assumes that there must be one or more reasons that can be potentially identified. Within the positivist paradigm, much research activity is directed at understanding the underlying causes of phenomena.

TABLE 1.2: Major Assumptions of the Positivist and Constructivist Paradigms

TYPE OF QUESTION

POSITIVIST PARADIGM ASSUMPTION

CONSTRUCTIVIST PARADIGM ASSUMPTION

Ontologic
: What is the nature of reality?

Reality exists; there is a real world driven by real natural causes and subsequent effects paradigms and methods for nursing research

Reality is multiple and subjective, mentally constructed by individuals; simultaneous shaping, not cause and effect

Epistemologic
: How is the inquirer related to those being researched?

The inquirer is independent from those being researched; findings are not influenced by the researcher

The inquirer interacts with those being researched; findings are the creation of the interactive process

Axiologic
: What is the role of values in the inquiry?

Values and biases are to be held in check; objectivity is sought

Subjectivity and values are inevitable and desirable

Methodologic
: How is evidence best obtained?

Deductive processes → hypothesis testing

Inductive processes → hypothesis generation

Emphasis on discrete, specific concepts

Emphasis on entirety of some phenomenon, holistic

Focus on the objective and quantifiable

Focus on the subjective and nonquantifiable. paradigms and methods for nursing research.

Corroboration of researchers’ predictions

Emerging insight grounded in participants’ experiences

Outsider knowledge—researcher is external, separate

Insider knowledge—researcher is internal, part of process

Fixed, prespecified design

Flexible, emergent design

Controls over context

Context-bound, contextualized

Large, representative samples

Small, information-rich samples

Measured (quantitative) information

Narrative (unstructured) information

Statistical analysis

Qualitative analysis

Seeks generalizations. paradigms and methods for nursing research

Seeks in-depth understanding

Positivists value objectivity and attempt to hold personal beliefs and biases in check to avoid contaminating the phenomena under study. The positivists’ scientific approach involves using orderly, disciplined procedures with tight controls of the research situation to test hunches about the phenomena being studied.

Strict positivist thinking has been challenged, and few researchers adhere to the tenets of pure positivism. In the 
postpositivist paradigm
, there is still a belief in reality and a desire to understand it, but postpositivists recognize the impossibility of total objectivity. They do, however, see objectivity as a goal and strive to be as neutral as possible. Postpositivists also appreciate the impediments to knowing reality with certainty and therefore seek 
probabilistic
 evidence—that is, learning what the true state of a phenomenon 
probably
is, with a high degree of likelihood. This modified positivist position remains a dominant force in nursing research. For the sake of simplicity, we refer to it as positivism. paradigms and methods for nursing research.

The Constructivist Paradigm

The 
constructivist paradigm
 (often called the 
naturalistic paradigm
) began as a countermovement to positivism with writers such as Weber and Kant. Just as positivism reflects the cultural phenomenon of modernism that burgeoned after the industrial revolution, naturalism is an outgrowth of the cultural transformation called 
postmodernism
. paradigms and methods for nursing research. Postmodern thinking emphasizes the value of
deconstruction
—taking apart old ideas and structures—and 
reconstruction
—putting ideas and structures together in new ways. The constructivist paradigm represents a major alternative system for conducting disciplined research in nursing. 
Table 1.2
 compares the major assumptions of the positivist and constructivist paradigms.

For the naturalistic inquirer, reality is not a fixed entity but rather is a construction of the individuals participating in the research; reality exists within a context, and many constructions are possible. Naturalists thus take the position of relativism: If there are multiple interpretations of reality that exist in people’s minds, then there is no process by which the ultimate truth or falsity of the constructions can be determined. paradigms and methods for nursing research.

The constructivist paradigm assumes that knowledge is maximized when the distance between the inquirer and those under study is minimized. The voices and interpretations of study participants are crucial to understanding the phenomenon of interest, and subjective interactions are the primary way to access them. Findings from a constructivist inquiry are the product of the interaction between the inquirer and the participants.

Paradigms and Methods: Quantitative and Qualitative Research

Research methods
 are the techniques researchers use to structure a study and to gather and analyze information relevant to the research question. The two alternative paradigms correspond to different methods for developing evidence. A key methodologic distinction is between 
quantitative research
, which is most closely allied with positivism, and 
qualitative research
, which is associated with constructivist inquiry—although positivists sometimes undertake qualitative studies, and constructivist researchers sometimes collect quantitative information. This section provides an overview of the methods associated with the two paradigms. paradigms and methods for nursing research.

The Scientific Method and Quantitative Research

The traditional, positivist 
scientific method
 refers to a set of orderly, disciplined procedures used to acquire information. Quantitative researchers use deductive reasoning to generate predictions that are tested in the real world. They typically move in a systematic fashion from the definition of a problem and the selection of concepts on which to focus to the solution of the problem. By 
systematic
, we mean that the investigator progresses logically through a series of steps, according to a specified plan of action. paradigms and methods for nursing research.

Quantitative researchers use various control strategies. 
Control
 involves imposing conditions on the research situation so that biases are minimized and precision and validity are maximized. Control mechanisms are discussed at length in this book.

Quantitative researchers gather 
empirical evidence
—evidence that is rooted in objective reality and gathered through the senses. Empirical evidence, then, consists of observations gathered through sight, hearing, taste, touch, or smell. Observations of the presence or absence of skin inflammation, patients’ anxiety level, or infant birth weight are all examples of empirical observations. The requirement to use empirical evidence means that findings are grounded in reality rather than in researchers’ personal beliefs. paradigms and methods for nursing research.

Evidence for a study in the positivist paradigm is gathered according to an established plan, using structured methods to collect needed information. Usually (but not always) the information gathered is 
quantitative
—that is, numeric information that is obtained from a formal measurement and is analyzed statistically.

A traditional scientific study strives to go beyond the specifics of a research situation. For example, quantitative researchers are typically not as interested in understanding why a 
particular
 person has a stroke as in understanding what factors influence its occurrence in people generally. The degree to which research findings can be generalized to individuals other than those who participated in the study is called the study’s 
generalizability
.

The scientific method has enjoyed considerable stature as a method of inquiry and has been used productively by nurse researchers studying a range of nursing problems. This is not to say, however, that this approach can solve all nursing problems. One important limitation—common to both quantitative and qualitative research—is that research cannot be used to answer moral or ethical questions. Many persistent, intriguing questions about human beings fall into this area—questions such as whether euthanasia should be practiced or abortion should be legal.

The traditional research approach also must contend with problems of 
measurement
. To study a phenomenon, quantitative researchers attempt to measure it by attaching numeric values that express quantity. For example, if the phenomenon of interest is patient stress, researchers would want to assess if patients’ stress is high or low, or higher under certain conditions or for some people. Physiologic phenomena such as blood pressure and temperature can be measured with great accuracy and precision, but the same cannot be said of most psychological phenomena, such as stress or resilience. paradigms and methods for nursing research.

Another issue is that nursing research focuses on humans, who are inherently complex and diverse. Traditional quantitative methods typically concentrate on a relatively small portion of the human experience (e.g., weight gain, depression) in a single study paradigms and methods for nursing research. Complexities tend to be controlled and, if possible, eliminated, rather than studied directly, and this narrowness of focus can sometimes obscure insights. Finally, quantitative research within the positivist paradigm has been accused of an inflexibility of vision that does not capture the full breadth of human experience.

Constructivist Methods and Qualitative Research

Researchers in constructivist traditions emphasize the inherent complexity of humans, their ability to shape and create their own experiences, and the idea that truth is a composite of realities. Consequently, constructivist studies are heavily focused on understanding the human experience as it is lived, usually through the careful collection and analysis of 
qualitative
 materials that are narrative and subjective.

Researchers who reject the traditional scientific method believe that it is overly 
reductionist
—that is, it reduces human experience to the few concepts under investigation, and those concepts are defined in advance by the researcher rather than emerging from the experiences of those under study. Constructivist researchers tend to emphasize the dynamic, holistic, and individual aspects of human life and attempt to capture those aspects in their entirety, within the context of those who are experiencing them paradigms and methods for nursing research.

Flexible, evolving procedures are used to capitalize on findings that emerge in the course of the study. Constructivist inquiry usually takes place in the 
field
 (i.e., in naturalistic settings), often over an extended time period. In constructivist research, the collection of information and its analysis typically progress concurrently; as researchers sift through information, insights are gained, new questions emerge, and further evidence is sought to amplify or confirm the insights. Through an inductive process, researchers integrate information to develop a theory or description that helps illuminate the phenomenon under observation.

Constructivist studies yield rich, in-depth information that can elucidate varied dimensions of a complicated phenomenon. Findings from in-depth qualitative research are typically grounded in the real-life experiences of people with first-hand knowledge of a phenomenon. Nevertheless, the approach has several limitations. Human beings are used directly as the instrument through which information is gathered, and humans are extremely intelligent and sensitive—but fallible—tools. The subjectivity that enriches the analytic insights of skillful researchers can yield trivial and obvious “findings” among less competent ones.

Another potential limitation involves the subjectivity of constructivist inquiry, which sometimes raises concerns about the idiosyncratic nature of the conclusions. Would two constructivist researchers studying the same phenomenon in similar settings arrive at similar conclusions? paradigms and methods for nursing research The situation is further complicated by the fact that most constructivist studies involve a small group of participants. Thus, the generalizability of findings from constructivist inquiries is an issue of potential concern.

Multiple Paradigms and Nursing Research

Paradigms should be viewed as lenses that help to sharpen our focus on a phenomenon, not as blinders that limit intellectual curiosity. The emergence of alternative paradigms for studying nursing problems is, in our view, a healthy and desirable path that can maximize the breadth of evidence for practice. Although researchers’ worldview may be paradigmatic, knowledge itself is not. Nursing knowledge would be thin if there were not a rich array of methods available within the two paradigms—methods that are often complementary in their strengths and limitations. We believe that intellectual pluralism is advantageous.

We have emphasized differences between the two paradigms and associated methods so that distinctions would be easy to understand—although for many of the issues included in 
Table 1.2
, differences are more on a continuum than they are a dichotomy. paradigms and methods for nursing research. Subsequent chapters of this book elaborate further on differences in terminology, methods, and research products. It is equally important, however, to note that the two main paradigms have many features in common, only some of which are mentioned here:

Ultimate goals
. The ultimate aim of disciplined research, regardless of the underlying paradigm, is to gain understanding about phenomena. Both quantitative and qualitative researchers seek to capture the truth with regard to an aspect of the world in which they are interested, and both groups can make meaningful—and mutually beneficial—contributions to evidence for nursing practice.

External evidence
. Although the word 
empiricism
has come to be allied with the classic scientific method, researchers in both traditions gather and analyze evidence empirically, that is, through their senses. Neither qualitative nor quantitative researchers are armchair analysts, depending on their own beliefs and worldviews to generate knowledge. paradigms and methods for nursing research.

Reliance on human cooperation
. Because evidence for nursing research comes primarily from humans, human cooperation is essential. To understand people’s characteristics and experiences, researchers must persuade them to participate in the investigation 
and
 to speak and act candidly.

Ethical constraints
. Research with human beings is guided by ethical principles that sometimes interfere with research goals. As we discuss in 
Chapter 7
, ethical dilemmas often confront researchers, regardless of paradigms or methods.

Fallibility of disciplined research
. Virtually all studies have some limitations. Every research question can be addressed in many ways, and inevitably, there are trade-offs. The fallibility of any single study makes it important to understand and critique researchers’ methodologic decisions when evaluating evidence quality.

Thus, despite philosophic and methodologic differences, researchers using traditional scientific methods or constructivist methods share overall goals and face many similar challenges. The selection of an appropriate method depends on researchers’ personal philosophy and also on the research question paradigms and methods for nursing research. If a researcher asks, “What are the effects of cryotherapy on nausea and oral mucositis in patients undergoing chemotherapy?” the researcher needs to examine the effects through the careful measurement of patient outcomes. On the other hand, if a researcher asks, “What is the process by which parents learn to cope with the death of a child?” the researcher would be hard pressed to quantify such a process. Personal worldviews of researchers help to shape their questions. paradigms and methods for nursing research.

In reading about the alternative paradigms for nursing research, you likely were more attracted to one of the two paradigms. It is important, however, to learn about both approaches to disciplined inquiry and to recognize their respective strengths and limitations. In this textbook, we describe methods associated with both qualitative and quantitative research in an effort to assist you in becoming 
methodologically bilingual
. This is especially important because large numbers of nurse researchers are now undertaking 
mixed methods
 research that involves gathering and analyzing both qualitative and quantitative data (
Chapters 26
–
28
). paradigms and methods for nursing research.

THE PURPOSES OF NURSING RESEARCH

The general purpose of nursing research is to answer questions or solve problems of relevance to nursing. Specific purposes can be classified in various ways. We describe three such classifications—not because it is important for you to categorize a study as having one purpose or the other but rather because this will help us to illustrate the broad range of questions that have intrigued nurses and to further show differences between qualitative and quantitative inquiry.

Applied and Basic Research

Sometimes a distinction is made between basic and applied research. As traditionally defined, 
basic research
 is undertaken to enhance the base of knowledge or to formulate or refine a theory. For example, a researcher may perform an in-depth study to better understand normal grieving processes, without having 
explicit
 nursing applications in mind. Some types of basic research are called 
bench research
, which is usually performed in a laboratory and focuses on the molecular and cellular mechanisms that underlie disease.

Example of Basic Nursing Research:
 Kishi and a multidisciplinary team of researchers (2015) studied the effect of hypo-osmotic shock of epidermal cells on skin inflammation in a rat model, in an effort to understand the physiologic mechanism underlying aquagenic pruritus (disrupted skin barrier function) in the elderly.

Applied research
 seeks solutions to existing problems and tends to be of greater immediate utility for EBP. Basic research is appropriate for discovering general principles of human behavior and biophysiologic processes; applied research is designed to indicate how these principles can be used to solve problems in nursing practice. In nursing, the findings from applied research may pose questions for basic research, and the results of basic research often suggest clinical applications.

Example of Applied Nursing Research:
S. Martin and colleagues (2014) studied whether positive therapeutic suggestions given via headphones to children emerging from anesthesia after a tonsillectomy would help to lower the children’s pain. paradigms and methods for nursing research.

Research to Achieve Varying Levels of Explanation

Another way to classify research purposes concerns the extent to which studies provide explanatory information. Although specific study goals can range along an explanatory continuum, a fundamental distinction (relevant especially in quantitative research) is between studies whose primary intent is to 
describe
 phenomena, and those that are 
cause-probing
—that is, designed to illuminate the underlying causes of phenomena paradigms and methods for nursing research..

Within a descriptive/explanatory framework, the specific purposes of nursing research include identification, description, exploration, prediction/control, and explanation. For each purpose, various types of question are addressed—some more amenable to qualitative than to quantitative inquiry and vice versa.

Identification and Description

Qualitative researchers sometimes study phenomena about which little is known. In some cases, so little is known that the phenomenon has yet to be clearly identified or named or has been inadequately defined. The in-depth, probing nature of qualitative research is well suited to the task of answering such questions as, “What 
is
 this phenomenon?” and “What is its name?” (
Table 1.3
). In quantitative research, by contrast, researchers begin with a phenomenon that has been previously studied or defined—sometimes in a qualitative study. Thus, in quantitative research, identification typically precedes the inquiry. paradigms and methods for nursing research.

Critiquing Quantitative and Qualitative Study.

Nursing research has experienced remarkable growth, providing nurses with a growing evidence base from which to practice (Polit & Beck, 2017).  Qualitative data are collected in a natural setting and the data are not numerical: rather, they are full and rich descriptions from participants (Williamson, 2009). Quantitative research gathers numerical data that strongly influence the quality of the evidence in the study (Polit & Beck, 2017).A key methodologic distinction is between quantitative research, which is most closely allied with positivism, and qualitative research, which is associated with constructivist inquiry (Polit & Beck, 2017). The review of literature can be a valuable tool, to ensure that policies are developed based on a body of evidence that has been systematically synthesized and analyzed (Houde, 2009). Critiquing Quantitative and Qualitative Study. Critiquing a study identifies areas of adequacy and inadequacy in an unbiased manner (Polit & Beck, 2017). The purpose of this paper is to review and critique two research articles, and to compare the advantages and disadvantages of the two articles.

BUY A PLAGIARISM-FREE PAPER HERE

Research Articles

           
The first article chose was a qualitative study in parental perceptions and understanding of SIDS-reduction guidance in a UK bi-cultural urban community by Denise Crane and Helen Ball, 2016. This study aimed to discover how white British and Pakistani mothers in Bradford recall, understand and interpret SIDS-guidance, and to explore whether and how they implement this guidance in caring for their infants (Crane & Ball, 2016). The study also aimed to elicit detailed qualitative explanations for inter-cultural differences in infant care in the Bradford community (Crane & Ball, 2016). In-depth narrative interviews were conducted to obtain data from mothers of 8-12 week old infants (Crane & Ball, 2016). Being a qualitative study, it reflected the real experience and viewpoints of participants.

The second article was a quantitative case-control study about the socioeconomic factors affecting infant sleep-related deaths in St. Louis by Cathy Hogan, 2014. The study was to identify or determine whether there is a relationship between maternal socioeconomic factors (race, poverty, maternal education, and parity) and sleep-related infant death. The study was conducted using secondary data analysis. The study involved two study populations and the data was collected from matched birth/death certificates and living birth certificates of infants who were born died within the time frame of the study. The study found a significant relationship between race and sleep-related infant death. The study involved numerical data that supported the hypothesis. Being a quantitative study, results that support the researcher’s hypothesis are described as significant (Polit & Beck, 2017). Critiquing Quantitative and Qualitative Study.

Advantages and Disadvantages

           
Every method of study has its advantages and disadvantages. The first research article being a qualitative study about the parental perceptions and understanding of SIDS-reduction and guidance mainly aimed at identifying the practices and cultural influences of the mothers in taking care of the infants. The study includes narrative interviews of mothers that helped collect data focusing on understanding the human experience as it is lived (Crane & Ball, 2016). The study emphasized on the dynamic, holistic, and individual aspects of mothers while taking care of their infants (Crane & Ball, 2016). Findings from this study is typically grounded in the real-life experiences of people with first-hand knowledge (Polit & Beck, 2017). This helped to gain a better knowledge of the phenomena. Critiquing Quantitative and Qualitative Study. The study also provided suggestions for individually tailored approaches for SIDS-reduction (Crane & Ball, 2016). The disadvantage of this particular study was a small sample size and the study being, limited to one group of community.

           
The second study was a quantitative study about the socioeconomic factors affecting infant sleep-related death. This quantitative research was mainly numerical and pointed to objectivity. Also the research had a constructed a theory/framework, that helped the researcher work around it. Secondary data analysis of birth/death certificates and living birth certificates of infants born/died within the time frame, was used in this study (Hogan, 2014). So there was no direct involvement of the human subjects. Numerical data and tables was presented throughout the study. The disadvantages of the study includes the study population which mainly included the African American community (Hogan, 2014). This might have limited the generalizability of the findings. The sample size was information on 26,211 individuals in a 4 year period (2005-2009), which might have consumed the time frame of the study Critiquing Quantitative and Qualitative Study.

Qualitative Research not Real Science

Response to claim qualitative research not real science can be answered different ways by people. Qualitative research is always valued for its relevance, but is considered lacking in scientific accuracy. Qualitative researchers undertake in-depth studies that usually reveals pattern and processes suggesting casual interpretations which will need more systematic testing with controlled methods of inquiry (Polit & Beck, 2017). Qualitative research does not have standard rules or procedures that makes the researcher hard to explain how to do analyses. Qualitative and quantitative researches provide outcomes in their own ways that is important to the researches. Critiquing Quantitative and Qualitative Study.  Quantitative data mainly provides numerical data and include a hypothesis to work towards the directions (Eliyahu, 2014). Qualitative research will serve the research with descriptive goals, while the quantitative research will deliver specific variable measures (Sinaga, 2014). The insights of these two studies can help the researchers chose which is the best and appropriate design for the study.

Conclusion

           
Understanding the factors that causes the increasing rates of Sudden Infant Death Syndrome is very important for the reduction rates. The two articles critiqued in this paper shows the factors causing the infant sleep-related deaths. Analyzing the different methods of research used in the articles reviewed helps to learn more about the two designs of the study, qualitative and quantitative study. Study designs discovers significant amount of information about the researches. Qualitative study is subjective and quantitative study is analyzed through statistical means (Polit & Beck, 2017). Knowing the different methods of designs used in research helps the researchers choose a better one for any new research. Critiquing Quantitative and Qualitative Study.

 

References

Crane, D., & Ball, H. L. (2016). A qualitative study in parental perceptions and understanding

of SIDS-reduction guidance in a UK bi-cultural community.
BMC Pediatrics, 161.
doi: 10.1186/s12887-016-0560-7

Eliyahu, A. (2014). Understanding different types of research: The difference between

qualitative and quantitative approaches. Retrieved from:
http://chronicle.umbmentoring.org/on-methods-whats-the-difference-between-qualitataive-and-quantitative-approaches/

Hogan. C. (2014). Socioeconomic Factors Affecting Infant Sleep-Related Deaths in St. Louis.

Public Health Nursing.
31(1), 10-18. doi: 10.1111/phn.12052

Houde, S. C. (2009). The systematic review of literature: A tool for evidence-based policy.

Journal of Gerontological Nursing,
35(9), 9-12. Critiquing Quantitative and Qualitative Study.

Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for

nursing practice (9th ed.). Philadelphia, PA: Wolters Kluwer

Sinaga, A. M. H. P. (2014). Differences Between Qualitative And Quantitative Analysis And

How It Should Be Applied In Our Research. Retrieved from:  
http://www.academia.edu/10722206/Difference_Between_Qualitative_And_Quantitative_Analysis_And_How_It_Should_Be_Applied_In_Our_Research

Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence.

Journal of the American Psychiatric Association, 15(3), 202-207. Critiquing Quantitative and Qualitative Study.

 

Critique Template for a Quantitative Study

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or Mixed Methods Studies (due by Day 7 of Week 7)

Date: 10/15/2017

Your name: Sandhya Thomas

Article reference (in APA style): Hogan. C. (2014). Socioeconomic Factors Affecting Infant Sleep-Related Deaths in St. Louis.
Public Health Nursing.
31(1), 10-18. doi: 10.1111/phn.12052

URL: http://onlinelibrary.wiley.com.ezp.waldenulibrary.org/doi/10.1111/phn.12052/epdf

 

What is a critique? Simply stated, a critique is a critical analysis undertaken for some purpose. Nurses critique research for three main reasons: to improve their practice, to broaden their understanding, and to provide a base for the conduct of a study. Critiquing Quantitative and Qualitative Study.

When the purpose is to improve practice, nurses must give special consideration to questions such as these:

 

Are the research findings appropriate to my practice setting and situation?

What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness?

How might a proposed change in practice trigger changes in other aspects of practice?

 

To help you synthesize your learning throughout this course and prepare you to utilize research in your practice, you will be critiquing a qualitative, quantitative, or mixed methods research study of your choice.

 

If the article is unavailable in a full-text version through the Walden University Library, you must
e-mail the article as a PDF or Word attachment to your Instructor.

 
 

QUANTITATIVE RESEARCH CRITIQUE

 

Research Problem and Purpose

 

What are the problem and purpose of the referenced study? (Sometimes ONLY the purpose is stated clearly and the problem must be inferred from the introductory discussion of the purpose.) Critiquing Quantitative and Qualitative Study.
 

Though the Back to Sleep Campaign that began in 1994 caused an overall decrease in sudden infant death syndrome (SIDS) rates, racial disparity has continued to increase in St. Louis. The purpose of the study is to determine whether there is a relationship between maternal socioeconomic factors and sleep-related infant death in St. Louis.

 

Hypotheses and Research Questions

 

What are the hypotheses (or research questions/objectives) of the study? (Sometimes the hypotheses or study questions are listed in the Results section, rather than preceding the report of the methodology used. Occasionally, there will be no mention of hypotheses, but anytime there are inferential statistics used, the reader can recognize what the hypotheses are from looking at the results of statistical analysis.) Critiquing Quantitative and Qualitative Study.

 

The research question was,” Is there a relationship between socioeconomic factors (level of poverty, race, level of education, and number of children born) pertaining to the mother and infant sleep-related deaths?”

 
 

Literature Review

 
What is the quality of the literature review? Is the literature review current? Relevant? Is there evidence that the author critiqued the literature or merely reported it without critique? Is there an integrated summary of the current knowledge base regarding the research problem, or does the literature review contain opinion or anecdotal articles without any synthesis or summary of the whole? (Sometimes the literature review is incorporated into the introductory section without being explicitly identified.)

 

The quality of the literature review was current and relevant. Citations are included in the literature review that shows evidence of the literature review. There is integration of current knowledge base regarding the research in the background section of the study. The literature review highlighted evidence of variables (level of poverty, race, level of education, and number of children born) that affect parental choices for infant safe sleep.

 

 

Theoretical or Conceptual Framework

 

Is a theoretical or conceptual framework identified? If so, what is it? Is it a nursing framework or one drawn from another discipline? (Sometimes there is no explicitly identified theoretical or conceptual framework; in addition, many “nursing” research studies draw on a “borrowed” framework, e.g., stress, medical pathology, etc.)

 

The theoretical or conceptual framework was to determine whether there are modifiable factors that may reduce racial disparity and the tragedy of infant death. Critiquing Quantitative and Qualitative Study.

 

Population

 

What population was sampled? How was the population sampled? Describe the method and criteria. How many subjects were in the sample?

 

There were two study populations. The study population of all mothers of infants younger than 1 year who resided in St. Louis, MO at the time of the infant’s birth and whose infants died in St. Louis between January 1, 2005 and December 31, 2009 was included as the case set in analysis. The control population was a systematic sampling of all mothers who resided in St. Louis at the time of the infants’ birth and whose infants lived past their first year. The dataset collected included information on 26,211 individuals and represented all birth recorded in St. Louis, MO between January 1, 2005 and December 31, 2009.  Critiquing Quantitative and Qualitative Study. The sample includes matched birth/death certificates and living birth certificates of infant’s who were born/died within the time frame.

 

Protection of Human Research Participants

 

What steps were taken to protect human research subjects?

 

The study was an observational study using secondary data analysis. The Missouri DHSS institutional review board requirements were satisfied to obtain de-identified data.

 

Research Design

 

What was the design of the study? If the design was modeled from previous research or pilot studies, please describe.

 

Quantitative case-control study used secondary data collected by the Missouri Department

Of Health and Senior Services between 2005 and 2009. Because this observational study compared cases where there was no death, a case-control study was appropriate. Since there was no control over the original data collection, the study falls into the category of observational studies using secondary data analysis.

 

Instruments and Strategies for Measurement

 

What instruments and/or other measurement strategies were used in data collection? Was information provided regarding the reliability and validity of the measurement instruments? If so, describe it.

 

Matched birth/death data were coded according to International Statistical Classification of Diseases and Related Health Problems. The database included information on the study’s outcome variable (whether they had a sleep-related death) and on demographic independent variables, such as mother’s race, whether she was married to the infant’s father, whether she received food stamps, years of education, and parity. The same independent variables were used in analysis if the infant death cases and the nondeath cases. Critiquing Quantitative and Qualitative Study.

 

Data Collection

 

What procedures were used for data collection?

 

Data was collected through secondary data analysis from the matched birth/death data of infants between 2005 and 2009 in St. Louis, MO.

Data Analysis

 

What methods of data analysis were used? Were they appropriate to the design and hypotheses?

 

Descriptive statistics and frequency distributions were generated for each variable. The case and control results were compared once the separate analyses was complete. Since the data being analyzed categorically, the technique of choice was logistic regression. The chi-square test was used to determine if there was a significant relationship between the categorical independent variables. A cross-tabulation was performed to determine the frequency with which the variables occur together. The methods used for data analysis was appropriate to the design and hypotheses.

 

Interpretation of Results

 

What results were obtained from data analysis? Is sufficient information given to interpret the results of data analysis?

 

The results showed Caucasian mothers were significantly less likely than African American mothers (by a factor of OR = .228, p = .005) to experience sleep related infant death. Although poverty was significant in the chi-squared analysis, it was significant in logistic regression. Even though previous researches showed racial disparity regarding sleep-related infant deaths that occurred while co-sleeping, the data presented by the Missouri Department of Health and Senior Services did not provide specific information about the individual deaths beyond unintentional suffocation Critiquing Quantitative and Qualitative Study.

Sufficient information was given to interpret the results of the data analysis the study included tables of all the findings.

 

 

Discussion of Findings

 

Was the discussion of findings related to the framework? Were those the expected findings?  Were they consistent with previous studies? Were serendipitous (i.e., accidental) findings described
?

 

Discussion of findings was related to the framework. Previous research has suggested that socioeconomic factors have an impact on infant sleep-related deaths, this study found a significant relationship only between race and infant sleep-related death. So the study was not consistent with the previous studies. Critiquing Quantitative and Qualitative Study.

 

 

Limitations

 

Did the researcher report limitations of the study? (Limitations are acknowledgments of internal characteristics of the study that may help explain insignificant and other unexpected findings, and more importantly, indicate those groups to whom the findings CANNOT be generalized or applied. It is a fact that all studies must be limited in some way; not all of the issues involved in a problem situation can be studied all at once.)

 

Researcher did report limitations for the study. The study population was a limitation, as it is a largely an African American community. The size of the sample may also limit the validity and the generalizability of the study. Although the sample for mothers who have experienced sleep-related infant deaths is a valid presentation, the sample taken from the mothers who have not experienced sleep-related infant deaths may provide an inaccurate basis for comparison, especially given the size of the sample in relation to the total population. Critiquing Quantitative and Qualitative Study.

 

Implications

 

Are the conclusions and implications drawn by the author warranted by the study findings? (Sometimes researchers will seem to ignore findings that don’t confirm their hypotheses as they interpret the meaning of their study findings.)

 

The conclusions and implications drawn by the author are warranted by the study findings. The results of the study have a social change potential. This study provides evidence that there continues to be racial disparity in ST. Louis, Missouri despite messages of the Back to Sleep Campaign and drastic reductions in sleep-related deaths in Caucasian population. The findings from this study serve to inform the concerned offices that there is a specific demographic group for them to target and educate the dangers of sleep-related infant death. Critiquing Quantitative and Qualitative Study.

 

Recommendations

 

Does the author offer legitimate recommendations for further research? Is the description of the study sufficiently clear and complete to allow replication of the study? (Sometimes researchers’ recommendations seem to come from “left field” rather than following obviously from the discussion of findings. If a research problem is truly significant, the results need to be confirmed with additional research; in addition, if a reader wishes to design a study using a different sample or correcting flaws in the original study, a complete description is necessary.)

 

Author does offers legitimate recommendations for further research. The study did not show significant relationship between maternal level of education, poverty and sleep-related deaths. There were limitations in the study, mainly being the size. Further research in a larger scale maybe beneficial. Critiquing Quantitative and Qualitative Study.

 

Research Utilization in Your Practice

 

How might this research inform your practice? Are the research findings appropriate to your practice setting and situation? What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness? How might the utilization of this research trigger changes in other aspects of practice?

 

Being an OB nurse the research findings are appropriate to my practice setting and situation. Further research should be done including a larger sample size, teen parents and single parents. Rather providing a single message about Sudden Infant Death Syndrome, the education needs to be targeted to the individual. Further research on this topic will trigger changes in practice with a positive outcome.

 

Critique Template for a Qualitative Study

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or Mixed Methods Studies (due by Day 7 of Week 7)

Date: 10/15/2017

Your name: Sandhya Thomas

Article reference (in APA style): Crane, D., & Ball, H. L. (2016). A qualitative study in parental perceptions and understanding of SIDS-reduction guidance in a UK bi-cultural community.
BMC Pediatrics, 161.
doi: 10.1186/s12887-016-0560-7

URL:http://eds.a.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=66&sid=5449fa37-5ab8-4d72-b95a-d4cf314731b6%40sessionmgr4009

 
 

What is a critique? Simply stated, a critique is a critical analysis undertaken for some purpose. Nurses critique research for three main reasons: to improve their practice, to broaden their understanding, and to provide a base for the conduct of a study. Critiquing Quantitative and Qualitative Study.

 

When the purpose is to improve practice, nurses must give special consideration to questions such as these:

 

Are the research findings appropriate to my practice setting and situation?

What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness?

How might a proposed change in practice trigger changes in other aspects of practice?

 

To help you synthesize your learning throughout this course and prepare you to utilize research in your practice, you will be critiquing a qualitative, quantitative, or mixed-methods research study of your choice

 

If the article is unavailable in a full-text version through the Walden University Library, you must
e-mail the article as a PDF or Word attachment to your Instructor.

 
 

QUALITATIVE RESEARCH CRITIQUE

 

Research Issue and Purpose

 

What is the research question or issue of the referenced study? What is its purpose? (Sometimes ONLY the purpose is stated clearly and the question must be inferred from the introductory discussion of the purpose.)

 

The research question or issue of the referenced study was, why parents appear to follow some guidelines for SIDS-reduction and not others. The purpose of the study was to discover how white British and Pakistani mothers in Bradford recall, understand and interpret SIDS-guidance, and to explore whether and how they implement this guidance in caring for their infants. This will help explore the cultural context in which infant care is performed in order to inform future public health interventions and similar ethnically diverse populations.

 

Researcher Pre-understandings

 

Does the article include a discussion of the researcher’s pre-understandings? What does the article disclose about the researcher’s professional and personal perspectives on the research problem? Critiquing Quantitative and Qualitative Study.

 

The researchers pre-understanding was not included in the article.

 

Literature Review

 

What is the quality of the literature review? Is the literature review current, relevant? Is there evidence that the author critiqued the literature or merely reported it without critique? Is there an integrated summary of the current knowledge base regarding the research problem, or does the literature review contain opinion or anecdotal articles without any synthesis or summary of the whole? (Sometimes the literature review is incorporated into the introductory section without being explicitly identified.)

 

The quality of the literature review is good. The literature is current and relevant. There is citations for all the evidence that the author critiqued. There is no integrated summary of the current knowledge base regarding the research problem, but the study contains anecdotal article citations, without the summary of the literature review as a whole. Critiquing Quantitative and Qualitative Study.

 

Theoretical or Conceptual Framework

 

Is a theoretical or conceptual framework identified? If so, what is it? Is it a nursing framework or one drawn from another discipline? (Sometimes there is no explicitly identified theoretical or conceptual framework; in addition, many “nursing” research studies draw on a “borrowed” framework, e.g., stress, medical pathology, etc.)

 

A theoretical or conceptual framework for this study was that, differences existed in infant care practices between white British and UK Pakistani mothers. The background of the study also reveals that South Asian infant care protects infants from the most important SIDS-related factors such as cigarette smoking, alcohol consumption, sofa-sharing, prone sleep and solitary sleep.

 

Participants

 

Who were the participants? Is the setting or study group adequately described? Is the setting appropriate for the research question? What type of sampling strategy was used? Was it appropriate? Was the sample size adequate? Did the researcher stipulate that information redundancy was achieved?

 

The participants of the study was mothers of 8-12 week old infants. The setting for the study was at Bradford Royal Infirmary Maternity Unit. The setting was appropriate for the research question. Purposive sampling strategy was used which was appropriate for the study. The interviews were done with 46 participants, 25 white British and 21 Pakistani mothers. The sample size for the study was small. The researcher did not stipulate that information redundancy was achieved. Critiquing Quantitative and Qualitative Study.

 

Protection of Human Research Participants

 

What steps were taken to protect human research subjects?

 

Ethical approval was granted by Durham University and the NHS National Research Ethics Committee of Yorkshire and Humber. R&D Management approval was granted by Bradford Teaching Hospitals NHS Foundation Trust and Bradford Institute for Health Research. Participant’s received oral and written information about the study at recruitment and again prior to the interview when written consent was obtained.

 

 

Research Design

 

What was the design of the study? If the design was modeled from previous research or pilot studies, please describe.

 

The study design was a qualitative, cohort study. The study was based on findings from other studies that showed differences in infant care practices between white British and UK Pakistani mothers. Critiquing Quantitative and Qualitative Study.

 

Data Collection/Generation Methods

 

What methods were used for data collection/generation?

Was triangulation used? 

 

In depth narrative interviews was conducted to obtain qualitative data. All interviews were conducted and analyzed by one researcher with the guidance and supervision of the second researcher. The interviews were audio-taped and verbatim transcripts were thematically analyzed via a continuous comparative method as they were generated. Themes were discussed and agreed by both researchers. Triangulation was not used in this study.

 

Credibility

 

Were the generated data credible? Explain your reasons.

 

The data that was generated by this study was credible. The participants of the study was mothers of infants 8-12 weeks old, who was aware of the SIDS-reduction guidance, implemented different infant sleeping practices for personal and cultural reasons. Mostly they were verbalizing their own experiences and reasons for doing so.

 

Data Analysis

 

What methods were used for data analysis? What evidence was provided that the researcher’s analysis was accurate and replicable?

 

Narrative interviews was conducted and audio-taped. They were conducted in 4 equal batches from the two ethnic groups concurrently to ensure that developing themes were explored and cross-checked. The interviewer produced verbatim transcripts which were thematically analyzed through a continuous comparative methods as they were generated. Themes were discussed and agreed by both authors. Critiquing Quantitative and Qualitative Study.

 

Findings

 

What were the findings?

 

All mothers were aware of UK SIDS-reduction guidance from leaflets presented to them during antenatal or postnatal interactions with healthcare providers. Pakistani mothers tended to dismiss the guidance as being irrelevant to their cultural practices; white British mothers dismissed, adapted and adopted aspects of the guidance to suit their preferred parenting decisions and personal circumstances. Many mothers misunderstood or misinterpreted the guidance given and explained their infant care behavior according to their social and cultural circumstances. The findings of the study suggests guidance and literature should be actually with acknowledgment, understanding and appreciation of variations in infant caregiving and discussion of the barriers to implementation encountered in different settings.

 

Discussion of Findings

 

Was the discussion of findings related to the framework? Were those the expected findings?  Were they consistent with previous studies? Were serendipitous (i.e., accidental) findings described
?

 

The discussion of the findings was related to the framework of the study. Research has not explored why parents appear to follow some SIDS-reduction guidelines and not others. The findings of the study was expected. There was no accidental findings described in the study.

 

Limitations

 

Did the researcher report limitations of the study? (Limitations are acknowledgments of internal characteristics of the study that may help explain insignificant and other unexpected findings, and more importantly, indicate those groups to whom the findings CANNOT be generalized or applied. It is a fact that all studies must be limited in some way; not all of the issues involved in a problem situation can be studied all at once.)

 

The researchers have not reported any limitations in the study. After reviewing the study, the limitations could be the small sample size of the participants and the study was focused only to the mothers of bi-cultural community in Bradford.

 

Implications

 

Are the conclusions and implications drawn by the author warranted by the study findings? (Sometimes researchers will seem to ignore findings that don’t confirm their expectations as they interpret the meaning of their study findings.) Critiquing Quantitative and Qualitative Study.

 

The conclusions and implications drawn by the researchers warranted the study findings. The study suggests that more emphasis needs to be placed on the recommendations that are associated with the greater risk reduction in order to achieve the greatest benefit.

 

Recommendations

 

Does the author offer legitimate recommendations for further research?  Is the description of the study sufficiently clear and complete to allow replication of the study? (Sometimes researchers’ recommendations seem to come from “left field” rather than following obviously from the discussion of findings. If a research problem is truly significant, the results need to be confirmed with additional research; in addition, if a reader wishes to design a study using a different sample or correcting flaws in the original study, a complete description is necessary.)

 

The researchers did not specifically recommend for further research. But recommendations were made for the need for risk minimization in infant sleep recommendations with an individually tailored approach by acknowledging the cultural preferences.

 

Research Utilization in Your Practice

 

How might this research inform your practice? Are the research findings appropriate to your practice setting and situation? What further research or pilot studies need to be done, if any, before incorporating findings into practice to assure both safety and effectiveness? How might the utilization of this research trigger changes in other aspects of practice?

 

The findings are appropriate for my setting. We come across a lot bi-cultural mothers that provides infant care as per their cultural beliefs and practices. Further studies needs to be done how to incorporate the individually tailored approach to help new mothers or parents to be more compliant about following the SIDS-reduction guidance. The utilization of the research can health professional be trained more to be aware and understand of how infant care decisions are mediated and performed, in differing social and cultural environments, and to provide tailored information to allow parents to work within their personal constraints. Critiquing Quantitative and Qualitative Study.

NURS 6051 – Assignment: The Nurse Leader as Knowledge Worker Essay

NURS 6051N

In this Discussion, you will consider a scenario that would benefit from access to data and how such access could facilitate both problem-solving and knowledge formation.

To Prepare:

Reflect on the concepts of informatics and knowledge work as presented in the Resources.

Consider a hypothetical scenario based on your own healthcare practice or organization that would require or benefit from the access/collection and application of data. Your scenario may involve a patient, staff, or management problem or gap. NURS 6051 – Assignment: The Nurse Leader as Knowledge Worker Essay.

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

Part 2:  

Assignment: The Nurse Leader as Knowledge Worker

The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?

Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways. NURS 6051 – Assignment: The Nurse Leader as Knowledge Worker Essay.

In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a presentation with an info graphic  to educate others on the role of nurse as knowledge worker.

 

Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.

 

To Prepare:

 

Review the concepts of informatics as presented in the Resources.

Reflect on the role of a nurse leader as a knowledge worker.

Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

 

Explain the concept of a knowledge worker.

Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.

Develop a simple infographic to help explain these concepts. NURS 6051 – Assignment: The Nurse Leader as Knowledge Worker Essay.

 

NOTE: For guidance on infographics, including how to create one in PowerPoint, see “How to Make an Infographic in PowerPoint” as presented in the Resources.

 

Present the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ replies. NURS 6051 – Assignment: The Nurse Leader as Knowledge Worker Essay.

Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research

Quantitative & Qualitative Research

Quantitative and qualitative research have been used by researchers for many years.  In research, these two types are used to draw conclusions to further evidence based practice. “Research methods are the techniques researchers use to structure a study and to gather and analyze information relevant to the research question” (Polit, & Beck, (2017), p. 11). What exactly is quantitative and qualitative research? Quantitative research is an approach for testing objective theories.  This is achieved by examining a relationship among different variables.  These variables can then be measured and number data can be analyzed through statistical procedures. Qualitative research is an approach for exploring and understanding the meaning individuals or groups ascribe to a social or human problem. This is achieved by formulating questions and procedures.  The data is obtained in the participant’s setting and data is analyzed to particulars to general themes. The researcher then makes interpretations of the meaning of the data. Both types of research contain strengths and weaknesses. If the correct method is used and the researcher yields the results that were desired, it can help shape the health care profession in many ways. In this paper, the advantages and disadvantages of the two types of approaches will be discussed in regard to the topic of interest that was selected as well as discussing a valid response to claim that qualitative research is not real science. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

BUY A PLAGIARISM-FREE PAPER HERE

Advantages

The first article selected involved reviewing central line-associated blood stream infection (CLABSI) rates and examining a hospitals pre- and post implementation of the Society for Healthcare Epidemiology of America (SHEA) guidelines. Hospital-acquired infections, specifically CLABSIs were once thought to be an unavoidable risk. Therefore, the aim of this study was to prove that with the proper guidelines and preventative measures in place, CLABSIs and the deaths associated with them can be decreased. The main advantage of this study was the method of quantitative analysis lead the researchers in yielding statistically great results.

The second article selected involved interviewing health care staff on the believe that the empowerment of patients to be involved in their care would reduce the burden of health care-associated infections. The active engagement of patients in their care has also been used as a strategy to promote medication adherence, improve patient safety, and foster open communication with health care providers. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. Therefore, “the study set out to examine the level of awareness toward patient empowerment, previous experiences with campaigns, and degree of acceptance toward the introduction of a new empowerment program focused on engaging patients around infection control strategies” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). The main advantage of this article was that it “heavily focused on understanding the human experience and used careful collection and analysis of subjects that are narrative and subjective” (Polit, & Beck, (2017), p. 12).

Disadvantages

A few disadvantages were noted within this quantitative study. The single-site retrospective design was of concern. Future studies with a larger more diverse sample size would be of benefit. With this disadvantage, the study limits it generalizability. In addition, randomized prospective studies looking closely at individual interventions may be of benefit. Lastly, the study also employed various methods of data collection. This in return may have impacted the validity and analysis within the study. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

A few disadvantages were also noted within the qualitative study. The main disadvantage to the qualitative study was the small sample size of hospital staff that were used. It is important in a research study to have a sufficient number of individuals involved because “generalizability of findings from constructivist inquiries is an issue for potential concern” and decreases validity (Polit, D. F., & Beck, C. T. (2017) p. 12). In addition, the study did not include other health care staff from other departments within the hospital. The interviews were conducted with staff from the surgical unit. It would have been beneficial to see the opinions and answers from those throughout the hospital.

Response to claim

Qualitative research is not real science? Absurd it what I call the claim. Why do I call it absurd? Well, as nurses in the healthcare profession qualitative research is done each day with patient interaction by getting the patients point of view on their care and disease process. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.  “Much of the work of clinicians (including pharmacists) takes place within a social, clinical, or interpersonal context where statistical procedures and numeric data may be insufficient to capture how patients and health care professionals feel about patients’ care” (Austin, & Sutton, (2014).

Qualitative & quantitative are the two main types of research. Qualitative is more of a subjective method of data collection and deals with thoughts, feelings and beliefs, etc. Quantitative research gathers absolute data. It focuses on numeric information and is an objective method of data collection. Quantitative research is often carried out in a lab setting whereas qualitative research occurs in the natural setting. In this sense, it could be assumed that quantitative methods are more scientific because the experiments can be controlled, whereas qualitative is not very reliable due to the susceptible nature.  “It is important to note that although quantitative methods seem to be more scientific, the results are very rigid and do not give us any rich data. Qualitative methods, however, allow us to look further, beyond yes and no, beyond one to five, to give us information which is far more detailed. And through this, we can examine, explore and further theories” (Alhoward. (2011). Using both methods of research together can provide the best end result. Evidence based practices will be delivered in the health care setting.

 

Critique Template for a Quantitative Study

 

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or

Mixed Methods Studies

 

Date:
January 11, 2018

Your name:
Jessica Toney

Article reference (in APA style):
 Curlej, M. H., Katrancha, E. (2016). One Rural Hospital’s Experience Implementing the Society of Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections.
Journal of Trauma Nursing.
Vol. 23, Issue 5, pp. 290-297. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

URL:

https://eds-a-ebscohostcom.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=3&sid
=

3fb92985-309b-4e9d-8252-0eb0e8e630c5%40sessionmgr4008

______________________________________________________________________________

 

QUANTITATIVE RESEARCH CRITIQUE

 

Research Problem and Purpose

 

“Hospital-acquired infections, specifically CLABSIs, were once thought to be an unavoidable risk of intensive care. The high use of CVCs (3 million/year in the United States) (Edgeworth, 2009). has created a risk that resulted in a CLABSI rate of 80,000 in the ICU per year and this number climbs to 250,000/year with inclusion of patients outside of the ICU (Mermel.2000) and in 2008 alone, 37,000 CLABSIs occurred among patients receiving outpatient hemodialysis, which has resulted in a major public health problem (Centers for Disease Control and Prevention [CDC], 2011). The purpose of this article was to review the CLABSI rates and examination of the prevention strategies following implementation of the SHEA guidelines” (Curlej, M. H., Katrancha, E. (2016). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Hypotheses and Research Questions

 

“In an effort to take advantage of the Highmark Quality Blue Initiative, information from hospitals detailing their CLABSI surveillance system, quality improvement program, and statistics regarding the CLABSI events, this institution investigated the latest evidence-based recommendations to reduce CLABSIs. Will implementation of the Central Line Bundle and using SHEA guidelines decrease the rates of CLABSIs? (Curlej, M. H., Katrancha, E. (2016).

 

 

Literature Review

 

“Hospital-acquired infections (HAIs) affect 1.7 million patients annually and result in 99,000 deaths each year (US Department of Health and Human Services, 2010). There are major categories of HAIs; urinary tract infections that account for 34%, surgical site infections 17%, bloodstream infections 14%, and pneumonia 13%. CLABSIs are a subset of bloodstream infections, and while Klevens et al (2007) estimated that the deaths caused by or associated with an HAI were 98,987 per year, one-third of these were secondary to CLABSIs resulting in a 12.3% mortality rate (U.S. Department of Health and Human Services, 2009). CLABSIs result in prolonged stays in the intensive care unit (ICU) with medical costs averaging an additional $11,971 per patient (Warren et al., 2006). The overall effect of CLABSIs results in annual expenditures of 2.3 million dollars in U.S. hospitals (Blot et al., 2005). However, with preventive measures, these costs could be greatly reduced and perhaps eliminated. Central line-associated bloodstream infections (CLABSIs) can be a devastating complication of intensive care in the hospital. Central venous catheters (CVCs) are venous access devices that end at or near the entry to the heart. While they are often necessary for hemodynamic monitoring and administration of fluids, medications, and total parenteral nutrition, they are not without considerable risk” (Curlej, M. H., Katrancha, E. (2016). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Theoretical or Conceptual Framework

 

The implementation of the SHEA guidelines and Central Line Bundle provided a conceptual framework for CLABSI which led to increased nursing knowledge of hub cleansing and physician dictation of line necessity, and a decrease in femoral line utilization.

 

Population

 

“Any patient with a CLABSI infection admitted to this hospital July 2007 to June 2010 (
N
= 78). Inclusion criterion was a diagnosed CLABSI per the three levels of criterion set forth by the CDC (2010) as detailed in Table 1. The sample consisted of patients meeting inclusion criteria between July 2007 and June 2010. The sample was divided over three time periods. The sample ranged in age from 26 weeks to 91 years with 61% of the total being male” (Curlej, M. H., Katrancha, E. (2016).

 

Protection of Human Research Participants

 

This quantitative analysis does not address the protection of Human Rights

 

 

 

 

Research Design

 

“Descriptive retrospective program evaluation examined the hospital’s pre- and post-SHEA implementation methods of decreasing CLABSIs and the subsequent CLABSI rates” (Curlej, M. H., Katrancha, E. (2016).

 

Instruments and Strategies for Measurement

 

Charts were used to collect data for measurement. The first chart consisted of “Criterion for Classification of a CLABSIs.” The second chart consisted of the characteristics of each patient in each period that included the number of CLABSIs, rate per 1,000 CVC days, mean patient age, gender, line type, and line location.

 

Data Collection

 

“The CLABSI rates were obtained from CDC National Healthcare and Safety Network (CDC, 2010) database. CLABSI rate is calculated by multiplication of CLABSI episodes with 1,000 and then dividing by the total number of CLDs. (CDC, 2010). Data collection was made over three periods, that is, Period 1 (July 2007–June 2008), Period 2 (July 2008–June 2009), and Period 3 (July 2009–June 2010). CLABSI (defined as laboratory-confirmed bloodstream infection in Table 2) event reporting was obtained from NHSN database (CDC, 2011) The outcome of decreasing CLABSI rates was examined and evaluated for compliance to quality improvement strategies. The IV therapy team performed daily inspections on central line management and line insertion compliance. The team located central line insertion departments (interventional radiology, emergency department, and ICU/ critical care unit [CCU]) and identified the certified insertion performers. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. The LSS team gathered data using the “Get Off Your Armchair” (GOYA) method. The GOYA is a method of observation found in the LSS Pocket Tool book (2005) that calls for visiting the site, questioning staff, observing technique, and then documenting quality improvement strategies. Variations were corrected on the spot by providing education on an immediate basis” (Curlej, M. H., Katrancha, E. (2016).

 

Data Analysis

 

“Descriptive statistics, including demographic data (age, sex) and comparison of outcomes (femoral line utilization rates [FLURs], dictation of maximal barrier use, nursing care of the line, and necessity dictations), were calculated across the time periods using standard analysis of variance (ANOVA) and correlation techniques. The monthly CLABSI rates over the period of 3 years (July 2007–September 2010) divided into three time periods were evaluated. In addition, an in-depth review of each prevention strategy and compliance to the strategy was analyzed”

(Curlej, M. H., Katrancha, E. (2016).

 

Interpretation of Results

 

CLABSI rates showed a downward trend across the three time periods (1.9, 1.7, and 1.3, respectively). Interventions were introduced at each time period to correct deficiencies. Currently CLABSI rates at this facility remain lower than the baseline of 2.4 for calendar year 2013, 2014, and 2015. An ANOVA was calculated and no significant decrease in the FLUR was observed. The utilization rates and the femoral line days however, decreased. An ANOVA was applied to compare compliance to dictation of MBP between the three time periods. Results showed no change over time for MBP as well as for skin asepsis. Despite a nursing education in-service, baseline re- call was only 30% for nurses on the “Scrubbing the Hub” program. There was an increase in knowledge from this baseline in July 2009 to 86% in November 2009 following the educational intervention, but no significant increase in technique knowledge between November 2009 and May 2010. Chi-square test revealed no changes with 95%. There was a statistically significant increase in line necessity dictations from 55% to 82%. An ANOVA also revealed significant improvement to adherence in dictating line necessity for physicians” (Curlej, M. H., Katrancha, E. (2016). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Discussion of Findings

 

“The collaborative aspects of this program managed to decrease CLABSIs by compliance to the quality improvement strategies. Steady decline was observed in the periods with 1.3/1,000 CLDs at the end of fiscal year 2010. Each individual strategy was scrutinized for compliance and any additional shortcomings were identified and addressed. This retrospective study demonstrated a facilities ability to reduce CLABSI rates over time using the SHEA method. It reinforced the importance of ongoing education and evaluation of the consistent use of the SHEA methodology. Current CLABSI rates continue to stay below the baseline” (Curlej, M. H., Katrancha, E. (2016). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Limitations

 

“The single-site retrospective design of this study limits its generalizability. The study also employed various methods of data collection that may have impacted validity and analysis. Difference in data interpretation due to various sources/methods of observations is also a concern. There are two special approaches in the SHEA guidelines, CHG bathing of ICU patients and CHG sponge dressings for CVCs. These were executed at the end of Period 3 but not evaluated for this study” (Curlej, M. H., Katrancha, E. (2016).

 

Implications

 

Yes, the conclusions and implications drawn by the author warranted by the study

 

 

Recommendations

 

“Future studies with a larger more diverse sample size would be of benefit. In addition, randomized prospective studies looking closely at individual interventions may be of benefit. Future evaluation of CLABSI rates at this facility should include these 2 items and their impact on the CLABSI rates” (Curlej, M. H., Katrancha, E. (2016).

 

Research Utilization in Your Practice

 

I believe that the implementation of such guidelines as those found within SHEA and Central Line Bundle will educate nurses and other staff on how to care and prevent the incidences of Central Line-Associated Bloodstream Infections. There was enough analysis and statistical research complete in order to provide sufficient findings. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

 
 

Critique Template for a Qualitative Study

 

NURS 5052/NURS 6052

Week 6 Assignment: Application: Critiquing Quantitative, Qualitative, or

Mixed Methods Studies

 

Date:
January 11, 2018

Your name:
Jessica Toney

Article reference (in APA style):
Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Empowering patients in the hospital as a new approach to reducing the burden of health care-associated infection: The attitudes of hospital health care workers.
American Journal of Infection Control
. Vol. 44, Issue 3, pp. 263-268. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

URL:
https://www-sciencedirectcom.ezp.waldenulibrary.org/science/article/pii/

S0196655315010 378?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&

md5=b8429449ccfc9c30159a5f9aeaa92ffb&ccp=y

_____________________________________________________________________________

 

 

QUALITATIVE RESEARCH CRITIQUE

 

 

Research Issue and Purpose

 

“Patient engagement programs have largely focused on involving the public in various aspects of organizational planning and governance, research, or empowering individuals or groups of individuals in the self-management of chronic conditions. Any approach promoting a culture of safety and the prevention of health care–associated infections (HCAIs) should involve all stakeholders, including by definition the patients themselves. This qualitative study explored the knowledge and attitudes of health care workers toward the concept of patient empowerment focused on improving infection control practices. This study set out to examine the level of awareness toward patient empowerment, previous experiences with campaigns, and degree of acceptance toward the introduction of a new empowerment program focused on engaging patients around infection control strategies” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Researcher Pre-understandings

 

The researchers were all professors at Health Universities in Australia who hold PhD degrees. The study was approved by the Human Research Ethics Committee of the South-Eastern Sydney Local Health Distract-Northern Sector. “We thank all the participants who gave their time to take part in the interviews. We also thank Professor Raina MacIntyre, Professor Phillip Crowe, and Professor Julian Gold for their input into the design” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

 

Literature Review

 

“Patient engagement programs have largely focused on involving the public in various aspects of organizational planning and governance, research, or empowering individuals or groups of individuals in the self-management of chronic conditions. The active engagement of patients in their care has also been used as a strategy to promote medication adherence, improve patient safety after surgery, and foster open communication with health care providers.
7
 Since 2009, the World Health Organization has advocated for patient empowerment in health care and has specifically emphasized the role of patients in urging health care workers (HCWs) to comply with hand hygiene (HH) standards. To date, most of the studies examining patient empowerment programs relating to infection control have focused on the knowledge, attitude, and practices of the patients. Relatively few studies have considered the experience of the HCWs themselves. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. Despite universal recognition of the potential value of such an approach, patient engagement remains an underused method of preventing HCAI in Australia. To our knowledge, the knowledge and attitudes of Australian hospital HCWs toward the concept of patient empowerment has not been previously explored” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Theoretical or Conceptual Framework

 

The conceptual framework that was used in the study was conventional content analysis.

 

Participants

 

“Clinical staff members (nurses, doctors, and allied health staff) from the department of surgery were invited to participate. Of the participants, 18 were women, 12 were aged ≤34 years, and 20 were registered nurses. Participants covered a broad range of experiences working in health care, ranging from 1-39 years (median, 14 years). Most participants had been working in their current role for a median period of 4.6 years (minimum, 3 weeks; maximum, 32 years). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. Researchers liaised with a senior staff member from the surgical ward to invite staff members to participate. In addition to clinical staff, a member of hospital management and 3 staff members responsible for implementing infection control strategies were interviewed. Participants were recruited into the study when full written consent had been received. A shopping voucher was given to all participants to compensate them for their time” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Protection of Human Research Participants

 

Participation in the study was voluntary and was performed by staff of a hospital and not by patients themselves.
 

 

Research Design

 

“A qualitative methodology was used for 3 reasons. First, qualitative research methods are used extensively where the research topic is exploratory, as in the case of this study. Second, such methods are considered both appropriate and valuable in the study of quality improvement processes in health care. Finally, the same methods (semi-structured interviews) has been used in published research on HCAIs. An iterative 2-round process of in-depth interviews was undertaken with hospital HCWs from a major public hospital in Sydney, Australia. The first round of interviews was conducted between June and July 2013, and the second round was conducted between February and September 2014” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Data Collection/Generation Methods

 

“Semi-structured interviews were undertaken with 29 staff from a large hospital in Sydney, Australia. An interview guide was developed based on scoping information gathered from a consultation session held with senior surgical staff members at the hospital and on available literature. The guide was pretested with a small sample to ensure it was acceptable (ie, on topic), understandable, and unambiguous and that the open-ended questions would elicit a response from interviewees. Questions addressed the following topics: perceived patient information needs and role-responsibility; understanding of, and experience with, patient empowerment strategies; experience of being asked factual versus challenging questions related to the quality and safety of the patients’ health care; attitudes toward a proposed empowerment intervention; and perceived benefits and perceived barriers and facilitators of participating in such an intervention. Questions were asked in an open-ended manner to allow room for expansion. Paraphrasing and additional questions were added to seek clarification during the interviews. This was to ensure that the study included the widest possible representation of opinions and so that the interview guide could be used in flexible manner. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. For participants with very little understanding of patient empowerment, a short definition was provided to them after the knowledge questions were asked. (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Credibility

 

“Member checking was conducted during the interviews to ensure rigor of research and to ensure that participants’ views were represented accurately. This process involved summarizing and feeding back participants’ views at the end of the interview to compare the investigator’s account with participants’ views. The use of member checking in this study was primarily to ensure the study’s descriptive validity. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research. Participant recruitment was continued until data saturation was reached (ie. additional interviews produced no new ideas or issues). Participants were also asked to complete a short survey that collected general demographic information” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Data Analysis

 

“All interviews were audio recorded, professionally transcribed verbatim, and analyzed thematically. Transcripts for each taped interview were checked for internal consistency and corroborated with other interviews. The researchers used NVivo 10 (QSR International, Doncaster, VC, Australia) to code the data. After repeated and close reading of the individual interview transcripts, 3 researchers independently constructed a code list of major themes emerging from the data. These code lists were compared and cross-checked, and a final list was compiled. An agreed thematic framework was applied to another subsample of transcripts and further modified. Using this final framework, all the transcripts were analyzed and coded” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Findings

 

“A total of 29 interviews were undertaken with hospital staff members (12 in the first round and 17 in the second round). There was almost unanimous agreement among the participants that patients should be stakeholders or play a role in the prevention of HCAI. What varied was the degree of responsibility or engagement in which participants felt patients should be involved” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

Discussion of Findings

“This study explored the opinions of health care workers toward the concept of patient empowerment and the role of the patient in promoting hand hygiene and preventing health care associated infections. Among the participants of this study, there was a strong tendency to relate the concept of empowerment, which was understood to be the process for improving patient safety, primarily to encourage patients to improve their own behaviors, such as improving their or their family’s compliance with personal hygiene or HH, and to the provision of educational material about infection control or HH. Very few participants associated patient empowerment with any on-going exchanges between HCWs and their patients. This view of empowerment reflects an emphasis in current guidelines, which focus on information provision rather than engagement. During the interviews, participants closely related patient empowerment to patient-centered care, a concept with which they were more familiar. This is not unexpected, because apart from the recent predominance of the latter, patient empowerment and patient centeredness are both based on the principles of shared responsibility and the building of partnerships of mutual trust and respect between the caregiver and patient. Structural issues, such as workloads and competing priorities, including the change and quality improvement initiatives, are difficult to manage without commitment, as noted by participants, from senior staff. Participants in this study were open to the idea of patient empowerment because they felt that such a process could improve patient outcomes and communication between patients and their health care providers. Given that staff members are very accepting of the concept of patient-centered care, emphasis should be placed on how patient empowerment builds on from that now well-established approach. The success of patient empowerment fundamentally depends on how well the caregiver and patient can communicate with each other. Health care providers need to promote and enhance the patient’s ability to feel in control. Most of the study participants felt that improved communication would be one of the positive outcomes of an empowerment program; however, many did not link the promotion of participation and buy-in from patients with their own communication skills” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Limitations

 
Some limitation noted within this study were “interviews were only undertaken with a select group of participants from one hospital; therefore, the possibility of other important themes emerging cannot be ruled out and this was a small, qualitative study” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research

 

Implications

 
“Most health organizations have recognized the potential of patient empowerment as a way of improving the HH behaviors of HCWs. Before facilities consider introducing a program such as this, they need to consider the following: (1) whether they have the infrastructure to support the program; (2) the mechanism they are going to use to educate and promote engagement and communication; (3) how they are going to align the culture at the facility toward the approach; and (4) how to evaluate the impact of the program. Although the role of the patient in HH as a means to prevent infection has been recommended by others, patient engagement remains an underused method of preventing HCAIs. By extending the concept of patient empowerment to other infection prevention opportunities, the positive impacts of this intervention will not only extend to the patient but to the system itself” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

 

Recommendations

 

“The findings should be explored further in larger studies to establish whether the issues raised in this study are generalizable to the wider Australian health care community. Issues regarding variation in response between different categories and levels of seniority of staff members need to be explored in a larger quantitative study” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research.

 

Research Utilization in Your Practice

 

Investing in staff development related to patient and family engagement helps staff partner meaningfully with patients and families not only in direct patient care but also in quality and safety initiatives, educational endeavors, evaluation, and research.” This can be concept can my implemented into any practice. “By extending the concept of patient empowerment to a range of infection prevention opportunities, the positive impact of this intervention will not only extend to the patient but to the system itself” (Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015). Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research

 

References

Alhoward. (2015). “Qualitative research isn’t as scientific as quantitative research methods.”

Received from
https://alhoward.wordpress.com/2011/11/16/qualitative-research-

isn’t-as-scientific-as-quantitative-methods/

Polit, D. F., & Beck, C. T. (2017).
Nursing research: Generating and assessing evidence for

nursing practice
(10th ed.). Philadelphia, PA: Wolters Kluwer. Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research

Creswell, J. W., & Creswell, J. D. (2018). Research Design: Qualitative, Quantitative, and Mixed

Methods Approaches. Fifth Edition. Los Angeles: SAGE, (2018). Retrieved from https://books.google.com/books?hl=en&lr=&id=KGNADwAAQBAJ&oi=fnd&pg=PP1&dq=quantitative+and+qualitative+research&ots=XCEed93gcZ&sig=lSs52Q22qXZ-foMRU1ete9JjWQU#v=onepage&q=quantitative%20and%20qualitative%20research&f=false

Curlej, M. H., Katrancha, E. (2016). One Rural Hospital’s Experience Implementing the Society

of Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections.
Journal of Trauma Nursing.
Vol. 23, Issue 5, pp. 290-297. Retrieved from https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=3&sid=3fb92985-309b-4e9d-8252-0eb0e8e630c5%40sessionmgr4008

Seale, H., Chughtai, A. A., Kaur, R., Phillipson, L., Novytska, Y., & Travaglia, J. (2015).

Empowering patients in the hospital as a new approach to reducing the burden of health care-associated infection: The attitudes of hospital health care workers.
American Journal of Infection Control
. Vol. 44, Issue 3, pp. 263-268. Retrieved from https://www-sciencedirect-com.ezp.waldenulibrary.org/science/article/pii/S0196655315010 378?_rdoc=1&_fmt=high&_origin=gateway&_docanchor=&md5=b8429449ccfc9c30159a5f9aeaa92ffb&ccp=y Nursing 6052 – Week 7 – Critiquing Quantitative/ Qualitative Research

Please use the patient information provided below for this Health Promotion Essay paper.

This assignment assesses intended course outcome(s)

#4 Use information found in patients’ health histories, genograms, and assessments to formulate an individualized plan of nursing care that focuses on the patient’s individual health promotion and disease prevention needs

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

Students will use the information found in Tina’s history, physical exam, and problem list to formulate an individualized health promotion and disease prevention plan of care. Recommendations should be evidence-based and from credible sources Health Promotion Essay. The readings in module eight contains some suggested sources for obtaining health and screening recommendations for your patient.

The plan for addressing the health promotion and disease prevention needs for your patient should include:

Demographics:

 

–          Age, gender and race of patient

 

–          Education level (health literacy)

 

–           Access to health care

 

Insurance/Financial status

 

–          Is the patient able to afford medications and health diet, and other out-of-pocket expenses?

 

Screening/Risk Assessment

 

–          Identified health concerns based on screening assessments and demographic information

 

Nutrition/Activity

 

–          What is the patients activity level, is the environment where the patient lives safe for activity

 

–          Nutrition recommendations based on age, race gender and pre-existing medical conditions

 

–          Activity recommendations Health Promotion Essay

 

Social Support

 

–          Support systems, family members, community resources

 

Health Maintenance

 

–          Recommended health screening based on age, race, gender and pre-existing medical conditions

 

Patient Education:

 

–          Identified knowledge deficit areas/patient education needs (medication teaching etc).

 

–          Self-care needs/ Activities of daily living Health Promotion Essay

 

* The paper should be written and referenced in APA format and be no longer than 4 pages (excluding cover page and references).

 

Your paper will be evaluated based on the following criteria:

 

Criteria

Level 3

Level 2

Level 1

Demographics

(5%)

Includes age, race and gender of patient

Missing one data item

Missing 2 or more data items

Insurance/Financial status

(10%)

Includes information regarding patient’s insurance status and ability to afford medications and other  out-of-pocket expenses

Missing some information regarding insurance status and ability to pay for medications and other out-of-pocket expenses.

Missing information regarding the patients insurance status, ability to pay of medications and other out-of-pocket expenses

Screening /risk assessment

(10%)

Identifies health concerns based on screening assessments and demographic information.

Missing some information regarding health concerns, by excluding information from screening assessments and demographics

Health concerns are not identified due to information missing from screening assessments and demographics Health Promotion Essay

Nutrition/activity

(20%)

Completely asses patient’s nutrition and activity levels and makes recommendations based on age, race, gender and pre-existing medical conditions

Missing some information regarding the patients nutrition and activity levels, make recommendations based on age, race, gender and pre-existing medical conditions

Most of the information regarding the patient’s nutrition and activity levels are missing, recommendations are missing or not based on the patient’s age, race, gender and pre-existing medical conditions

Social support

(10%)

Identifies support systems such as family members and community resources

Missing some information regarding support systems such as family members and/or community resources

Little to no information regarding social support

Health Maintenance

(20%)

Overall health maintenance recommendations made based on age, race, gender and pre-existing medical conditions

Missing some recommendations, mostly based on age, race, gender and pre-existing medical conditions

Missing many recommendations, loosely related to age, race, gender and pre-existing medical conditions

Patient Education

(20%)

Identified knowledge deficit areas/patient education needs including self-care needs and activities of daily living

Missing one or more areas of knowledge deficit/patient education needs including self-care and activities of daily living

Lacks identification of knowledge deficit areas/patient education needs. Does not consider self-care needs or activities of daily living.

Organization, spelling and grammar, APA

(5%)

Organized, easy to read, no spelling or grammar mistakes, appropriate use of APA Health Promotion Essay

Organized and easy to read, few spelling or grammar mistakes, few errors in APA

Disorganized, difficult to read, many spelling and grammar errors mistakes. Does not use APA

Overall score

Points

(60-100)

Points

(24-59)

Points

( 0-23)

 

 

Health History

Student Documentation

Model Documentation

Identifying Data & Reliability

Tina Jones is a 28 year old African american female AOX4. Pt is reliable historian

Ms. Jones is a pleasant, 28-year-old African American single woman who presents for a pre-employment physical. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Speech is clear and coherent. She maintains eye contact throughout the interview.

General Survey

Alert and oriented X4. Feels tired because she was just coming from her other job. Health Promotion Essay

Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. She is well-nourished, well-developed, and dressed appropriately with good hygiene.

Reason for Visit

Presenting to shadow health hospital clinic for a complete health assessment for a pre-employment physical.

“I came in because I’m required to have a recent physical exam for the health insurance at my new job.”

History of Present Illness

Tina Jones is a 28year old African America female with a history of diabetes and Asthma presenting to get a complete health assessment for a pre-employment physical.

Ms. Jones reports that she recently obtained employment at Smith, Stevens, Stewart, Silver & Company. She needs to obtain a pre-employment physical prior to initiating employment. Today she denies any acute concerns. Her last healthcare visit was 4 months ago, when she received her annual gynecological exam at Shadow Health General Clinic. Ms. Jones states that the gynecologist diagnosed her with polycystic ovarian syndrome and prescribed oral contraceptives at that visit, which she is tolerating well. She has type 2 diabetes, which she is controlling with diet, exercise, and metformin, which she just started 5 months ago. She has no medication side effects at this time. She states that she feels healthy, is taking better care of herself than in the past, and is looking forward to beginning the new job.

Medications

Metformin 850mg twice daily Yaz birth control daily in the morning Flovent MDI twice daily proventil 90mcg/spray 2 puffs as needed for wheezing

• Fluticasone propionate, 110 mcg 2 puffs BID (last use: this morning) • Metformin, 850 mg PO BID (last use: this morning) • Drospirenone and ethinyl estradiol PO QD (last use: this morning) • Albuterol 90 mcg/spray MDI 2 puffs Q4H prn (last use: three months ago) • Acetaminophen 500-1000 mg PO prn (headaches) • Ibuprofen 600 mg PO TID prn (menstrual cramps: last taken 6 weeks ago) Health Promotion Essay

Allergies

Penicillin- Rash, hives cats- sneezing, itchy watery eyes, asthma exacebation No Known food allergies No latex allergies

• Penicillin: rash • Denies food and latex allergies • Allergic to cats and dust. When she is exposed to allergens she states that she has runny nose, itchy and swollen eyes, and increased asthma symptoms.

Medical History

Asthma- diagnosed at age 2 1/2 Diabetes Type 2 – diagnosed at 24 was on metformin but stopped due to side effects

Health Promotion Essay

Asthma diagnosed at age 2 1/2. She uses her albuterol inhaler when she is around cats. Her last asthma exacerbation was three months ago, which she resolved with her inhaler. She was last hospitalized for asthma in high school. Never intubated. Type 2 diabetes, diagnosed at age 24. She began metformin 5 months ago and initially had some gastrointestinal side effects which have since dissipated. She monitors her blood sugar once daily in the morning with average readings being around 90. She has a history of hypertension which normalized when she initiated diet and exercise. No surgeries. OB/GYN: Menarche, age 11. First sexual encounter at age 18, sex with men, identifies as heterosexual. Never pregnant. Last menstrual period 2 weeks ago. Diagnosed with PCOS four months ago. For the past four months (after initiating Yaz) cycles regular (every 4 weeks) with moderate bleeding lasting 5 days. Has new male relationship, sexual contact not initiated. She plans to use condoms with sexual activity. Tested negative for HIV/AIDS and STIs four months ago.

Health Maintenance

Has been eating healthy and trying to stay active by walking 30-40 mins two times per week and also swimming once a week

Last Pap smear 4 months ago. Last eye exam three months ago. Last dental exam five months ago. PPD (negative) ~2 years ago. Immunizations: Tetanus booster was received within the past year, influenza is not current, and human papillomavirus has not been received. She reports that she believes she is up to date on childhood vaccines and received the meningococcal vaccine for college. Safety: Has smoke detectors in the home, wears seatbelt in car, and does not ride a bike. Uses sunscreen. Guns, having belonged to her dad, are in the home, locked in parent’s room. Health Promotion Essay

Family History

-Father died 2 1/2 ears ago in a car accident. History of high blood pressure,type 2 diabetes and high cholesterol -Mother is still alive. has history of hypertension and high cholesterol. -Brother is overweight -Sister has asthma

• Mother: age 50, hypertension, elevated cholesterol • Father: deceased in car accident one year ago at age 58, hypertension, high cholesterol, and type 2 diabetes • Brother (Michael, 25): overweight • Sister (Britney, 14): asthma • Maternal grandmother: died at age 73 of a stroke, history of hypertension, high cholesterol • Maternal grandfather: died at age 78 of a stroke, history of hypertension, high cholesterol • Paternal grandmother: still living, age 82, hypertension • Paternal grandfather: died at age 65 of colon cancer, history of type 2 diabetes • Paternal uncle: alcoholism • Negative for mental illness, other cancers, sudden death, kidney disease, sickle cell anemia, thyroid problems

Social History

she does not have any children, has never been pregnant and has never been married. she lives with her mother and sister. currently works but is hoping to start a new jop as an accounting clerk at smith, stevens, steward silver company. drinksa alcohol ocassionally when she goes out with friends

Never married, no children. Lived independently since age 19, currently lives with mother and sister in a single family home, but will move into own apartment in one month. Will begin her new position in two weeks at Smith, Stevens, Stewart, Silver, & Company. She enjoys spending time with friends, reading, attending Bible study, volunteering in her church, and dancing. Tina is active in her church and describes a strong family and social support system. She states that family and church help her cope with stress. No tobacco. Cannabis use from age 15 to age 21. Reports no use of cocaine, methamphetamines, and heroin. Uses alcohol when “out with friends, 2-3 times per month,” reports drinking no more than 3 drinks per episode. Typical breakfast is frozen fruit smoothie with unsweetened yogurt, lunch is vegetables with brown rice or sandwich on wheat bread or low-fat pita, dinner is roasted vegetables and a protein, snack is carrot sticks or an apple. Denies coffee intake, but does consume 1-2 diet sodas per day. No recent foreign travel. No pets. Participates in mild to moderate exercise four to five times per week consisting of walking, yoga, or swimming.

Mental Health History

Denies any history of depression or suicidal thoughts. denies any problems with mood. no overall safety concerns.

Reports decreased stress and improved coping abilities have improved previous sleep difficulties. Denies current feelings of depression, anxiety, or thoughts of suicide. Alert and oriented to person, place, and time. Well-groomed, easily engages in conversation and is cooperative. Mood is pleasant. No tics or facial fasciculation. Speech is fluent, words are clear

Health Promotion Essay

MN502-4: Develop a philosophy that supports advanced nursing practice reflecting the values, beliefs, and cultural competencies relative to nursing practice, science, and theory

MN502-4: Develop a philosophy that supports advanced nursing practice reflecting the values, beliefs, and cultural competencies relative to nursing practice, science, and theory.

BUY A PLAGIARISM-FREE PAPER HERE

Now that you have spent the last 8 weeks discussing theory development and exploring models and philosophies that guide advance practice nursing, it is time for you to put it all together. In this Assignment, you will create a presentation using any form of presentation software (e.g., PowerPoint®, Prezi™, Movenote™, Powtoons™, Slidedog™, and so on). Your presentation should bring together the theory that best fits your concept of advance practice nursing, the model that you will use to translate this into practice, and your final philosophy of advance practice nursing related to your role after graduation.

Please remember that your presentation should contain slides that have bullet points. The bullets should number no more than four to six per slide. The bullet point is not written as a complete sentence. It contains key words. You, as the presenter will explain in depth what each bullet point means in the audio portion of the presentation. Slides may contain graphics, but should be uncluttered. Background and font colors should be of sufficient contrast to make reading them easy on the eyes. Attention to colors should be paid so that a person who is colorblind can easily read the presentation. MN502-4: Develop a philosophy that supports advanced nursing practice reflecting the values, beliefs, and cultural competencies relative to nursing practice, science, and theory.

Assignment Details

The presentation should consist of a series of slides that include:

Title Slide: A title slide that identifies the title of the presentation and name of the student.

Introduction Slide: An introduction slide that includes brief information about you and your program track. The slide should also explain to the audience the purpose of the presentation.

Model Slides: The third and fourth slides will address your chosen model. The bullet points should consist of the specific characteristics of the model. You will need at least one citation that identifies where the model came from. Your audio will expound upon the model and what the characteristics mean. The fourth slide should include why you chose the model and how you will apply it in practice. MN502-4: Develop a philosophy that supports advanced nursing practice reflecting the values, beliefs, and cultural competencies relative to nursing practice, science, and theory

Theory Slides: The next three slides will focus on your chosen theory. The first slide should present your theory and why you chose it. The next slide would present the key concepts of the theory and how it has been used to date in past research no older than 5 years ago. The third slide will discuss how you will use this theory in practice as an advance practice nurse upon graduation.

Philosophy Slide: The next area will consist of one slide that presents your philosophy of advance practice nursing in the post-graduate role you will assume. The philosophy statement will consist of one to three sentences that distill the essence of what you believe advance practice nursing is and your conception of nursing as a profession. It is written in the first person and present tense. It is a personal statement of your beliefs about the profession of nursing. This should present guiding statements for your future practice in the advanced practice role. An example of a philosophy statement might read this way:Advanced practice nursing takes the art and science of nursing to a level of “other” and “self” interacting together to reach a state of optimal wellness guided with compassion and love for the culture of the “other.”

Graphical Slide: The next-to-last slide will be a graphical representation of how the model, theory, and your philosophy fit together.

Conclusion Slide: The last slide will be a conclusion that brings together everything you have presented. It isnota summary that just reiterates what you presented. It is a judgment about what you presented and bring the audience home, ending the presentation on a positive note about the future.

You will need supporting citations for your theory and model slides, and possibly for your philosophy, as appropriate. You will include the citations where appropriate and your very last slide will be a reference slide.

The total slide count should not exceed 15 slides. This does not include the reference slide(s) or the title slide.

Organization, documentation, references formatting guidelines must follow APA 6th edition:To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Home. MN502-4: Develop a philosophy that supports advanced nursing practice reflecting the values, beliefs, and cultural competencies relative to nursing practice, science, and theory

Total points: 300

Assignment Requirements

Before finalizing your work, you should:

be sure toread the Assignment description carefully(as displayed above);

consult the Grading Rubric(under the Course Home) to make sure you have included everything necessary; and

utilizespellingandgrammar checkto minimize errors.

Your writing Assignment should:

follow the conventions ofStandard American English(correct grammar, punctuation, etc.);

bewell ordered,logical,andunified, as well asoriginal and insightful;

displaysuperior content, organization, style,andmechanics; and

useAPA 6th Editionformat. MN502-4: Develop a philosophy that supports advanced nursing practice reflecting the values, beliefs, and cultural competencies relative to nursing practice, science, and theory

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD)

In a 750-1000 word essay in APA format,  critically evaluate the following scenario:

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD. Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD)

BUY A PLAGIARISM-FREE PAPER HERE

Subjective Data

Is very anxious and asks whether she is going to die.

Denies pain but says she feels like she cannot get enough air.

Says her heart feels like it is “running away.”

Reports that she is exhausted and cannot eat or drink by herself.

Height 175 cm; Weight 95.5kg.

Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.

Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.

Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%. Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD)

Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

IV furosemide (Lasix)

Enalapril (Vasotec)

Metoprolol (Lopressor)

IV morphine sulphate (Morphine)

Inhaled short-acting bronchodilator (ProAir HFA)

Inhaled corticosteroid (Flovent HFA)

Oxygen delivered at 2L/ NC

Describe the clinical manifestations present in Mrs. J.

Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.

Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend. Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD)

Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.

Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.

Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered. Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD)

NAPSRx Final Exam

1. How are drugs sorted into therapeutic groups and classes?

A. first by the conditions that they are used to treat. and then by their mechanisms of action

B. first by their mechanisms of action. and then by their therapeutic effects

C. first by their side effects. and then by their therapeutic effects

D. first by their toxicity. and then by their effectiveness

2. Bone marrow transplants…

A. require that the patient first undergo chemotherapy or radiation to kill the diseased stem cells and promote white blood cell production. NAPSRx Final Exam

B. are a type of stem cell therapy. unless patient’s own cells are reinjected.

C. are always a type of stem cell therapy.

D. can help people with leukemia. a condition in which the body does not produce enough white blood cells.

3. What does AMA stand for?

A. American Medical Academy

BUY A PLAGIARISM-FREE PAPER HERE

B. American Medical Accreditation

C. American Medical Association

D. Association of Medical Assistants

4. What section of a drug’s package insert describes situations in which the drug should not be used because the risks outweigh the therapeutic benefits?

A. adverse reactions

B. contraindications

C. overdosage

D. warning/precautions

5 What is tertiary care?

A. adding medications together to achieve a better clinical effect

B.highly specialized medical and surgical care provided by a large medical center for unusual or complex medical problems

C. receiving medical or surgical care that does not require an overnight stay in the treatment facility

D. seeing a physician for routine checkups and general healthcare

6. Which of the following is NOT one of the stages in the classic approach to brand development strategy covered in your manual? NAPSRx Final Exam

A. brand personality

B. brand positoning

C.brand quality

D. brand values

7 What are vasodilators used to do?

A. decrease vascular resistance and increase blood flow

B. mimic pathogens to stimulate the immune system

C. narrow the blood vessels

D.stimulate the CNS to make the heart beat faster

8. What is the name of the condition that occurs after a specific dose of a drug is given at such regular intervals that absorption and elimination (and therefore drug plasma concentration) have become fairly constant?

A. homeostasis

B.steady state

C. titration

D. tolerance

9. Which statement is TRUE about ocular administration?

A. Ocular administration is primarily for drugs that must cross the blood-brain barrier.

B. Ocular administration is used primarily to treat the eye. NAPSRx Final Exam

C. Ocular administration is used when a drug must enter the bloodstream immediately.

D. Ocular administration is used when a drug must produce immediate effects on the brain or spinal cord.

10. Which entities invest’s the most money in pharmaceutical R&D?

A. Canadian pharmaceutical companies

B. the NIH

C. the U.S. Government

D.U.S. pharmaceutical companies

11. How are most drugs excreted?

A. via the bloodstream

B. via the heart

C. via the kidneys

D. via the skin

12. Over the last few decades, what has happened to legal limitations on sales’ reps discussions about off label uses?

A. Limitations have decreased.

B. Limitations have increased significantly.

C. Limitations have increased slightly.

D. Limitations have remained about the same.

 

13. Answer: Branding name

 

14. What does it mean if two drugs are at parity?

A. Both drugs are essentially in a neutral position.

B. Both drugs are generics.

C. Both drugs have exclusive preferred status.

D. The two drugs are bioequivalent.

15 Who is most likely to benefit from electronic sampling programs?

A. Everyone would benefit equally from electronic sampling programs

B. physicians in hospitals who are too busy to see representatives

C. physicians in rural areas who are not as frequently visited by representatives

D. physicians in urban areas who are too busy to see representatives

16. When referring to medication dosage, which abbreviation means “one-half’:

A.MS

B.OH

C. SM

D. SS

17 What is an internist?

A. a physician who practices internal medicine

B. a physician’s intern

C. a type of oncologist who specializes in chemotherapy

D. an internal sales representative

18. Which of the following is a type of white blood cell?

A. erythrocytes

B. insulin

C. Lymphocytes

D.HCs

19. Why are novice sales representatives often placed in charge of negotiating MCO formularies?

A. to become more familiar with the healthcare industry

B. to become more familiar with their territories

C. P&T committees are more receptive to new faces.

D. They are not. This job is usually reserved for more experienced reps.

20. What distinguishes pharmacodynamics from pharmacokinetics?

A. Pharmacodynamics studies a drug’s ex vivo effects.

B. Pharmacodynamics studies how drugs affect the body.

C. Pharmacodynamics studies the how the body affects drugs.

D. Pharmacodynamics studies the time required for a drug’s absorption.

21 What proportion of the drugs tested on human subjects are eventually approved by the FDA?

A. about 20%

B. about 60%

C. about 70%

D. about 95%

22. According to a study discussed in your manual, how do most physicians prefer to receive their drug samples?

A. by borrowing them from hospitals

B. by ordering them over the Internet

C. by trading them for services

D.directly from sales representatives

23. Which of the following is an example of a central value?

A. I buy Advil to show that I’m a modern consumer.

B. I like Advil because we were both born in the 80s.

C. I prefer Advil because I like the flavor.

D. I prefer Advil because it’s easier to swallow.

24. Which of the following specialties likely has the MOST emergency calls?

A. cardiology

B. psychiatry

C. urology

D. All specialists have the same number of emergency calls.

25. What affects the rate of active transport?

A. the availability of carriers. but not energy

B. the availability of energy. but not carriers

C. the availability of carriers and energy

D. neither the availability of carriers nor the availability of energy

26. Over the last few decades, what has happened to the FDA approval time for new drugs?

A. It has been lengthened to ensure safer drug products.

B. It has been lengthened to limit DTC marketing

C. It has been shortened to improve drug quality

D. It has been shortened to reduce the cost of new drug development.

27. Which of the following would NOT help improve compliance?

A. patients liking their providers

B. patients using only one pharmacist

C. pharmacists understanding how generics differ from brand name drugs

D.  support groups

28. Which entity chooses a drug’s trade name?

A. the drug’s inventor

B. the drug’s manufacturer

C.the FDA

D. the United States Pharmaceutical Council

29. What type of stem cells are obtained from embryos and can develop into any cell type?

A. multipotent

B.  pluripotent

C. totipotent

D. All stem cells can develop into any cell type.

30. As the price a patient pays for a prescription increases, what happens to the likelihood that the patient will fill it?

A. It decreases.

B. It increases.

C. It remains unaffected because the prescription is needed.

D. It remains unaffected because the prescription’s increased cost is offset by its perceived value.

31. Most involuntary movements come from which type of muscle tissue?

A. cardiac and smooth

B. only skeletal

C. skeletal and cardiac

D. skeletal and smooth

32. Which of the following is NOT one of the body’s major organ systems?

A. the cardiovascular system

B. the cellular system

C. the gastrointestinal system

D.  the musculoskeletal system

33. How do most drugs exert their primary physiological effects?

A.  by activating synapses between different types of tissues

B. by binding to cell receptors that are sensitive to their presence

C. by inhibiting synapses between different types of tissues

D.  through genetic mutation

34. What is the most reliable source of information for determining therapeutically equivalent drug products?

A. AMA guide

B. Blue Book

C. FDA drug list

D.  Orange Book

35. What does subcutaneous mean?

A. beneath the intervention

B. beneath the muscle tissue

C. beneath the outer skin

D. beneath the suture

36. What should a sales representative do if all of the prime spaces in a drug cabinet are coccupied?

A. ask staff for permission to move some of the other products in the cabinet

B. ask staff for permission to throw away expired products in the cabinet

C. ask the doctor if he still needs some of the other products in the cabinet

D. surreptitiously move your largest competitors’ products out of the way

37. It is inappropriate for physicians’ prescribing behaviors to be educated by their personal tastes and idiosyncrasies

A. TRUE

B. FALSE

38.The FDA defines API as the active__ ingredient in a drug, which produces the desired change in the body.

A. pharmaceutical

B. positive

C. potent

D.  primary

39. What are the 2 legal classifications of wholesalers?

A. distributors and supply chains

B. pharmacists and NAMs

C. primary and secondary wholesale distributors

D. retailers and institutions

40.What term describes the usage of a medication for purposes other than the FDA-approved indications on the labeling?

A. contraindicative indication

B. off-indication usage

C or D. off-label

 

41. What is the acronym for pharmacokinetics?

A. KN

B. PC

C. PK

D. pT

42. The dosage range of a drug that is both safe and beneficial is known as the therapeutic window.

A. TRUE

B. FALSE

43. What is typically NOT a characteristic of a pharmaceutical sales rep?

A. Pharmaceutical sales reps are authentic and real.

B. Pharmaceutical sales reps are creative.

C. Pharmaceutical sales reps are focused.

D. Pharmaceutical sales reps are not concerned about competitors.

44. What entity grants drug patents?

A. the FDA

B. the FDA if the drug is over-the-counter and the U.S. Patent and Trademark Office if the drug is prescription

C. the FDA if the drug is prescription and the U.S. Patent and Trademark Office if the drug is over-the-counter

D. the U.S. Patent and Trademark Office

45. Which of the following refers to all active and inert pharmaceutical ingredients in a drug, including fillers and colors?

A. formulation

B. mycoplasma

C. peptide

D. saccharide

46. What is the difference between potency and efficacy?

A. Doctors prefer more potent drugs.

B. Drug manufacturers prefer more potent drugs.

C. Potency refers to the drug’s effectiveness. while efficacy refers to its strength.

D. Potency refers to the drug’s strength, while efficacy refers to its effectiveness.

47. What is the minimum level of education required for a nurse practitioner?

A. a certification program

B. an associate’s degree

C. a bachelor’s degree

D. a graduate degree

48. How many names must a drug have?

A. at most three

B. at least three

C. at most five

D. at least five

49. How has a longer development time increased the cost of bringing a new drug to market?

Answer: Increasing the cost of capital

Explaination (Option Not taken so find out in below para): Lengthening development time dramatically increase the cost of bringing a new drug to market by increasing the cost of capital needed for R&D. The cost of capital increases as companies are exposed to Economic Risk and uncertainty over a longer period of development time. Stringent FDA guideline and long approval times have greatly increased the cost of developing new drugs.

 

50. Senior citizens consume over times as many pharmaceuticals as people under 65.

A. three

B. five

C. ten

D. fifteen

51. What agency regulates the distribution and use of narcotics?

A. DEA

B. FTC

C. OIG

D.TSA

52. What is passive diffusion?

A. a type of pinocytosis

B. membrane transport via vesicles

C. the use of energy to help a substance pass from a low concentration gradient to a high one

D. when a substance freely moves through a membrane from a high concentration gradient to a low one

53. What are the MAIN categories of drugs under FDA jurisdiction?

A. active drugs and active placebos

B. biopharmaceuticals and nutraceuticals

C. non-prescription and nutraceuticals

D. prescription and non prescription

 

54. Answer: Oxytocin

 

55. What are all metabolites?

A. active substances

B. inactive substances

C. injections

D. products of metabolism

56. When a drug is administered orally, where does first-pass metabolism occur?

A. intestine

B. liver

C. pancreas

D. stomach

57. What is the medical term for swelling?

A. assay

B. edema

C. instillation

D. protease

58. Which of the following is NOT part of the Seven Step Cascade of Emotion?

A. be a consultant. not a rep

B. identify what your product does

C. reflect

D. visualize the power of 10

59. Which part of a clinical research paper is frequently referred to as the road map?

A. abstract

B. findings

C. letter to the editor

D .methods

60. Which of the following is a main active ingredient in lung surfactants?

A. animal lung extract

B.  germicides

C.  sympathomimetic drugs

D.  theophylline

61. What does parenteral mean?

A. child prescriptions

B. injection

C. oral

D. tablet

62. Which term denotes a type of substance that enhances the action of a drug or antigen?

A. adjuvant

B. indicated

C. ligase

D peptide

63. If a sales representative’s product is placed on the second tier of a standard three-tier formulary, which of the following is most likely true?

A. It has not been reviewed by the P&T committee.

B. It is in a neutral position unless it is at parity with other drugs.

C. It probably has exclusive preferred status if it is not at parity with any other drugs.

D. It will essentially sell itself if it is granted exclusive preferred status.

64. Which of the following is NOT one of the four basic transport mechanisms?

A. active transport

B. homeostasis

C. passive diffusion

D. pinocytosis

65. Which statement accurately describes a relationship between drug agonists and antagonists?

A. Agonists and antagonists can be used together.

B. Agonists and antagonists should not be used together.

C. Antagonist drugs activate receptors. while agonists block access to receptors.

D. Antagonists are endogenous whereas agonists are man-made.

66. What is the study of the effects and movement of drugs in the human body?

A. anatomy

B. antology

C. clinical pharmacology

D. pathology

67. According to your manual, what is a common complaint that physicians have about traditional sampling methods?

A. that drug sample supply is too unpredictable

B. that patients are less likely to take free samples because they think they are lower quality

C. that patients do not like seeing drug representatives in their offices

D. that they receive too many drug samples

68. Which of these entities is formed by two or more hospitals or other healthcare entities to negotiate reduced rates with its aggregated purchasing power?

A. GPO

B. In-state wholesaler

C. PPO

D. RPO

69. What is another name for a drug derived from a biologic compound?

A. large molecule

B. oligonucleotide

C. orgaanism

D. small molecule

70. What is the most common policy regarding pharmaceutical reps dispensing drug samples in hospitals?

A. By federal law. drug sampling is permitted in all hospitals.

B. By federal law. it is up to individual physicians. not the hospital.

C. Drug sampling is encouraged. but not required.

D. Drug sampling is often forbidden.

71 Which of the following would help you build trust with a physician?

A. asking if he or she is having any problems with the managed care coverage of your products

B. repeating a question you already asked

C. surprising the office staff with a new poster in the break room

D. None of these would help you build trust with a physician.

72. What term denotes the difference between the usual effective dose and the dose that induces severe or life-threatening side effects?

A. dose-response relationship

B. margin of safety

C. the placebo effect

D. therapeutic window

73. What are excipients?

A. a type of cell receptor to which antagonists bind to decrease the effects of the body’s natural agonists

B. another term for generic equivalents

C. sites of action besides the target sites of action

D.the inert ingredients in a drug formulation

74. What is another term for the AWP?

A. dock-to-dock price

B. float price

C. list price

D. non-stock price

75. Which of these is the most likely use for auterotonic agent?

A. to induce labor

B. to make the urine more alkaline

C. to supplement oral food intake

D. to treat hyperthyroidism

76. As of November 2013, which of these countries has legalized DTC advertising of prescription drugs?

A. Canada

B. Japan

C. Spain

D. none of these

77. Why are oral drugs often taken on an empty stomach?

A.  to be more wholly absorbed by the stomach

B. to minimize absorption by the intestine

C.  to minimize nausea

D.to pass through the stomach more quickly

78. What is one factor that differentiates community health centers from hospitals?

A.  Community health center formularies are more restrictive.

B. Community health centers have higher reimbursement rates.

C. Newer brand name drugs are easier to access at community health centers.

D. None of these

79. How does drug sampling provide a social benefit?

A. Doctors donate their unused drug samples to charities.

B. Doctors often use drug samples to treat patients who otherwise could not afford it.

C. It allows patients to try out different prescription medications before consulting with physicians.

D.  Drug sampling provides a social benefit in all of these ways.

80. Which medical term denotes the use of a stethoscope to listen to the heart?

A. auscultation

B. cardioversion

C. catheterization

D. echocardiography

81. What do enteric coatings do?

A. facilitate vomiting

B. help drugs dissolve in the stomach

C. help drugs enter the bloodstream more quickly

D. prevent dissolution in the stomach

82. What is the duration of exclusivity for orphan drugs?

A.  6 months

B. 1 year

C.  7 years

D.  15 years

83. What do National Account Managers do?

A. act as the sales reps’ primary point of contact with the rest of the corporation

B. manage the FDA approval process

C. negotiate contracts with MCOs and PBMs

D.  sell only to pharmacies

84. What does it usually mean if a drug recall is voluntary?

A. Pharmacies may choose whether to return the drug or dispense it.

B. The FDA has determined that the drug is perfectly safe. but ineffective.

C. The manufacturer has recalled the product on its own. but negotiated with the FDA beforehand.

D. The manufacturer has recalled the product without negotiating with the FDA.

85. Which phase of clinical trials is also known as the pivotal phase?

A. Phase I

B. Phase III

C Phase IV

D. Phase IX

86. During which phase of clinical trials is the new drug’s safety and effectiveness first tested in the target group?

A. preclinical NAPSRx Final Exam

B. Phase I

C. Phase II

D. Phase III

87. How do antacids work?

A. by increasing blood flow to the stomach

B. by lowering gastric pH

C. by raising gastric pH

D. by suppressing cholesterol formation by the liver

88. What is one of the biggest time wasters for a pharmaceutical sales rep?

A. Caterers

B. Pharcists

C. receptionists

D. travel time

89. What happens when equilibrium is reached?

A.  equal numbers of molecules cross the membrane in both directions

B.  molecules stop moving

C. the concentration gradient decreases indefinitely

D. the concentration gradient increases indefinitely

90. What are the most common vectors used in gene therapy?

A.  autologous antigens

B. liposomes

C. naked DNA

D. viruses

91. What is the percentage fee that the dispenser pays the wholesaler for distribution?

A. margin fee

B. recharge

C. standard fee

D. upcharge

92. What is the difference between a chronic (or continuing) reaction, and a delayed reaction?

A. Chronic reactions are exaggerated. whereas delayed reactions are idiosyncratic.

B. Chronic reactions occur only during treatment. whereas delayed reactions only occur during withdrawal.

C. Chronic reactions persist for a long time. whereas delayed reactions take some time to develop.

D. Delayed reactions are always idiosyncratic. but chronic reactions are not. NAPSRx Final Exam

93 What is clinical effect?

A. federally funded research condition

B. the effect of maximum dosage

C. the response produced by a medication

D. the use of treatment drugs in chemotherapy

94. Which of the following is an example of noncompliance?

A. a patient forgetting to take a drug at a specified time of day

B. a patient taking a drug. but only because it has been court-mandated

C. a pharmacist dispensing a generic equivalent of a drug instead of the brand name

D. a physician refusing to prescribe a drug because he or she does not trust the clinical studies on it

95. What is the average circulation time of blood?

A. about a minute

B. about 5 minutes

C. about 5 to 10 minutes depending on the patient’s age and health conditions

D. about 10 minutes

96. What is one way in which pharmaceutical selling is different from selling in most other industries?

A. In pharmaceutical sales. the decisions-makers. consumers. and payers are usually the same entity.

B. Pharmaceutical selling takes less time because doctors are so busy.

C. Representatives do NOT sell to the end user of the product. NAPSRx Final Exam

D. Representatives DO sell to the end user of the product.

97. From what types of entities do primary wholesale distributors buy most of their drugs?

A. brokerages

B. buying clubs

C. manufacturers

D. physicians

98.What is the Office of the Inspector General (01G)?

A. a department in pharmaceutical companies

B. an arm of the Department of Health and Human Services

C. an arm of the European Medicines Agency D an arm of the FDA

99. What are doctors required to consider when deciding whether or not to prescribe a particular drug?

A. quantity of life over quality of life

B. that no drugs with adverse effects should ever be used

C. the inferiority of OTC drugs

D. the severity of the disorder being treated and the effect it has on the patient’s quality of life

100. Which entity assigns a new drug its generic names?

A. the drug’s inventor

B. the Food and Drug Administration

C. the United States Adopted Name Council

D. the United States Pharmaceutical Council

101. Drugs can be used days beyond their expiration date.

A.  2-7 days. depending on the most current monograph.

B.  2-90 days. depending on state laws

C. 7-90 days. depending on the type of drug and its therapeutic class.

D. none of these

102. What is necessary for a drug to be excreted extensively via the kidneys?

A. The drug must be water-soluble. and not bind too tightly to proteins in the bloodstream.

B. The drug must have a phospholipid bilayer and be non-water-soluble.

C. The drug must have a phospholipid bilayer and bind well to proteins in the bloodstream.

D. The drug must not be water-soluble.

103. Which organization or individual initiates the clinical trial and finances the study?

A. clinical research organization

B. investigator

C. researcher

D. sponsor

104. The name describes the atomic or molecular structure of a drug.

A. chemical

B.  generic

C. pharmaceutical

D. proprietary

105. Under PhRMA Code, is it acceptable or unacceptable for a pharmaceutical sales rep to take a physician and the physician’s spouse to a fundraising dinner?

A. acceptable if only the physician attends

B. acceptable if only the physician attends. and the total is under $100

C. acceptable if the total is under $100

D. unacceptable

106. The Hatch-Waxman Act is considered the most significant drug-related affecting the pharmaceutical industry since 1962. NAPSRx Final Exam

A. experiment

B. legislation

C. process

D. research

107. What term denotes the the extent, quality, or degree to which a substance is poisonous or harmful to the body?

A. caliber

B. chronicity

C. indication

D. toxicity

108. What issue has MOST encouraged consumers’ desire to see more OTC medications?

A. a weaker patients’ rights movement

B.lack of insurance coverage

C. less reliance on the Internet

D. proliferation of herbal remedies

109. What is the degree to which a medication produces a therapeutic effect?

A. diffusion

B. efficacy

C. protease

D. vector

110. What is the most important benefit of electronic prescribing?

A. Choice

B. cost

C. inquiries

D.  safety

111. When does the FDA regulate generic drugs?

A. only if they are branded generics

B. only if they have been contested

C. always

D never

112. Which phase of trials largely determines the clinical dose?

A. preclinical trials

B. Phase II trials

C. Phase III trials

D. Phase IV trials

113. What is an advantage of inactivated vaccines over attenuated vaccines?

A.  Inactivated vaccines are less expensive to prepare.

B. Inactivated vaccines have a higher probability of eliciting the desired immunological response.

C. Inactivated vaccines have a more stable shelf life. NAPSRx Final Exam

D.  Inactivated vaccines only require a single dose.

114. Which medical term denotes a low supply of oxygen due to low blood flow?

A. potentiation

B. ischemia

C. TID

D. titration

115. What are the two main types of prescription drug marketing?

A. (1) marketing to insurance companies. and (2) marketing to pharmacies

B. (1) PBM marketing. and (2) marketing to governments

C. (1) professional physician promotions. and (2) direct-to-consumer advertising

D. (1) publicly-funded marketing. and (2) physician-funded marketing

116. What is the site of delivery for subcutaneous injections?

A. fatty tissuebeneath the surface of the skin

B.  lymphatic tissue

C. muscle tissue

D. the stomach, via a special type of needle

117. What must be contained in the Description section of a pharmaceutical package insert?

A. adverse effects

B. mechanism of action

C. pharmacokinetics

D. the proprietary name and the established name

118. What is the study of a medication’s effects as it travels through the body?

A. pharmacodynamics

B. pharmacogenetics

C. pharmacogenomics

D. pharmacokinetics

119. Customers purchase products from people they like, trust, and respect. This is called the

A. closing of the sale

B. first time advantage

C. likeability factor

D. power of knowledge

120. What is penicillin’s primary mechanism of action?

A. It disturbs bacterial cell wall synthesis.

B It inhibits the production of viruses.

C. It prevents proper DNA replication.

D. It sends a messenger to the bone marrow to produce extra white blood cells

121. According to your manual, how has the U.S. healthcare marketplace changed in the last few decades?

A. Fewer and fewer prescription drugs have been made available as OTCs.

B. Managed care has been increasingly replaced by more patient-centered approaches.

C. The aging Baby Boomer generation has begun demanding more personalized attention.

D. There has been decreased emphasis on preventive health.

122. How does pharmaceutical marketing help narrow the treatment gap?

A. It encourages patients to take more active roles in their healthcare. NAPSRx Final Exam

B. It makes doctors more skeptical of the pharmaceutical industry.

C. It makes patients more skeptical of their doctors’ opinions.

D. all of these

123. What do immunosuppressive agents do?

A. decrease risk of infection

B. increase risk of infection

C. reduce the risk of rejection of foreign bodies

D. treat psoriasis

124. What types of drugs are EGFR inhibitors?

A. antineoplastics

B. cardiovascular agents

C. CNS agents

D. mitotic inhibitors

125. Which of the following means outside of the living body?

A. en vivo

B. ex vitro

C. ex vivo

D. intra vivo

126. The FDA requirements for nutraceuticals and medicinal herbs are just as stringent as for pharmaceuticals.

A. TRUE

B. FALSE

127. What is the estimated net gain of private-sector healthcare’s contributions to increased U.S. life expectancy?

A. $5-10 billion

B. $40-50 billion

C. $800-900 billion

D.$ 2-5 trillion

128. Which statement is TRUE regarding post-approval drug monitoring?

A. All side effects are determined during clinical trials.

B. Drug manufacturers are only required to report adverse effects if they are severe or life-threatening.

C. Drug manufacturers are only required to report adverse effects if they have been proven in clinical studies.

D. The FDA can choose to withdraw their approval if new evidence arises.

129. Which term denotes when tolerance to one medication causes increased tolerance to another medication? NAPSRx Final Exam

A. cell tolerance

B. cross-tolerance

C. indicated tolerance

D. minimized tolerance

130. Patents expire __ years from the date of filing.

A. ten

B.  fifteen

C. twenty

D. thirty

131. After a trade-name drug’s patent expires, how may generic versions of it be sold?

A. only under the branded generic name

B. only under the generic name

C. only under the original trade name

D. under the original trade name or a generic name

132. What is required for a new pharmaceutical to be considered a viable therapy?

A. It causes no serious adverse effects.

B. It causes no side effects.

C. It has an active placebo.

D. It is more effective and/or causes fewer serious adverse effects than other drugs on the market.

133. Under the AMA guidelines, who is ultimately responsible for minimizing conflicts of interest?

A.  doctors

B. lawyers and office managers

C. pharmaceutical companies

D. sales representatives

134. The act of dispensing a pharmaceutical alternative for the product prescribed is

A. alternative licensure

B. equivalence practice

C.  necessitated substitution

D. pharmaceutical substitution

135. What does it mean if a drug is said to have a wide margin of safety?

A. Its safety levels have yet to be adequately verified.

B. Its safety varies widely among different types of patients.

C. There is a greater chance of severe or life-threatening side effects.

D. There is a lower chance of severe or life-threatening side effects.

136. Which of the following is the correct medical acronym for effective dose?

A. DE

B. ED

C. EFD

D. eff D

137. Why is one group of subjects given an active drug, while another group only receives a placebo? NAPSRx Final Exam

A. to assess patients’ expectations

B. to assess the drug’s effectiveness

C. to assess the professionalism of the study staff

D. to assess the subjects’ demographics

138. A generic version is likely to have some inactive ingredients that are different from those of the original drug.

A. TRUE

B. FALSE

139. Which of the following is an example of a functional value?

A.  I drink Coca-Cola because I am a citizen of the world.

B.  I drink Coca-Cola because I like looking like a traditionalist.

C.  I drink Coca-Cola because I like the taste.

D.  I drink Coca-Cola because it is an international brand.

140. Where are most drugs metabolized?

A.  interstitial spaces

B.  liver

C. stomach

D .the bloodstream

141. What is essential to the ethical requirement that subjects be selected fairly?

A. Selection criteria should be well-supported by documented evidence.

B. Studies should make every attempt to conduct research on subjects who are underprivileged and in need of medical attention.

C. Subjects should be selected based on scientific objectives.

D. all of these

142. Which of the following is the most appropriate salutation for a cover letter if you cannot find a contact name?

A. Dear Personnel Department. NAPSRx Final Exam

B. Dear Sir or Madam,

C. Dear Sir

D.To Whom It May Concern.

143. What is part of becoming an indispensable pharmaceutical sales rep?

A. asking for feedback

B. giving the doctors anything they ask for to prescribe your products

C. keeping your market share goals the same each term

D. not bothering busy doctors in hospitals

144. Which of the following is NOT typically included in the indications and usage section of the package insert information?

A. diseases or conditions that the drug is approved to treat

B. the drug’s active metabolites

C. the drug’s recommended usual dosage

D. the drug’s usual dosage range

145. Which term denotes the practice of classifying physicians and other potential prescribers by anticipated prescription volume?

A. conditioning

B. deciling

C. detailing

D. private labeling

146. What makes a drug eligible for fast track approval from the FDA?

A. It is a generic that has already been approved as a branded drug.

B. It is a new drug.

C. It is less expensive than what is currently on the market.

D. It treats patients with a serious. life-threatening condition.

147. In the gastrointestinal tract, help break up tablets to ensure full release of the active pharmaceutical ingredient.

A. binders

B. disintegrants

C. dispersing agents

D. lubricants

148. According to your manual, what does the PDRP do?

A. It educates patients on their treatment options.

B. It expands sales representatives’ access to patient information.

C. It improves communication between sales representatives and patients in doctors’ offices.

D. It limits sales representatives’ abilities to see individual physicians’ prescribing data.

149. What are the components of the central nervous system?

A. the brain and sense organs

B. the brain and spinal cord

C. the brain. spinal cord. and peripheral nervous system

D. the spinal cord and sense organs

150. Which term denotes the origin or cause of a medical condition?

A. cytology

B.  discovery

C.  etiology

D. pathology

151. Patients diagnosed with Type 1 diabetes…

A.  …do not produce enough insulin because they do not have enough B cells.

B.  …have an autoimmune disease.

C.  …produce enough insulin. but it is not as effective.

D.  …rely on insulin from porcine sources.

152. Which DTC pharmaceutical marketing tactic is permitted in European countries?NAPSRx Final Exam

A. disease state ads

B. branded billboards and disease state ads

C. branded highway billboards

D. branded radio ads

153. What is one way in which psychologists DIFFER from psychiatrists?

A. Psychologists are more concerned with subconscious memories than conscious ones.

B. Psychologists deal more with emotional than physical issues.

C. Psychologists deal more with physical issues than emotional ones.

D. Psychologists do not have graduate degrees.

154. What are PBMs?

A. governmental organizations that provide healthcare

B. organizations that design marketing campaigns

C. organizations that negotiate between pharmaceutical companies and large drug purchasers

D. organizations that write FDA new drug applications

155. How does the Hatch-Waxman Act protect research-based drug manufacturers?

A. by limiting the competition

B. by making it easier to bring generic drugs to market

C. by providing a 30-month cooling off period

D. by requiring the FDA to only look at bioavailability studies when approving an ANDA

156. What is the process of adjusting drug doses to achieve the maximum positive therapeutic effects while minimizing adverse or side effects?

A. homeostatic maximization

B. steady stateadministration

C.Sustained release

D. Titration

157. Which of the following is studied more in pharmacodynamics than in pharmacokinetics?

A. absorption. Distribution metabolism and excretion

B. dose-response effects

C. the transportation of the drug to the specific site for drug-receptor interaction

D. the way the human body deals with a drug after it has been administered

158. How does the healthy human immune system use MHC markers?

A. Substances with MHC markers are discerned as foreign and targeted for destruction.

B. Substances with MHC markers as discerned as foreign and quarantined in the liver.

C. Substances with MHC markers as discerned as foreign and quarantined in the pancreas.

D. Substances without MHC markers are discerned as foreign and targeted for destruction.

159. What is a behind-the-counter drug? NAPSRx Final Exam

A. an OTC drug that must be closely monitored by the pharmacist

B. another term for a generic prescription drug

C. another term for a prescription drug

D. another term for an OTC drug

160. When do MSLs meet with clinicians?

A. at nearly any stage of the product’s life cycle

B. only after the district’s sales representatives

C. only prior to launch

D. MSLs do not meet with physicians. NAPSRx Final Exam

PHIL 347N Final Exam | Complete Solution

(TCOs 1, 2) Determine whether the following passage is an argument.

Mark is the newest member of the requisitions department. The requisitions department oversees the purchasing of all goods, services, and capital equipment for the entire company. (Points : 5)

Argument

Not an argument because there are no claims or only one claim

Not an argument because none of the claims offers a reason for the other

Not an argument because the reasons explain rather than prove the other claims

Question 2.

BUY A PLAGIARISM-FREE PAPER HERE

2. (TCOs 1, 2) Determine whether the following passage is an argument.

Either you are planning to vote in the fall election or you donât really want to improve the politics of the local community. (Points : 5) PHIL 347N Final Exam

Argument

Not an argument because there are no claims or only one claim

Not an argument because none of the claims offers a reason for the other

Not an argument because the reasons explain rather than prove the other claims

Question 3.

3. (TCOs 2, 3) Choose the best answer.

Donât drive over the speed limit. Itâs against the law. You donât want a speeding ticket.

Which of the following claims represents the conclusion of this argument? (Points : 5)

Driving over the speed limit is against the law.

You donât want a speeding ticket.

You should not drive over the speed limit.

Question 4.

4. (TCOs 2, 3) Choose the best answer.

Healthy. Delicious. Drink Ovaltine!

Which of the following claims represents the implied conclusion of this argument? (Points : 5) PHIL 347N Final Exam

Ovaltine is healthy.

Ovaltine is delicious

You should drink Ovaltine.

None; this is not an argument.

Question 5.

5. (TCOs 3, 4) Identify the kind of argument.

Since all Ford Mustangs are automobiles, and not all Ford Mustangs are red, some automobiles are not red. (Points : 5)

Causal argument

Categorical argument

Inductive generalization

Analogical argument

Question 6.

6. (TCOs 3, 4) Identify the kind of argument.

Using a lemon when cooking is like using a lime. Given that limes can be added to bland foods to give them some zest, lemons, too, will give zest to bland foods. (Points : 5)

Analogical argument

Categorical argument

Truth-functional argument

Causal argument

Question 7.

7. (TCO 3, 4) Identify the kind of argument.

Learning to think critically is like learning to play the piano. Given that you have to practice a lot to be good at playing the piano, you must practice a lot to be a critical thinker. (Points : 5)

Causal argument

Truth-functional argument

Inductive generalization

Analogical argument

Question 8.

8. (TCOs 2, 3, 5) Relate to the proper terminology.

What evaluative language should you use for analogical arguments? (Points : 5)

Valid/invalid; cogent/uncogent

Valid/invalid; sound/unsound

Strong/weak; cogent/uncogent

Strong/weak; sound/unsound

Question 9.

9. (TCOs 2, 3, 5) Relate to the proper terminology.

What evaluative language should you use for truth-functional arguments? (Points : 5)

Valid/invalid; cogent/uncogent

Valid/invalid; sound/unsound

Strong/weak; cogent/uncogent

Strong/weak; sound/unsound

Question 10.

10. (TCO 4) Select the answer that represents the proper standard form for the following statement.

The bill should be paid by whoever bought the item. (Points : 5)

All people who bought the items are not people who should pay the bill.

All people who pay the bill are people who bought the item.

All people who bought the item are people who should pay the bill.

Question 11.

11. (TCO 4) Select the answer that represents the proper standard form for the following statement.

Some sports cars are red. (Points : 5)

No red things are sports cars.

Some sports cars are red things.

All sports cars are red things.

Question 12.

12. (21. (TCO 4) Select the answer that represents the proper standard form for the following statement.

If you want to be a nursing major, then you must take an anatomy class. (Points : 5) PHIL 347N Final Exam

Valid/invalid; cogent/uncogent

Valid/invalid; sound/unsound

All people who want to be nursing majors are people who must take an anatomy class.

Strong/weak; sound/unsound

Question 13.

13. (TCO 4) Choose the correct translation for each of the following compound claims.

You cannot enter the chess tournament (C) unless you are ranked (R). (Points : 5)

R ⢠~ C

C > R

~ C > R

~ R > ~ C

Question 14.

14. (TCO 4) Choose the correct translation for each of the following compound claims.

Small-scale agriculture will be profitable (P) and growers will get subsidies (S) only if demand (D) for local food does not decrease. (Points : 5)

~ [D > (P ⢠S)]

(P ⢠S) > ~ D

~ D > (P ⢠S)

P ⢠(S > ~ D)

Question 15.

15. (TCOs 3, 5) Which inductive generalization is stronger? (Points : 5)

Our universityâs womenâs basketball team has won its last three games. Thus, it seems obvious that the team will repeat as champions this year.

Our universityâs womenâs basketball team has won its last six games. Thus, it seems obvious that the team will repeat as champions this year. PHIL 347N Final Exam

Question 16.

16. (TCOs 3, 5) Which analogical argument is stronger? (Points : 5)

Grease, oil, road tar, and paint thinner are all flammable. Thus, paint thinner is a refined product because grease, oil, and road tar are refined products.

Grease, oil, and paint thinner are all flammable. Thus, paint thinner is a refined product since grease and oil are refined products.

Question 17.

17. (TCOs 3, 5) Which causal argument is stronger? (Points : 5)

The population of frogs in three California counties has declined dramatically in the last decade. Loss of habitat must be the cause because increased demand for housing has eliminated more than half of the available wetlands in all three counties, and this appears to be the only factor all three have in common.

The population of frogs in three California counties has declined dramatically in the last decade. Loss of habitat must be the cause because increased demand for housing has eliminated more than half of the available wetlands in all three counties, and this appears to be the only factor all three have in common. Only one county is rural, and only two counties have experienced an increase in frog predators.

Question 18.

18. (TCO 6) Identify the fallacy.

The Chinese government should encourage freedom of speech because doing so would be a good idea. (Points : 5)

Begging the question

Appeal to ignorance

Strawman

No fallacy committed

Question 19.

19. (TCO 6) Identify the fallacy.

Has anyone ever proven that soccer players would be protected from head injuries if they wore some kind of helmet? Then it must be true that helmets are unnecessary in soccer. (Points : 5) PHIL 347N Final Exam

Ad hominem

Appeal to ignorance

Strawman

Begging the question

Question 20.

20. (TCO 6) Identify the fallacy.

Mr. Banks cancels meetings at the last minute for no reason at all. At the meetings he does not cancel, he has lately been showing up smelling of alcohol. Now he cannot account for the disappearance of over 700 dollars raised last year. Clearly, it is inappropriate to keep him on as scout leader. (Points : 5)

Appeal to ignorance

Red herring

No fallacy committed

Ad hominem PHIL 347N Final Exam

NURS 6512 FINAL & MIDTERM EXAMS

NURS 6512 FINAL EXAM: WALDEN UNIVERSITY

1. Costovertebral angle tenderness should be assessed whenever you suspect the patient may have: –

2. In older adults, overflow fecal incontinence is commonly due to:

3. A 1 month old boy has been vomiting for 2 weeks. How is this symptom of GERD and pyloric stenosis further differentiated in this child’s assessment?

4. Auscultation of borborygmi is associated with:

5. When auscultating the abdomen, which finding would indicate collateral circulation between the portal and systemic venous systems? –

BUY A PLAGIARISM-FREE PAPER HERE

6. Conversion of fat-soluble wastes to water-soluble material for renal excretion is a function of the: –

7. The major function of the large intestine is: –

8. Which structure is located in the hypogastric region of the abdomen? –

9. A 45 year old man relates a several week history of severe intermittent abdominal burning sensations. He relates that the pain is relieved with small amounts of food. Before starting the physical examination, you review his laboratory work, anticipating a (n): – NURS 6512 FINAL & MIDTERM EXAMS

10. You are caring for a patient with trigeminal neuralgia. During the assessment, the patient would describe the pain as: –

11. Your 85 year old patient is complaining of right knee pain. She has a history of osteoarthritis for which she is given anti-inflammatory medication. To assess her right knee pain, you should ask her if: – 12. A 5 year old is complaining of nondescriptive “belly pain.” Your next action should be to ask him to: – 13. The perception of pain: –

14. Patients presenting with ascites, jaundice, cutaneous spider veins, and nonpalpable liver exhibit signs of: –

15. A patient presents to the emergency department after a motor vehicle accident. The patient sustained blunt trauma to the abdomen and complains of pain in the upper left quadrant that radiates to the left shoulder. What organ is most likely injured?

16. Imaging studies reveal that a patient has dilation of the renal pelvis from an obstruction in the ureter, what condition will be documented in this patient’s health record? –

17. Visible intestinal peristalsis may indicate: –

18. Infants born weighing less than 1500g are at higher risk for:

19. Which of the following factors is not known to affect patient compliance with his or her treatment regimen? –

20. One of the most important aspects to consider in the orthopedic screening examination is: –

21. The sequence of the physical examination should be individualized to:

22. As you greet the patient, which examination technique is first implemented? –

23. Which of the following is most likely to enhance examiner reliability?

24. A 7 year old boy is brought to your office with a chief complaint of possible fracture to his left third finger. He jammed it while playing basketball 2 days ago. The mother states that she really does not think it is broken because he can move it. What is your best response? –

25. A patient presenting for the first time with typical low back pain should receive which of the following diagnostic tests?

26. Skeletal changes in older adults are the result of: –

27. A positive straight leg raise test usually indicates: –

28. What technique is performed at every infant examination during the first year of life to detect hipdislocation? –

29. Expected normal findings during inspection of spinal alignment include-

30. Temporalis and masseter muscles are evaluated by:-

31. When palpating joints, crepitus may be caused when: –

32. A 3 year old is brought to the clinic complaining of a painful right elbow. He is holding the right arm slightly flexed and pronated and refuses to move it. the mother states that symptoms started right after his older brother had been swinging him around by his arms. This presentation supports a diagnosis of: –

33. Light skin and thin body habitus are risk factors for: –

34. Risk factors for sports-related injuries include: –

35. Injuries to long bones and joints are more likely to result in fractures than in sprains until: –

36. Ligaments are stronger than bone until: –

37. The family history for a patient with joint pain should include information about siblings with: –

38. The Thomas test is used to detect: –

39. A goniometer is used to assess: –

40. During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee you should initially perform the ­­­­­­­­­­­­­­­­________ test. –

41. You note that a child has a positive Gower Sign. You know that this indicates generalized:  –

42. The dowager hump is: –

43. What temporary disorder may be experienced by pregnant women during the third trimester because of fluid retention?–

44. A common finding in markedly obese and pregnant women is: –

45. A 45-year-old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression?A 45 year old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression? –

46. Mrs. Bower is a 57 year old patient who comes in for an office visit. Which of the following disorders is known to be hereditary? –

47. Testing of cranial nerve ­­­­________ is not routinely performed unless a problem is suspected. – I

48. The patient is able to rapidly touch each finger to his thumb in rapid sequence. What does this finding mean? –

49. Which question asked by the examiner may hellp to determine prevention strategies for seizures that a patient is experiencing? –

50. A patient has a complaint of dizziness. The patient makes the following statement: “I sometimes feel as if the whole room is spinning.” What type of neurologic dysfunction should the examiner suspect? –

51. The examiner asks the patient to close her eyes, then places a vibrating tuning fork on the patient’s ankle and asks her to indicate what is felt. What is being assessed? –

52. Which of the following findings should an examiner consider a normal finding if associated with pregnancy? – –

52. Jack is a 52 year old obese man with a history of poorly controlled diabetes. He also smokes. Based on the above data, the examiner should recognize that Jack has several risk factors for: – –

53. Mrs. Jones is a 24 year old patient who presents to your office 2 days postpartum. She complains that she is experiencing foot drop. Which of the following problems should the examiner consider? –

54. The examiner is assessing deep tendon reflex response in a 12 year old boy. The response is an expected reflex response. Which of the following scores should be documented? –

55. A 68 year old patient presents to your office for follow-up. He tells you, “I have a hard time finding the right words when I am talking;” he also is experiencing numbness. On examination, you note postural instability. This symptom may be: –

56. Motor maturation proceeds in an orderly progression from: –

57. The thalamus is the major integration center for perception of: –

58. The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is ________old. –

59. Normal changes of the aging brain include: – –

60. When interviewing a 70 year old female clinic patient, she tells you that she takes ginkgo biloba and St. John’s Wort. You make a short note to check for results of the: —

61. The area of body surface innervated by a particular spinal nerve is called a: – –

62. If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation? – –

63. The finger-to-nose test allows assessment of: – –

64. You ask the patient to follow a series of short commands to assess: – –

65. As Mr. B. enters the room, you observe that his gait is wide based and he staggers from side to side while swaying his trunk. You would document Mr. B.’s pattern as: –

66. When is the mental status portion of the neurologic system examination performed? –

67. An aversion to touch or being held, along with delayed or absent language development, is a characteristic of: —

68. The autonomic nervous system coordinates which of the following? –

69. The major function of the sympathetic nervous system is to: – –

70. The parasympathetic nervous system maintains the day-to-day function of: –

71. Cerebrospinal fluid serves as a: – –

72. You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the: —

73. Which type of hallucination is most commonly associated with alcohol withdrawal? – –

74. On a scale of 0 to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient? –

75. Which statement is true regarding mental status changes in older adults? – –

76. A characteristic related to syphilis or diabetic neuropathy is testicular: —

77. When collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding: – –

78. What risk factor is associated with cervical cancer? – –

79. A 23 year old female presents with severe right lower quadrant tenderness. All of the following should be considered in the differential except: – –

80. What is the initial diagnostic radiology test that should be ordered if you suspect a ruptured ovarian cyst? – –

81. A 17 year old male was brought into the emergency room with testicular/scrotal pain. The differential diagnosis should include all except: –

82. The nursing mother complains that her breasts are tender. You assess hard, shiny, and erythremicbreasts bilaterally. You should advise the patient to: – –

83. A normal vas deferens should feel: – –

84. In a woman complaining of a breast lump, it is most important to ask about: – –

85. The finding of a painless indurated lesion on the glans penis is most consistent with: – –

86. Thrombosed hemorrhoids are: – –

87. Pregnancy-related cervical changes include: –

88. You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should: – –

89. An adolescent male is being seen for acute onset of left testicular pain. The pain started 3 hours ago. He complains of nausea and denies dysuria or fever. Your prioritized assessment should be to: –

90. A 23 year old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. Your further response to this finding is: – –

91. What accommodations should be used in the position of a hearing-impaired woman for a pelvic examination? – –

92. Sexual differentiation in the fetus has occurred by ­­­_______weeks gestation. – –

93. You are performing a clinical breast examination for a 55 year old woman. While palpating the supraclavicular area, you suspect that you felt a node. In order to improve your hooked technique, you should: —

94. If a firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40 year old patient’s breast, you should: —

95. A therapeutic technique for dealing with grieving individuals is to: –

96. The examination of the newborn should begin with: – –

97. Which one of the following patient characteristics is most likely to limit patient reliability during history taking? – –

98. In crying infants, it is often difficult to: – –

99. Which of the following statements accurately reflects the sensitivity and specificity of laboratory tests? –-

100. Which medical condition would exclude one from sports participation? – –

101. Your 15 year old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You question this patient about her: – –

102. Which of the following are examined with the patient in a reclining 45 degree position? –-

103. Functional assessment is most important during the examination of a(n): —

104. The best way to ease the apprehension of a 3 year old child before a physical examination is to: – –

105. An ophthalmoscopic eye examination involves: – –

106. When conducting a geriatric assessment, basic activities of daily living (ADLs) include: –

107. The checkout station for preparticipation physical evaluation (PPE) is critical because at this point: –

108. Which of the following is true regarding the relationship between the examiner and the patient? –

109. Which of the following factors is not known to affect patient compliance with his or her treatment regimen? –

110. One of the most important aspects to consider in the orthopedic screening examination is: –

111. As you greet the patient, which examination technique is first implemented? –

112. Which portion of the physical examination is best done with the patient standing? –

113. Which patient position facilitates inspection of the chest and shoulders? –

114. The least reliable indicator of newborn distress is: –

115. Proprioception should be assessed while the patient is: –

116. Part of the screening orthopedic component of the examination includes evaluating the person while: –

NURS 6512 
Week 6 Midterm Exam: Advanced Health Assessment: Walden University

 

1. Before performing an abdominal examination, the examiner should:

2. During an interview, tears appear in the patient’s eyes and his voice becomes shaky. Initially, you should:

3. Which of the following is the most accurate reflection of an individual’s food intake?

4. Percussing at the right midclavicular line, below the umbilicus, and continuing upward is the correct technique for locating the:

5. A fixed image of any group that rejects its potential for originality or individuality is known as a:

6. Peritonitis produces bowel sounds that are

7. Brittle nails are typical findings in:

8. Which of the following is an expected change in the assessment of the thyroid during pregnancy?

9. You are planning to palpate the abdomen of your patient. Which part of the examiner’s hand is best for palpating vibration?

10. A 5-year-old child presents with nasal congestion and a headache to assess for sinus tenderness you should palpate over the:

11. During physical examination of a 30-year-old Chinese man you notice a slight asymmetry of his face. the cranial nerve examination is normal. Your best action is to

12. Unusual white areas on the skin may be due to

13. You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selector clockwise, then counterclockwise to compensate for:

14. Mrs. Webb is a 38-year old patient who has been changing her lifestyle to eat in a healthy way and lose weight: during your health promotion education regarding her nutritional status, you explain the function of dietary protein as:

15. Mr. Akins is a 78-y/o patient who presents to the clinic with complaints of hearing loss. Which of the following are changes in hearing that occur in the elderly? Select all that apply.

16. The most superior part of the stomach is the

17. Mrs. Grace is a 58-year-old patient who has a diagnosis of pernicious anemia. Which B vitamin is deficient in patients with pernicious anemia?

18. A 51-y/o woman calls with complaints of weight loss and constipation. She reports enlarged hemorrhoids and rectal bleeding. You advise her to:

19. Placing the base of a vibrating tuning fork on the midline vertex of the patient’s head is a test for:

20. Which technique is most likely to result in the patients understanding of questions?

21. Mr. Williams, age 25, has recovered recently from an upper and lower respiratory infection. He describes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone away. Information concerning his chronic postnasal drip should be documented within which section of the history?

22. Nasal symptoms that imply an allergic response include:

23. Mr. Franklin is speaking with you the health care provider, about his respiratory problem. Mr. Franklin says, “I’ve had this cough for 3 days and it’s getting worse.” You reply, “Tell me more about your cough.” Mr. Franklin states, “I wish I could tell you more, that’s why I am here! You tell me what’s wrong.” Which caregiver response would be the most appropriate for enhancing communication?

24. When taking a history, you should:

25. Which of the following formats would be used for visits that address problems not yet identified in the problem-oriented medical record (POMR)?

26. Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear drainage. When examining an infant’s middle ear, the nurse should use one hand to stabilize the otoscope against the head while using the other hand to:

27. Which question would be considered a leading question?

28. Mr. Black is a 44y/o patient who presents to the clinic with complaints of neck pain that he thinks is from his job involving computer data entry.  As the examiner, you are checking the range of motion in his neck and note the greatest degree of cervical mobility is at?

29. The term denoting the caregiver’s need to do no harm to the patient is:

30. A tool used to screen adolescents for alcoholism is the:

31. Under normal circumstances, how much water is lost daily by the body?

32. You have just completed a skin assessment on Mr. Baker. During your assessment, you have transilluminated a skin lesion. During the physical examination, you know that skin lesions are transilluminated to distinguish:

33. Mr. Mills is a 55/y/o patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of activities of daily living is part of a(n):

34. Sweat glands, hair, and nails are all formed from?

35. A brief statement of the reason the patient is seeking health care is called the?

36. Which part of the information contained in the patient’s record may be used in court?

37. Which cranial nerves innervate the face?

38. In counseling a client regarding nutrition education, you explain that linoleic acid, a major fatty acid, is thought to be essential for?

39. When are open-ended questions generally most useful?

40. Knowledge of the culture or cultures represented by the patient should be used to?

41. Mrs. Berger is a 39-year-old woman who presents with a complaint of epigastric abdominal pain. You have completed the inspection of the abdomen. What is your next step in the assessment process?

42. A guideline for history taking is for caregivers to?

43. Which type of speculum should be used to examine a patient’s tympanic membrane?

44. You are palpating a patient’s thyroid and find that its broadest dimension measures 4cm. the right lobe is 25% larger than the left. These data would indicate?

45. Mr. L. presents to the clinic with severe groin pain and a history of kidney stones. Mr. L.’s son tells you that, for religious reasons, his father wishes to keep any stone that is passed into the urine filter that he has been using. What is your most appropriate response?

46. Before performing an abdominal examination, the examiner should?

47. You are examining a pregnant patient and have noted a vascular lesion. When you blanche over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a?

48. As you explain your patient’s condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, your most appropriate response to this behavior is to?

49. When palpating the abdomen, you should note whether the liver is enlarged in the?

50. Expected normal percussion tones include?

51. Mr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You ate concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to?

52. Fluorescing lesions are best distinguished using a(n)?

53. Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is a vegetarian. Deficiency of which of the following is a concern in the vegetarian diet?

54. Underestimation of blood pressure will occur if the blood pressure cuff’s width covers?

55. Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4’3cm, rough, elevated area of psoriasis. This is an example of a?

56. Penicillin is considered a?

57. Small, minute bruises are called?

58. After thorough inspection of the abdomen, the next assessment step is?

59. When you are questioning a patient regarding alcohol intake, she tells you that she is only a social drinker. Which initial response is appropriate?

60. Regardless of the origin, discharge is described by noting?

61. Recommended carbohydrate content of total dietary intake (% total calories) is?

62. Tuning forks with a frequency of 500 to 1000 Hz are most commonly used to measure?

63. Auscultation should be carried out last, except when examining the?

64. Mr. Kevin Marks is a new health care provider. What is the best method to develop cultural competence?

65. Which of the following is an “ABCD” characteristic of malignant melanoma?

66. Tracheal tug suggests the presence of a(n)?

67. Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least likely to be associated with this condition early in its course?

68. The review of systems is a component of the:

69. Cherry angiomas are a common finding in:

70. Mr. Donalds is a 45-year-old roofer. Your inspection to determine color variations of the skin is best conducted:

71. To correctly document absent bowel sounds, one must listen continuously for:

72. The adult recommended dietary fat intake should be ____g/day.

73. Mr. Jones is a 45-year-old patient who presents for a physical examination. On examination, you note costochondral beading, enlarged skull, and bowed legs and diagnose him with rickets. A deficiency of which fat-soluble micronutrient can result in rickets?

74. A flat, nonplapable lesion is described as a macule if the diameter is:

75. Mrs. Raymonds is a 24-year-old patient who has presented for a routine concern over her current weight.  In your patient teaching with her, you explain the importance of macronutrients. Which of the following is a macronutrient?

76. Which of the following organs is part of the alimentary tract?

77. Mr. Sanchez is a 45-year-old gentleman who has presented to the office for a physical examination to establish a new primary care health care provider. Which of the following describes a physical, not a cultural, differentiator?

78. To approximate vocal frequencies, which tuning fork should be used to assess hearing?

79. During percussion, a dull tone is expected to be heard over:

80. The attitudes of the health care professional:

81. When recording physical findings, which data are recorded first for all systems?

82. Spasmodic muscular contractions of the head, face, or neck are called:

83. Which of the following occurs when firm pressure is used to apply the stethoscope’s bell end-piece to the skin?

84. Differential diagnoses belong in the:

85. Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish:

86. Mr. Walter’s, a 32-year-old patient, tells you that his ears are “stopped up.” An objective assessment of this complaint is achieved by using the:

87. Mrs. Leonard brings her newborn infant into the pediatrician’s office for a first well-baby visit. As the health care provider, you teach her that newborns are more vulnerable to hypothermia due to:

88. Tympanic thermometers measure body temperature when a probe is placed:

89. A serous membrane that lines the abdominal cavity and forms a protective cover for many abdominal structures is the:

90. White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:

91. When assessing abdominal pain in a college-age woman, one must include:

92. Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:

93. The infant should be placed in which position to have his or her height or length measured?

94. Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which question has the most potential for exploring a patient’s cultural beliefs related to a health problem?

95. Which of the following is the most vital nutrient?

96. What finding is unique to the documentation of a physical examination of an infant?

97. Mrs. G. reports an increase in her alcohol intake over the past 5 years. To screen her for problem drinking, you would use the:

98. Mr. D. complains of a headache. During the history he mentions his use of alcohol and illicit drugs. This information would most likely belong in the:

99. You are completing a general physical examination on Mr. Rock, a 39-year-old man with complaints of constipation. When examining a patient with tense abdominal musculature, a helpful technique is to have the patient:

100. When communicating with older children and teenagers, you should be sensitive to their:

101
. 
Periods of silence during the interview can serve important purposes, such as:

NURS 6512 
Week 6 Midterm Exam: Advanced Health Assessment: Walden University

 

Which of the following is an expected change in the assessment NURS 6512 FINAL & MIDTERM EXAMS

of the thyroid during pregnancy?

 

When recording physical finding, which data are recorded first for all systems?

 

In counseling a Client regarding education .,you explain that Linoleic acid, a major fatty acid, is thought to be essential for:

Peritonitis produces bowel sounds that are:

 

Sweat glands, hair, and nails are all formed:

 

The adult recommended dietary fat intake

 

Recommended carbohydrate content of total dietary intake (% total calories) is

____ %.

 

Which of the formats would be used for a  (POMR)

 

Question 141 out of 1 pointsMr. Abdul is a 40-year-old Middle Eastern man who presents to the office for a first visit with the complaint of new abdominal pain. You are concerned about violating a cultural prohibition when you prepare to do his rectal examination. The best tactic would be to:

 

Question 151 out of 1 pointsYour patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:

 

Question 161 out of 1 pointsWhen examining the skull of a 4-month-old baby, you should normally find:

 

Question 171 out of 1 pointsMs. G. is being seen for her routine physical examination. She is a college graduate and president of a research firm. Although her exact salary is unknown, she has adequate health insurance. Most of the above information is part of Ms. G.’s _____ history. NURS 6512 FINAL & MIDTERM EXAMS

 

To perform the Rinne test, place the tuning fork on the:

 

Question 71 out of 1 pointsWhen are open-ended questions generally most useful?

Question 80 out of 1 pointsThe review of systems is a component of the:

 

Fluorescing lesions are best distinguished using a(n):

 

Pigmented, raised, warty lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish:

 

Mr. Franklin is speaking with you, the health care provider, about his respiratory problem. Mr. Franklin says, “I’ve had this cough for 3 days, and it’s getting worse.” You reply, “Tell me more about your cough.” Mr. Franklin states, “I wish I could tell you more. That’s why I’m here. You tell me what’s wrong!” Which caregiver response would be most appropriate for enhancing communication?

 

The term denoting the caregiver’s need to do no harm to the patient is:

 

Underestimation of blood pressure will occur if the blood pressure cuff’s width covers:

 

Mrs. Hartzell is a 34-year-old patient who has presented for nutritional counseling because she is a vegetarian. Deficiency of which of the following is a concern in the vegetarian diet?

 

The most superior part of the stomach is the:

 

When recording physical findings, which data are recorded first for all systems?

 

Kevin Marks is a new health care provider. What is the best method to develop cultural competence?

 

Which cranial nerves innervate the face?

 

When communicating with older children and teenagers, you should be sensitive to their:

 

Before performing an abdominal examination, the examiner should:

 

The infant should be placed in which position to have his or her height or length measured?

 

Regardless of the origin, discharge is described by noting:

 

Mrs. Berger is a 39-year-old woman who presents with a complaint of epigastric abdominal pain. You have completed the inspection of the abdomen. What is your next step in the assessment process?

 

To correctly document absent bowel sounds, one must listen continuouslyfor:

 

The position on a clock, topographic notations, and anatomic landmarks:

 

Bulging of an amber tympanic membrane without mobility is most often associated with:

 

Mr. Marks is a 66-year-old patient who presents for a physical examination to the clinic. Which question has the most potential for exploring a patient’s cultural beliefs related to a health problem? NURS 6512 FINAL & MIDTERM EXAMS

 

A flat, nonpalpable lesion is described as a macule if the diameter is:

 

Your patient returns for a blood pressure check 2 weeks after a visit during which you performed a complete history and physical. This visit would be documented by creating a(n):

 

Which type of speculum should be used to examine a patient’s tympanic membrane?

 

During physical examination of a 30-year-old Chinese man, you notice slight asymmetry of his face. The cranial nerve examination is normal. Your best action is to:

 

Mrs. Britton is a 34-year-old patient who presents to the office with complaints of skin rashes. You have noted a 4′ 3-cm, rough, elevated area of psoriasis. This is an example of a:

 

Knowledge of the culture or cultures represented by the patient should be used to:

 

A tool used to screen adolescents for alcoholism is the:

 

Mr. and Mrs. Johnson have presented to the office with their infant son with complaints of ear drainage. When examining an infant’s middle ear, the nurse should use one hand to stabilize the otoscope against the head while using the other hand to:

 

To approximate vocal frequencies, which tuning fork should be used to assess hearing?

 

During an interview, tears appear in the patient’s eyes and his voice becomes shaky. Initially, you should:

 

Nuchal rigidity is most commonly associated with:

Question 221 out of 1 pointsA serous membrane that lines the abdominal cavity and forms a protectivecover for many abdominal structures is the:

 

Question 261 out of 1 pointsWhen assessing abdominal pain in a college-age woman, one must include:

 

Question 281 out of 1 pointsA fixed image of any group that rejects its potential for originality or individuality is known as a(n):

 

Question 301 out of 1 pointsMr. Walters, a 32-year-old patient, tells you that his ears are “stopped up.” An objective assessment of this complaint is achieved by using the:

 

Question 311 out of 1 pointsMs. Davis is a 27-year-old patient with a BMI of 33. Based on her BMI, yourdiagnosis would be:

 

Question 321 out of 1 pointsTracheal tug suggests the presence of a(n):

 

Question 331 out of 1 pointsMr. Black is a 44-year-old patient who presents to the clinic with complaints of neck pain that he thinks is from his job involving computer data entry. As the examiner, you are checking the range of motion in his neck and note the greatest degree of cervical mobility is at:

 

Question 341 out of 1 pointsThe most common form of birth trauma of the scalp is:

 

Which question would be considered a leading question?

 

A brief statement of the reason the patient is seeking health care is called the:

 

Expected hair distribution changes in older adults include:

 

Mr. Johnson presents with a freely movable cystic mass in the midline of the high neck region at the base of the tongue. This is most likely a: NURS 6512 FINAL & MIDTERM EXAMS

 

When hearing is evaluated, which cranial nerve is being tested?

Which of the following is the most accurate reflection of an individual’s food intake.

 

Percussing at the right midclavicular line, below the umbilicus, and continuing upward is the correct technique for locating the:

 

Brittle nails are typical findings in:

 

You are planning the palpate the abdomen of your patient. Which part of the examiner’s hand is best for palpating vibrations?

 

A 5 year old child presents with nasal congestion and a headache. To assess for sinus tenderness you should palpate over the :

 

Unusual white areas on the skin may be due to:

 

You are using an ophthalmoscope to examine a patient’s inner eye. You rotate the lens selector clockwise, then counterclock wise to compensate for:

 

Mrs. Webb is a 38 year old patient who has been changing her lifestyle to eat in a health way and lose weight. During your health promotion education regarding her nutritional status, you explain the function of dietary protein as:

 

Mr. Atkins is a 78 year old patient who presents to the clinic with complaints of hearing loss. Which of the following are changes in hearing that occur in the elderly? Select all that apply.

Mrs. Grace is a 58year old patient who has a diagnosis of pernicious anemia. Which B vitamin is deficient in patients with pernicious anemia?

 

A 51 year old woman calls with complaints of weight loss and constipation. She reports enlarged hemorrhoids and rectal bleeding. You advise her to:

 

Placing the base of a vibrating tuning fork on the midline vertex of the patient’s head is a test for:

 

Which technique is most likely to result in the patient’s  understanding of questions?

 

MR WILLIAMS, AGE 25 HAS RECOVERED RECENTLY FROM AN UPPER AND LOWER RESPIRATORY INFECTION. HE DESCRIBES A LONG-STANDING NASAL DRIPPING. HE IS SEEKING TREATMENT FOR A MILD HEARING LOSS THAT HAS NOT GONE AWAY. INFORMATION CONCERNING HIS CHRONIC POSTNASAL DRIP SHOULD BE DOCOUMENTED WITHING WHICH SECTION OF HIS HISTORY?

 

NASAL SYMPTOMS THAT IMPLY AN ALLERGIC RESPONSE INCLUDE:

WHEN TAKING A HISTORY, YOU SHOULD:

 

Under normal circumstances, how much water is lost daily by the body?

 

You have just completed a skin assessment on Mr. Baker. During your assessment, you have transiluminated a skin lesion. During the physical examination, you know the skin lesions are transiluminated to distinguish:

 

Mr. Mills is a 55 year old patient who presents to the office for an initial visit for health promotion. A survey of mobility and activities of daily living (ADLs) is part of a(n):

 

Which part of the information contained in the patient’s record may be used in court? NURS 6512 FINAL & MIDTERM EXAMS

 

A guideline of history taking is for caregivers to:

 

You are palpating a patient’s thyroid and find that its broadest dimension measure 4cm. The right lobe is 25% larger than the left. These data would indicate:

 

Mr. L presents to the clinic with severe groin pain and a history of kidney stones. Mr. L’s son tells you that , for religious reasons, his father wishes to keep any stone that is passed into the urine filter that he has been using. What is your most appropriate response?

 

You are examining a pregnant patient and have noted a vascular lesion. When you blanche over the vascular lesion, the site blanches and refills evenly from the center outward. The nurse documents this lesion as a:

 

As you explain you patient’s condition to her husband, you notice that he is leaning toward you and pointedly blinking his eyes. Knowing that he is from England, you most appropriate response to this behavior is to:

 

When palpating the abdomen, you should note whether the liver is enlarged in the:

 

Expected normal percussion tones include:

 

Penicillin is considered a:

 

Small, minute bruises are called:

 

When you are questioning a patient regarding alcohol intake, she tells you that she is only a social drinker, which initial response is appropriate?

 

Tuning forks with a frequency of 20 to 100 Hz are most commonly used to measure:

 

Auscultation should be carried out last, except when examining the:

 

Which of the following is an ABCD characteristic of malignant melanoma?

Your patient presents with symptoms that lead you to suspect acute appendicitis. Which assessment finding is least like to be associated with this condition early in its course?

 

Cherry angiomas are a common finding in:

 

Mr. Donalds is a 45 year old roofer. Your inspection to determine color variations of the skin is best conducted:

92.

Mr. Jones is a 45 year old patient who presents for a physical examination. On examination, you note costochondral beading, enlarged skull, and bowed legs and diagnose him with rickets. A deficiency of which fat-soluble micronutrient can result in rickets?

 

Which of the following organs is part of the alimentary tract?

 

Mr. Sanchez is a 45 year old gentleman who has presented to the office for a physical examination to establish a new primary care health care provider. Which of the following describes a physical, not a cultural, differentiator?

93.

To approximate vocal frequencies, which tuning fork should be used to assess hearing?

 

The attitude of the health care professional:

 

When recording physical findings, which data are recorded first for all systems?

 

Spasmodic muscular contraction of the head, face, or neck are called:

 

Which of the following occurs when firm pressure is used to apply the stethoscope’s ball end piece to the skin? NURS 6512 FINAL & MIDTERM EXAMS

 

Differential diagnosis belong in the:

 

Pigmented, raised, watery lesions over the face and trunk should be assessed by an experienced practitioner who can distinguish:

 

Mrs. Leonard brings her newborn infant into the pediatrician’s office for a first well baby visit. As a health care provider, you teach her newborns are more vulnerable to hypothermia due to:

 

Tympanic thermometers measure body temperature when a probe is placed:

 

White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are:

 

Your patient is complaining of acute, intense sharp epigastric pain that radiates to the back and left scapula with nausea and vomiting. Based on this history, your prioritized physical examination should be to:

Which of the following is the most vital nutrient?

 

What finding is unique to the documentation of a physical examination of an infant?

 

Mrs. G reports and increase in her alcohol intake over the past 5 years. To screen her for problem drinking, would use the:

 

Mrs. D complains of a headache. During the history, he mentions his use of alcohol and illicit drugs. The information would most likely belong in the:

 

You are completing a general physical examination of Mr. Rock, a 39 year old man with complaints of constipation. When examining a patient with tense abdominal musculature, a helpful technique is to have the patient: NURS 6512 FINAL & MIDTERM EXAMS