Deck 4: Evidence-Based Psychiatric Nursing Practice

Question 1

Several nursing colleagues have formulated a task force to identify a process to set up clinical pathways for patient care of those who are severely depressed.The initial step is to:

A) identify the nursing skills used while depressed patients are hospitalized.
B) review patient records to identify why most depressed patients are admitted.
C) identify the number of depressed patients who are admitted more than once within a calendar year.
D) review for efficiency and necessity of the interventions that are implemented during admission and aftercare for the depressed patient.

Answer 1

review for efficiency and necessity of the interventions that are implemented during admission and aftercare for the depressed patient.

Question 2

The categories of outcome indicators include:

A) process and reliability.
B) clinical and functional.
C) process and evaluation.
D) measurement and evaluation.

Answer 2

clinical and functional.

Question 3

To focus a patient's treatment or medication regimen in a very specific format,which tool would be used?

A) Patient satisfaction survey
B) Clinical pathway
C) Algorithm
D) Graph

Answer 3

Algorithm

Question 4

Most often,clinical pathways are used in:

A) inpatient units.
B) outpatient settings.
C) home-care settings.
D) mental health clinics.

Question 5

A nurse is developing a set of practice guidelines for a clinical unit and is conducting a literature review to search for examples of criteria that will be relevant to achieving patient-care goals.The search criteria that will be most relevant are those that:

A) explain their complexity in detail.
B) include reduced costs as a major criterion for use.
C) document preferred practices among other mental health professionals.
D) provide methods and procedures that ensure safe and effective treatment.

Question 6

Which statement could a nurse use in an argument to support evidence-based psychiatric nursing practice?

A) "Licensing helps ensure effective clinicians."
B) "Clinical supervision results in more effective clinicians."
C) "It is unreliable to make generalized assumptions of patients based on only a small sample."
D) "Information gathered by clinical means tends to be in the form of systematic observations."

Question 7

For psychiatric nurses,an essential part of outcome measurement is the:

A) development of practice guidelines.
B) systematic review of research literature.
C) systematic use of reliable patient-rating scales.
D) identification of the core knowledge and skills of psychiatric nurses.

Question 8

Which best describes the evidence-based model for psychiatric nursing practice?

A) Proof that the psychiatric nurse in a home-care setting really does care for assigned patients
B) Description of what the psychiatric nurse does including how the nurse adds value to the health care organization
C) How psychiatric nurses prove to their employers that they do what they are required to do for patient care
D) The process by which the psychiatric nurse documents nursing care on the psychiatric nursing unit

Question 9

A nurse working at a facility that has just introduced the use of clinical pathways must understand that clinical pathways:

A) do not require quality monitoring.
B) are more specific than clinical algorithms.
C) do not depend on an interdisciplinary approach.
D) are maps with timetables for patient care delivery.

Question 10

To substantiate clinical practice the psychiatric nurse should place the greatest reliance on the _____ basis.

A) traditional
B) regulatory
C) evidence
D) philosophical/conceptual

Question 11

Nurses are easily oriented to the use of algorithms because they are familiar with the format of:

A) tables.
B) free text.
C) flow charts.
D) nursing notes.

Question 12

Which activity will be most useful to a nurse wishing to provide evidence-based psychiatric nursing care?

A) Relying on findings of one properly designed, randomized, controlled trial
B) Using a protocol from several well-designed, cohort, quasiexperimental studies
C) Seeking sound, opinion-based processes and maintaining self-directed practice
D) Applying findings from a meta-analysis of relevant randomized, controlled trials

Question 13

The psychiatric nurse is preparing discharge information for a patient diagnosed with schizophrenia.Knowing that the patient will be discharged to a home shared with the patient's elderly parents,you want to develop evidence-based care for the patient.You will first:

A) identify the major support person for the patient.
B) define the patient's current acute clinical problems.
C) help the patient to find appropriate, attainable employment.
D) help the patient to be reoriented to living outside a locked psychiatric unit.

Question 14

The psychiatric nurse uses evidence-based practice as a means to better meet patients' needs.The most current source of nursing research is:

A) textbooks.
B) journal articles.
C) the DSM-IV-TR.
D) databases of systematic reviews.

Question 15

For a theory to be useful in practice,nurses need to validate the theory by:

A) learning the theory.
B) performing research.
C) formulating a theoretical paradigm.
D) informing other clinicians of theoretical frameworks.

Question 16

A patient is scheduled to be discharged from the locked inpatient psychiatric unit.In order to best evaluate the appropriateness of the patient's care the nurse:

A) brings the care plan and ongoing documentation to an interdisciplinary team meeting, where the patient's progression towards discharge will be discussed.
B) gathers evidence from the chart that shows progression in the patient's medical condition to prepare for the evaluation of the outcomes.
C) asks the patient's family to discuss the discharge because they have visited daily since the patient's admission.
D) asks the patient to meet with you to discuss any feelings about discharge and returning home.

Question 17

Practice guidelines are formulated to:

A) establish evidence of appropriate psychiatric care based on anecdotal data collected only on the unit where you are using the practice guidelines.
B) promote consistency of patient care for all patients with a particular need regardless of age or DSM-IV-TR diagnosis.
C) identify treatments that are safe and effective for a particular psychiatric disorder based on collected data.
D) minimize the need for nurses to continuously update the guidelines after they have been established.

Question 18

To what extent is outcome measurement important to the delivery of psychiatric nursing care?

A) It is more "nice" than it is necessary.
B) It will support the legitimacy of psychiatric nursing.
C) It will promote descriptive and correlational nursing research.
D) It gives information about the appropriate settings for treatment.

Question 19

Which nursing activities are necessary to provide evidence-based psychiatric nursing care?

A) Obtaining advanced degrees and providing clinical supervision for peers
B) Seeking sound opinion-based processes and maintaining self-directed practice
C) Attending educational programs and supporting the advanced practice licensure
D) Critically synthesizing research findings and applying relevant evidence to practice

Question 20

Which prevention and treatment option used in informed decision making regarding behavioral health assessment and treatment has the strongest evidence base?

A) Standards
B) Algorithms
C) Best practices
D) Practice guidelines

Question 21

Dimensions that are considered regarding outcome measurement tools such as quality report cards include: (Select all that apply.)

A) patient care goals.
B) nurses' system evaluations.
C) performance appraisals.
D) situational content.
E) intended audience.

Question 22

The reason for routinely using the behavioral rating scale is to assess the: (Select all that apply.)

A) changes in the patient's condition related to treatment.
B) effectiveness of the unit's patient behavior scales.
C) strength of the behavioral scale's reliability.
D) patient's state at the time of admission.
E) patient's status to support discharge.