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Research Article Critique Part 2 Multiple Choice Questions
Research Article Critique, Part 2
Occupational Stressors, Stress Perception Levels, and Coping Styles of Medical Srugical RNs: A Generalized Perspective
(Wakim, 2014)
Your assigned article for critique is:
Wakim, N. (2014). Occupational stressors, stress perception levels, and coping styles of medical surgical RNs. Journal of Nursing Administration, 44(12), 632-639. doi:10.1097/NNA.0000000000000140
Instructions: A major skill that is learned in this course is how to critically read and critique nursing research articles. The purpose for critiquing an article is to critically evaluate the research process followed by the author(s) of the assigned article. This is an information-intensive, time-intensive process that is not learned overnight. To demonstrate your skill at critiquing an article, you will complete this open-book multiple choice assignment.
Here’s how you should approach completing this week’s assignment to finish critiquing an article:
1. First, do your assigned reading in Grove, Gray, and Burns (2015) and complete the reading worksheets early in the week. This will introduce you to the critique skills you will need for the week.
2. Skim the entire instructor assigned research article that has been posted on Blackboard for you so that you will have an idea of what it is about. Lightly cross out the abstract for the article (you won’t be using it). Then, for this week, re-read carefully from the study design section through the end of the article.
3. Print this document and find the best answer to each question below based on your Grove, Gray, and Burns (2015) assigned reading for the week and what you have read in the instructor assigned research article.
4. Some of the questions in the critique assignment below will seem unfamiliar to you. Look up key terms from the question in your textbook. Some examples of these terms might be: power analysis, inter-rater reliability, and generalization. You can also look in Chapter 12 for an example of a critical appraisal (or critique) of a quantitative research article.
5. Once you have completed this assignment “on paper”, go into blackboard and enter your answers by the assignment due date and time listed in the syllabus. Ignore any wording from Blackboard that indicates that “this is a test” and carefully enter your answers from this document.
6. You will have two access attempts to record your answers. This is given to you so that if you encounter technical difficulties on your first attempt, or you would like a second attempt to try to improve your grade, you may do so. You will not be able to see the questions that you missed when you submit your attempt. Blackboard will record the highest grade from the two submissions.
If you have questions about this assignment, you can post them to your group discussion board for help. Please do not post the exact question from the assignment below and ask the group for the answer as this would constitute academic dishonesty.
Questions 1 – 9: Sample. (For help with these questions, refer to chapters: 9 & 12)
1. What sampling method or plan was used by the authors in this study?
a. Simple random sampling
b. Systematic sampling
c. Convenience sampling
d. Network sampling
2. According to Grove, Gray, and Burns (2015), what are the potential biases of this sampling method?
a. This is a strong probability sampling method with very little potential for bias
b. This method is used when an ordered list of all members of the population are available, and provides a random but not equal chance for inclusion in the study.
c. This method provides little opportunity to control for bias because subjects are included in the study merely because they happen to be in the right place at the right time.
d. This method is specific to the individuals who were recruited and the information gained cannot be generalized to others who don’t share these types of experiences.
e. None of the above biases best describe the sampling method chosen by the author.
3. What was the final sample size reported by the authors for this study?
a. 200 participants
b. 84 participants
c. 159 participants
d. 161 participants
4. Was a power analysis conducted? If so, which statement best describes the results of the power analysis?
a. The authors mention that an a priori power analysis was conducted, and 200 subjects were
determined to be needed for the study.
b. The authors mention that a power analysis was conducted using four predictors and 1-way ANOVA using three independent groups for a needed sample size of 159.
c. The authors do not report that a power analysis was conducted.
5. Which of these statements would be considered an inclusion criterion for the sample in the research article?
a. English-speaking
b. Have at least two years of experience as a nurse
c. Work on a Medical Surgical unit
d. Be a member of the Medical Surgical Nurses Association
6. Which of these statements would be considered to be exclusion criterion specifically identified by the author for the sample in the research article?
a. The exclusion criteria were explained verbally during recruitment.
b. History of depression/ mental health issue.
c. Report of no stress related problems by the participant.
d. Participants only worked on the night shift.
7. What is the refusal rate for this study? (Hint: see page 253 in your text)
a. 161/200 X 100% = 80%
b. 84/159 X 100% = 53%
c. unknown / cannot be calculated.
d. 39/200 x 100% = 19.5%
8. Which of the following would be accurate for the attrition rate for this study?
a. 161/200 X 100% = 80%
b. 39/200 X 100% = 20%
c. 84/159 X 100% = 53%
d. 0%
9. What was the setting for this research study? Briefly describe the setting and indicate whether it was appropriate for conducting this study.
a. The setting for this study was a partially controlled setting and was appropriate for this study’s research design.
b. The setting for this study was not well described by the authors and therefore not appropriate for
conducting this study.
c. The setting for this study was a highly controlled setting and was appropriate for this study’s research design.
d. The setting for this study was a natural or field setting and was appropriate for this study’s research design.
Question 10 – 14: Measurement Methods. (For help with these questions, refer to chapters 10 & 12.)
10. Which ones of these questionnaires, scales, or physiologic measures is used in this research study?
(Select all that apply).
a. The Ways of Coping Questionaire (WAYS)
b. The Nursing Stress Scale (NSS)
c. The Perceived Stress Scale (PSS)
d. The Quality of Life Scale (QOLS)
11. How do the authors describe the reliability of the Nursing Stress Scale (NSS) in previous studies?
a. Two follow-up emails were sent to potential participants.
b. they compared the odd and even questions on the test to determine their equivalence.
c. a team of staff nurses was trained by the primary investigator to administer the questionnaire.
d. they tested a group of subjects twice using the same questionnaire (test-retest reliability).
e. they computed a Cronbach’s alpha on the Nurse Stress Scale that was administered to this group of subjects.
12. How do the authors describe the validity of The Ways of Coping Questionnaire (WAYS).
a. discriminant validity demonstrated that each subscale measured the same constructs.
b. evidence of validity from contrasting groups because they gave it to spouses of MS nurses.
c. no was no mention of determining the validity of WAYS questionnaire.
d. The authors had experience with administering this questionnaire.
13. What types of questionnaires or surveys were used in this research study? (Select all that apply.)
a. The authors developed the Professional Quality of Life Scale.
b. Interviews were reportedly used, but the authors do not explain what was included in them.
c. The authors developed their own questions to ask about demographic information.
d. The authors report adding a few of their own questions at the end of the demographic questionnaire.
e. This study did not use any questionnaires or surveys.
f. The authors used previously developed questionnaires or surveys to measure the study
variables.
14. Were any physiological measurements collected from the subjects for the purpose of this study?
a. Yes
b. No
Question 15- 16: Data Collection. (For help with these questions, refer to chapters 10 & 12)
15. Which one of the following best describes the data collection process used in this study?
a. questionnaires / surveys were completed via the telephone.
b. participants were given the questionnaires on enrollment in the study and asked to drop the sealed envelope in a locked box at the nurse’s station.
c. questionnaires / surveys were mailed to the prospective participants and returned in a self-
addressed stamped envelope.
d. nurse researchers interviewed the study participants in a focus group.
16. If there were more than one data collector for the study, would an estimation of inter-rater reliability be an important concept for the authors to report on for this study?
a. yes, and the authors reported their efforts to achieve inter-rater reliability.
b. yes, but the authors do not discuss any efforts to achieve inter-rater reliability.
c. no, the issue of inter-rater reliability does not apply here.
Question 17 – 19: Data Analysis. (For help with these questions, refer to chapters 11 & 12)
17. What descriptive statistics are used in this study? (Select all that apply).
a. mean
b. median
c. mode
d. standard deviation
e. z-scores
f. percentage distributions
18. What inferential statistics were used to examine the data obtained from the subjects? (Select all that apply)
a. Bivariate correlational analysis
b. Factor Analysis
c. t-Test
d. Chi-Square
e. ANCOVA
f. ANOVA
g. regression analysis
h. None of the above inferential statistics were used in this study.
19. What is the level of significance (alpha) set at for this study?
a. .05 or 5%
b. .10 or 90%
c .01 or 1%
d. an alpha level or level of significance chosen by the authors was not specifically mentioned in the text
of the article.
Question 20-25: Researcher’s Interpretation of the Findings. (For help with these questions, refer to chapters 11 & 12)
20. There are several statistically significant findings in this study. Which of these statements from the article would be considered a significant and predicted result? (select all that apply)
a. As MS nurses’ perceptions of their stress increases, their use of ways to cope increases (r = .357, P<.00)
b. Younger nurses have lower levels of perceived stress, per post hoc Tukey analysis.
c. Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses when dealing with occupational stressors.
d. The stress perception level is thus determined by the type of occupational stressor that the nurse is
exposed to.
21. Which of these statements from the article would be considered a non-significant result. (Select all that apply)
a. The older the nurse, the higher the level of stress.
b. There was no difference between the scores on ways of coping related to age cohorts (F2158 = 1.12, P=.33)
c. Age, years of experience, and educational levels are not significant factors in levels of perceived stress among MS nurses.
d. Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses
when dealing with occupational stressors.
22. Which one of these statements from the article would be considered clinically important?
a. According to this study results, a high level of occupational stress is not a known factor for nursing
turnover in MS nurses.
b. Younger nurses have better coping skills to combat perceived stress compared to more
experienced nurses.
c. Baby boomers reported higher use of self-controlling behaviors when dealing with occupational
stressors compared with Gen X and Gen Y.
d. Six participants were removed from the study due to incomplete surveys.
23. Which statements below implied from the article would be considered a limitation of the study? (Select all that apply)
a. The researchers utilized a qualitative method in the research design.
b. Lack of standardization of the conditions of administering the instruments.
c. A small sample size with a low response rate.
d. A measure of social desirability in giving responses as the participants worked with the researcher.
24. Which one of these statements would be considered a statement regarding generalization of these results?
a. The results indicated that there were high levels of perceived stress in this group of MS nurses and can be generalized to all MS nurses in the United States.
b. The survey was mailed only to MS nurses who were members of the Medical Surgical Nurses Association (MSNA).
c. A convenience sample of MS nurses decreases generalizability.
d. The use of a power analysis influenced the generalization of the results to all MS nurses.
25. Which one of these statements from the article would be considered a recommendation for future studies? (Select al that apply.)
a. Future development of programs to help relieve the occupational stress in MS nurses.
b. Research to discover why older nurses have a higher perceived stress compared to younger nurses.
c. Sufficiently educating nursing leaders in generational differences.
d. Identification of occupational stressors, perceived stress, and coping styles among generational cohorts.
PHARMACY QUIZ
Question 1
A nurse who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?
A. A patient whose stage III pressure ulcer required intravenous antibiotics and a vacuum dressing
B. A patient with a history of angina who experienced a non-ST wave myocardial infarction
C. A patient who received treatment for kidney failure due to an overdose of acetaminophen
D. A patient whose pulmonary embolism was treated with a heparin infusion
1 points
Question 2
A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that
A. she will report this to the physician immediately.
B. it may take up to 6 months for the drug to relieve her anxiety.
C. optimum relief of anxiety usually occurs after 3 to 4 weeks of treatment.
D. the drug is not going to work for her and the medication needs to be changed.
1 points
Question 3
A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of
A. diabetic hyperlipidemia.
B. increased intraocular pressure.
C. seizure disorders.
D. low blood pressure.
1 points
Question 4
A 39-year-old patient who is having trouble sleeping is beginning drug treatment with zaleplon (Sonata). The nurse will be sure to ask the patient if she is taking
A. oxycodone (Percodan).
B. secobarbital (Seconal).
C. cimetidine (Zantac).
D. meperidine (Demerol).
1 points
Question 5
A nurse is caring for a patient who has been admitted with acute cocaine intoxication. Which of the following vital signs would the nurse expect to find initially when assessing the patient?
A. BP: 130/88, P: 92, R: 28
B. Blood pressure (BP): 98/50, pulse (P): 120, respirations (R): 40
C. BP: 170/98, P:110, R: 20
D. BP: 150/90, P: 80, R: 16
1 points
Question 6
A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly of
A. no nursing action unless the patient experiences a “bad trip.”
B. nonpharmacologic interventions combined with an exercise program.
C. aggressive respiratory assistance
D. drug therapy with bromocriptine (Parlodel).
1 points
Question 7
A patient is suffering from acute inhalant intoxication. The priority nursing intervention will be to
A. assess the patient’s psychosocial status.
B. administer oxygen therapy.
C. provide an emesis basin.
D. administer epinephrine.
1 points
Question 8
A 20-year-old man has begun treatment of the psychotic symptoms of schizophrenia using olanzapine (Zyprexa). Which of the following symptoms would be categorized as a negative symptom of schizophrenia?
A. Visual hallucinations
B. Auditory hallucinations
C. Delusional thinking
D. Lack of interest in normal activities
1 points
Question 9
A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient’s characteristics likely to influence possible treatment with phenytoin?
A. The patient’s heavy alcohol use will compete with phenytoin for binding sites and he will require a higher-than-normal dose.
B. The patient’s protein deficit will likely increase the levels of the free drug in his blood.
C. Phenytoin is contraindicated within 48 hours of alcohol use due to the possibility of paradoxical effects.
D. The patient will require oral phenytoin rather than intravenous administration.
1 points
Question 10
The wife of a patient who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be
A. “I’ll ask the nurse practitioner if the dosage can be increased.”
B. “Continue the prescribed dose. It may take several days to work.”
C. “I’ll ask the nurse practitioner if the haloperidol can be discontinued and another drug started.”
D. “I’ll report this to the nurse practitioner and see if he will add another drug to enhance the effects of the haloperidol.”
1 points
Question 11
A patient who is experiencing acute alcohol withdrawal is being treated with intravenous lorazepam (Ativan). This drug achieves a therapeutic effect by
A. inhibiting the action of monoamine oxidase.
B. increasing the effects of the neurotransmitter GABA.
C. increasing the amount of serotonin available in the synapses.
D. affecting the regulation of serotonin and norepinephrine in the brain.
1 points
Question 12
A nurse will be prepared to administer naloxone (Narcan) to a patient who has had an overdose of morphine. Repeated doses of Narcan will be necessary because Narcan
A. has a shorter half-life than morphine.
B. has less strength in each dose than do individual doses of morphine.
C. causes the respiratory rate to decrease.
D. combined with morphine, increases the physiologic action of the morphine.
1 points
Question 13
A 4-year-old child is brought to the emergency department by her mother. The mother reports that the child has been vomiting, and the nurse notes that the child’s face is flushed and she is diaphoretic. The mother thinks that the child may have swallowed carbachol drops. A diagnosis of cholinergic poisoning is made. Which of the following drugs would be administered?
A. Nicotine
B. Cevimeline
C. Atropine
D. Acetylcholine
1 points
Question 14
A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in
A. gastrointestinal distress.
B. cognitive deficits.
C. acute renal failure.
D. liver damage.
1 points
Question 15
A patient has been hospitalized for treatment of substance abuse after being arrested and jailed for the past 24 hours. The patient is experiencing severe muscle and abdominal cramps, seizures, and acute psychosis due to abrupt withdrawal. Which of the following drug classes is the most likely cause of these severe and potentially fatal withdrawal symptoms?
A. Amphetamines
B. Opioids
C. Benzodiazepines
D. Sedative–hypnotic drugs
1 points
Question 16
A 59-year-old woman has presented to a clinic requesting a prescription for lorazepam (Ativan) in order to treat her recurrent anxiety. Her care provider, however, believes that a selective serotonin reuptake inhibitor (SSRI) would be more appropriate. What advantage do SSRIs have over benzodiazepines in the treatment of anxiety?
A. SSRIs have a more rapid therapeutic effect.
B. SSRIs require administration once per week, versus daily or twice daily with benzodiazepines.
C. SSRIs generally have fewer adverse effects.
D. SSRIs do not require serial blood tests during therapy.
1 points
Question 17
A 64-year-old-patient has been prescribed lorazepam (Ativan) because of increasing periods of anxiety. The nurse should be careful to assess for
A. a history of current or past alcohol use.
B. a diet high in fat.
C. current nicotine use.
D. a diet high in carbohydrates.
1 points
Question 18
Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency?
A. Restoration of normal sinus rhythm
B. Resolution of respiratory acidosis
C. Reduction of severe hypertension
D. Increased level of consciousness
1 points
Question 19
A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient’s
A. bowel patterns.
B. urine specific gravity.
C. skin integrity.
D. core body temperature.
1 points
Question 20
A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient’s subsequent care, what nursing diagnosis should the nurse prioritize?
A. Risk for Injury related to drug–drug interactions or drug–nutrient interactions
B. Risk for Constipation related to decreased gastrointestinal peristalsis
C. Risk for Ineffective Peripheral Tissue Perfusion related to cardiovascular effects of phenelzine
D. Risk for Infection related to immunosuppressive effects of phenelzine
1 points
Question 21
A nurse works in a sleep disorder clinic and is responsible for administering medications to the patients. Which of the following patients would be most likely to receive zaleplon (Sonata)?
A. A 20-year-old woman who will take the drug about once a week
B. A 46-year-old man who receives an antidepressant and needs a sleep aid
C. A 35-year-old man who is having difficulty falling asleep, but once asleep can stay asleep
D. A 52-year-old woman who needs to fall asleep quickly and stay asleep all night
1 points
Question 22
A 26-year-old professional began using cocaine recreationally several months ago and has begun using the drug on a daily basis over the past few weeks. He has noticed that he now needs to take larger doses of cocaine in order to enjoy the same high that he used to experience when he first used the drug. A nurse should recognize that this pattern exemplifies
A. drug tolerance.
B. dependence.
C. addiction.
D. withdrawal.
1 points
Question 23
A postsurgical patient has been provided with a morphine patient-controlled analgesic (PCA) but has expressed her reluctance to use it for fear of becoming addicted. How can the nurse best respond to this patient’s concerns?
A. “It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction.”
B. “You don’t need to worry. It’s actually not true that you can get addicted to the medications we use in a hospital setting.”
C. “It’s important that you accept that your current need to control your pain is more important than fears of becoming addicted.”
D. “If you do become addicted, we’ll make sure to provide you with the support and resources necessary to help you with your recovery.”
1 points
Question 24
A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia. Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)
A. The drug does not cause sleepiness in the morning.
B. It is available in both quick-onset and continuous-release oral forms.
C. The drug should not be used for longer than 1 month.
D. It should be taken 1 hour to 90 minutes before going to bed.
E. One of the most common adverse effects of the drug is headache.
1 points
Question 25
A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome?
A. The patient develops yellowed sclerae and intense pruritis (itchiness).
B. The patient demonstrates a significant increase in agitation after being given haloperidol.
C. The patient develops muscle rigidity and a sudden, high fever.
D. The patient complains of intense thirst and produces copious amounts of urine.
1 points
Question 26
A nurse is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the nurse should be aware that
A. there is a risk of systemic absorption of the lidocaine through the patient’s traumatized skin.
B. intravenous lidocaine may be preferable to topical application.
C. lidocaine must be potentiated with another anesthetic in order to achieve pain control.
D. pain relief is unlikely to be achieved due to the destruction of nerve endings in the burn site.
1 points
Question 27
Which of the following drugs used to treat anxiety would be appropriate for a patient who is a school teacher and is concerned about feeling sedated at work?
A. Lorazepam (Ativan)
B. Diazepam (Valium)
C. Alprazolam (Xanax)
D. Buspirone (BuSpar)
1 points
Question 28
A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse’s priority assessments?
A. Liver function studies, pain intensity, and blood glucose level
B. Pain intensity, respiratory rate, and level of consciousness
C. Respiratory rate, seizure activity, and electrolytes
D. Respiratory rate, pain intensity, and mental status
1 points
Question 29
A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The nurse will be sure to
A. administer after diluting the drug with gabapentin in intravenous solution.
B. inject very slowly, no faster than 100 mg/minute.
C. inject the diazepam very quickly, 15 mg in 10 to15 seconds.
D. avoid the small veins in the dorsum of the hand or the wrist.
1 points
Question 30
A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for
A. increased secretions.
B. facial flushing.
C. dizziness
COMMENT SUZZET
I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS
After discussion with your mentor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account in developing the evidence-based practice project. Explain how your proposal will, directly and indirectly, impact each of the aspects.
Speaking with the mentor, the financial aspect of the project would be hours spent trying to get nurses educated on the proposed guidelines for late preterm infants. Hours will be needed as well to get the basic checklist implemented into the computer in this particular area, which requires going to different committees and getting approvals needed. This takes more than one nurse or person to get this done. This requires more hours of pay, and that would be the financial aspect of the proposed project.
Now, the clinical aspect that has to be taken into account with developing the project would be how the nurses will accept the project. As lifelong learners, staff nurses continually encounter new knowledge of relevance to their patients. The conscientious nurse remains alert to clinical problems and encourages investigation into ways to improve patient outcomes(Di Lenoardi, 2014). The nurses need to be given research and data that proves this could help readmission of late preterm infants. If given this data, they would be involved in the process of implementing as well,
In 2001, the Institute of Medicine (IOM) recommended evidenced based practice to improve healthcare outcomes(Stephens, 2013). This project is to improve the quality outcome of late preterm infants and prevent their readmission to hospital.
All the aspects brought together will make a good impact on the project the author believes with the research and data given to the nurses, implementation and then follow up of results will show this is a great solution to help alleviate many readmissions nationwide as well. If this hospital shows that the guidelines are helping there, then they can show other colleagues in the nation that this helps and also will cut costs by preventing readmissions.
References
Di Lenoardi, B. C. (2014). Bringing evidence-based practice to life. Retrieved from https://lms.rn.com/getpdf.php/2145.pdf
Stephens, K. R. (2013, May 13). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing., 18. https://doi.org/10.3912/OJIN.Vol18No02Man04