lOMoAR cPSD| 8510046
, lOMoAR cPSD| 8510046
Chapter 01: Science and the Therapeutic Use of Self in Psychiatric Mental Health
hj
Nursing
Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communicatio
hj hj hj hj hj hj hj hj
nApproach to Evidence-Based Care, 4th Edition
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j hj hj hj hj hj
MULTIPLE CHOICE hj
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient li
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
ving in the community and diagnosed with serious and persistent mental illness? Within 3
hj hj hj hj hj hj hj hj hj hj hj hj hj j
h
months, the patient will demonstrate what behavior?
hj hj hj hj hj hj
a. Denying suicidal ideation hj hj
b. Reporting a sense of well-being hj hj hj hj
c. Taking medications as prescribed hj hj hj
d. Attending clinic appointments on time hj hj hj hj
ANS: B hj
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving r
hj hj hj hj hj hj hj hj hj
ole performance. The goal of recovery is to empower the individual with mental illness to ach
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
ieve a sense of meaning and satisfaction in life and to function at the highest possible levelof
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj j
h hj
wellness. The incorrect options focus on the classic medical model rather than recovery.
hj hj hj hj hj hj hj hj hj hj hj hj
DIF:
Cognitive Level: Application (Applying) T hj hj hj hj
OP: Nursing Process: Outcomes Identification MS
hj hj hj hj hj
C: NCLEX: Health Promotion and Maintenance
h j hj hj hj hj
2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
adivorce. Select the nurse’s most caring comment.
j
h hj hj hj hj hj hj
a. “Let’s discuss healthy means of coping when you have suicidal feelings.”
hj hj hj hj hj hj hj hj hj hj
b. “I understand why you’re so depressed. When I got divorced, I was devastate
hj hj hj hj hj hj hj hj hj hj hj hj
dtoo.” j
h
c. “You should forget about your marriage and move on with your life.”
hj hj hj hj hj hj hj hj hj hj hj
d. “How did you get so depressed that hospitalization was necessary?”
hj hj hj hj hj hj hj hj hj
ANS: A hj
The nurse’s communication should evidence caring and a commitment to work with the patie
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nt. This commitment lets the patient know the nurse will help. Probing and advice are nothelp
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj j
h
ful for therapeutic interventions.
hj hj hj
DIF: Cognitive Level: Application (Applying) hj hj hj
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
h j hj hj h j hj hj
3. In the shift-change report, an off-
hj hj hj hj hj
going nurse criticizes a patient who wears extremely heavymakeup. Which comment by the
hj hj hj hj hj hj hj hj j
h hj hj hj hj hj
nurse who receives the report best demonstrates advocacy?
hj hj hj hj hj hj hj
a. “This is a psychiatric hospital, so we expect our patients to behave bizarrely.”
hj hj hj hj hj hj hj hj hj hj hj hj
b. “Let’s all show acceptance of this patient by wearing lots of makeup too.”
hj hj hj hj hj hj hj hj hj hj hj hj
c. “Your comments are inconsiderate and inappropriate. Keep the report objective.”
hj hj hj hj hj hj hj hj hj
d. “Our patients need our help to learn behaviors that will help them get along i
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
nsociety.” j
h
PRIMEXAM.COM
, lOMoAR cPSD| 8510046
ANS: D hj
Accepting patients’ needs for self- hj hj hj hj
expression and seeking to teach skills that will contribute totheir well-
hj hj hj hj hj hj hj hj hj j
h hj
being demonstrate respect and are important parts of advocacy. The on-
hj hj hj hj hj hj hj hj hj hj
coming nurse needs to take action to ensure that others are not prejudiced against the patient.
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
Humor can be appropriate within the privacy of a shift report but not at the expense of respect
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
for patients. Judging the off-
hj hj hj hj hj
going nurse in a critical way will create conflict. Nurses must show compassion for each othe
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
r.
DIF: Cognitive Level: Application (Applying) hj hj hj
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
h j hj hj h j hj hj hj hj
4. A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Whic
hj hj hj hj hj hj hj hj hj hj hj hj
hstatement is an example of “attending”?
j
h hj hj hj hj hj
a. “We all have stress in life. Being in a psychiatric hospital is not the end of th
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
eworld.” j
h
b. “Tell me why you felt you had to be hospitalized to receive treatment for your
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
depression.”
c. “You will feel better after we get some antidepressant medication started for you.”
hj hj hj hj hj hj hj hj hj hj hj hj
d. “I’d like to sit with you for a while, so you may feel more comfortable talking wit
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
hme.” j
h
ANS: D hj
Attending is a technique that demonstrates the nurse’s commitment to the relationship and
hj hj hj hj hj hj hj hj hj hj hj hj hj
reduces feelings of isolation. This technique shows respect for the patient and demonstrate
hj hj hj hj hj hj hj hj hj hj hj hj
scaring. Generalizations, probing, and false reassurances are nontherapeutic.
j
h hj hj hj hj hj hj hj
DIF: Cognitive Level: Application (Applying) hj hj hj
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
h j hj hj h j hj hj
5. A patient shows the nurse an article from the Internet about a health problem. Which charac
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
teristic of the website’s address most alerts the nurse that the site may have biased andpreju
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj j
h
diced information? hj
a. Address ends in “.org.” hj hj hj
b. Address ends in “.com.” hj hj hj
c. Address ends in “.gov.” hj hj hj
d. Address ends in “.net.” hj hj hj
ANS: B hj
Financial influences on a site are a clue that the information may be biased. “.com” at the en
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
dof the address indicates that the site is a commercial one. “.gov” indicates that the site is ma
j
h hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
intained by a government entity. “.org” indicates that the site is nonproprietary; the site may
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
or may not have reliable information, but it does not profit from its activities. “.net” can have
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
multiple meanings.
hj hj
DIF: Cognitive Level: Comprehension (Understanding) hj hj hj
TOP: Nursing Process: EvaluationMSC: NCLEX: Health Promotion and Maintenance
h j hj hj j
h h j hj hj hj hj
6. A nurse says, “When I was in school, I learned to call upset patients by name to get their a
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
ttention; however, I read a descriptive research study that says that this approach does not
hj hj hj hj hj hj hj hj hj hj hj hj hj hj j
h
work. I plan to stop calling patients by name.” Which statement is the best appraisal of thi
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
snurse’s comment?
j
h hj
a. One descriptive research study rarely provides enough evidence to change practice.
hj hj hj hj hj hj hj hj hj hj
PRIMEXAM.COM
, lOMoAR cPSD| 8510046
b. Staff nurses apply new research findings only with the help from clinical nurs
hj hj hj hj hj hj hj hj hj hj hj hj
especialists. j
h
c. New research findings should be incorporated into clinical algorithms before usin
hj hj hj hj hj hj hj hj hj hj
gthem in practice. hj hj hj
d. The nurse misinterpreted the results of the study. Classic tenets of practice do no
hj hj hj hj hj hj hj hj hj hj hj hj hj
tchange. j
h
ANS: A hj
Descriptive research findings provide evidence for practice but must be viewed in relation to
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
other studies before practice changes. One study is not enough. Descriptive studies are low o
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
nthe hierarchy of evidence. Clinical algorithms use flowcharts to manage problems and do no
j
h hj hj hj hj hj hj hj hj hj hj hj hj hj
t specify one response to a clinical problem. Classic tenets of practice should change as resea
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
rch findings provide evidence for change.
hj hj hj hj hj
DIF: Cognitive Level: Analysis (Analyzing) hj hj hj
TOP: Nursing Process: EvaluationMSC: NCLEX: Health Promotion and Maintenance
h j hj hj j
h h j hj hj hj hj
7. Two nursing students discuss career plans after graduation. One student wants to enter psyc
hj hj hj hj hj hj hj hj hj hj hj hj hj
hiatric nursing. The other student asks, “Why would you want to be a psychiatric nurse?All
hj hj hj hj hj hj hj hj hj hj hj hj hj hj j
h hj
they do is talk. You will lose your skills.” Select the best response by the student interested
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
in psychiatric nursing.
hj hj
a. “Psychiatric nurses’ practice in safer environments than other specialties and hj hj hj hj hj hj hj hj hj j
h
nurse-to-patient ratios are better because of the nature of patients’ problems.” hj hj hj hj hj hj hj hj hj hj
b. “Psychiatric nurses use complex communication skills, as well as critical thinking, hj hj hj hj hj hj hj hj hj hj
to solve multidimensional problems. I’m challenged by those situations.”
hj hj hj hj hj hj hj hj
c. “I think I will be good in the mental health field. I do not like clinical rotations in
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
school, so I do not want to continue them after I graduate.”
hj hj hj hj hj hj hj hj hj hj hj
d. “Psychiatric nurses do not have to deal with as much pain and suffering as hj hj hj hj hj hj hj hj hj hj hj hj hj
medical-surgical nurses. That appeals to me.” hj hj hj hj hj
ANS: B hj
The practice of psychiatric nursing requires a different set of skills than medical-
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surgical nursing, although substantial overlap does exist. Psychiatric nurses must be able to
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help patients with medical and mental health problems, reflecting the holistic perspective th
hj hj hj hj hj hj hj hj hj hj hj hj
ese nurses must have. Nurse–
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patient ratios and workloads in psychiatric settings have increased,similar to other specialtie
hj hj hj hj hj hj hj hj j
h hj hj hj
s. Psychiatric nursing involves clinical practice, not simply documentation. Psychosocial pai
hj hj hj hj hj hj hj hj hj hj
n is real and can cause as much suffering as physical pain.
hj hj hj hj hj hj hj hj hj hj hj
DIF: Cognitive Level: Application (Applying) hj hj hj
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
h j hj hj h j hj hj hj hj
8. Which research evidence would most influence a group of nurses to change their practice?
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a. Expert committee report of recommendations for practice
hj hj hj hj hj hj
b. Systematic review of randomized controlled trials hj hj hj hj hj
c. Nonexperimental descriptive study hj hj
d. Critical pathway hj
ANS: B hj
PRIMEXAM.COM
, lOMoAR cPSD| 8510046
Chapter 01: Science and the Therapeutic Use of Self in Psychiatric Mental Health
hj
Nursing
Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communicatio
hj hj hj hj hj hj hj hj
nApproach to Evidence-Based Care, 4th Edition
h
j hj hj hj hj hj
MULTIPLE CHOICE hj
1. Which outcome, focused on recovery, would be expected in the plan of care for a patient li
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
ving in the community and diagnosed with serious and persistent mental illness? Within 3
hj hj hj hj hj hj hj hj hj hj hj hj hj j
h
months, the patient will demonstrate what behavior?
hj hj hj hj hj hj
a. Denying suicidal ideation hj hj
b. Reporting a sense of well-being hj hj hj hj
c. Taking medications as prescribed hj hj hj
d. Attending clinic appointments on time hj hj hj hj
ANS: B hj
Recovery emphasizes managing symptoms, reducing psychosocial disability, and improving r
hj hj hj hj hj hj hj hj hj
ole performance. The goal of recovery is to empower the individual with mental illness to ach
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
ieve a sense of meaning and satisfaction in life and to function at the highest possible levelof
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj j
h hj
wellness. The incorrect options focus on the classic medical model rather than recovery.
hj hj hj hj hj hj hj hj hj hj hj hj
DIF:
Cognitive Level: Application (Applying) T hj hj hj hj
OP: Nursing Process: Outcomes Identification MS
hj hj hj hj hj
C: NCLEX: Health Promotion and Maintenance
h j hj hj hj hj
2. A patient is hospitalized for depression and suicidal ideation after their spouse asks for
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
adivorce. Select the nurse’s most caring comment.
j
h hj hj hj hj hj hj
a. “Let’s discuss healthy means of coping when you have suicidal feelings.”
hj hj hj hj hj hj hj hj hj hj
b. “I understand why you’re so depressed. When I got divorced, I was devastate
hj hj hj hj hj hj hj hj hj hj hj hj
dtoo.” j
h
c. “You should forget about your marriage and move on with your life.”
hj hj hj hj hj hj hj hj hj hj hj
d. “How did you get so depressed that hospitalization was necessary?”
hj hj hj hj hj hj hj hj hj
ANS: A hj
The nurse’s communication should evidence caring and a commitment to work with the patie
hj hj hj hj hj hj hj hj hj hj hj hj hj
nt. This commitment lets the patient know the nurse will help. Probing and advice are nothelp
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj j
h
ful for therapeutic interventions.
hj hj hj
DIF: Cognitive Level: Application (Applying) hj hj hj
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
h j hj hj h j hj hj
3. In the shift-change report, an off-
hj hj hj hj hj
going nurse criticizes a patient who wears extremely heavymakeup. Which comment by the
hj hj hj hj hj hj hj hj j
h hj hj hj hj hj
nurse who receives the report best demonstrates advocacy?
hj hj hj hj hj hj hj
a. “This is a psychiatric hospital, so we expect our patients to behave bizarrely.”
hj hj hj hj hj hj hj hj hj hj hj hj
b. “Let’s all show acceptance of this patient by wearing lots of makeup too.”
hj hj hj hj hj hj hj hj hj hj hj hj
c. “Your comments are inconsiderate and inappropriate. Keep the report objective.”
hj hj hj hj hj hj hj hj hj
d. “Our patients need our help to learn behaviors that will help them get along i
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
nsociety.” j
h
PRIMEXAM.COM
, lOMoAR cPSD| 8510046
ANS: D hj
Accepting patients’ needs for self- hj hj hj hj
expression and seeking to teach skills that will contribute totheir well-
hj hj hj hj hj hj hj hj hj j
h hj
being demonstrate respect and are important parts of advocacy. The on-
hj hj hj hj hj hj hj hj hj hj
coming nurse needs to take action to ensure that others are not prejudiced against the patient.
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
Humor can be appropriate within the privacy of a shift report but not at the expense of respect
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
for patients. Judging the off-
hj hj hj hj hj
going nurse in a critical way will create conflict. Nurses must show compassion for each othe
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
r.
DIF: Cognitive Level: Application (Applying) hj hj hj
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
h j hj hj h j hj hj hj hj
4. A nurse assesses a newly admitted patient diagnosed with major depressive disorder. Whic
hj hj hj hj hj hj hj hj hj hj hj hj
hstatement is an example of “attending”?
j
h hj hj hj hj hj
a. “We all have stress in life. Being in a psychiatric hospital is not the end of th
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
eworld.” j
h
b. “Tell me why you felt you had to be hospitalized to receive treatment for your
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
depression.”
c. “You will feel better after we get some antidepressant medication started for you.”
hj hj hj hj hj hj hj hj hj hj hj hj
d. “I’d like to sit with you for a while, so you may feel more comfortable talking wit
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
hme.” j
h
ANS: D hj
Attending is a technique that demonstrates the nurse’s commitment to the relationship and
hj hj hj hj hj hj hj hj hj hj hj hj hj
reduces feelings of isolation. This technique shows respect for the patient and demonstrate
hj hj hj hj hj hj hj hj hj hj hj hj
scaring. Generalizations, probing, and false reassurances are nontherapeutic.
j
h hj hj hj hj hj hj hj
DIF: Cognitive Level: Application (Applying) hj hj hj
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
h j hj hj h j hj hj
5. A patient shows the nurse an article from the Internet about a health problem. Which charac
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
teristic of the website’s address most alerts the nurse that the site may have biased andpreju
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj j
h
diced information? hj
a. Address ends in “.org.” hj hj hj
b. Address ends in “.com.” hj hj hj
c. Address ends in “.gov.” hj hj hj
d. Address ends in “.net.” hj hj hj
ANS: B hj
Financial influences on a site are a clue that the information may be biased. “.com” at the en
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
dof the address indicates that the site is a commercial one. “.gov” indicates that the site is ma
j
h hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
intained by a government entity. “.org” indicates that the site is nonproprietary; the site may
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
or may not have reliable information, but it does not profit from its activities. “.net” can have
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
multiple meanings.
hj hj
DIF: Cognitive Level: Comprehension (Understanding) hj hj hj
TOP: Nursing Process: EvaluationMSC: NCLEX: Health Promotion and Maintenance
h j hj hj j
h h j hj hj hj hj
6. A nurse says, “When I was in school, I learned to call upset patients by name to get their a
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
ttention; however, I read a descriptive research study that says that this approach does not
hj hj hj hj hj hj hj hj hj hj hj hj hj hj j
h
work. I plan to stop calling patients by name.” Which statement is the best appraisal of thi
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
snurse’s comment?
j
h hj
a. One descriptive research study rarely provides enough evidence to change practice.
hj hj hj hj hj hj hj hj hj hj
PRIMEXAM.COM
, lOMoAR cPSD| 8510046
b. Staff nurses apply new research findings only with the help from clinical nurs
hj hj hj hj hj hj hj hj hj hj hj hj
especialists. j
h
c. New research findings should be incorporated into clinical algorithms before usin
hj hj hj hj hj hj hj hj hj hj
gthem in practice. hj hj hj
d. The nurse misinterpreted the results of the study. Classic tenets of practice do no
hj hj hj hj hj hj hj hj hj hj hj hj hj
tchange. j
h
ANS: A hj
Descriptive research findings provide evidence for practice but must be viewed in relation to
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
other studies before practice changes. One study is not enough. Descriptive studies are low o
hj hj hj hj hj hj hj hj hj hj hj hj hj hj
nthe hierarchy of evidence. Clinical algorithms use flowcharts to manage problems and do no
j
h hj hj hj hj hj hj hj hj hj hj hj hj hj
t specify one response to a clinical problem. Classic tenets of practice should change as resea
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
rch findings provide evidence for change.
hj hj hj hj hj
DIF: Cognitive Level: Analysis (Analyzing) hj hj hj
TOP: Nursing Process: EvaluationMSC: NCLEX: Health Promotion and Maintenance
h j hj hj j
h h j hj hj hj hj
7. Two nursing students discuss career plans after graduation. One student wants to enter psyc
hj hj hj hj hj hj hj hj hj hj hj hj hj
hiatric nursing. The other student asks, “Why would you want to be a psychiatric nurse?All
hj hj hj hj hj hj hj hj hj hj hj hj hj hj j
h hj
they do is talk. You will lose your skills.” Select the best response by the student interested
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
in psychiatric nursing.
hj hj
a. “Psychiatric nurses’ practice in safer environments than other specialties and hj hj hj hj hj hj hj hj hj j
h
nurse-to-patient ratios are better because of the nature of patients’ problems.” hj hj hj hj hj hj hj hj hj hj
b. “Psychiatric nurses use complex communication skills, as well as critical thinking, hj hj hj hj hj hj hj hj hj hj
to solve multidimensional problems. I’m challenged by those situations.”
hj hj hj hj hj hj hj hj
c. “I think I will be good in the mental health field. I do not like clinical rotations in
hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj hj
school, so I do not want to continue them after I graduate.”
hj hj hj hj hj hj hj hj hj hj hj
d. “Psychiatric nurses do not have to deal with as much pain and suffering as hj hj hj hj hj hj hj hj hj hj hj hj hj
medical-surgical nurses. That appeals to me.” hj hj hj hj hj
ANS: B hj
The practice of psychiatric nursing requires a different set of skills than medical-
hj hj hj hj hj hj hj hj hj hj hj hj
surgical nursing, although substantial overlap does exist. Psychiatric nurses must be able to
hj hj hj hj hj hj hj hj hj hj hj hj hj
help patients with medical and mental health problems, reflecting the holistic perspective th
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ese nurses must have. Nurse–
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patient ratios and workloads in psychiatric settings have increased,similar to other specialtie
hj hj hj hj hj hj hj hj j
h hj hj hj
s. Psychiatric nursing involves clinical practice, not simply documentation. Psychosocial pai
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n is real and can cause as much suffering as physical pain.
hj hj hj hj hj hj hj hj hj hj hj
DIF: Cognitive Level: Application (Applying) hj hj hj
TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment
h j hj hj h j hj hj hj hj
8. Which research evidence would most influence a group of nurses to change their practice?
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a. Expert committee report of recommendations for practice
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b. Systematic review of randomized controlled trials hj hj hj hj hj
c. Nonexperimental descriptive study hj hj
d. Critical pathway hj
ANS: B hj
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