Jarvis: Physical Examination and Health Assessment, 8th Edition Chapter 01: Evidence-Based Assessment Answer Keys: Study Guide and Lab Manual 1. Individual answers may vary. Use the answers provided as a guideline. Stage Example Cue recognition A.J., a 62-year-old male, appears pale, diaphoretic, and anxious. Hypothesis formulation A.J. states that he feels a terrible “tightness” and pain in his chest. The pain started while he was shoveling snow. At this point, you formulate a hypothesis of angina pectoris. Data gathering for hypothesis testing During the history and physical examination, you gather hypothesis testing data to support or reject the tentative hypothesis: you take vital signs, measure the PO2 by pulse oximetry, listen to breath sounds and heart sounds, assess the characteristics of the chest pain, and order a STAT ECG. Hypothesis evaluation You synthesize the new data collected, which support the hypothesis of angina pectoris, which has now subsided with two doses of sublingual nitroglycerin. The final diagnosis is activity-induced angina pectoris. 2. To identify assumptions, recognize that you could take information for granted, or see it as fact when, in reality, there is no evidence for it. In this situation, the speaker is assuming that Ellen must break up with her boyfriend due to rough treatment. To get facts in this situation, one needs to find out more information about how Ellen’s boyfriend has acted toward her and what they have done to resolve this situation, if anything. A joint counseling session could accomplish this. In the meantime, it would be prudent for Ellen to seek safe shelter if indeed her boyfriend is abusing her. A more appropriate response is: “Please tell me more about your relationship with your boyfriend.” 3. Findings from case study include the following: For Mr. Quinn, ask him to step on the scale again so that you can validate that the weight was measured accurately. For Ellen, validate the counselor’s statements with Ellen. Using an open-ended approach, say, “Ellen, it can be upsetting to be admitted to residential treatment. How are you feeling about this?” When auscultating a heart sound that you may not be sure about, ask an experienced colleague to listen to it as well and compare assessments. 4. Barriers to evidence-based practice on an individual and organizational level include the following: It often takes up to 17 years for research findings to be implemented into practice. Copyright © 2020 by Elsevier Inc. All rights reserved. Answer Keys: Study Guide and Lab Manual 5. 6. 7. 8. 9. 1-2 Nurses lack time to go to the library or perform Internet research. Health care institutions have inadequate library research holdings. Organizational support for EBP is lacking when nurses wish to implement changes in patient care. The differences are: Subjective data: complaint of sore shoulder; family has just moved to a new area; dizziness; sore throat; earache. Objective data: unconscious; blood in the urine; weight gain. The correct data collection types are as follows: Barbiturate overdose: emergency. Ambulatory patient presenting with rash: focused (problem-centered). Checkup visit: complete (total health). Patient on new anti-hypertensive regimen: follow-up. Close to 50% of the U.S. population soon will consist of people from diverse racial, ethnic, and cultural groups. Some groups expect culturally relevant health care that incorporates their specific beliefs and practices. However, the cultural health rites often conflict with the unicultural, Western, biomedical view taught in U.S. educational programs. Thus, knowledge of and concern for diverse cultural beliefs and practices are increasingly important. Individual answers may vary. Individual answers may vary. Copyright © 2020 by Elsevier Inc. All rights reserved.