Test Bank for Theoretical Basis for Nursing 5th Edition by Melanie McEwen & Evelyn Wills-Part

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Theoretical Basis for Nursing 5th Edition Melanie McEwen Evelyn M. Wills 2023

Theoretical Basis for Nursing 5th Edition by Melanie McEwen & Evelyn M. Wills

ISBN-10 9781496351203 ISBN-13 978-1496351203

Test bank for Theoretical Basis for Nursing 5th Edition by Melanie McEwen & Evelyn M. Wills

ISBN-10 9781496351203 ISBN-13 978-1496351203

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TABLE OF CONTENTS

Unit I: Introduction to Theory Chapter 1-Philosophy, Science, and Nursing Chapter 2-Overview of Theory in Nursing Chapter 3-Concept Development: Clarifying Meaning of Terms Chapter 4-Theory Development: Structuring Conceptual Relationships in Nursing Chapter 5-Theory Analysis and Evaluation

Unit II: Nursing Theories Chapter 6-Overview of Grand Nursing Theories Chapter 7-Grand Nursing Theories Based on Human Needs Chapter 8-Grand Nursing Theories Based on Interactive Process Chapter 9-Grand Nursing Theories Based on Unitary Process Chapter 10-Introduction to Middle-Range Nursing Theories Chapter 11-Overview of Selected Middle-Range Nursing Theories Chapter 12-Evidence-Based Practice and Nursing Theory

Unit III: Shared Theories Used by Nurses Chapter 13-Theories From the Sociologic Sciences Chapter 14-Theories From the Behavioral Sciences Chapter 15-Theories From the Biomedical Sciences Chapter 16-Theories, Models, and Frameworks From Leadership and Management Chapter 17-Learning Theories Chapter 18-Ethical Theories and Principles

Unit IV: Application of Theory in Nursing Chapter 19-Application of Theory in Nursing Practice Chapter 20-Application of Theory in Nursing Research Chapter 21-Application of Theory in Nursing Administration and Management Chapter 22- Application of Theory in Nursing Education Chapter 23-Future Issues in Nursing Theory

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Parker/Smith, Nursing Theories and Nursing Practice, 5e Chapter 1: Nursing Theory and the Discipline of Nursing Multiple-Choice Questions 1. The purpose of theory is to: A. Explain experience.

B. Describe relationships.

C. Project outcomes.

D. All of the above.

ANS: D

2. Members of a community of scholars share a commitment to all of the following except: A. Values.

B. Knowledge.

C. Geographic location.

D. Processes.

ANS: C

3.

and

discipline and are inherent in nursing theories.

A. Paradigm and metaparadigm.

B. Syntactical and conceptual.

C. Middle and grand.

D. Language and symbol.

ANS: B

structures are essential to any

Parker/Smith, Nursing Theories and Nursing Practice, 5e 4. Books and periodicals are examples of: A. Communication networks.

B. Heritage of literature.

C. Nursing organizations.

D. Nursing discipline.

ANS: B

5. The basic building blocks of theories are: A. Concepts and their definitions.

B. Statements of relationships.

C. Concepts and statements of relationships.

D. Empirical indicators.

ANS: C

6. Nursing theories: A. Are discovered in nature.

B. Serve as exact representations of reality.

Parker/Smith, Nursing Theories and Nursing Practice, 5e C. Are invented by humans.

D. Cannot be modified.

ANS: C

7. A paradigm is defined as a: A. Worldview.

B. General framework.

C. Set of shared perspectives held by members of a discipline.

D. All of the above.

ANS: D

8. The dependence of nursing theory development on human imagination is an attribute of nursing as a(n): A. Occupation.

B. Discipline.

C. Vocation.

D. Profession.

ANS: B

9. The primary purpose of nursing theory is to: A. Structure nursing knowledge.

B. Demonstrate creativity in nursing.

C. Guide the thinking about, being, and doing of nursing.

Parker/Smith, Nursing Theories and Nursing Practice, 5e D. Organize nursing curricula.

ANS: C

10. The first nursing theorist who identified the importance of theory in nursing was: A. Virginia Henderson.

B. Hildegard Peplau.

C. Lydia Hall.

D. Florence Nightingale.

ANS: D

11. The most abstract level of knowledge is the: A. Paradigm.

B. Metaparadigm.

C. Theory.

D. Concept.

ANS: B

12. Statements of enduring values or beliefs are considered: A. Conceptual models.

B. Philosophies.

C. Grand theories.

D. Practice theories.

Parker/Smith, Nursing Theories and Nursing Practice, 5e ANS: B

13. Theories that include specific concepts, are broad enough to be useful in complex situations, and can be empirically tested are called: A. Grand theories.

B. Middle-range theories.

C. Practice-level theories.

D. Nursing theories.

ANS: B

14. Theories that have the most limited scope and level of abstraction that are useful in within a specific range of nursing situations are called: A. Grand theories.

B. Middle-range theories.

C. Practice-level theories.

D. Nursing theories.

ANS: C

15. The name for the boundaries or focus of a discipline is: A. Imagination.

B. Domain.

C. Tradition.

D. Value.

Parker/Smith, Nursing Theories and Nursing Practice, 5e ANS: B

True/False Questions

16. Every discipline has a unique focus that directs inquiry and distinguishes it from other fields of study.

ANS: T

17. Theories are not discovered in nature but are human inventions.

ANS: T

18. Science generally evolves as a smooth, regular, continuing path of knowledge development over time.

ANS: F

19. Early nursing theorists relied on definitions of theory from nursing practice to guide the development of theories within nursing.

ANS: F

20. The best test of any nursing theory is its usefulness in professional practice.

ANS: T

Parker/Smith, Nursing Theories and Nursing Practice, 5e

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

1. Nursing has been considered both a profession and an occupation. Which of the following supports defining nursing as a profession?

A) Autonomy B) Learned vocation C) Varied level of skill D) Career with varied knowledge

2. How many levels of entry into practice exist for registered nurses?

A) One B) Two C) Three D) Four

3. Nursing is classified as which type of science?

A) Pure B) Natural C) Human D) Applied

4. In defining the philosophy of nursing, which of the following would not be included?

A) Purpose of human l iTf e B) Nature of being C) Theory of knowledge D) Scientific method

5. When discussing the science and philosophy of a discipline, how would one define the two in relation to each other?

A) Autonomous B) Reliant C) Linked D) Unrelated

6. Philosophy's definition includes which of the following?

A) Study of problems that are abstract and general B) Measures observable phenomena of interest in a discipline C) Empirical way of gathering data D) Grounded and tested in experience

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

7. Based on the science and philosophical schools of thought, which one is founded on the belief that what is experienced is what exists and that experiences be verified through scientific methodology?

A) Received view B) Human science C) Phenomenology D) Constructivism

8. Based on the science and philosophical schools of thought, which one centers on descriptions that are derived from collectively lived experiences, interrelatedness, human interpretation, and learned reality?

A) Empiricism B) Positivism C) Rationalism D) Perceived view

9. When defining nursing philosophy, which of the following is appropriate?

A) Refers to the belief system of the profession and provides perspectives for practice, scholarship, and research.

B) The substantive, discipline-specific knowledge that focuses on the human-universe-health process.

C) Refers to the systemToEf S reTlaBtiA onNsK hiS pEoL f hLuEmRa.n C reOs pMons e in health and illness.

D) Responsible for generation of knowledge, which provides direction for future.

10. When discussing the knowledge development in nursing science, the study of theory is referred to as which of the following?

A) Ontology B) Epistemology C) Methodology D) Philosophy

11. There are several defined ways of knowing. Which way of knowing is defined as “a priori knowledge that pertain to knowledge gained from thought alone?”

A) Empirics B) Personal C) Intuitive D) Somatic

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

12. Patterns of knowledge in nursing include use of knowledge from nursing and other disciplines, abstracted and generalized beyond personal experience. Of which pattern of knowledge is this representative?

A) Clinical knowledge B) Emancipatory knowing C) Conceptual knowledge D) Empirical knowledge

13. Nursing is described as a human science based on inclusion of which of the following in the discipline?

A) Physiology B) Human health C) Anthropology D) All of the above

14. A study is conducted and the methodology used for the data collection is focused on testing a hypothesis and seeking to prove or disprove the hypothesis. Which type of methodology is being used?

A) Qualitative B) Quantitative C) Methodologic pluralism

15. During the course of a nursing research study, the research selects a theory with a phenomenological foundation seeking to explore the experiences of teens living with HIV. Which type of methodology is being used?

A) Qualitative B) Quantitative C) Methodologic pluralism

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

Answer Key 1. A 2. C 3. D 4. D 5. C 6. A 7. A 8. D 9. A 10. B 11. B 12. C 13. D 14. B 15. A

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

1. Myra Levine expressed nurses are often confused about theory. Which of the following was given as one reason for the confusion related to nursing theory?

A) Clearly understandable B) Obscure concepts C) Application to practice D) New concepts

2. If a theory is to be useful in nursing, it must include which of the following?

A) Broad concepts B) Understandable concepts C) Concepts specific to nursing D) Operationally defined concepts

3. Theories developed for nursing include all of the following except which of the following?

A) Identify standards for nursing practice B) Guide development of client cares C) Direct quality assurance programs D) Align with other health care disciplines

4. Which of the following wTaE sS thT eB fiA rsN t sKtaSgE eL inLtE heRd.eC veOloMpment of a nursing theory and philosophy?

A) Silent knowledge B) Received knowledge C) Subjective knowledge D) Procedural knowledge

5. The silent knowledge stage of theory and philosophy development was driven based on which of the following?

A) Nursing as an independent discipline B) Medical model, dependent on physicians C) Interdisciplinary team design D) Nursing as an academic discipline

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

6. During the 1970s, the nursing profession viewed itself as a scientific discipline evolving toward a theoretically based practice focusing on the client. Which stage of theory and philosophy development is this the correct description?

A) Silent knowledge B) Received knowledge C) Subjective knowledge D) Procedural knowledge

7. What is the current stage of knowledge development for the discipline of nursing?

A) Silent knowledge B) Received knowledge C) Subjective knowledge D) Constructed knowledge

8. Development of a metatheory includes which of the following?

A) Broad processes and generalized understanding B) Specific application of theory C) Development of theory through practice D) Use of only nursing concepts

SoTsB 9. Which type of theory is tT heEm t bArN oaKdSaE ndLcLoEmRp.leC x OinMscope?

A) Grand theory B) Middle range theory C) Practice theory D) Microtheory

10. Which type of theory may describe a phenomenon, explain relationships of concepts or predict effects of a phenomenon?

A) Metatheory B) Grand theory C) Middle range theory D) Practice theory

11. Which type of theory is the least complex and is situation specific?

A) Methatheory B) Grand theory C) Middle range theory D) Practice theory

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

12. A nursing theory designed to explain or relate concepts in a theory to one another is considered which type or purpose of theory?

A) Factor-isolating theories B) Factor-relating theories C) Situation-relating theories D) Situation-producing theories

13. A nursing theory which prescribes activities to reach a goal is which type of theory?

A) Factor-isolating theories B) Factor-relating theories C) Situation-relating theories D) Situation-producing theories

14. Which of the following discipline or disciplines may be used in the design of a nursing theory?

A) Psychology B) Physical biology C) Sociology D) Psychology, physical biology, and sociology

BhAiN 15. Based on the work by FaT wE ceSttT ,w chKoSfEthLeLfoEllRo.wC inO g Mis not part of the defined nursing metaparadigm?

A) Person B) Health C) Environment D) Caring

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

Answer Key 1. B 2. B 3. D 4. A 5. B 6. D 7. D 8. A 9. A 10. C 11. D 12. B 13. D 14. D 15. D

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

1. A concept used in a theory may be which of the following?

A) A sentence B) One or two words C) A sentence or a paragraph D) A word, two words, or a phrase

2. The definition of a concept should include consideration of which of the following factor?

A) Potential publication B) Context of concept C) Researcher opinion D) Use in other disciplines

3. Concepts used in nursing theory have been derived from which of the following?

A) Nursing practice B) Psychology and medicine C) Nursing research D) Nursing practice and other disciplines

4. A concept which is independent of time and space is considered which type of concept?

A) Concrete B) Abstract C) Variable D) Nonvariable

5. The concept of male or female gender is considered what type of concept?

A) Concrete B) Abstract C) Variable D) Nonvariable

6. A concept which can be measured using a hypotheses and may be tested is considered which of the following?

A) Theoretical B) Operational C) Abstract D) Nonvariable

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

7. Which of the following is not a reason for concept analysis?

A) Identify gaps in knowledge B) Determine knowledge of researcher C) Clarify concepts and meaning D) Determine fit between concept and clinical application

8. Who as the first nursing scholar developed a process for defining concepts and used 11 steps or techniques?

A) Wilson B) Walker and Avant C) Rodgers D) Swartz-Barcott and Kim

9. Based on the work of Rodgers, why is concept analysis necessary?

A) Concepts are static.

B) Concepts are context dependent.

C) Concepts vary based on type of theory.

D) Concepts provide information on data results.

10. Which of the following steps is last in Rodgers' process of concept analysis?

A) None. All are complTetEedST siB mA ulNtaKneSoEuL slL y.ER.COM B) Select appropriate sample for data collection C) Identify hypothesis and implications D) Analyze data regarding the concept

11. In the work of Swartz-Barcott and Kim, one of the phases of the hybrid model of concept development involves literature searches and determines the relevance for nursing. In which phase of the model does this occur?

A) Analytical phase B) Fieldwork phase C) Theoretical phase D) Concept development

12. What is the purpose of concept clarification based on the work by Meleis?

A) Define new concepts B) Identify dimension of concepts C) Explore use in the discipline D) Refine existing concepts

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

Answer Key 1. D 2. B 3. D 4. B 5. D 6. B 7. B 8. A 9. B 10. A 11. C 12. D

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

1. Theory development in nursing assists nursing in all of the following ways except one. Which of the following is not accomplished through theory development?

A) Helps the nurse understand practice B) Identifies key ideas of practice C) Organizes knowledge for use D) Disproves prior nursing knowledge

2. What is the term which refers to the process and methods used to create, modify, or refine a theory?

A) Theory construction B) Theory development C) Theory production D) Theory design

3. What is the term that is used to describe the final steps of theory development in which the components of the theory are organized and linkages specified?

A) Theory development B) Theory production C) Theory construction D) Theory design

4. When discussing theory, the theory termed as a worldview that deals with generating knowledge and broad abstract concepts is which type of theory?

A) Practice theory B) Metatheory C) Middle range theory D) Microtheory

5. Theories that consist of conceptual frameworks defining broad perspectives for practice and looking at phenomena based on perspectives and lacking operational definitions are which type of theories?

A) Grand theories B) Microtheories C) Practice theories D) Middle range theories

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

6. Which theories contain limited numbers of concepts and are limited in scope with some degree of generalization, but the concepts are clear and hypotheses can be derived?

A) Microtheories B) Practice theories C) Metatheories D) Middle range theories

7. Which theories are narrow in scope and have few concepts with a focus on reality?

A) Metatheories B) Practice theories C) Middle range theories D) Grand theories

8. The level of theory that names and classifies characteristics of a phenomenon and determines what will be perceived as the essence of the phenomenon is categorized as which of the following?

A) Explanatory theory B) Descriptive theory C) Predictive theory D) Prescriptive theory

9. The categorization of theories that provide the relationship between phenomena under study and describe some of the associations or interrelations between and among the concepts is which type of theory?

A) Prescriptive theory B) Descriptive theory C) Explanatory theory D) Predictive theory

10. Which theory addresses nursing therapeutics and predicts consequences of interactions?

A) Predictive theory B) Descriptive theory C) Prescriptive theory D) Explanatory theory

11. The foundations of theories are which of the following?

A) Propositions B) Relationships C) Concepts D) Hypotheses

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

12. Concepts are fully developed and presented in combination with other concepts to create theoretical statements. Which type of theoretical statement is the following: “As children grow in height their weight will increase.”?

A) Relational statement B) Existence statement C) Nonrelational statement D) Linear statement

13. The linkages in concepts of theories assist in which of the following?

A) Developing hypotheses B) Identifying new knowledge C) Assisting in conceptual map D) Provide a framework for the theory

14. Nursing theories are built on levels of abstraction. Which type of theory is the foundation on which other theories are built?

A) Microtheory B) Practice theory C) Middle range theory D) Grand theory

15. How are nursing theories developed?

A) Discovered in research.

B) Revealed in practice.

C) Invented to describe events.

D) Designed to tie research to practice.

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

Answer Key 1. D 2. B 3. C 4. B 5. A 6. D 7. B 8. B 9. C 10. C 11. C 12. A 13. A 14. D 15. C

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

1. Theory analysis and evaluation provides for all except which of the following?

A) Provide information on theory B) Identify gaps in theory C) Determine use in practice D) Assess the theorist validity

2. When conducting theory evaluation, the result is all of the following except which one?

A) Theory's origin B) Testability C) New information D) Generalizability

3. The systematic process of objectively examining the content, structure, and function of a theory is which of the following?

A) Theory description B) Theory analysis C) Theory evaluation D) Theory development

4. When assessing a theory's potential contribution to the discipline's knowledge base, what is this considered?

A) Theory description B) Theory analysis C) Theory evaluation D) Theory development

5. Which nursing scholar was the first to document the following criteria for analyzing theories: scope, complexity, testability, usefulness, implicit values of the theorist, information generation, and meaningful terminology?

A) Hardy B) Ellis C) Chinn D) Meleis

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

6. One nursing scholar wrote theory should be evaluated based on universal standards.

The same theorist discussed logical adequacy and the need for analysis of internal consistency in theory. Who is the appropriate nursing scholar?

A) Meleis B) Chinn C) Hardy D) Ellis

7. One nursing scholar used a two-phase process for analysis and evaluation of theories and frameworks. In her view of analysis, she indicated a significant need to be nonjudgmental and detailed in examination of a theory. She further indicated a need for theory to be evaluated by unique focus, the metaparadigm of nursing. Who is the appropriate nursing scholar?

A) Barnum B) Fawcett C) Meleis D) Whall

8. Who is the only nurse scholar to outline three separate criteria for analysis and evaluation for the three levels of nursing theory?

A) Whall B) Barnum C) Hardy D) Chinn

9. The process for critically reviewing nursing theory provides the ability to assess the relevance of the theory to which of the following?

A) Nursing administration, practice, and medicine B) Nursing research and nursing education C) Nursing practice, research, and education D) Nursing practice 10. Chinn and Kramer defined the term “critical reflection” as part of their process to analyze theory. What is the purpose of critical reflection in theory analysis?

A) It provides for external criticism.

B) It determines how well a theory serves its purpose.

C) It explains how the theory is used after development.

D) Does the theory include the nursing metapardigm?

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

11. Theory evaluation criteria by Barnum includes internal criticism. Which of the following is included in the internal criticism of theory evaluation?

A) Clarity B) Complexity C) Significance D) Scope

12. Chinn and Kramer included six elements in their theory description. Which element is defined as the following: “concepts are structured into a systematic form that links each concept with other”?

A) Structure B) Relationships C) Assumptions D) Definitions

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

Answer Key 1. D 2. C 3. B 4. C 5. B 6. C 7. B 8. A 9. C 10. B 11. A 12. B

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

1. Based on categories by Tomey and Alligood, theories that look at phenomenon for description or explanation for the purpose of control or prediction of the phenomenon in the practice setting would fall under which category?

A) Nursing theories B) Middle range theories C) Grand theories D) Nursing philosophies

2. Which of the following would be the category of a theory when basing the category on: philosophies, nursing models, nursing theories, theories, and middle range nursing theories?

A) Theoretical background B) Paradigms C) Nursing domains D) Scope

3. In the categorization of nursing theories by Meleis, one group focused on the domain of human beings and pan-dimensional energy fields. In which domain is this classified?

A) Nursing therapeutics B) Interactions C) Client (human being)—environment interactions D) Nursing clients

4. There are seven criteria for analysis of grand theories that have been selected and discussed. Which of the following is not one of the criteria?

A) Background of the theorist B) Usefulness C) Parsimony D) Time period

5. Three scholars developed categorization of theories based on paradigms. Which nursing scholar used the categories of totality paradigm and simultaneity paradigm?

A) Parse B) Newman C) Fawcett D) Orem

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

6. Scholars have developed categorization of theories based on paradigms. Which nursing scholar used the categories of particulate-deterministic school, interactiveintegrative school, and unitary-transformative?

A) Parse B) Newman C) Fawcett D) Rodgers

7. Scholars have developed categorization of theories based on paradigms. Which nursing scholar used the categories of reaction, reciprocal interaction, and simultaneous action?

A) Parse B) Newman C) Fawcett D) Roy

8. When using analysis criteria for a grand theory, why it is important to consider the background of the theorist?

A) It reveals the foundations of the theorist's ideas B) It examines the assumptions of the author C) It leads to understanding application to practice D) It determines the complexity of the thought process

9. When assessing a theory, the analysis reveals an influence from the reaction world view. In which of the following areas of analysis is this considered?

A) Background of theorist B) Philosophical underpinning of the theory C) Major assumptions, concepts, and relationships D) Parsimony

10. Which of the following is the criterion for assessing the complexity of a theory?

A) Major assumptions, concepts, and relationships B) Usefulness C) Value in extending nursing science D) Parsimony

11. What is the purpose for critiquing theories?

A) To determine usefulness in nursing science B) Evaluate the scholar's work for publication C) Determine applicability to other disciplines D) Prove the theory

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

12. When using a grand theory for a research study, the researcher is aware the concepts and propositions are which of the following?

A) Simplistic B) Amenable to testing C) Lack operation definitions D) Succinct and well defined

13. Grand theories in nursing provide an overview and foundation for future development of which type of theory?

A) Practice B) Middle range theory C) Microtheory D) Metatheory

14. Nurses are using theory to guide practice. Which of the following is not a noted reason for using theory in nursing practice?

A) Improve patient outcomes B) Renew and update practice C) Enhance quality of healthcare D) Advance the view of nursing in society

15. Based on the categorization of nursing theories and nursing domains by Meleis, Levine's and Orem's theories on nursing were placed together into a category. Which of the categories, as defined by Meleis, are these theories considered to be classified?

A) Nursing clients B) Interactions C) Human being—environment interactions D) Nursing therapeutics

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

Answer Key 1. A 2. D 3. C 4. D 5. A 6. B 7. C 8. A 9. B 10. D 11. A 12. C 13. B 14. D 15. D

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

1. Grand nursing theories that are based on human needs include all but one of the following. Which is not considered to be a part of needs-based theories?

A) Focus is on the client.

B) Client is considered biopsychosocially.

C) Individual parts of the client are considered.

D) Interventions are prescribed to meet client needs.

2. Florence Nightingale developed a model for nursing practice that was inductively derived based on her experiences during a time of war. What is the model considered by most nursing scholars?

A) Philosophy B) Practice theory C) Schema D) Research theory

3. One of the concepts of Nightingale's model included the following five points: pure air, pure water, efficient drainage, cleanliness, and light. In which concept are these five points included?

A) Social considerations B) Personal cleanliness C) Ventilation and warming D) Health of house

4. The nurse theorist Virginia Henderson developed which theory?

A) The Principles and Practice of Nursing B) Patient-Centered Approaches to Nursing C) The Self-Care Deficit Nursing Theory D) The Behavioral System Model

5. In the theory by Virginia Henderson, The Principles and Practice of Nursing, she defines nursing and considers her definition of nursing which of the following?

A) A concept B) A model C) An assumption D) An axiom

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

6. One nurse theorist and her colleague listed 10 steps in identifying the client's problems and 10 nursing skills to be used in developing a treatment typology. Who is this nurse theorist?

A) Betty Neuman B) Dorothy Johnson C) Faye Abdellah D) Florence Nightingale

7. The nurse theorist Dorothea E. Orem developed which nursing theory?

A) Patient-Centered Approaches to Nursing B) The Self-Care Deficit Nursing Theory C) The Principles and Practice of Nursing D) The Behavioral System Model

8. Included in The Self-Care Deficit and Nursing Theory by Orem, there are three nested theories. Which is not one of the nested theories?

A) Self-care B) Nursing system C) Family system D) Self-care deficit

9. The nurse theorist Dorothy Johnson developed which nursing theory?

A) The Behavioral System Model B) The Principles and Practice of Nursing C) The Self-Care Deficit Nursing Theory D) Patient-Centered Approaches to Nursing

10. In the theory developed by Dorothy Johnson, The Behavioral System Model, she incorporated all but one of the following into her theory. Which one is not included?

A) Systems theory B) Human behavior C) Stress D) Family

11. Which of the following theories was founded on general systems theory, stress theory, and stress and coping theory?

A) The Neuman Systems Model B) The Self-Care Deficit Model C) Patient-Centered Approaches to Nursing D) The Principles and Practice of Nursing

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

12. In the model by Betty Neuman, she focused on system theory, human needs of protection, or relief from stress. Which of the following was emphasized by her theory?

A) Humans have a need for dynamic balance that the nurse can provide.

B) The healthful house is a vital concept.

C) Nurses should care for the patient until the patient can care for self.

D) Behaviors should be organized around specific goals.

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

Answer Key 1. C 2. A 3. D 4. A 5. A 6. C 7. B 8. C 9. A 10. D 11. A 12. A

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

1. Theorists who use grand nursing theories based on interactive processes ascribe to which of the following theories?

A) Behavioral B) Social C) Systems D) Change

2. One nurse theorist developed a nursing theory based on four conservation principles. Which of the following theories is based on these principles?

A) Intersystem Model B) Modeling and Role-Modeling C) Systems Framework and Theory of Goal Attainment D) The Conservation Model

3. Which nurse theorist(s) developed the Intersystem Model?

A) Levine B) Artinian C) Erickson, Tomlin, and Swain D) Roper, Logan, and Tierney

4. Which nurse theorist devT elE opSeT d BthAeNCKoS ncEeL ptL uaElR S.ysCteOmMFramework and Theory of Goal Attainment?

A) Watson B) King C) Levine D) Artinian

5. Which theory was developed by Sister Roy? A) Modeling and Role-Modeling B) Theory of Goal Attainment C) Model of Nursing Based on Activities of Living D) Adaptation Model

6. One model has two levels. In the first level the interaction is the person's individual knowledge of a problem and the second level is seen when the client and nurse interact. Which model does this represent?

A) Modeling and Role-Modeling B) System Framework and Theory of Goal Attainment C) Conservation Model D) Intersystem Model

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

7. The Active Potential Assessment Model (APAM) directs nursing assessment in which theory?

A) Modeling and Role-Modeling B) Systems Framework and Theory of Goal Attainment C) Adaptation Model D) Model of Nursing Based on Activities of Living

8. One nursing theory includes the following relationships: nurse and client are purposeful interacting systems; nurse and client perceptions; judgments and actions if congruent lead to goal direction transactions as well as other relationships. Which theory includes these relationships?

A) Theory of Goal Attainment and Transactional Process B) Philosophy and Science of Caring C) Modeling and Role-Modeling D) Adaptation Model

9. In the theory by Roper, Logan, and Tierney, The Model of Nursing Based on Activities of Living, there are three major concepts. Which of the following is not a major concept of this theory?

A) Activities of living B) Lifespan C) Dependence/Independence D) Health of environment

10. In the Roy Adaptation Model assumptions are specified into one of three categories. Which of the following is not one of the categories?

A) Philosophical B) Scientific C) Cultural D) Biologic

11. One nursing theorist included the assumption, that caring and love are universal and mysterious forces, in addition to other assumptions in her theory. In which theory is this an assumption?

A) Philosophy and Science of Caring B) Adaptation Model C) Intersystem Model D) Modeling and Role-Modeling

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

12. Jean Watson included all of the following except one when developing her theory. Which of the following is not included in the development of her theory?

A) Nursing writers B) Psychology writers C) Medical writers D) Philosophical writers

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

Answer Key 1. C 2. D 3. B 4. B 5. D 6. D 7. A 8. A 9. D 10. D 11. A 12. C

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

1. What paradigm is used to describe a group of theories that adhered to a unitary process perception of human beings?

A) Simultaneity paradigm B) Being paradigm C) Human paradigm D) Unitary paradigm

2. Which nurse theorist developed the Science of Unitary Human Beings?

A) Rogers B) Newman C) Parse D) Roy

3. Which nurse theorist developed the theory of Health as Expanding Consciousness?

A) Rogers B) Newman C) Parse D) Watson

4. Which nurse theorist developed The Human Becoming School of Thought?

A) Rogers B) Newman C) Parse D) Roy

5. In her work, Martha Rogers presented several assumptions about man. Which of the following is not one of her assumptions?

A) Man is a unified whole possessing integrity and manifesting characteristics that are more than and different from the sum of his parts.

B) The life process evolves bi-directionally.

C) Man is characterized by the capacity for abstraction and imagery, language and thought, sensation and emotion.

D) Pattern and organization identify man and reflect his innovative wholeness.

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

6. Two of the central components of Rogers' work include openness and pan-dimensionality. Which of the following did Rogers consider to be the focus of nursing practice?

A) Unitary human being B) Time and space C) Energy field D) Expanding consciousness

7. Margaret Newman built on the metaparadigm concepts by Rogers. Which of the following was not included in the work of Newman?

A) Human B) Caring C) Environment D) Health

8. What research methodology is most often used when a researcher uses the theory of Margaret Newman?

A) Quantitative B) Qualitative C) Mixed D) Quantitative and qualitative are used equally.

9. What are the two main concepts used in Newman's model?

A) Health and environment B) Caring and consciousness C) Health and consciousness D) Caring and environment

10. In the theory by Parse, she incorporates which of the following principles?

A) Concepts by Rogers B) Existential-phenomenology C) Nursing metaparadigm D) All of the above

11. Which method of research is used with the theory by Parse?

A) Qualitative B) Quantitative C) Mixed D) Any method of research may be used.

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

12. Nurses in practice may have a difficult time with Parse's theory. Which of the following is the primary reason for this difficulty?

A) The organization is illogical B) It is based on a medical model of care C) It has unfamiliar terminology D) It is more effective when used in educational settings.

Theoretical Basis for Nursing 5th Edition McEwen Test Bank

Answer Key 1. A 2. A 3. B 4. C 5. B 6. A 7. B 8. B 9. C 10. D 11. A 12. C

1. Nursing researchers may prefer to use middle range theories for which of the following reasons?

A) More abstract B) Easy to generalize C) Provide basis for testable hypotheses D) Address nursing as an entire disciple

2. Characteristics of middle range theories include all of the following except which one?

A) Straightforward and relatively simple B) Receptive to empirical testing C) Primarily center on client problems D) Include other disciplines

3. Middle range theories link phenomena or concepts in which way?

A) Relationship statements B) Schema models C) Implicit information D) Descriptive statements

4. A middle range theory with a high level of abstraction is considered which of the following?

A) High-middle theory B) Middle theory C) Low-middle theory D) Grand theory

5. From which of the following are middle range theories most often developed?

A) Abstract concepts B) Metatheory C) Global viewpoints D) Nursing Practice

6. Middle range theories need to consider the nursing practice. How would this be incorporated into the theory?

A) Use only the nursing metaparadigm concepts B) Describe concepts in user-friendly style C) Develop the theory based on abstract concepts D) Provide extensive examples in the theory

7. From which of the following are middle range theories derived or developed?

A) Grand Theory B) Practice C) Interdisciplinary Theory D) Education

8. On what criteria should middle range theories be evaluated?

A) Criteria are the same for all theories.

B) Criteria developed for each individual theory.

C) Similar criteria as grand with consideration for differences.

D) Criteria used for practice theories are appropriate for middle range theory.

9. What is one of the major roles of middle range theories?

A) Defines components of nursing science.

B) Tests hypotheses in practice setting.

C) Compares theory in concepts and practice.

D) Provides general overview of nursing practice.

10. All middle range theories include which of the following?

A) Relatively concrete and specific phenomena B) Models for use in prT acEtiSceTBANKSELLER.COM C) Definitions of the nursing paradigm D) Specific application principles for practice

Answer Key 1. C 2. D 3. A 4. A 5. D 6. B 7. B 8. C 9. A 10. A

1. The categorization of middle ranges theories by the terms “high,” “middle,” and “low” refers to which of the following?

A) The number of concepts in the theory B) The ability to generalize the theory in nursing C) The degree of abstraction in the theory D) The number of research studies conducted with the theory

2. Which of the following theorists is considered to have a theory in the highmiddle range?

A) Mishel B) Kolcaba C) Reed D) Benner

3. Which of the following is not a concept included in Benner's Model of Skill Acquisition in Nursing?

A) Competence B) Clinical knowledge C) Experience D) Caring

4. What is the central purpose of the model developed by Benner in the Model of Skill Acquisition in Nursing?

A) The model demonstrates the need for nurses to conduct research.

B) The model focuses on the need for caring for clients.

C) The model seeks to describe clinical expertise including six areas of practical knowledge.

D) The model is useful in assessing a nurse only in the first year of practice.

5. Which nurse theorist focused her work on the importance of culture and health and healing?

A) Benner B) Leininger C) Pender D) Reed

6. What is one central tenet of the theory by Leininger of culture care diversity and universality theory?

A) All patients should be treated equal.

B) Respect the patient and family.

C) Optimal health is the goal.

D) Understand the individual's view of illness.

7. Which nurse theorist developed the Health Promotion Model?

A) Pender B) Reed C) Beck D) Mercer

8. What is the purpose of the Omaha System?

A) It is a classification system that promotes documentation of client care.

B) It articulates nurses' contributions, activities, and outcomes with regard to caring for critically ill patients.

C) It explains how clients cognitively process illness-related stimuli and construct meaning in these events.

D) It defines comfort within nursing practice to meet the basic human needs of relief and comfort.

9. What is the context for the synergy model?

A) Designing practice and developing competencies required to care for critically ill patients.

B) Integrating nursing and behavioral science perspectives on factors that influence health behaviors.

C) Guiding community health nursing practice and serving as a method for documentation of care and data management.

D) Explaining how clients cognitively process illness-related stimuli and construct meaning in these events.

10. The nurse theorist, Mishel, developed which theory?

A) Uncertainty of Illness Theory B) Theory of Comfort C) Theory of Unpleasant Symptoms D) Self-Transcendence Theory

11. The nurse theorist, Kolcaba, developed which theory?

A) Conceptualization of Maternal Role Attainment B) Postpartum Depression Theory C) Theory of Chronic Sorrow D) Theory of Comfort 12. Which theory has the purpose “to improve understanding of symptoms experienced in various contexts and to provide information useful for designing effective means to prevent, ameliorate, or manage unpleasant symptoms and their negative effects” ?

A) Heath Promotion Model B) Theory of Unpleasant Symptoms C) Theory of Comfort D) Theory of Chronic Sorrow

13. The context of the theory developed by Reed is used by nurses to attend to which of the following?

A) Self-transcendence in end of life issues B) Evaluation of the spiritual setting C) Individual relationships D) Caregiver strain for terminal patients

14. The purpose of the Theory of Chronic Sorrow is to analyze individuals characterized as experiencing which of the following?

A) Loss of child B) Chronic illness C) Bereavement D) All of the above

15. What is the purpose of Beck's postpartum depression theory?

A) To provide insight into the experience of postpartum depression B) To develop nursing interventions for postpartum depression C) To assess the patients at highest risk for postpartum depression D) To evaluate tools used in the screening of postpartum depression clients.

Answer Key 1. C 2. D 3. D 4. C 5. B 6. D 7. A 8. A 9. A 10. A 11. D 12. B 13. A 14. D 15. A

1. Which type of modern social exchange theory gives greater weight to society?

A) Individualistic B) Microlevel C) Personal D) Collectivist

2. Which of the following is not a theory from the social sciences?

A) Health Promotion Theory B) Exchange Theory C) General Systems Theory D) Role Theory

3. Which social science theories are founded on utilitarianism?

A) Feminist theory B) Chaos theory C) General systems theory D) Exchange theory

4. A nurse researcher is interested in lack of reciprocity in family and divorce rates.

Which theory might the researcher consider using?

A) Individualistic sociaTl eExSchTaBn A g eNKSELLER.COM B) Chaos theory C) General systems theory D) Social networks

5. Which of the following theories is not a type of exchange theory?

A) Symbolic Interactionism B) Rational Choice C) General Systems Theory D) Social Networks

6. From which philosophical framework did symbolic interactionism theory arise?

A) Pragmatism B) Utilitarianism C) Empiricism D) Phenomenology

7. Which variation of feminist theory is founded on the ideas of the Karl Marx and was exemplified by Millet?

A) Liberal feminism B) Socialist feminism C) Radical feminism D) Cultural feminism

8. Which of the following is one of the considerations in chaos theory?

A) Understanding how change occurs in systems over time B) Following the disorder of individuals lives C) Identifying the meaning of chaos by individuals D) Examining the interactions which lead to instability in society

9. Based on the writings and conflict theory of Karl Marx, which of the following is a reason for conflict in society?

A) Equal resources B) Individual pathology C) Capitalist inequality D) Democratic government

10. Which of the following isTnEoS tT coBnA siN deKreSdEaLtyLpEeRo.f cCoOnfMl i ct theory?

A) Feminist theory B) Critical social theory C) Cultural bias D) Exchange theory

What is the purpose of cultural feminism theory?

A) To explore the differences between the sexes B) To condone separatism and work toward a female-dominated community C) To focus on the political aspect of women in society D) To refute the notion of the Oedipal complex

11.

12. Which of the following theories uses societal awareness to expose social inequalities that keep people from reaching their full potential?

A) Critical social theory B) Systems theory C) Rational choice theory D) Social networks

13. Which exchange theory attempts to explain the behavioral process of both small and large social systems?

A) General systems theory B) Role theory C) Rational choice theory D) Social networks

14. A researcher conducting a study focusing on the social support of a patient undergoing chemotherapy and the outcomes of the patient might considering using which theory?

A) Feminist theory B) Chaos theory C) Symbolic interactionism D) Exchange theory

15. A researcher is conducting a study on role strain of acute care nurses in emergency departments at large urban hospitals. Which theory would be most appropriate for the researcher to use?

A) Role theory B) Chaos theory C) Systems theory D) Critical social theory

Answer Key 1. D 2. A 3. D 4. A 5. A 6. A 7. B 8. A 9. C 10. D 11. B 12. A 13. C 14. D 15. A

1. Which of the following is an appropriate focus of applied sciences?

A) Empirical testing of basic science B) Research related to application of concepts C) Application of scientific method D) Addition of knowledge to a field

2. Theories from the behavioral sciences look at which of the following?

A) Physiological development B) Physically manifested illness symptoms C) An individual's psychological response to stimuli D) A person's growth in response to environment

3. Which of the following theorists did not develop a psychodynamic theory?

A) Freud B) Erickson C) Sullivan D) Beck 4. Which theorist was considered “radical” when describing his work on human thoughts and behaviors in the early 1900s?

A) Erickson B) Freud C) Sullivan D) Skinner 5. Which system did Freud describe as focusing on the moral issues of “what is right” and “what is wrong” in his theory?

A) Id B) Ego C) Superego D) Self

6. Which developmental theorist continued his theory of human development throughout adulthood?

A) Freud B) Erickson C) Sullivan D) Skinner

7. Which theorist based his developmental theory on the premise that an individual does not and cannot exist apart from his or her relations with other people?

A) Erickson B) Ellis C) Freud D) Sullivan

8. Which nursing theorist based her nursing theory, Interpersonal Relations in Nursing, on Sullivan's theory of Interpersonal Theory of Psychiatry?

A) Watson B) Rodgers C) Peplau D) Roy

9. Which theory did Skinner develop?

A) Operant conditioning theory B) Cognitive theory C) Rational emotive theory D) Human needs theory

10. Which theorist developedTaEtS heToBryAbNaK seSdEoL nL hiEsRw.oC rkOwMith depressed patients?

A) Skinner B) Beck C) Erickson D) Ellis

11. Which theory was developed with a focus on the underlying premise that an individual has the cognitive ability to think and that he or she thinks either rationally or irrationally?

A) Cognitive theory B) Rational emotive theory C) Operant conditioning D) Human needs theory

12. Which theorist is considered the father of humanistic psychology?

A) Maslow B) Freud C) Erickson D) Skinner

13. Which of the following theories is based on a model of psychotherapy that emphasizes the uniqueness of the individual?

A) Human needs theory B) Stress, coping, adaptation theory C) Person-centered theory D) General adaptation syndrome

14. Which theory was developed by Hans Selye who defined stress as wear and tear on the body?

A) General Adaptation Syndrome B) Stress, Coping, Adaptation Theory C) Health Belief Model D) Person-Centered Theory

15. Which theorist developed the stress, coping, and adaptation theory?

A) Selye B) Rogers C) Lazarus D) Maslow

Answer Key 1. B 2. C 3. D 4. B 5. C 6. B 7. D 8. C 9. A 10. B 11. B 12. A 13. C 14. A 15. C

1. Evolution of modern germ theory is credited to which of the following scientists?

A) Pasteur B) Harvey C) MacMahon D) Pugh

2. Which of the following theories is not a theory of disease causation?

A) Germ theory B) Epidemiologic triangle C) Web of causation D) Homeostasis

3. Which disease causation theory posited that a specific organism was capable of causing an infectious disease?

A) Epidemiologic triangle B) Germ theory C) Web of causation D) Natural history of disease

4. In germ theory, for an infection to occur, the host must be susceptible to the organism. What is the term given f oTr E suSsT ceBpA tibNilKitS yE inLtL hiE sR th.eoCryO?M A) Risk B) Infection C) Threat D) Contagion

5. Which theory or model is depicted by the interrelationships among host, agent, and environment?

A) Germ theory B) Natural history of disease C) Web of causation D) Epidemiologic triangle

6. Which theory is based on the recognition that many health problems have multiple causes and there are rarely simple solutions?

A) Web of causation B) Epidemiologic triangle C) Natural history of disease D) Germ theory

7. Which theory is founded on the progression of disease and discusses the two periods of natural disease, prepathogenesis, and pathogenesis?

A) Germ theory B) Epidemiologic triangle C) Natural history of disease D) Web of causation

8. A research study that focuses on the balance of fluid and electrolytes and the importance of maintaining that balance would be based on what theory?

A) Stress and adaptation B) Homeostasis C) Web of causation D) Theory of immunity

9. Which theory was founded on the basis of dynamic equilibrium?

A) Theories of immunity and immune function B) Homeostasis C) Genetic principles D) Cancer theories

AaNltKerSC EaLnL 10. Which theory was develoTpE edSbTyBW onEaRn.d CisObMased on the body's fight or flight reaction?

A) Homeostasis B) Genetic principles C) Natural history of disease D) Stress and adaptation

11. A study conducted on the adjunct intervention, massage therapy, in children with cancer and the impact on the immune system response would be based on which theory?

A) Web of causation B) Stress and adaptation C) Theory of immunity D) Homeostasis

12. A study conducted on the risk factors of specific birth defects born to parents with identified genetic markers would use which theory?

A) Web of causation B) Epidemiologic triangle C) Genetic principles and theory D) Theory of immunity

13. Theories of cancer development suggest that cancer arises from which of the following?

A) Cancer arises from genetic errors causing abnormal cells to be present at birth.

B) Cancer arises from changes in one abnormal cell and chemical irritants.

C) Cancer arises from a single exposure to an agent.

D) Cancer arises from multiple factors including lifestyle.

14. A nurse is conducting a research study on the use of oral sucrose prior to immunization for pain management. Which theory would be used?

A) Gate-control theory B) Immune function C) Stress and adaptation D) Homeostasis

Answer Key 1. A 2. D 3. B 4. A 5. D 6. A 7. C 8. B 9. B 10. D 11. C 12. C 13. D 14. A

1. The Great Man theory approach to defining leadership is considered which type of theory?

A) Trait theory B) Emotional intelligence C) Behavioral theory D) Leader-member exchange theory

2. Which theory identified self-awareness as a foundational trait of leaders?

A) Trait theory B) Emotional intelligence C) Behavioral theory D) Leader-member exchange theory

3. Which theory seeks to explain the specific actions taken by a leader?

A) Trait theory B) Emotional intelligence C) Behavioral theory D) Leader-member exchange theory 4. Which theory includes the idea of “in-groups” and “out-groups” of individual relationships between leaTdeErS s aTnBdAsuNbKoS rdEinLaL teE s?R.COM A) Trait theory B) Emotional intelligence C) Behavioral theory D) Leader-member exchange theory

5. Which theory expanded on behavioral theories of leadership by focusing on factors that enhance worker/employee satisfaction and identifying factors that have a negative impact on those factors?

A) Motivational theory B) Contingency theory C) Charismatic leadership D) Transactional and transformational leadership

6. Which theories began to include the idea of situation influence on leadership and management?

A) Motivational theories B) Contingency theories on leadership C) Charismatic leadership D) Transactional and transformational leadership

7. Which leadership theory includes adjustment of leadership style dependent upon the maturity level of the employee?

A) Situational leadership theory B) Charismatic leadership C) Transactional and transformational leadership D) Visionary leadership

8. Which contemporary leadership theory is based on two types of leaders in management; leaders who are visionary and leaders who are concerned with day-today operations?

A) Situational leadership theory B) Charismatic leadership C) Transactional and transformational leadership D) Visionary leadership

9. Which of the following is an extenuation of attribution theory that views leaders as strong agents for change with behavioral characteristics that are unconventional and out of the ordinary?

A) Situational leadership theory B) Charismatic leadership C) Transactional and transformational leadership D) Visionary leadership

10. Which leadership theory is based on the idea that leaders convey new values by example and providing clear communication of their vision?

A) Situational leadership theory B) Charismatic leadership C) Transactional and transformational leadership D) Visionary leadership

11. Which organizational management theory evolved based on the theorist idea of inefficiencies in the worker's techniques?

A) Scientific management B) Theory of bureaucracy/organizational theory C) Classic management theory D) Expectancy theory

12. Which motivation theory is expressed as a mathematical statement: performance = ability X motivation?

A) Achievement-motivation theory B) Expectancy theory C) Management theory D) Equity theory

13. Which theory or model is based on the primary assumption of economic rationality and has ties to economic theory?

A) The rational decision-making model B) Problem-solving process C) Group decision making D) Organizational quantitative decision making

14. Which of the following is not a characteristic of a conflict situation in conflict management?

A) Two or more parties involved B) Strong emotions and behavior C) No power involved D) Mutually exclusive needs

15. Deming and Juran are known for which movement in the world?

A) Quality B) Conflict C) Scientific D) Leadership

Answer Key 1. A 2. B 3. C 4. D 5. A 6. B 7. A 8. C 9. B 10. D 11. A 12. B 13. A 14. C 15. A

1. Which of the following is not a way to define learning?

A) Change in behavior B) Change in mental functioning C) Change in emotional functioning D) Change in meaning of information

2. Which type of learning occurs in a skills lab when students are practicing administration of intramuscular injections on mannequins?

A) Cognitive B) Affective C) Psychomotor D) Effective

3. Which behavioral learning theorist was the first to attempt scientific studies to understand the learning process?

A) Thorndike B) Pavlov C) Skinner D) Hull

4. Which behavioral theorisTt E isSasTsB ocAiaNteKdSwEitLhLcE laR ss.icC alOcMonditioning?

A) Hull B) Thorndike C) Pavlov D) Skinner

5. Which of the following is not considered part of the foundation for learning in cognitive learning theories?

A) External motivation B) Personal feelings C) Learner's goals D) Ability to process information

6. Which cognitive learning theory is founded on the idea of fields which are patterned and organized and the whole is greater than the sum of the parts?

A) Cognitive-field theories B) Information processing models C) Cognitive development theories D) Psychodynamic theories

7. Which stage was not one of the ones noted by Piaget in his cognitive development theory?

A) Sensorimotor B) Preoperational C) Formal operational D) Informal operational

8. Which developmental learning theorist believed learning required different conditions for success and classified learning into five different stages?

A) Gagne B) Perry C) Bandura D) Piaget

9. Which theorist developed the social learning theory based on reciprocal determinism?

A) Gagne B) Bandura C) Perry D) Piaget

KoSrE .uCnO 10. Which learning theory, bT asEedSoTnBtA heNw kL ofLSEigRm dM Freud, includes motivation as part of the superego and is abstract in nature?

A) Humanistic learning theory B) Social learning theory C) Psychodynamic learning theory D) Developmental learning theory

11. Which learning theory believes learners have positive experiences and positive learning from emotions and wants learners to have interpersonal relationships to improve learning?

A) Social learning theory B) Humanistic learning theory C) Psychodynamic learning theory D) Developmental learning theory

12. Which learning theory is founded on the idea that knowledge has no existence outside of the individual's mind?

A) Constructivism theory B) Cognitive learning theory C) Humanistic learning theory D) Psychodynamic learning theory

13. Who is credited with adult learning and the term andragogy?

A) Piaget B) Bandura C) Knowles D) Perry 14. What type of learner might make the following comment: “I hear what you are saying?”

A) Tactual B) Kinesthetic C) Auditory D) Visual

15. Which of the following is not an appropriate consideration under the principles of learning?

A) Provide feedback at the conclusion of the learning event.

B) Assess learner's readiness for learning.

C) Consider the method and needs of the learner for style of learning.

D) Individualize information for best facilitation.

Answer Key 1. D 2. C 3. A 4. C 5. A 6. A 7. D 8. A 9. B 10. C 11. B 12. A 13. C 14. C 15. A

1. How is nursing theory used in nursing practice?

A) Provides nurses with perspective to organize care B) Assists in directing and analyzing care C) To plan and implement care D) All of the above

2. What is the relationship between nursing theory and practice?

A) Reciprocal between theory and practice B) Practice always comes before theory C) Research is driven by practice D) Practice should be focused on validation of research

3. Which of the following is not included in the development of evidence-based practice guidelines and protocols in nursing?

A) Evidence in literature B) Current practice C) Research knowledge D) Personal preference 4. Which of the following would describe nursing practice without theory?

A) Rote performance oT f tEasSkTBANKSELLER.COM B) Informed clinical paths based on evidence C) Updated and current assessment techniques D) Cultural considerations in patient care

5. The nurse who implements use of nursing theory in practice will be able to do which of the following?

A) Describe patient care B) Discuss patient outcomes C) Control nursing events D) All of the above

6. The evolution of nursing theory has continued over the past several decades.

Which of the following is still a commonly held belief related to theory and nursing practice?

A) There is a “gap” between theory and practice.

B) Theory is an integrated part of all nursing practice.

C) All nursing practice supports theory use.

D) Research is integrated into the design of all levels of nursing.

7. Which of the following is a suggested reason for the theory-practice gap in nursing?

A) There are two types of nurses - those who “practice” and those who “teach” B) Use of theory is limited due to current standards C) Theory supports current practice and protocol D) Publication of research in clinical journals

8. Which of the following is one reason that nurses lack knowledge of theory?

A) Current exposure in publications B) Multiple entries into practice levels C) Limited use of theory in practice D) Lack of support by nursing organizations for use of theory

9. Which of the following would support closure of the theory-practice nursing gap?

A) Reciprocal interaction between theory and practice B) Only using practice theory in practice C) Development of research based on theory D) Use of grand theories only in nursing

10. Which of the following is not considered a benefit of practice theories?

A) Development of nursing interventions B) Provide guidance f oTr E coSmTmBuAnN icK atS ioE n LLER.COM C) Lead performance of psychomotor procedures D) Development of grand theories

11. Where do practice theories often emerge from in nursing?

A) Grounded theory research B) Practice of all healthcare C) Grand theories D) Macrotheories

12. Which of the following is not true regarding evidence-based practice?

A) Evidence-based practice is the same as research.

B) It may assist in filling the theory-practice gap.

C) It provides methods for providing the best practice methods.

D) It is founded on information and research.

Answer Key 1. D 2. A 3. D 4. A 5. D 6. A 7. A 8. B 9. A 10. D 11. A 12. A

1. Who is considered the first nurse theorist to publish integration of research and theory?

A) Roy B) Nightingale C) Henderson D) Peplau

2. In what time frame was the initial publication of Nursing Research?

A) 1940s B) 1950s C) 1960s D) 1970s

3. Where does nursing research gain its significance?

A) Use in practice setting B) The context in which it is placed C) Application of research to various models D) Integration theory in education

4. Which of the following is not a given reason for the lag in knowledge development in nursing?

A) Limited theoretical bTaE seStT oBgA uiN deKpSrE acLtiL ceER.COM B) Studies not tied to theory or placed in theoretical context C) Poor efforts to link theory and data in research D) Lack of available study ideas

5. Which one of the following is not considered to be a reason that research is conducted?

A) Describe variables B) Explain variables C) Predict variables D) Prove variables

6. Which of the following is not one of the steps in the research process?

A) Identify the problem for study B) Develop a plan for data collection C) Define the population sample to be studied D) State proof of the research question or hypothesis

7. Which of the following is not considered part of the framework for use of theory in research?

A) Provide direction of study B) Selection of research design C) Identify the measurement approach D) Specify the population for study

8. Which type of theory and research would be used in a study observing a mother's care of a newborn after delivery from a Cesarean section birth with a goal to explore the phenomenon of the first-time mother?

A) Descriptive theory/Descriptive research B) Explanatory theory/Correlational research C) Predictive theory/Experimental research D) Explanatory theory/Experimental research

9. A study designed to explore the relationships between positive health practices during the period of adolescence is which of the following?

A) Descriptive theory/Descriptive research B) Explanatory theory/Correlational research C) Predictive theory/Experimental research D) Explanatory theory/Experimental research

10. A study which uses a controlled design to evaluate the effectiveness of a specific educational intervention is which type of study?

A) Descriptive theory/Descriptive research B) Explanatory theory/Correlational research C) Predictive theory/Experimental research D) Explanatory theory/Experimental research

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Answer Key 1. B 2. B 3. B 4. D 5. D 6. D 7. D 8. A 9. B 10. C

1. Which of the following is not a part of the formal framework in the management processes?

A) Provision of chain of command B) System of communication C) Method for organizational work completion D) Identification of specific dates for progression in management

2. A nurse working in the role of a cardiac clinical nurse specialist (CNS) is an example of what element of organizational design and structure?

A) Work specialization B) Chain of command C) Span of control D) Authority and responsibility

3. An RN working in the ICU is responsible to report to the charge nurse for the shift.

The charge nurse is responsible to report to the nurse manager of the ICU. This is an example of what element of organizational design?

A) Work specialization B) Chain of command C) Span of control D) Authority and responsibility

4. A hospital with unit based decision making by a committee of staff nurses describes what element of organizational design?

A) Departmentalization B) Centralization versus decentralization C) Authority and responsibility D) Chain of command

5. In shared governance, which model is based on utilization of councils and subcommittees?

A) Administrative model B) Congressional model C) Councilor model D) Shared model

6. Which of the following is not considered one of the strategies of transformational leadership?

A) Developed vision by leadership through hierarchy B) Building a social architecture for organizational identity C) Developing and sustaining organizational trust D) Attending to self-esteem of other

7. Which of the following is the patient care delivery model that emphasizes care at the bedside and is derived from total quality management/continuous quality improvement?

A) Patient-focused/Patient-centered care B) Primary nursing C) Team nursing D) Total patient care

8. Which type of patient care delivery model implements care by a professional nurse as a leader of a group of workers who is responsible for the care of a group of patients?

A) Patient-focused/Patient-centered care B) Primary nursing C) Team nursing D) Total patient care

9. Which of the following nursing organizations was responsible for development of The Magnet Recognition Program?

A) National League of Nursing B) American Academy of Nursing C) American Nurses Credentialing Center D) American Nurses Association

10. Which degree is the recommended minimal educational requirement for a case manager?

A) Associate degree nurse B) Baccalaureate degree nurse C) Master degree nurse D) Doctorate in nursing practice

11. Which of the following is not one of the core components to a clinical pathway?

A) Care focused on an acute event B) Time management C) Interdisciplinary interventions D) Expected patient outcomes

12. Which of the following is not one of the key elements in quality management?

A) Focus is on the system B) Process improvement C) Variance analysis D) Employee involvement

Answer Key 1. D 2. A 3. B 4. B 5. C 6. A 7. A 8. C 9. C 10. B 11. A 12. A

1. Which of the following is not part of the formal curricula in nursing education and is not tied to the framework of the program?

A) Clinical competencies B) Course objectives C) Course outlines D) Clinical agencies

2. What is the first step in the Tyler Curriculum Development Model?

A) Identify the educational purpose/objectives B) Define experiences of students C) Develop the mission of a program D) Plan courses

3. Which governing body is responsible for setting the required number of hours to be included in a nursing program?

A) National League for Nursing Accrediting Committee B) American Association of Colleges of Nursing C) State Boards of Nursing D) Commission on Collegiate Nursing Education

4. In what timeframe did t h T eE NS atT ioB naAlNLK eaSgE ueLoLfENRu.rsC inOgM(NLN) complete the first accreditation visits?

A) 1920s B) 1930s C) 1940s D) 1950s

5. When a program is designing the conceptual framework, what is the basis for the framework?

A) Metaparadigm of nursing B) School's philosophy C) Faculty design from current trends D) Outcomes and course plans

6. Which of the following is not noted as a reason for curriculum change in nursing education?

A) Change in healthcare delivery B) Increase in critical thinking C) Evolution of technology D) Faculty preference for content

7. Rote lecture of material to a class of nursing students prior to use of the information is considered what content category of education?

A) Cognitive content B) Psychomotor content C) Application of content D) Development of content

8. Nursing students are learning to perform insertion of intravenous lines. What is this type of content category in nursing education?

A) Cognitive content B) Psychomotor content C) Application of content D) Development of content

9. A group of students are integrating the information they have learned in class and using the information in the clinical setting when working with patients. What is this content considered in nursing education?

A) Cognitive content B) Psychomotor content C) Application of content D) Development of conTteEnS t TBANKSELLER.COM 10. Faculty who use interactive case studies as a theory for development of course learning are using what type of learning strategy?

A) Operational teaching B) Problem-based learning C) Dialectic learning D) Logistic teaching

11. Faculty who use sequential and planned mastery of content theory for design of a course are using which type of learning strategy?

A) Operational teaching B) Problem-based learning C) Dialectic learning D) Logistic teaching

12. Faculty who are responsible for the design and implementation of technologybased curriculum are directly responsible for all of the following except one. For which one are faculty not responsible in distance education?

A) Design of course B) Delivery method of information C) Facilitation of support system D) Hardware selection by student

Answer Key 1. D 2. A 3. C 4. B 5. B 6. D 7. A 8. B 9. C 10. B 11. D 12. D

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Nursing Theoretical Works represents The most comprehensive ideas and systematic knowledge about nursing; Therefore theory is vital to both the discipline and the profession.

Discipline is specific to academia and a branch of education, a department of learning or field of knowledge.

Profession refers to specialized field of practice, which is founded upon the theoretical structure of the science or knowledge of that discipline and the accompanying practice abilities.

Significance of theory for nursing as a discipline 1.

University baccalaureate programs proliferated, masters programs in nursing were developed, and the curricula began to be standardized through the accreditation process.

2.

Attention to the importance of nursing conceptualizations for the research process and the role of a conceptual framework in the purpose and design of research production of science and nursing theoretical works also began to publish.

3.

Works began to be recognize for their theoretical nature, such as Henderson, Nightingale and

etc.

4.

Keynote Address, New nursing doctoral programs were beginning to open and they reopened the discussion of the nature of nursing science. This becomes the first classic reference for nursing as discipline and for distinguishing between the discipline and profession.

5.

Fawcett’s conceptualization of metaparadigm of nursing and unifying conceptual-theoretical structure of knowledge recognize works of major nursing theorist as conceptual framework and paradigms of nursing.

6.

MAJOR SIGNIFICANCE IS;THE DISCIPLINE IS DEPENDENT UPON THEORY

6.1. Theoretical works have taken nursing to a higher level.

6.2. The emphasis has shifted from a focus on knowledge about how nurses function, which concentrated on the nursing process, to focus on what nurses know and how they use knowledge to guide their thinking and decision making while concentrating on the patient.

Significance of theory for nursing as a profession Clearly, nursing is recognize as a profession today.

1.

Bixler and Bixler published a set of criteria tailored to nursing in the American Journal of Nursing in 1959. They stated that a profession:

a.

Utilizes in its practice a well-defined and well-organized body of specialized knowledge that is on the intellectual level of the higher learning.

b.

Constantly enlarges the body of knowledge it uses and improves its techniques of education and service by the use of the scientific method.

c.

Entrusts the education of its practitioners to institution of higher education.

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d.

Applies its body of knowledge in practical services that are vital to human and social welfare.

e.

Functions autonomously in the formulation of professional policy and in the control of professional activity thereby.

f.

Attracts individuals of intellectual and personal qualities who exalt service above personal gain and who recognizes their chosen occupation as a life work.

g.

Strives to compensate its practitioners by providing freedom of action, opportunity for continuous professional growth and economic security.

These criteria have historical value because they provide an understanding of the developmental path the nursing followed.

2.

Nursing theory is a useful tool for reasoning, critical thinking, and decision making in nursing

practice.

3.

Nursing theoretical works provide a perspective of the patient.

4.

Nursing theory provides more direction for nursing practice.

5.

The conceptual models of nursing are comprehensive and the reader to the specifics of the

practice.

6.

Middle range theories contain the specifics of nursing practice.

NURSING THEORETICAL WORKS; Philosophies

·

Florence Nightingale: Patient-Environment Interaction

·

Ernestine Wiedenbach: Art of Nursing

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Virginia Henderson: The 14 Basic Human Needs

·

Faye Glenn Abdella: The 21 Nursing Problems

·

Lydia E. Hall: Care, Core and Cure Theory Conceptual Models and Grand Theories

·

Dorothea E. Orem: Self-care Deficit Theory

·

Myra Estrin Levine: Wrote the “Introduction to Clinical Nursing”

·

Martha Rogers: Key Concepts of Science of Unitary Human Being, and Principles of Hemodynamic

· ·

Dorothy E. Johnson: Behavioral System Model

·

Betty Neuman: Neumans System Model

·

Imogene King: Goal Attainment Theory Theories and Middle-Range Nursing Theories

Sister Callista Roy: Adaptation Model

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·

Hildegard E. Peplau: Interpersonal Relation in Nursing

·

Ida Jean Orlando: Dynamic-Nurse Relationship

·

Joyce Travelbee: Human to Human Relationship and ETC

INTRODUCTION-Nursing theory is the term given to the body of knowledge that is used to support nursing practice.

Nursing theory is a framework designed to organize knowledge and explain phenomena in nursing, at a more concrete and specific level.

A nursing theory is a set of concepts, definitions, relationships, and assumptions or propositions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining, predicting, and or prescribing.

Each discipline has a unique focus for knowledge development that directs its inquiry and distinguishes it from other fields of study. (Smith & Liehr, 2008).

Theory-guided, evidence-based practice is the hallmark of any professional discipline.

Nursing is a professional discipline (Donaldson & Crowley, 1978).

Almost 90% of all Nursing theories are generated in the last 20 years.

Nursing models are conceptual models, constructed of theories and concepts A paradigm is a model that explains the linkages of science, philosophy, and theory accepted and applied by the discipline.

METAPARADIGMS IN NURSING Person Recipient of care, including physical, spiritual, psychological, and sociocultural components.

Individual, family, or community Environment All internal and external conditions, circumstances, and influences affecting the person Health Degree of wellness or illness experienced by the person Nursing

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Actions, characteristics and attributes of person giving care. COMPONENTS OF A THEORY DEFINITIONS Theory: a set of related statements that describes or explains phenomena in a systematic way. the doctrine or the principles underlying an art as distinguished from the practice of that particular art. a formulated hypothesis or, loosely speaking, any hypothesis or opinion not based upon actual knowledge. A provisional statement or set of explanatory propositions that purports to account for or characterize some phenomenon.

Concept: a mental idea of a phenomenon Concepts are the building blocks (the primary elements) of a theory. Construct a phenomena that cannot be observed and must be inferred Constructs are concepts developed or adopted for use in a particular theory. The key concepts of a given theory are its constructs.

Proposition: a statement of relationship between concepts Conceptual model: made up of concepts and propositions They represent ways of thinking about a problem or ways of representing how complex things work the way that they do.

Different Frameworks will emphasize different variables and outcomes and their interrelatedness.( Bordage, 2009) Models may draw on a number of theories to help understand a particular problem in a certain setting or context. They are not always as specified as theory.

Variables : Variables are the operational forms of constructs. They define the way a construct is to be measured in a specific situation.

Match variables to constructs when identifying what needs to be assessed during evaluation of a theory-driven program.

Middle range theory: a testable theory that contains a limited number of variables, and is limited in scope as well, yet is of sufficient generality to be useful with a variety of clinical research questions.

NURSING PHILOSOPHIES Florence Nightingale’s Legacy of caring: Focuses on nursing and the patient environment relationship.

Ernestine Wiedenbach: The helping art of clinical nursing Helping process meets needs through the art of individualizing care.

Nurses should identify patients ‘need-for –help’ by: Observation Understanding client behaviour Identifying cause of discomfort

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Determining if clients can resolve problems or have a need for help Virginia Henderson’s Definition of Nursing:Patients require help towards achieving independence. Derived a definition of nursing Identified 14 basic human needs on which nursing care is based. Faye G.Abedellah’s Typology of twenty one Nursing problems-Patient’s problems determine nursing care Lydia E. Hall :Care, Cure, Core model:Nursing care is person directed towards self love. Jean Watson’s Philosophy and Science of caring: Caring is a universal, social phenomenon that is only effective when practiced interpersonally considering humanistic aspects and caring.

Caring is central to the essence of nursing. Patricia Benner’s Novice to Expert Described systematically five stages of skill acquisition in nursing practice – novice, advanced beginner, competent, proficient and expert.

CONCEPTUAL MODELS AND GRAND THEORIES Dorothea E. Orem’s Self care deficit theory in nursing-Self–care maintains wholeness. Three Theories: Theory of Self-Care Theory of Self-Care Deficit Theory of Nursing Systems Nursing Care: Wholly compensatory (doing for the patient) Partly compensatory (helping the patient do for himself or herself) Supportive- educative (Helping patient to learn self care and emphasizing on the importance of nurses’ role Myra Estrin Levine’s: The conservation model Proposed that the nurses use the principles of conservation of: Client Energy Personal integrity Structural integrity Social integrity A conceptual model with three nursing theories – Conservation Redundancy Therapeutic intention Martha E.Roger’s: Science of unitary human beings Person and environment are energy fields that evolve negentropically Nursing is a basic scientific discipline Nursing is using knowledge for human betterment.

The unique focus of nursing is on the unitary or irreducible human being and the environment (both are energy fields) rather than health and illness

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Dorothy E.Johnson’s Behavioural system model Individuals maintain stability and balance through adjustments and adaptation to the forces that impinges them.

Individual as a behavioural system is composed of seven subsystems: the subsystems of attachment, or the affiliative, dependency, achievement, aggressive, ingestive-eliminative and sexual.

Disturbances in these causes nursing problems. Sister Callista: Roy‘s Adaptation model Stimuli disrupt an adaptive system The individual is a biopsychosocial adaptive system within an environment.

The individual and the environment provide three classes of stimuli-the focal, residual and contextual.

Through two adaptive mechanisms, regulator and cognator, an individual demonstrates adaptive responses or ineffective responses requiring nursing interventions Betty Neuman’s : Health care systems model Neuman’s model includes intrapersonal, interpersonal and extrapersonal stressors.

Nursing is concerned with the whole person.

Nursing actions (Primary, Secondary, and Tertiary levels of prevention) focuses on the variables affecting the client’s response to stressors.

Imogene King’s Goal attainment theory Transactions provide a frame of reference toward goal setting.

Major concepts (interaction, perception, communication, transaction, role, stress, growth and development) Perceptions, Judgments and actions of the patient and the nurse lead to reaction, interaction, and transaction (process of nursing).

Nancy Roper, WW.Logan and A.J.Tierney-A model for nursing based on a model of living Individuality in living.

A conceptual model of nursing from which theory of goal attainment is derived.

Living is an amalgam of activities of living (ALs).

Most individuals experience significant life events which can affect ALs causing actual and potential problems.

This affects dependence – independence continuum which is bi- directional.

Nursing helps to maintain the individuality of person by preventing potential problems, solving actual problems and helping to cope.

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Hildegard E. Peplau: Psychodynamic Nursing Theory Interpersonal process is maturing force for personality.

Stressed the importance of nurses’ ability to understand own behaviour to help others identify perceived difficulties.

The four phases of nurse-patient relationships are:

1. Orientation 2. Identification 3. Exploitations 4. Resolution The six nursing roles are:

1. Stranger 2. Resource person 3. Teacher 4. Leader 5. Surrogate 6. Counselor Interpersonal process alleviates distress. Ida Jean Orlando’s Nursing Process Theory Nurses must stay connected to patients and assure that patients get what they need, focused on patient’s verbal and non verbal expressions of need and nurse’s reactions to patient’s behaviour to alleviate distress.

Elements of nursing situation: Patient -Nurse reactions Nursing actions Joyce Travelbee’s Human To Human Relationship Model Therapeutic human relationships.

Nursing is accomplished through human to human relationships that began with the original encounter and then progressed through stages of emerging identities.

Kathryn E. Barnard’s Parent Child Interaction Model Growth and development of children and mother–infant relationships Individual characteristics of each member influence the parent– infant system and adaptive behaviour modifies those characteristics to meet the needs of the system.

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Ramona T.Mercer’s :Maternal Role Attainment A complex theory to explain the factors impacting the development of maternal role over time.

Katharine Kolcaba’s Theory of comfort Comfort is desirable holistic outcome of care.

Health care needs are needs (physical, psycho spiritual, social and environmental needs) for comfort, arising from stressful health care situations that cannot be met by recipients’ traditional support system.

Comfort measures include those nursing interventions designed to address the specific comfort needs.

Madeleine Leininger’s Transcultural nursing, culture-care theory Caring is universal and varies transculturally.

Major concepts include care, caring, culture, cultural values and cultural variations Caring serves to ameliorate or improve human conditions and life base.

Care is the essence and the dominant, distinctive and unifying feature of nursing

Rosemarie Rizzo Parse’s :Theory of human becoming Indivisible beings and environment co-create health.

A theory of nursing derived from Roger’s conceptual model.

Clients are open, mutual and in constant interaction with environment.

The nurse assists the client in interaction with the environment and co creating health Nola J.Pender’s :The Health promotion; model

Promoting optimum health supersedes disease prevention.

Identifies cognitive, perceptual factors in clients which are modified by demographical and biological characteristics, interpersonal influences, situational and behavioural factors that help predict in health promoting behaviour CONCLUSION The conceptual and theoretical nursing models help to provide knowledge to improve practice, guide research and curriculum and identify the goals of nursing practice.

Nursing knowledge is the inclusive total of the philosophies, theories, research, and practice wisdom of the discipline.As a professional discipline this knowledge is important for guiding practice.(Smith & Liehr, 2008).

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REFERENCES Donaldson, S. K., & Crowley, D. M. (1978). The discipline of nursing. Nursing Outlook, 26, 113–120.

Smith, M. J., & Liehr, P. R. (2008). Middle range theory for nursing. New York: Springer Publishing.

George B. Julia , Nursing Theories- The base for professional Nursing Practice, 3rd ed. Norwalk, Appleton & Lange.

Wills M.Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott Williams& wilkins.

Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed. Philadelphia, Lippincott.

Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philadelphia, Lippincott.

Potter A Patricia, Perry G Anne (1992) Fundamentals Of Nursing – Concepts Process & Practice 3rd ed. London Mosby Year Book.

Tomey AM, Alligood. MR. Nursing theorists and their work. (5th ed.). Mosby, Philadelphia, 2002 Alligood M.R, Tomey. A.M. Nursing theory utilization and application. 2nd Ed. Mosby, Philadelphia, 2002.

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The Parts of a Nursing Model All nursing theories or models have several essential parts. In order to be considered a valid nursing theory, a model must include a method of assessment to determine a patient's individual needs, and a method of implementing and measuring appropriate patient care. Most nursing models can be used to produce a care plan that will document a patient's treatment by all the healthcare professionals and workers who come into contact with him or her. The care plan should be flexible, so that it can be changed and evaluated daily as the patient's needs and abilities change.

The care plans themselves will be shaped by the theories behind the nursing model. Care plans fall roughly into five categories: metatheories, grand theories, mid-range theories, min-theories and micro theories, in order from the range of factors considered.

A Brief History of Nursing Theories Originally, the role of the nurse was to carry out the orders of a physician. Nursing theories that arose from this model of patient care were essentially biomedical and focused on treating diseases rather than patients. These theories allowed little variation in care based on a patient's individual needs and abilities. The biomedical theories of nursing assume that all patients with the same illness have the same problems and require the same care. These theories do not take into account differences in patient knowledge and abilities due to socioeconomic, psychological or cultural differences.

Social models of nursing, by contrast, consider the patient from varying degrees of holistic viewpoints.

They take into account differences among patients due to culture, economic and social status and other factors. One of the first nursing theorists, though her work is only considered a body of 'nursing theory" in retrospect, was Florence Nightingale, who published her thoughts on nursing during the Crimean War in, Notes on Nursing: What it Is and What it Is Not, in 1859.

Nightingale's beliefs about nursing have influenced the shape of the profession for well over 150 years.

She was the first to view the nurse as more than a servant carrying out the orders of a physician, but rather as a caregiver in her own right, who could manipulate the environment and situation to influence the patient's well-being. Since then, there have been many models of nursing proposed and accepted by various communities and types of nursing. The most familiar names in nursing theory include Madeleine Leininger, who brought concerns of recognizing cultural needs into nursing care, and Hildegard Peplau, who introduced the idea of nursing roles and the nurse- client relationship as major influences in quality of nursing care.

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Using Nursing Theory in the Real World As a student nurse, you will be expected to learn about and be able to describe various bodies of work and knowledge about nursing and nursing theories.

Some programs may require you to develop and articulate your own nursing theory to help you formulate nursing care and nursing plans, and differentiate yourself as a nursing professional. In the real world, however, you will often find that different fields of nursing subscribe to specific theories of nursing.

While there is a great deal of semantic debate about whether the abundance of "nursing theory" is beneficial to the profession or splits it needlessly, there is no doubt that the study of nursing theory can help you understand nursing as a profession from multiple viewpoints, and can afford you the capability to begin to formulate your own concept of what it means to be a nurse, and how your actions fit into a full plan to best care for your patients

2. History and philosophy of science “Why should nurses be interested in the history and philosophy of science? The history and philosophy of science is important as a foundation for exploring whether scientific results are actually truth. As nurses our practice should be based upon truth and we need the ability to interpret the results of science. Nursing science provides us with knowledge to describe, explain and predict outcomes.

The legitimacy of any profession is built on its ability to generate and apply theory.”

(McCrae, 2011, p. 222) Modern science was established over 400 years ago as an intellectual activity to formalize given phenomena of interest in an attempt to describe, explain, predict, or control states of affairs in nature. Scientific activity has persisted because it has improved quality of life and has satisfied human needs for creative work, a sense of order, and the desire to understand the unknown (Bronowski, 1979; Gale, 1979; Piaget, 1970). The development of nursing science has evolved since the 1960s as a pursuit to be understood as a scientific discipline. Being a scientific discipline means identifying nursing’s unique contribution to the care of patients, families, and communities. It means that nurses can conduct clinical and basic nursing research to establish the scientific base for the care of individuals across the life span. For example, research revealed gaps between the pain management needs of patients and the information communicated by patients and clinicians during office visits. Although many older adults have painful but not readily visible conditions (e.g., symptomatic osteoarthritis), little research has examined how the style or format of a health care practitioner’s questions influence the quality and amount of diagnostic information obtained from older adults. A recent study tested the theory that a certain type of question would elicit the most response. The theory was confirmed

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when findings supported that the open- ended questions prompted patients to provide a larger amount of diagnostically useful pain information than did the closed-ended questions (McDonald, Shea, Rose, & Fedo, 2009). While this study is one example of nursing science, advance practice nurses should be familiar with the long history of the science of nursing.

Previous author: Sue Marquis Bishop.

Historical views of the nature of science To formalize the science of nursing, basic questions must be considered, such as: What is science, knowledge, and truth? What methods produce scientific knowledge? These are philosophical questions. The term epistemology is concerned with the theory of knowledge in philosophical inquiry. The particular philosophical perspective selected to answer these questions will influence how scientists perform scientific activities, how they interpret outcomes, and even what they regard as science and knowledge (Brown, 1977). Although philosophy has been documented as an activity for 3000 years, formal science is a relatively new human pursuit (Brown, 1977; Foucault, 1973). Scientific activity has only recently become the object of investigation.

Two competing philosophical foundations of science, rationalism and empiricism, have evolved in the era of modern science with several variations. Gale (1979) labeled these alternative epistemologies as centrally concerned with the power of reason and the power of sensory experience. Gale noted similarity in the divergent views of science in the time of the classical Greeks. For example, Aristotle believed that advances in biological science would develop through systematic observation of objects and events in the natural world, whereas Pythagoras believed that knowledge of the natural world would develop from mathematical reasoning (Brown, 1977; Gale, 1979).

Nursing science has been characterized by two branching philosophies of knowledge as the discipline developed. Various terms are utilized to describe these two stances: empiricist and interpretive, mechanistic and holistic, quantitative and qualitative, and deductive and inductive forms of science.

Understanding the nature of these philosophical stances facilitates appreciation for what each form contributes to nursing knowledge.

Rationalism Rationalist epistemology (scope of knowledge) emphasizes the importance of a priori reasoning as the appropriate method for advancing knowledge. A priori reasoning utilizes deductive logic by reasoning from the cause to an effect or from a generalization to a particular instance. An example in nursing is to reason that a lack of social support (cause) will result in hospital readmission (effect). This causal reasoning is a theory until disproven. The traditional approach proceeds by explaining hospitalization with a systematic explanation (theory) of a given phenomenon (Gale, 1979). This conceptual system is analyzed by addressing the logical structure of the theory and the logical reasoning involved in its development. Theoretical assertions derived by deductive reasoning are then subjected to experimental testing to corroborate the theory.

Reynolds (1971) labeled this approach

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the theory-then-research strategy. If the research findings fail to correspond with the theoretical assertions, additional research is conducted or modifications are made in the theory and further tests are devised; otherwise, the theory is discarded in favor of an alternative explanation (Gale, 1979; Zetterberg, 1966). Popper (1962) argued that science would evolve more rapidly through the process of conjectures and refutations by devising research in an attempt to refute new ideas. For example, his point is simple; you can never prove that all individuals without social support have frequent rehospitalizations since there might be one individual that presents with no rehospitalization. A single person with no social support that does not have a readmission disproves the theory that all individuals with a lack of social support have hospital readmissions. From Popper’s perspective, “research consists of generating general hypotheses and then attempting to refute them” (Lipton, 2005, p. 1263). So the hypothesis that a lack of social support results in hospital readmission is the phenomena of interest to be refuted.

The rationalist view is most clearly evident in the work of Einstein, the theoretical physicist, who made extensive use of mathematical equations in developing his theories.

The theories Einstein constructed offered an imaginative framework, which has directed research in numerous areas (Calder, 1979). As Reynolds (1971) noted, if someone believes that science is a process of inventing descriptions of phenomena, the appropriate strategy for theory construction is the theory-then-research strategy. In Reynolds’ view, “as the continuous interplay between theory construction (invention) and testing with empirical research progresses, the theory becomes more precise and complete as a description of nature and, therefore, more useful for the goals of science” (Reynolds, 1971, p. 145).

Empiricism The empiricist view is based on the central idea that scientific knowledge can be derived only from sensory experience (i.e., seeing, feeling, hearing facts). Francis Bacon (Gale, 1979) received credit for popularizing the basis for the empiricist approach to inquiry.

Bacon believed that scientific truth was discovered through generalizing observed facts in the natural world. This approach, called the inductive method, is based on the idea that the collection of facts precedes attempts to formulate generalizations, or as Reynolds (1971) called it, the research-then-theory strategy. One of the best examples to demonstrate this form of logic in nursing has to do with formulating differential diagnoses. Formulating a differential diagnosis requires collecting the facts and then devising a list of possible theories to explain the facts.

The strict empiricist view is reflected in the work of the behaviorist Skinner. In a 1950 paper, Skinner asserted that advances in the science of psychology could be expected if scientists would focus on the collection of empirical data. He cautioned against drawing premature inferences and proposed a moratorium on theory building until further facts were collected. Skinner’s (1950) approach to theory construction was clearly inductive. His view of science and the popularity of behaviorism have been credited with influencing psychology’s shift in emphasis from the building of theories to the gathering of facts between the 1950s and 1970s ( Snelbecker, 1974). The difficulty with the inductive mode of inquiry is that the world presents an infinite number of possible observations, and, therefore, the scientist must bring ideas to his or her experiences to

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decide what to observe and what to exclude (Steiner, 1977).

In summary, deductive inquiry uses the theory-then-research approach, and inductive inquiry uses the research-then-theory approach. Both approaches are utilized in the field of nursing.

Early twentieth century views of science and theory During the first half of this century, philosophersfocused on the analysis of theory structure, whereas scientists focused on empirical research (Brown, 1977). There was minimal interest in the history of science, the nature of scientific discovery, or the similarities between the philosophical view of science and the scientific methods (Brown, 1977). Positivism, a term first used by Comte, emerged as the dominant view of modern science (Gale, 1979). Modern logical positivists believed that empirical research and logical analysis (deductive and inductive) were two approaches that would produce scientific knowledge (Brown, 1977).

The logical empiricists offered a more lenient view of logical positivism and argued that theoretical propositions (proposition affirms or denies something) must be tested through observation and experimentation (Brown, 1977). This perspective is rooted in the idea that empirical facts exist independently of theories and offer the only basis for objectivity in science (Brown, 1977). In this view, objective truth exists independently of the researcher, and the task of science is to discover it, which is an inductive method ( Gale, 1979). This view of science is often presented in research method courses as: “The scientist first sets up an experiment; observes what occurs …. reaches a preliminary hypothesis to describe the occurrence; runs further experiments to test the hypothesis [and] finally corrects or modifies the hypothesis in light of the results” (Gale, 1979, p. 13).

The increasing use of computers, which permit the analysis of large data sets, may have contributed to the acceptance of the positivist approach to modern science (Snelbecker, 1974). However, in the 1950s, the literature began to reflect an increasing challenge to the positivist view, thereby ushering in a new view of science in the late twentieth century (Brown, 1977).

Emergent views of science and theory in the late twentieth century In the latter years of the twentieth century, several authors presented analyses challenging the positivist position, thus offering the basis for a new perspective of science (Brown, 1977; Foucault, 1973; Hanson, 1958; Kuhn, 1962; Toulmin, 1961). Foucault (1973) published his analysis of the epistemology (knowledge) of human sciences from the seventeenth to the nineteenth century. His major thesis stated that empirical knowledge was arranged in

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different patterns at a given time and in a given culture and that humans where emerging as objects of study. In The Phenomenology of the Social World, Schutz (1967) argued that scientists seeking to understand the social world could not cognitively know an external world that is independent of their own life experiences. Phenomenology, set forth by Edmund Husserl (1859 to 1938) proposed that the objectivism of science could not provide an adequate apprehension of the world (Husserl 1931, 1970). A phenomenological approach reduces observations or text to the meanings of phenomena independent of their particular context. This approach focuses on the lived meaning of experiences.

In 1977, Brown argued an intellectual revolution in philosophy that emphasized the history of science was replacing formal logic as the major analytical tool in the philosophy of science. One of the major perspectives in the new philosophy emphasized science as a process of continuing research rather than a product focused on findings. In this emergent epistemology, emphasis shifted to understanding scientific discovery and process as theories change over time.

Empiricists view phenomena objectively, collect data, and analyze it to inductively proposed theory (Brown, 1977). This position is based upon objective truth existing in the world, waiting to be discovered. Brown (1977) set forth a new epistemology challenging the empiricist view proposing that theories play a significant role in determining what the scientist observes and how it is interpreted. The following story illustrates Brown’s premise that observations are concept laden; that is, an observation is influenced by values and ideas in the mind of the observer: “An elderly patient has been in a trauma and appears to be crying. The nurse on admission observes that the patient has marks on her body and believes that she has been abused; the orthopedist has viewed an x-ray and believes that the crying patient is in pain due to a fractured femur that will not require surgery only a closed reduction; the chaplain observes the patient crying and believes the patient needs spiritual support. Each observation is concept laden.”

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