Comprehensive examination
Bowie State University
Department of Nursing
GRADUATE NURSING COMPREHENSIVE EXAM REVIEW
PART I. THEORY
ANSWER ITEMS 1 OR 2 (Choose only one item.)
1. Identify the nursing theory you have selected to guide your practice and answer the following questions:
Imogene King: Theory of Goal Attainment
a. Describe the theory in general, and explain your rationale for selecting the nursing theory.
b. Define each concept of the nursing metaparadigm according to the nursing theory you have selected.
c. Provide an example of how you would apply the theory in practice.
PART II: RESEARCH
Read the RESEARCH ARTICLE below and answer the questions for this section.
The following is a synopsis of an article in Archives of Family Medicine as presented in APN SCAN Issue 32, March 2000. The reference for the entire article is as follows:
Volk, R.J., Cass, A.R., & Spann, S. J. (1999). A randomized controlled trial of shared decision making for prostate cancer screening. Archives of Family Medicine, 8 333-340.
As the title indicates, this was a study to evaluate a patient-educational, shared decision-making approach to prostate cancer screening in asymptomatic primary care patients. Using a videotape titled, “The PSA Decision: What YOU Should Know,” the researchers hypothesized that, compared with control patients, primary care patients who viewed the videotape would demonstrate improved core knowledge regarding the epidemiology of prostate cancer, screening accuracy, treatment effectiveness, and treatment complications. The researchers hypothesized further that fewer patients would prefer prostate-specific antigen (PSA) testing after viewing the videotape, compared with control subjects.
The sample was comprised of men aged 45 through 70 years, with no history of prostate cancer, who presented for care at a family medicine center. Eligible subjects completed questionnaires on socio-demographic indicators, family history of cancer (including prostate), previous PSA testing, preference for having a PSA test, and prostate cancer knowledge at entry, and 2 weeks post-intervention. They were randomized to one (1) of three (3) study groups: videotape intervention followed by a utility assessment (n=40), videotape intervention alone (n=40), or control (n=80). The utility assessment provided an additional test of the validity of the videotape intervention and was administered to only half of the intervention subjects. This allowed the authors to evaluate the effect of the assessment. The intervention consisted of an educational videotape and an accompanying brochure on the risks and benefits of PSA testing for prostate cancer in men aged 50 Years or older and in good overall health. The control group received no intervention before their office visits. After completing the 2 week follow-up assessment, control subjects were mailed an educational brochure on prostate-specific antigen testing.
Results showed no significant differences between the intervention and control groups at baseline. Thirteen percent (13%) of the control group and 17% of the intervention group had a family history of prostate cancer; more than one third indicated having had a previous PSA test; and about 1 in 5 men were not sure about previous testing. Subjects in both groups answered slightly fewer than 3 to 10 knowledge questions correctly at entry. At the 2 week follow-up, the intervention group showed a 78% improvement (p=.001) in the prostate cancer knowledge scores. Change in knowledge for the control group was not significantly improved. Post-intervention evaluation found that 48 of the 78 intervention subjects planned to have a PSA test, compared to 64 of 80 control subjects. Overall evaluation of the videotape intervention showed that the majority (80%) of subjects believed the amount of information was appropriate, the length of the tape was about right, the presentation was balanced, and the issues were presented clearly. The authors discuss study limitations and strengths and conclude that patient education about prostate cancer can lead to informed decision making.
a. State the purpose of this research study.
b. Critique the purpose of this research study.
c. Identify the research design.
d. Explain how this study fits the criteria to be identified as that research design.
e. Identify the type of sample. Explain why it is that type of sample.
f. Discuss the strengths and weaknesses of the sample in this study.
g. Redesign the sample using a more representative sample. Explain exactly how to obtain the new sample.
h. Describe specifically how you would determine the sample size.
i. Explain reliability and validity of research instruments.
j. Cite several examples of how to determine reliability and several examples of how to determine validity of research instruments.
k. Analyze limitations of this study.
l. Explain application of findings to clinical practice to facilitate client wellness.
PART III: FAMILY NURSE PRACTITIONER ROLE
SECTION 1: ANSWER ITEMS A – H:
Column A :
Select one of the following types of clients:
Column B:
Describe a common health problem impacting one of the selected clients from Column A. You may choose one of the following common health problems, or choose one of your own.
Older Adult Client
Constipation ,
SECTION 1: ANSWER ITEMS A – H:
(To answer the following items, you may use a case study format or provide a general discussion of how you would manage the selected health problem.)
Chosen topic- Older adult client (constipation)
A. Describe the selected common health problem impacting clients selected from Column A.
B. Explain the model or theory you would use to implement the plan of care for this client.
C. Discuss the parameters of the health assessment for this client.
D. Describe the diagnostic and lab tests required for this condition, and provide an interpretation of the results.
E. Describe the other areas of assessment as indicated by the selected model.
F. Identify one common medical and nursing diagnosis associated with this health problem.
G. Design a comprehensive management plan for the selected client.
H. Describe how you would evaluate the outcomes of the interventions.
SECTION 2: ANSWER ONE OF THE THREE ITEMS IN THIS SECTION
2. The role of the Family Nurse Practitioner (FNP) has similarities and differences from that of other primary care providers. Answer the following:
a. Explain the concept of primary care as a system of health care in the U.S.
b. Describe the role of the FNP in primary care.
c. Compare the role of the physician with that of the FNP in primary care.
d. Compare the role of the FNP with that of other advanced practice nurses in primary care.
e. Discuss how the FNP collaborates with other health care providers in primary care.
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