A teenager who has just come in for her prenatal visit appears to be about 6 months pregnant. What are the most typical reasons that a teenage girl might wait so long to come in for prenatal care? Select all that apply.

Correct Answer: A

Rationale: The correct answer is A: Her friends were suggesting ways to make the problem go away. This is the most typical reason for a teenager to delay prenatal care because peer influence can lead to denial or avoidance of the pregnancy. The other choices are incorrect: B: She knew she could not be pregnant because her boyfriend said he used a condom - This is not a common reason as relying solely on a partner's claim is risky. C: She was afraid her parents would pressure her to terminate the pregnancy - While this could be a reason, it is not as common as peer influence. D: She kept hoping the pregnancy would just go away - This is an unrealistic expectation and not a common reason for delaying prenatal care.

Correct Answer: B

Rationale: The correct answer is B because comparing and contrasting randomized clinical trials related to learning in elementary school children allows the nurse to identify the most effective strategies backed by scientific evidence. This method ensures that the health education programs are based on proven interventions, increasing the likelihood of improving learning retention. Choice A is incorrect as it relies on anecdotal evidence and personal experiences rather than empirical data from research. Choice C involves developing games, but without referring to research or evidence, it lacks a systematic approach. Choice D suggests using the Internet, which may not guarantee access to high-quality, evidence-based programs.

Correct Answer: B

Rationale: The correct answer is B: Insurance companies and other third-party payers. They play a significant role in pressuring clinicians to use EBP due to their focus on cost-effectiveness and quality care. These entities often require clinicians to adhere to evidence-based guidelines to receive reimbursement, incentivizing the adoption of EBP. Incorrect choices: A: Administrators may see cost savings with EBP, but they do not have the same direct influence on clinicians as insurance companies. C: Nurses recognizing EBP's effectiveness is important but may not be the chief group pressuring clinicians. D: While physicians recognizing EBP's effectiveness is crucial, insurance companies hold more financial influence over clinical practice.

Correct Answer: B

Rationale: The correct answer is B because a knowledge manager can help the school health nurse by evaluating best practices to determine the ones with the highest success rates for weight control in children. By doing so, the nurse can save time and effort by focusing on implementing strategies that have been proven to be effective in addressing obesity. This approach aligns with evidence-based practice (EBP) principles, ensuring that interventions are based on the best available evidence. Choice A is incorrect because simply identifying obese students is not sufficient to address the issue effectively without a plan based on evidence-based practices. Choice C is incorrect as organizing files and handling administrative tasks may help with efficiency but does not directly address the issue of implementing evidence-based practices for obesity management. Choice D is incorrect as setting up a program without evaluating its effectiveness first may not lead to the desired outcomes.

Correct Answer: D

Rationale: The correct answer is D because supporting nurses in using practice-oriented research findings in decision making is crucial for incorporating evidence-based practice (EBP). Nurse managers can help by providing resources, training, and mentorship to ensure that nurses are equipped to integrate research into their clinical practice. This approach promotes a culture of continuous learning and improvement. Eliminating all protocols not evidence-based (A) is drastic and may hinder workflow. Encouraging group reflection (B) is beneficial but doesn't directly support EBP implementation. Referring agency nurses to Internet sources (C) may not ensure the quality or relevance of information accessed. In summary, choice D is the best way as it empowers nurses to utilize research findings effectively, leading to improved patient outcomes.