A nurse is reinforcing teaching with a client about healthful sleep habits.
Which of the following statements should the nurse identify as an indication that the client needs further instructions?

One of the highest levels of evidence are randomized, controlled, double-blind studies. This is because these studies reduce the risk of bias and confounding factors by randomly assigning participants to intervention or control groups, blinding the participants and researchers to the group allocation, and using a placebo or standard treatment as a comparison.

Choice B is wrong because ideas, editorials, and opinions are considered low levels of evidence as they are based on personal views and not on rigorous research methods.

Choice C is wrong because the purpose of the hierarchy of evidence is to help the nurse evaluate the quality and strength of the research findings, not to compare patient values with research findings.

Patient values are important for evidence-based practice, but they are not part of the hierarchy of evidence.

Choice D is wrong because all forms of evidence should not be considered equally when determining evidence-based practice. The hierarchy of evidence ranks different types of research designs according to their validity and applicability, and the nurse should use the highest level of evidence available for their clinical question.

According to the National Institute on Aging, health care providers play an important role in recognizing and reporting elder abuse. They have a legal and ethical obligation to report any suspected cases of abuse to the appropriate authorities. Reporting is not voluntary for health care workers.

Choice A is wrong because reporting is not voluntary for health care workers. Choice C is wrong because civil liability cannot result if the abuse can’t be proven. Health care providers are protected by immunity laws when they report suspected abuse in good faith.

Choice D is wrong because evidence of abuse does not need to be collected prior to reporting. Health care providers should report any signs or symptoms of abuse, even if they are not conclusive.