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Nursing
Q:
It is important for nurses to bridge the gap between practice and research to promote safe, evidence-based nursing care. One of the best ways to close this gap is by which of the following?
1. Extrapolate data from the electronic health record (EHR).
2. Write all patient data in the nurse's station notebook.
3. Analyze singular pieces of data and note its relevance to all patients.
4. Keep data that seem irrelevant from the research committee.
Q:
_______________________ provide up-to-date information from peer-reviewed data-based research.
Q:
The electronic health record (EHR) provides the database needed to support research and evidence-based practice. Which of the following best depicts the use of the EHR in the collection of data?
1. Only experienced clinicians understand the usage of EHR data.
2. Incorporation of evidence-based guidelines into the EHR can improve the quality of care.
3. Extrapolating data from an EHR can be a lengthy process and counterproductive.
4. The EHR can be a reservoir for research studies.
Q:
Which form of technology has recently been designated as useful at the point of care?
1. Computer on wheels
2. Monitoring DVDs
3. Portable Dynamap
4. Personal digital assistant
Q:
Which of the following activities are involved in producing a thorough and comprehensive review of research databases?
Standard Text: Select all that apply.
1. Understanding the process of comprehensive and systematic search of databases
2. Selecting and appraising relevant studies
3. Extracting relevant information from the research articles that have been found to be scientifically rigorous and meritorious
4. Developing competency and skills in extracting relevant information
5. Structuring the results of the systematic review in a clear and succinct manner
Q:
Which of the following technologies does collaborative computing not use to achieve its goals?
1. E-mail and desktop videoconferencing
2. Digital libraries
3. Handheld devices
4. Shared databases
Q:
A busy, inner city CCU has had a record number of nosocomial infections during the month of December. The head nurse held a meeting with the department to begin a systematic review process of all of the infected patients. In order to facilitate the collection of relevant data, she can eliminate a barrier to the collection of data by the point of care staff through which of the following?
1. Allowing nurses who are comfortable with the research process to collect data
2. Hiring a consultant to create the research process and collect data
3. Providing workshops and preceptors to guide the nurses
4. Asking the staff to work an extra hour per week to facilitate collection
Q:
Which of the following methods is not useful in the facilitation of both evidence-based practice and research through the identification of questions, location of literature, systematic reviews, and resources?
1. Electronic literature searches
2. Online discussion groups
3. Comparative effectiveness research (CER)
4. Digital libraries
Q:
__________________________ is an approach to providing care that integrates nursing experience and intuition with valid and current clinical research to achieve the best patient outcomes
Q:
Which of the following is essential to provide the means to search the literature and apply clinical knowledge, improving practice and safety as well as meeting the standards of excellence required for regulatory and credentialing standards and Magnet status?
1. Information technology tools
2. Computerized databases
3. Technology websites
4. Online libraries
Q:
____________________________________ have the capacity to locate a plethora of research, data, and information in a rapid period of time.
Q:
Data collection via the Internet can offer special advantages. Which of the following tools also facilitates research?
Standard Text: Select all that apply.
1. Electronic databases
2. Online group discussions
3. Privacy standards
4. Cookies
5. Digital libraries
Q:
Which of the following provides an effective means of researching primary research in a logical and systematic manner, providing a more efficient and effective means to find credible scientific information than if one were doing a general Web search?
1. Wikis
2. Systematic literature searches
3. Blogging
4. Telehealth
Q:
Which of the following best supports the need for translational research in health care?
1. More emphasis will be placed on interdisciplinary translation of research in the coming decade.
2. Nurses are the only health care provider capable of understanding best practice models.
3. There is not as much demand for translational research today as there was five years ago.
4. Translational research is a new concept in health care.
Q:
Standardized languages provide a mechanism to ensure common meanings to terms, facilitate data collection, and aid research. Which of the following languages includes all nursing specialties and demonstrates the ability to encompass other standardized nursing languages?
1. ICNP
2. NANDA
3. NIC
4. NOC
Q:
Clinical researchers have experienced barriers due to HIPPA. These researchers need to be aware of HIPAA's Privacy Rule because it establishes the conditions under which covered entities can use or disclose PHI. Which of the following statements about HIPPA covered entities is accurate?
1. Researchers are not covered entities unless they are also health care providers or employed by a covered entity or engage in any of the electronic transactions covered under HIPAA.
2. Researchers are always considered to be covered entities for transactions covered under HIPAA so long as they are conducting a valid study.
3. When difficulties arise with small sample size, covered entities are not allowed to disclose PHI to researchers to aid in study recruitment.
4. Covered entities do not include providers that transmit health information electronically for HIPAA transactions, health plans, and clearinghouses unless they are certified via a national examination.
Q:
Sigma Theta Tau International completed a landmark EBP study in 2006. Which of the following was included in the findings?
1. Nurses are comfortable seeking information to provide EBP patient care and had sufficient access to appropriate materials to personally engage in EBP.
2. Nurses who entered practice less than two years earlier were least comfortable with providing EBP patient care.
3. Nurses who entered practice five or more years earlier were most comfortable with providing EBP patient care.
4. Nurses lacked access to appropriate materials to personally engage in EBP.
Q:
Knowledge discovery in databases (KDD) is a term used in other industries that is now seen in health care circles. Which of the following statements about KDD is accurate?
1. It is a powerful tool suitable for the analysis of large or small amounts of data.
2. It is not available commercially, but platforms can be custom built to suit the facility.
3. The confidentiality of individual records may be protected through the use of data perturbation.
4. The lack of bias is guaranteed by the vendor related to the complex patterns in collected data.
Q:
The lack of a common language to facilitate data collection and decision making was recognized as a problem in health care and nursing several years ago. Which of the following are recognized nursing languages?
Standard Text: Select all that apply.
1. CCC
2. UMLS
3. NOC
4. PNDS
5. ICNP
Q:
A program outcome essential for health care students is that they be skilled in which of the following?
1. Electronic spreadsheet applications
2. Electronic database management applications
3. Applications that facilitate electronic literature searches
4. Electronic slide presentation applications
Q:
Which of the following statements about evidence-based practice (EBP) is true?
1. Hospitals have not yet begun to build EBP into their clinical ladders.
2. The standards of practice are not currently established with evidence-based competencies.
3. Staff nurses indicate higher levels of familiarity with EBP than advanced practice nurses.
4. A number of facilities now consider EBP to be part of everyday clinical practice.
Q:
Constant changes in health care and its delivery creates challenges for clinicians to keep abreast of the latest evidence-based practice (EBP) findings and recommendations. What can health care professionals do in order to narrow the time in synthesizing research from the "bench" to the client's "bedside"?
Standard Text: Select all that apply.
1. Use available toolkits to locate existing guidelines and develop EBP guidelines.
2. Locate nursing research Web links.
3. Enroll in a doctoral program.
4. Foster health care informatics skills.
5. Join a focused online discussion group to help identify specific areas for EBP or original research.
Q:
The Health Insurance Portability and Accountability Act (HIPPA) requires health care providers and insurers to obtain additional documentation from researchers related to assurances of patient safety and confidentiality. Which of the following is the key concern about human subjects in health care research?
1. That all subjects are protected from the researcher getting access to their confidential information before disclosing their health information
2. That authorization is still required even if an institutional review board grants a waiver or alteration of authorization requirements
3. That authorization is still required even if information has been de-identified according to Privacy Rule standards
4. That one signed authorization form for research is valid for a current research study and covers any future research projects
Q:
From a health information technology perspective, health care research has faced some impediments. Which of the following has impeded health care research?
Standard Text: Select all that apply.
1. Slow adoption of uniform languages
2. Limited funding
3. Rapid adoption of data exchange standards
4. Confidentiality of private health information (PHI)
5. Failure to attain a birth-to-death electronic health record (EHR)
Q:
A nurse researcher selects a notebook computer to collect data for a research study. Which statement regarding data collection using mobile devices is accurate?
1. Transcription errors may occur during data transmission.
2. An interactive data collection tool may not be appealing to the participant.
3. Time and costs relating to scrubbing data are usually much reduced.
4. Redundant data entry may occur until the researcher becomes more skilled.
Q:
Data mining supports sifting through large volumes of data at rapid speeds. In which instance would the use of data mining be inappropriate?
1. To provide information that may enhance the company's market share
2. To hide confidential information in databases using real values
3. To identify common factors relating to medication errors
4. To search databases to review trends in the health care arena
Q:
Which of the following is an advantage of uniform nursing languages, such as The Omaha System?
1. Standards for information systems are no longer needed.
2. Nursing data may be collected only in similar health care settings.
3. All contain the same type of data on nursing care and outcomes.
4. Studies using the same language may be replicated more easily.
Q:
Which type of research is best suited for using nurmetrics?
1. The compilation of unified medical language systems into a universal language
2. The collapsing of databases into one large data set for research purposes
3. The generation and testing of new models of health care delivery using computers
4. The collection of data to create a uniform data set for nursing care and outcomes
Q:
A nursing student wishes to initiate a search for interesting research topics. The student decides to peruse client positioning during pulmonary artery catheter readings. Among the following, which are suitable for this topic?
Standard Text: Select all that apply.
1. PsychINFO
2. MEDLINE
3. Google
4. CINAHL
5. PubMed
Q:
For which type of research is knowledge discovery in databases (KDD) least appropriate?
1. To cross-link risk factors for type 2 diabetes and cardiovascular disease
2. To identify the efficacy of a treatment for children with the rare and fatal Batten disease.
3. To test the hypothesis that polycystic kidney disease is best treated with antihypertensive
4. To determine the most significant risk factors for congestive heart failure
Q:
Which statement regarding data collection via the Internet is accurate?
1. Ethical issues are minimized because complete privacy of client response is assured.
2. E-mails cannot be used because there may be errors in interpretation and transcription.
3. Selection bias is eliminated because the Internet allows participation from all over the world.
4. Data collection is automated, allowing the data to be exported to other programs more easily.
Q:
Which statement is true regarding the realization of a universal electronic health record (EHR)?
1. Security and confidentiality issues have been resolved.
2. The EHR exists only in private, for-profit acute-care institutions.
3. Health care providers are unified in the standardization of the EHR.
4. The lack of common language prevents the EHR from becoming a reality.
Q:
An ethnographer selects Ethnograph, a software program to analyze data obtained from client interviews. Which of the following is a potential disadvantage of using software for qualitative research?
1. Data must be sorted manually into subsets for future analysis.
2. Research may be molded to fit the software program.
3. The researcher must input data separately for the best analysis.
4. There is less available time for data analysis.
Q:
A qualitative researcher studying lived experiences of congestive heart failure clients wishes to analyze data obtained from client interviews. Which of the following software programs are best suited for this researcher's purpose?
1. SYSTAT and HyperRESEARCH
2. NUD*IST and Nvivo
3. BMDP and DataDesk
4. SAS and SPSS
Q:
The relationship between information technology and the collection and analysis of data is part of the development of evidence-based practice and improved patient outcomes. Which of the following are essential elements that need to be considered to have a comprehensive, robust health information system to promote public health informatics?
Standard Text: Select all that apply.
1. Data definitions
2. Coding classification systems
3. Data transmission capability
4. Health information exchange (HIE)
5. Data storage
Q:
Research has suggested that there is a positive correlation between an individual's health literacy and which of the following?
1. Knowledge of illness
2. Managed care
3. Computer skills
4. Health outcomes
Q:
The ability to improve health outcomes and make data-driven decisions within a new or existing health information infrastructure is critical. This can be accomplished through which of the following?
1. Reliable databases
2. A cogent plan of action
3. Systems implementation
4. Public health informatics
Q:
There is a global concern that not all populations or subpopulations have the resources and capabilities to utilize or benefit from communication using technology and Internet. This phenomenon is called _____________.
Q:
The use of the Internet for health information has grown exponentially in the past few years. There are a multitude of reasons for individuals to check online before contacting their health care provider. Which of the following statements is a major reason why people turn to the Internet and websites for health related information?
1. Fewer people have health care insurance.
2. The long lines and waiting time in healthcare providers' offices prevent individuals from making appointments.
3. People refuse to pay the co-pay when they can find out about their illness for free.
4. People are reluctant to bother their primary healthcare provider.
Q:
Public health care is responsible for the protecting the health care needs of the public through a variety of ways. With the increase in technology, which of the following statements is true about information technology and public health protection?
1. Information technology provides the ability to access Center for Disease Control (CDC) updates on outbreaks of communicable disease.
2. Information technology diminishes the ability to make rapid decisions during crisis management.
3. Information technology controls communication during a crisis.
4. Information technology is unnecessary during a crisis.
Q:
The Homeland Security website has fact sheets and a series of scenario-based workshops that are free and can be completed online. Which of the following types of terrorist attacks have concomitant fact sheets on this website?
Standard Text: Select all that apply.
1. Chemical
2. Biological
3. Radiological
4. Nuclear
5. Improvised Explosive Attack
Q:
The Centers for Disease Control (CDC) have begun national initiatives to link public health electronic health records (EHRs) with an immunization tracking system (CDC, 2011). This tracking system is focused on allowing EHRs of state and local health departments to share data with immunization information systems and integrate these records with the CDC's vaccine tracking system. The initiative focuses on communication and which of the following?
1. The ability to provide reminders, extend resources, and track records
2. The ability to combine data with global initiatives
3. The ability to work in tandem with governmental databases
4. The ability to design public health resources in case of an pandemic
Q:
The _________________________ website has a wealth of information for nurses through fact sheets as well as a series of scenario-based workshops that are free of charge and can be completed online on topics related to nursing care and management during a crisis.
Q:
Which national organization has begun to link public health electronic health records (EHRs) with an immunization tracking system?
1. NIH
2. CDC
3. ANA
4. AACN
Q:
There are four major principles of public health informatics that are distinguishable from other types of informatics. Which of the following responses is not considered a principle?
1. Promote the health of populations as opposed to health of individuals.
2. Prevent disease and injury by altering the conditions or the environment putting populations at risk.
3. Should not reflect the governmental context in which public health is practiced.
4. Should explore the potential for prevention of all vulnerable points.
Q:
Public Health Informatics (PHI) is distinguished from other information systems and technology by its emphasis on ____________________ in populations
Q:
Which of the following is considered a major challenge with public health informatics (PHI)?
1. Need to have additional terminals in neutral locations
2. Need to have stronger linkages and interface between and among providers and systems
3. Need to convince health care providers of PHI benefits
4. Need for additional research on PHI effectiveness
Q:
What is the systematic application of information and computer science and technology to public health practice, research, and learning?
1. Public health nursing
2. Public health practice
3. Public health informatics
4. Public health research
Q:
Telenursing is defined as which of the following?
1. The synthesis of nursing and information systems
2. The synthesis of nursing and telecommunications and information technology
3. The synthesis of health care and telecommunications
4. The synthesis of nursing and communication technology
Q:
Which of the following statements is true about telehealth?
1. Telehealth can be used to treat prisoners.
2. Telehealth should not be used to offer mental health services.
3. Telehealth is not useful in treating rural patients.
4. There are not enough funds to support telehealth.
Q:
Which of the following statements about telenursing is true?
1. Telenursing has been in existence for decades, using available technology to serve its purposes.
2. The American Academy of Ambulatory Care Nursing was founded to promote nursing in telehealth.
3. Telehealth nursing practice is not yet considered to be a subspecialty of nursing.
4. Basic telehealth nursing principles have been widely integrated into basic nursing curricula.
Q:
Telehealth has become an attractive tool to improve the quality of health care and save money. Savings may be realized via which of the following measures?
Standard Text: Select all that apply.
1. Follow-up care is more convenient.
2. Access to care improves.
3. Physician services are provided.
4. Clients may be treated in their own community.
5. Quality of care improves.
Q:
For over 40 years, the U.S. government played a major role in the development and promotion of telehealth through various agencies. Which of the following was the first telehealth service provided?
1. Telephone consultations
2. Robotics telesurgery
3. Prison inmate care
4. Telepsychiatric treatment
Q:
Current or future trends in home health care include which of the following?
Standard Text: Select all that apply.
1. Helper robots
2. Biometric measurements monitored at another site
3. E-house calls
4. Sensors to detect when a frail elderly client falls down
5. Smart homes
Q:
Standards of care reflect best practices based on research findings. Which of the following is an example of how the incorporation of national standards of care and drug information helps health care institutions?
1. The incorporation of national standards of care and drug information helps to identify human errors.
2. The incorporation of national standards of care and drug information helps to eliminate wasteful spending.
3. The incorporation of national standards of care and drug information helps to eliminate co-pays.
4. The incorporation of national standards of care and drug information helps to decrease malpractice claims through adherence to standards of care.
Q:
Which of the following definitions is accurate?
1. Telecare is the remote delivery of health care services into the person's home facilitated by communication technologies that include the use of person-centered reactive monitoring devices.
2. Teletherapy is the use of a psychology-based website to provide therapy and counseling.
3. Telesurgery is defined as the use of technology that allows surgeons to complete surgical procedures with electronic tools.
4. Teleprevention is defined as the use of electronic databases to analyze communicable diseases within the community.
Q:
One major barrier to telehealth was removed with the passage of the Telecommunications Act of 1996. Which of the following was the outcome of removing this major barrier?
1. Telecommunications carriers were required to provide cost-free Internet access to those in rural areas.
2. Telecommunications carriers must offer services to urban health providers at rates higher than those charged in rural areas.
3. The act created the Agriculture Department's information Rural Development network.
4. Vendors of cable and telephone services were allowed to compete in each others' markets.
Q:
Which of the following are considered to be appropriate uses of telenursing?
Standard Text: Select all that apply.
1. Making follow-up calls
2. Obtaining test results
3. Checking biometric measurements
4. Advanced primary practice
5. Telephone triage
Q:
Telehealth is a tool that allows health care professionals to do which of the following?
Standard Text: Select all that apply.
1. Improve the overall quality of the client's record
2. Assess and monitor clients.
3. Tackle isolation and loneliness
4. Decrease hospital visits for clients with chronic conditions
5. Extend scarce health care resources
Q:
Telenursing is the use of telecommunications and computer technology for the delivery of nursing care. The National Council of State Boards identified advantages of authority to practice telenursing across state lines (1996). These advantages include which of the following?
Standard Text: Select all that apply.
1. Establishes legitimacy and availability to practice telenursing
2. Protects the nurse from liability when practicing across state lines without a license in the client's state
3. Establishes the nurse's responsibility and accountability to the board of nursing
4. Provides jurisdictional authority over the discipline of telenursing in the event of unsafe delivery
5. Provides statutory authority permitting telenursing services across borders for all of the states
Q:
Which statement related to telehealth technology is correct?
1. A DTV system may be used to transmit diagnostic images for third-party consultation.
2. Because international audio and visual standards are inconsistent, there is little international communication.
3. A frame-per-second rate of 10 provides acceptable diagnostic imagery for consultation.
4. Broad bandwidth of 384 kilobits and 30 frames per second is needed for diagnostic image interpretation.
Q:
Which of these home health clients is least suited for telehealth services?
1. A 63-year-old man with a large pressure ulcer who requires daily wound assessments and dressing
2. A 54-year-old client with congestive heart failure who is developing new onset chest pain
3. A 77-year-old client who requires glucose monitoring and daily foot ulcer assessment
4. A 49-year-old woman who is pregnant for the first time and requires fetal heart rate monitoring
Q:
Which example of an online resource is inappropriate for telehealth professionals?
1. Critical pathways and client outcomes information
2. Electronic prescriptions and medication information
3. Client electronic medical records with progress and treatment
4. Abstracts, full-text literature, and research data access
Q:
Which type of client information is least suited for "store-and-forward" technology?
1. A client's biopsy sample is digitally photographed and transmitted electronically to the pathology lab.
2. A client with increasing symptoms of heart failure is instructed to come to the clinic for a state CXR (chest x-ray).
3. A client's EEG (electroencephalogram) and brain scan are transmitted to the consulting surgeon to follow up a craniotomy of two months ago.
4. A client with chronic asthma comes to the clinic for a routine CXR (chest x-ray).
Q:
Which statement is true concerning telehealth?
1. Access to care may be delayed until the proper equipment can be delivered to the client's home.
2. Clients must travel to special on-site locations where equipment and telecommunication devices are available.
3. Nurse practitioner services may be reduced because physicians can assess and treat clients themselves.
4. Clients may stay within their own community to be assessed and treated, lowering potential costs.
Q:
In which setting would telehealth be least likely to be supported by government funding?
1. A small community hospital in an urban setting in the Northeast
2. A battlefield in a third-world country for the treatment of casualties
3. A space shuttle voyage during orbit around the earth
4. A prison infirmary to care for state inmates
Q:
Which of the following is a disadvantage of desktop videoconferencing (DTV) for telehealth?
1. DTV may not support high-resolution, high-speed transmissions.
2. DTV requires a personal computer with a modem to function.
3. DTV uses real-time synchronous encounters for face-to-face meetings.
4. DTV is more expensive than most videoconferencing systems.
Q:
Which situation best fits the use of a telehealth delivery system?
1. Chronic congestive heart failure clients are assessed in rural clinics using telecommunication technology, and are given instructions on how to best manage their care.
2. Clients may sign up with a telehealth provider, who provides the client with health promotion information and activities.
3. Continuing education courses for health care professionals are provided to the education department of acute-care institutions for continuing education credits.
4. A physician consultant receives an x-ray, CT scan, and EKG via the telecommunication network to manage the care of a client with congestive heart failure and diabetes.
Q:
Which telehealth transmission service is best when eight MRI scans must be sent to the consultant in a tertiary facility?
1. Switched Multimegabit Data Services (T1 line)
2. Integrated Services Digital Network (ISDN)
3. Asynchronous Transfer Mode (ATM)
4. Digital subscriber line (DSL)
Q:
Which statement is true regarding potential liability issues for telehealth?
1. Malpractice costs may be decreased because lawsuits may be filed in multiple locations, defraying costs.
2. Misinterpretation of advice provided over the telephone may cause the health care provider to be liable for poor outcomes.
3. Telehealth services may be used in the place of any face-to-face physical examination with the same results.
4. A nurse practitioner licensed in Wyoming may provide advice to a client in Montana without legal repercussions.
Q:
Which of the following statements about telenursing is accurate?
1. Since telenursing is a new subspecialty, standards of practice have yet to be developed.
2. Telenursing should be taught at a graduate school level.
3. The International TeleNurses Association (ITNA) published International Competencies for Telenursing in 2007.
4. The International TeleNurses Association (ITNA) was founded in 1995 to promote and support nursing involvement in telehealth and serve as a resource for nurses.
Q:
A new paradigm of care called _______________________ promises to reduce costs and improve quality by working with clients proactively
Standard Text:
Q:
Which of the following is not considered an issue pertaining to the practice of telenursing?
1. Nurses must be certified in telehealth nursing.
2. Reimbursement has been limited in several states.
3. Liability issues
4. State board of nursing regulations
Q:
Which of the following technological advances are telehealth applications?
Standard Text: Select all that apply.
1. Videoconferencing between client and physician
2. Transmission of diagnostic images
3. Electronic prescriptions
4. Support for caregivers
5. Voice recognition for dictation
Q:
Telehealth has caused officials concern about the privacy of information as it crosses state lines. Which of the following statements can be considered a resolution by health care professionals?
1. Experts have called for the discontinuation of telehealth.
2. Experts have called for the creation of standards for e-health, particularly for security and identity management.
3. Experts have enacted a number of bills stopping the growth of telehealth.
4. Experts have called for a limit in the number of telehealth patient encounters.
Q:
The role of the informaticist has broadened over the past several years. Which of the following are some of the specialty roles open to a nurse informaticist?
Standard Text: Select all that apply.
1. Educator
2. Advocate
3. Computer technician
4. Designer
5. Leader
Q:
The informatics specialist in an educator role has the tools to design consumer-friendly information retrieval tools, by designing electronic education that is readable at a _________________________ level and by providing consumers with helpful hints about vocabulary translations.
Q:
The informatics specialist is in a unique position to promote the integration of consumer informatics into the mainstream of health care delivery. Which of the following statements is true about the nurse informatics clinical specialist?
1. The nurse informatics clinical specialist can be part of the life cycle process.
2. The nurse informatics clinical specialist can eliminate the need for a help desk.
3. The nurse informatics clinical specialist can spearhead all changes to the information system.
4. The nurse informatics clinical specialist's role is to collect outcomes data.
Q:
The term home telemedicine encompasses a number of different tools that can be utilized by consumers to self-monitor and self-manage health conditions. Which of the following information technology tools can be used by the consumer at home?
Standard Text: Select all that apply.
1. Technology that can take vital signs
2. Blood glucose technology
3. Web-based video conferencing
4. Online patient educational sessions
5. Chemotherapy infusion
Q:
Social media networks, such as Facebook, offer the individual an online platform for support and data gathering. Facebook continues to grow in popularity, yet there are a number of concerns. Which of the following offer reason to be thoughtful before using social media networks?
Standard Text: Select all that apply.
1. Questionable scientific content
2. Minimization of anxiety
3. Sharing confidential issues with a network of "friends"
4. Research ethics issues when social networking sites are used to recruit research participants
5. Health care providers can 'friend' their patients