Official ICS nursing paper, model A, solved and explained

Hydrocolloids absorb little: they gel on contact with exudate and what they do is keep or add moisture to the wound, so their place is the lightly exuding wound. The ICS clinical guideline «Maneig i tractament d'úlceres d'extremitats inferiors» (1st ed., 2018) lists them, in its table of strategies for optimal moist wound healing, among the dressings used to increase or maintain moisture, and reserves alginates and hydrofibres for reducing it; the ICS short guideline on pressure ulcers says the same the other way round, recommending alginates when exudate is heavy. That makes b and c wrong, and d more so: the amount of exudate is precisely one of the dressing-choice criteria the guideline lists. Reviewed on 08.08.2026: no change of criterion.

The ERC sequence for foreign body airway obstruction (encourage coughing and, if it is ineffective, 5 back blows before abdominal thrusts) is retained in the ERC 2025 Guidelines.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

The stem describes one specific domain: adapting, coping, managing stress, and relating to oneself and to the environment. Of the four ATIC labels offered, only the first names that domain — adaptation to a new health state; the other three point at different objects: family caregiver burnout, child neglect as a social-risk situation, and acute deterioration as a sudden loss of clinical status. None of those three is about a person's coping mechanisms. ATIC is the interface nursing terminology of the ICS ARES programme, and the diagnosis «Risc de deteriorament de l'adaptació al nou estat de salut» appears in the ICS standardised care plans. Reviewed on 08.08.2026: ARES is still the programme in force.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

HPV is not a blood-borne virus: it infects the skin and mucosa of the genital area and passes from person to person by direct skin-to-skin contact, so transmission happens even without penetration or any exchange of fluids. That makes option a wrong. So is b, because the infection is usually asymptomatic and lesions, if they appear at all, may take months or years. And c reverses the recommendation in the Catalan immunisation schedule: the vaccine protects against an exposure that has not yet happened, which is why it is given before sexual debut, not after. Source: Canal Salut pages on human papillomavirus and on HPV vaccination (consulted 08.08.2026).

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

The rotator cuff is made up of four scapulohumeral muscles, identified by a simple rule: all four arise from the scapula and insert on the humerus, and all four rotate or abduct the arm. They are supraspinatus, infraspinatus, teres minor and subscapularis. Brachialis does not fit by definition: it arises from the humeral shaft, inserts on the ulna and its action is elbow flexion, not shoulder rotation, so it does not even cross the glenohumeral joint. Reviewed on 08.08.2026: anatomical content unchanged.

The tuberculin skin test dose is always 0.1 ml, never 0.15: the Spanish Medicines Agency's summary of product characteristics for Tuberculin PPD RT 23 states that «the dose, in every case, including the paediatric population, must be 0.1 ml», equal to 2 TU, given intradermally into the middle third of the volar forearm. The same document confirms the other three options, which is why they are true: the reaction is read at 48-72 hours and the product is considered safe throughout pregnancy and breastfeeding. Sokal's technique — running a ballpoint pen in from the periphery until it meets the edge of the induration — is an accepted way of delimiting it, since what is measured is the induration and not the erythema. Reviewed on 08.08.2026: SmPC current.

Doubling up after a missed dose is exactly what must not be done with an anticoagulant: it multiplies the peak concentration and with it the bleeding risk. The apixaban SmPC (Spanish Medicines Agency, section 4.2, missed doses) says so explicitly: take the missed dose as soon as you realise, but «the patient must not take two doses the following morning». The other three options are correct advice, set out on the direct-oral-anticoagulant page of the Catalan Department of Health's medicines portal, which warns against self-medicating with aspirin or anti-inflammatories — hence paracetamol as the preferred analgesic — and against contact and high-risk sports because of falls, bruising and bleeding. Reviewed on 08.08.2026, unchanged.

Each classical sexually transmitted infection has its own agent, and the question simply asks you to pair them. Treponema pallidum, a spirochaete, is the agent of syphilis. The other three names belong to different agents: chancroid is caused by Haemophilus ducreyi, gonococcal infection by Neisseria gonorrhoeae, and lymphogranuloma venereum by specific serovars (L1-L3) of Chlamydia trachomatis. Source: Canal Salut, the Catalan Department of Health's sexually transmitted infection pages. Reviewed on 08.08.2026, unchanged.

SNiSP Cat remains the patient safety incident reporting system of the SISCAT (Canal Salut, consulted on 28.07.2026).

The length-of-service thresholds of the ICS professional career pathway (level 1: 5 years or more; 2: 11; 3: 18; 4: 25) are retained in the call in force in 2026.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

Gluten is the protein fraction of wheat, barley, rye and their hybrids (such as triticale), which is why rye is the only prohibited food on the list. Rice, quinoa and maize contain no gluten and form the basis of a gluten-free diet; what has to be watched with them is not the grain itself but cross-contamination during processing. The way to get this question right is to remember the wheat-barley-rye trio, not to memorise long lists of permitted foods. Source: Canal Salut (Catalan Department of Health), coeliac disease page. Reviewed on 08.08.2026, unchanged.

The line between primary and secondary prevention is the point in the natural history of the disease at which you act. The Catalan Department of Health's public-health glossary defines primary prevention as measures aimed at reducing incidence, that is, placed before the disease appears, and secondary prevention as those that reduce prevalence by curing or relieving disease «through early diagnosis and treatment». A colorectal cancer early-detection programme looks for the disease while it is still asymptomatic so that it can be treated sooner: it is screening, and therefore secondary prevention. The other three — home-accident advice, school vaccination and a road-safety campaign — act on healthy people to stop the problem arising at all, and are primary prevention. Reviewed on 08.08.2026, unchanged.

The risk-drinking threshold (4 standard drink units (UBE)/day or 28/week in men; 2 UBE/day or 17/week in women) is still the one in force on Canal Salut. The 2021-2025 Health Plan has run out its period, but on 1.08.2026 it is still the only approved health plan: both the Department of Health's Health Plan page and the register of sector plans still list only 2021-2025, and no successor plan has been approved or published. In any case, the figure does not change.

The answer is in the acronym itself. PRECEDE stands for Predisposing, Reinforcing and Enabling Constructs in Ecosystem Diagnosis and Evaluation, and Green and Kreuter's model groups the determinants of a health behaviour into three blocks: predisposing factors, which sit inside the person and motivate the behaviour before it happens (knowledge, beliefs, attitudes and values); enabling factors, which make it possible (skills, resources, access to services); and reinforcing factors, which come from the environment after the behaviour (family, professionals, peer group). Values and attitudes belong by definition to the first block; «emotional factors» is not even a category in the model. Source: the Catalan Department of Health's public-health glossary, PRECEDE entry, citing Green LW et al., «Health education planning: a diagnostic approach». Reviewed on 08.08.2026, unchanged.

The Code of Ethics of the Nurses of Catalonia (2013) is still the code in force; the definition of the advance directives document (DVA) has not changed.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

Option c inverts the two properties that define each flora. Under the WHO Guidelines on Hand Hygiene in Health Care, resident flora lives in the deeper layers of the skin, is of low pathogenicity and, precisely because of where it sits, is hard to remove by simple washing: it needs an antiseptic, which is why surgical hand preparation targets it. Transient flora, by contrast, colonises the superficial layers, is picked up from the patient or from contaminated surfaces, is easily removed with antiseptic soap or an alcohol-based rub, and is responsible for most healthcare-associated infections. Saying that resident flora is easy to remove and is the one most linked to nosocomial infection is false on both counts. Reviewed on 08.08.2026, unchanged.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

The 2022 update of the Neumonía Zero project keeps oral hygiene with 0.12-0.2% chlorhexidine among the mandatory measures (a measure debated internationally, but still in force within the bundle).

Cough is precisely the sign that points to a viral rather than a streptococcal cause, which is why it is the only feature on the list that is NOT associated with acute streptococcal tonsillopharyngitis. The Centor criteria — the classic way of estimating the probability of streptococcal infection — count the ABSENCE of cough as a point in favour, alongside fever, tonsillar exudate and tender cervical nodes. Pain on swallowing, headache and abdominal pain, by contrast, are common features of the streptococcal picture in children. Source: the Centor criteria (Centor RM et al., 1981) and McIsaac's modification, the basis of antibiotic-use recommendations in sore throat. Reviewed on 08.08.2026, unchanged.

The breathing pattern of diabetic ketoacidosis is Kussmaul respiration — deep, rapid breaths through which the lung blows off CO2 to compensate the metabolic acidosis — and not Cheyne-Stokes, a cyclical pattern of hyperpnoea and apnoea seen in advanced heart failure and in central nervous system lesions. That is the only false word in option a, and it is enough to make it the answer. The other three statements describe ketoacidosis correctly: treatment is rehydration, electrolyte replacement and reversal of the acidosis with insulin; insulin deficiency reduces glucose entry into cells while hepatic glucose output rises; and the causes include missed insulin doses, illness or infection, and undiagnosed diabetes. Reviewed on 08.08.2026, unchanged.

Each option belongs to a different author, and that is how the question is cracked. Transitions theory is Afaf Ibrahim Meleis's: it studies how a person moves through life or health changes (illness, motherhood, migration, ageing) and what the nurse does to support a healthy transition. The theory of human caring is Jean Watson's and self-care deficit theory is Dorothea Orem's; «dysfunctional grief» is not a nursing theory at all but a diagnostic label. Source: reference literature on nursing models and theories indexed in SciELO España (Instituto de Salud Carlos III). Reviewed on 08.08.2026, unchanged.

The pain of a ruptured ectopic pregnancy does not stay in the pelvis, because the spilled blood irritates the diaphragm, and the diaphragm shares its nerve roots (C3-C5, phrenic nerve) with the skin of the shoulder: the pain is therefore referred to the shoulder. This is Kehr's sign, and it is the detail that separates option d from the rest. The other three options describe exactly what a complicated ectopic does not do: minimise the pain or deny that it radiates. Recognising that radiation is what lets you suspect haemoperitoneum and arrange urgent transfer instead of putting the pain down to a threatened miscarriage. Reviewed on 08.08.2026, unchanged.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

In pneumonia the problem is alveolar filling with exudate, and the core nursing intervention is helping the lung expand and move secretions: active breathing exercises, deep breathing and incentive spirometry. The other three pieces of advice work against that goal. Recommending physical activity in the acute phase competes with the rest that increased work of breathing demands; cutting fluid intake thickens secretions and makes them harder to clear, when hydration is exactly what is needed; and suppressing cough removes the mechanism that clears the airway, so pain should be treated to allow coughing, not by stopping it. Reviewed on 08.08.2026, unchanged.

All prevention of postoperative thrombophlebitis rests on avoiding venous stasis: moving the legs, changing position often, and elevating them slightly so venous return does not stall. Options a, c and d do exactly that. High Fowler's position does the opposite: sustained hip and knee flexion compresses the femoral and popliteal veins and encourages blood to pool in the lower limbs, which is precisely what major gynaecological surgery already predisposes to. That is why it is the measure that will NOT help prevention. Reviewed on 08.08.2026, unchanged.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

Partiality can never be a value of a public health service: the ICS serves the whole population, and equity and impartiality are conditions of the service, not admitted flaws. Competence, participation and innovation did appear in the corporate values the ICS published at the time this recruitment process was called. CURRENCY WARNING: as of 08.08.2026 the ICS mission, vision and values page no longer lists that set, but four new values tied to its 2026-2028 strategic plan: passion, respect, commitment and professionalism (the last defined as including technical competence). The official answer still stands, because partiality appears in no version, but anyone studying for the current call should memorise the four values in force, not those of 2022. Source: ICS, «Missió, visió i valors» (consulted on 08.08.2026).

The Sarcoptes scabiei mite needs time on the skin to pass from one person to another: Canal Salut states that scabies is transmitted by direct, prolonged skin contact with an affected person, or with recently used clothing, bedding and towels, and that a handshake or a quick hug is not a usual source of infection. That is why option c, which speaks of brief physical contact, is the false one. The other three are true and rest on the same source: it is a parasitic infestation by a mite, crusted or Norwegian scabies is its severe and highly contagious form, and the affected person must stay in strict home isolation until 24 hours after starting treatment. Source: Canal Salut, «Sarna» page (consulted 08.08.2026).

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

The ankle-brachial index is measured by inflating a pressure cuff over the ankle, which is why it is contraindicated wherever compressing the leg is dangerous or impracticable. The ICS guideline «Maneig i tractament d'úlceres d'extremitats inferiors» (2018) lists four contraindications: suspected thrombophlebitis, prosthetic vascular bypass, marked oedema, and pain on cuff compression; phlebitis, cellulitis and suspected venous thrombosis all fall squarely within them. Telangiectasia, by contrast, is simply dilated venules under 3 mm (CEAP class C1, in the same guideline's table): it causes no pain and carries no risk of dislodging a thrombus, so it does not prevent the test. Reviewed on 08.08.2026: the guideline is still the one the ICS publishes.

Myasthenia gravis is a disease of the neuromuscular junction: antibodies block the acetylcholine receptor at the motor end plate, so the defect is purely motor and fluctuating, with fatigability that worsens on exertion and improves with rest. That is why option d is false: sensation and coordination, which depend on the sensory pathways and the cerebellum, are intact. The other three are classic and clinically important features: diplopia and ptosis as the commonest presentation, bulbar involvement with dysphagia and dysphonia and the aspiration risk it brings, and myasthenic crisis with neuromuscular respiratory failure as the most serious complication. Reviewed on 08.08.2026, unchanged.

What makes grief dysfunctional is not intensity or duration on their own but impairment of the person's social and occupational functioning: that is the criterion separating it from normal grief, and it is what the NANDA-I diagnostic label «complicated grieving» (00135) captures. Options a and d, which describe grief as a natural process and a normal reaction to loss, therefore define uncomplicated grief. And b is false because the stages of grief are descriptive, not obligatory: not everyone goes through all of them, or in the same order. Source: NANDA-I diagnostic taxonomy. Reviewed on 08.08.2026, unchanged.

The rule is always the same: the independent variable is the one the researcher manipulates or assigns, and the dependent variable is the outcome measured, which is supposed to change as a consequence. Here the researcher decides who receives the health-education intervention, so the intervention is the independent variable, and what is expected to change — the incidence and prevalence of smoking — is the dependent one. Options b and c invert exactly that relationship, and d denies a distinction the stem lets you make without ambiguity. Reviewed on 08.08.2026, unchanged.

Co-administration of the influenza vaccine and the herpes zoster vaccine at the same vaccination visit is still accepted in Catalonia's current schedule.

The classic deformity of a fractured neck of femur is a shortened, adducted and EXTERNALLY rotated leg, because the external rotators and iliopsoas pull the distal fragment round. Option b says the opposite — that the person is more comfortable with the leg internally rotated — and that is why it is false. The other three are true and follow from the same mechanism: the deformity in option a, pain referred to the hip, groin or medial side of the knee (obturator nerve territory), and the fact that an impacted intracapsular fracture may cause only moderate discomfort, allow weight-bearing and show no obvious deformity — the clinical trap that makes these fractures easy to miss. Reviewed on 08.08.2026, unchanged.

Two rules govern ear irrigation, and option d is the only one that satisfies both. First, the stream is aimed at the SUPERIOR and posterior wall of the external auditory canal, never straight at the eardrum or at the plug: that way the water passes behind the wax and pushes it out. Second, to straighten the canal's physiological curve you pull the pinna up and back in an adult; in a small child you pull it down and back instead, because the canal is straighter and differently angled. Options a, b and c break one of the two rules or mix the adult manoeuvre with the child's. Reviewed on 08.08.2026, unchanged.

The Charter of rights and duties of citizens in relation to health and health care (2015 edition) is still the one in force.

Candida is a yeast that thrives where there is warmth, moisture and no air, and every piece of patient education points the other way: dry, ventilate and reduce friction. Loose absorbent clothing, keeping the skin dry, and weight loss if the person is obese (because it makes the skin fold shallower and drier) all follow that line. Occluding the lesion does exactly the opposite: it traps moisture, raises local temperature and encourages the yeast to grow, so it is the advice that must NOT be given. Reviewed on 08.08.2026, unchanged.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

The whispered voice test is the hearing screen that can be done in the consulting room with no equipment at all: the examiner stands a metre behind the person, masks the opposite ear and whispers a series of words or numbers for the person to repeat. The other three options do not test hearing: perimetry measures the visual field and the Amsler grid detects macular metamorphopsia, both vision tests, and the Langner-Amiel test is not an auditory test either. Noticing that two of the options are ophthalmic already settles the question. Reviewed on 08.08.2026, unchanged.

The picture described is autonomic dysreflexia, and the detail that identifies it is the level of the lesion: it occurs only in spinal cord injuries above T6, where the splanchnic sympathetic outflow is cut off from supraspinal inhibitory control. A noxious stimulus below the lesion — usually a full bladder or faecal impaction — triggers a massive sympathetic discharge with hypertension and sweating, while the intact baroreflex above the lesion answers with bradycardia and headache. That combination of hypertension with bradycardia is what sets it apart: none of the other three options (thrombophlebitis, pulmonary hypertension, pulmonary oedema) behaves that way. It is an emergency: sit the person up and find and remove the trigger. Reviewed on 08.08.2026, unchanged.

What separates the three eating disorders on the list is the presence or absence of compensatory behaviours and of restriction. Bulimia nervosa requires binges followed by purging, excessive exercise or fasting; anorexia nervosa requires restriction with low weight and intense fear of gaining it. Here there are recurrent, rapid binges with a sense of loss of control but no compensatory behaviour at all: that is exactly binge-eating disorder, recognised as an entity in its own right in DSM-5. Obsessive-compulsive disorder is not an eating disorder and has no place here. Source: DSM-5 diagnostic criteria, American Psychiatric Association. Reviewed on 08.08.2026: DSM-5-TR (2022) keeps the criteria.

The guide «Petits canvis per menjar millor» (ASPCAT) is still the reference dietary guide in Catalonia.

Organic Law 3/2021 regulating euthanasia remains in force (upheld by the Constitutional Court in 2023) and retains the requirement of two requests.

The Guide to healthy eating in early childhood (ASPCAT) remains in force on this point.

The five values that structure the Code of Ethics of the Nurses of Catalonia have not changed.

Adrenaline is the only drug that reverses all three mechanisms that kill in anaphylaxis at once: vasoconstriction (alpha) against hypotension, bronchodilation (beta-2) against bronchospasm, and mast-cell stabilisation. That is why it goes first, intramuscularly into the anterolateral thigh, using the 1:1000 presentation (1 mg/ml), which is the intramuscular ampoule; 1:100,000 is not a presentation used in anaphylaxis, and mistaking it for 1:10,000 — the dilution used intravenously in cardiac arrest — is the trap in this question. Corticosteroids and antihistamines are second-line: they act slowly and reverse neither airway obstruction nor shock, so they must never delay adrenaline. Source: European Resuscitation Council Guidelines (2025 edition), special circumstances chapter, anaphylaxis. Reviewed on 08.08.2026, unchanged.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

The three elements in the stem — rapidly progressive visual loss, severe ocular pain with periocular congestion, and acute obstruction of aqueous humour drainage — define acute angle-closure glaucoma: the iris blocks the trabecular meshwork, intraocular pressure rises sharply and compresses the optic nerve. It is an ophthalmic emergency. The distractors are excluded precisely by mechanism: iritis and scleritis cause pain and a red eye but not through obstruction of aqueous outflow and not with this abrupt loss of vision, and retinal detachment is typically painless, presenting with floaters, flashes and a shadow advancing across the visual field. Reviewed on 08.08.2026, unchanged.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

The Department of Health's organisational model for paediatric palliative care retains this definition of the objective.

In hypothesis testing there are two possible errors, distinguished by what is actually true. Alpha error, or type I error, is rejecting the null hypothesis when it is in fact true: concluding there is a difference that does not exist, a false positive. Its counterpart is beta error, or type II error: failing to reject the null hypothesis when it is false, that is, missing a difference that is really there. The significance level set for a study (usually 0.05) is precisely the maximum probability of alpha error that is accepted. Options a, c and d describe situations that match neither error or invert them. Reviewed on 08.08.2026, unchanged.

In patient safety, the first victim of an incident is the patient and those around them. The second victim is the professional or team involved in the adverse event, who is traumatised by it and may carry lasting emotional effects into their professional work and their personal life. The institution, when it takes the reputational and organisational damage, is the third victim: options a, b and d therefore sit at other points on the same scale, not at second victim. Source: Catalan Department of Health, «Actuació davant les segones víctimes» (patient-safety training and consensus series, 2016). Reviewed on 08.08.2026: the terminology remains in use in the 2023-2027 strategic plan for quality and patient safety.

Stable reference clinical-care content; reviewed on 28.07.2026 without finding any subsequent rule, guideline or consensus that would change the answer.

ICS skin antisepsis guideline: the principle (aqueous chlorhexidine, never alcohol-based, in infants and young children) is retained in current practice.

The PAPPS recommendations are updated every two years; the screening interval for dyslipidaemia is still longer than two years, so the option indicated is still the incorrect one.

Raised intracranial pressure compresses the third cranial nerve, and the result is a dilated, unreactive pupil — mydriasis, not miosis. That is why option d is the one that does NOT indicate raised intracranial pressure. The other three do: in a six-month-old, with the fontanelles still open, a bulging fontanelle is an early sign of rising pressure; decorticate or decerebrate posturing indicates brainstem compromise; and Cushing's triad (hypertension, bradycardia and irregular breathing) is the late, alarming sign of impending herniation. Reviewed on 08.08.2026, unchanged.

Flushing is the manual injection of 0.9% sodium chloride through the catheter lumen before, during and after every administration of drugs or blood products and every blood draw: it checks patency, clears drug residue and prevents incompatibilities and precipitates. Options a and d describe something else — locking, which is what you do when the catheter is not going to be used for a period; confusing flushing with locking is the central error the question targets. And option b is false because current evidence does not support heparin for maintaining venous catheter patency: normal saline suffices and avoids heparin's risks. Reviewed on 08.08.2026, unchanged.

The ILAE's 2017 operational classification defines a focal seizure as one originating within networks limited to one hemisphere, and a generalised seizure as one originating at some point and rapidly engaging bilaterally distributed networks. Option a gives the focal seizure the generalised seizure's definition, which is why it is the false one. The other three are correct: absences are typical of childhood, myoclonic seizures last a few seconds and often go unnoticed, and a generalised tonic-clonic seizure has a tonic phase followed by a clonic one. Source: Fisher RS et al., ILAE operational classification of seizure types, Epilepsia, 2017. Reviewed on 08.08.2026: still the classification in force.

Acute kidney injury is classified by where the problem sits, and prerenal injury is the one that happens with a healthy but underperfused kidney. Prolonged bleeding causes hypovolaemia and therefore a fall in glomerular filtration pressure: it is the prerenal cause on the list. The other three are intrarenal: nephrotoxicity and rhabdomyolysis damage the tubule directly (acute tubular necrosis), and glomerulonephritis damages the glomerulus. Recognising the mechanism is what changes management: a prerenal cause will reverse if circulating volume is restored in time, and it is the one that progresses to tubular necrosis if it is not. Reviewed on 08.08.2026, unchanged.

The aim of the study is lived experience, and that is exactly the object of phenomenology. The Catalan nursing dictionary (TERMCAT with the Department of Health) defines it as the method of exploring and describing phenomena in order to uncover their structure, and adds the key point: it rests on the theory that behaviour is determined by how the person perceives reality, not by an objective external reality. The other designs answer different questions: a randomised controlled trial measures the effect of an intervention, an observational design quantifies associations, and an ethnographic design describes the culture and shared patterns of a group rather than one person's subjective experience. Reviewed on 08.08.2026, unchanged.