Test Bank For Evidence-Based Practice in Nursing & Healthcare A
Guide to Best Practice 5th Edition
by Bernadette Mazurek Melnyk, Ellen Fineout-Overholt
Chapter 1 - 23 Complete
,Chapter 1 Making the Case for Evidence-
QW QW QW QW QW QW
Based Practice and Cultivating a Spirit of Inqui QW QWQW QW QW QW QW QW
ry
In the hospital where Nurse L. provides care, tradition dictates that oral temperatures be
QW QW QW QW QW QW QW QW QW QW QW QW QW
included in every set of patient vital signs, regardless of patient diagnosis or acuity. Thi
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
s is most likely an example of which of the following phenomena?
QW QW QW QW QW QW QW QW QW QW QW
A) The prioritization of internal evidence over external evidence
QW QW QW QW QW QW QW
B) Practice that lacks evidence to support its application QW QW QW QW QW QW QW
C) The integration of personal expertise into nursing care
QW QW QW QW QW QW QW
D) Evidence-based practice QW
2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a pat
QW QW QW QW QW QW QW QW QW QW QW QW QW
ient chart review after the implementation of a pilot program aimed at promoting earl
QW QW QW QW QW QW QW QW QW QW QW QW QW
y ambulation following surgery. Which of the following components of EBP is the nu
QW QW QW QW QW QW QW QW QW QW QW QW QW
rse putting into practice?
QW QW QW
A) Patient preferences QW
B) Research utilization QW
C) Experience
D) Internal evidence QW
3. Nurse R. has observed that reorienting demented patients as frequently as possible tends
QW QW QW QW QW QW QW QW QW QW QW QW Q
to minimize the patients' level of agitation in the evening. The nurse has shared this ob
W QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
servation with a colleague, who is skeptical, stating that, “It's best to stick to evidence-
QW QW QW QW QW QW QW QW QW QW QW QW QW QW
based practice.” How can Nurse R. best respond?
QW QW QW QW QW QW QW
A) “EBP can include clinicians' personal expertise.”
QW QW QW QW QW
B) “Personal experience is often more sound than formal evidence-based practice.”
QW QW QW QW QW QW QW QW QW
C) “Traditional practice and EBP are usually shown to be the same.” QW QW QW QW QW QW QW QW QW QW
D) “My years of experience can be just as valuable as any literature review or
QW QW QW QW QW QW QW QW QW QW QW QW QW
randomized trial.” QW QW
4. Which of the following factors provides the most important rationale for the consistent
QW QW QW QW QW QW QW QW QW QW QW QW Q
implementation of EBP?
W QW QW
A) EBP provides for the most cost-effective patient care.
QW QW QW QW QW QW QW
B) EBP is accessible to all healthcare clinicians.
QW QW QW QW QW QW
C) EBP provides consistency in care across healthcare settings.
QW QW QW QW QW QW QW
D) EBP improves patient outcomes. QW QW QW
,5. The Institute of Medicine's Roundtable on Evidence-
QW QW QW QW QW QW
Based Medicine has been established to address EBP. Which of the followin
QW QW QW QW QW QW QW QW QW QW QW
g issues is the Roundtable emphasizing?
QW QW QW QW QW
A) Ensuring that external evidence, rather than internal evidence, is integrated into
QW QW QW QW QW QW QW QW QW QW Q
care W
B) Fostering the level of learning that exists in the American healthcare system
QW QW QW QW QW QW QW QW QW QW QW
C) Issuing clinical guidelines to ensure best nursing practice
QW QW QW QW QW QW QW
D) Comparing the implementation of EBP in the United States with that of other QW QW QW QW QW QW QW QW QW QW QW QW
Western countries
QW QW
6. You have become frustrated with some aspects of patient care that you believe are out
QW QW QW QW QW QW QW QW QW QW QW QW QW QW
dated and ineffective at the long-
QW QW QW QW QW
term care facility where you have recently begun practicing. Consequently, you have r
QW QW QW QW QW QW QW QW QW QW QW QW
esolved to examine some of these practices in light of evidence. Which of the followin
QW QW QW QW QW QW QW QW QW QW QW QW QW QW
g should occur first in the steps of EBP?
QW QW QW QW QW QW QW QW
A) Conducting an electronic search of the literature and ranking individual sources QW QW QW QW QW QW QW QW QW QW
B) Creating “buy-in” from the other clinicians who provide care at the facility
QW QW QW QW QW QW QW QW QW QW QW
C) Developing an inquisitive and curious mindset QW QW QW QW QW
D) Assessing whether the practices in question may, in fact, be evidence-based
QW QW QW QW QW QW QW QW QW QW
7. Which of the following clinical questions best exemplifies the PICOT format?
QW QW QW QW QW QW QW QW QW QW
A) What effect does parents' smoking have on the smoking habits of their children,
QW QW QW QW QW QW QW QW QW QW QW QW Q
ages 13 to 16?
W QW QW QW
B) Among cancer patients, what role does meditation, rather than benzodiazepines,
QW QW QW QW QW QW QW QW QW Q
have on anxiety levels during the 7 days following hospital admission?
W QW QW QW QW QW QW QW QW QW QW
C) Among undergraduate college students, what is the effectiveness of a sexual health
QW QW QW QW QW QW QW QW QW QW QW
campaign undertaken during the first 4 weeks of the fall semester as measured b
QW QW QW QW QW QW QW QW QW QW QW QW QW QW
y incidence of new gonorrheal and chlamydial infections reported to the campus
QW QW QW QW QW QW QW QW QW QW QW QW
medical center? QW
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
a numeric rating scale in the emergency room context?
QW QW QW QW QW QW QW QW
8. After formulating a clinical question, a nurse has proceeded to search for evidence for
QW QW QW QW QW QW QW QW QW QW QW QW QW QW
ways to foster restful sleep in patients who are receiving care in the intensive care unit
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW Q
(ICU). The nurse has identified a relevant meta-
W QW QW QW QW QW QW QW
analysis in an electronic database. What will this source of evidence consist of?
QW QW QW QW QW QW QW QW QW QW QW QW
A) A statistical summary of the results from several different studies
QW QW QW QW QW QW QW QW QW
B) An examination of the theoretical and conceptual underpinnings of the issue
QW QW QW QW QW QW QW QW QW QW
C) An interdisciplinary analysis of the clinical question
QW QW QW QW QW QW
D) A qualitative study of different interventions related to the clinical question
QW QW QW QW QW QW QW QW QW QW
, 9. The nurses on a postpartum unit have noted that many primiparous (first-
QW QW QW QW QW QW QW QW QW QW QW
time) mothers are giving up on breastfeeding within the 24 hours following delivery, a
QW QW QW QW QW QW QW QW QW QW QW QW QW
nd the nurses want to create uniform guidelines for promoting breastfeeding on the unit
QW QW QW QW QW QW QW QW QW QW QW QW QW
. Which of the following sources is most likely to provide the best evidence in their qu
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
est for an intervention?
QW QW QW
A) Evidence from a randomized control trial that had more than 2500 participants
QW QW QW QW QW QW QW QW QW QW QW
B) Evidence from a study that is widely regarded as a classic within the obstetrical
QW QW QW QW QW QW QW QW QW QW QW QW QW
nursing community QW QW
C) Evidence from a systematic review of breastfeeding- QW QW QW QW QW QW
promotion studies that one of the nurses identified in an electronic database
QW QW QW QW QW QW QW QW QW QW QW
D) The consensus opinion of the most senior nurses on the unit
QW QW QW QW QW QW QW QW QW QW
10. The nurse educator on an acute medicine unit is advocating for the use of
QW QW QW QW QW QW QW QW QW QW QW QW QW
evidence-
based clinical practice guidelines on wound care in order to standardize and optimize
QW QW QW QW QW QW QW QW QW QW QW QW Q
the practice of the nurses on the unit. Which of the following statements best describe
W QW QW QW QW QW QW QW QW QW QW QW QW QW QW
s clinical practice guidelines?
QW QW QW
A) The result of replication studies of existing research by an impartial third party
QW QW QW QW QW QW QW QW QW QW QW QW
B) A collection of authorized interventions that are required by law
QW QW QW QW QW QW QW QW QW
C) A number of interventions that are the result of a large, publically-funded RCT
QW QW QW QW QW QW QW QW QW QW QW QW
D) A group of practice recommendations that result from a rigorous review of the
QW QW QW QW QW QW QW QW QW QW QW QW Q
literature W
11. A nurse is conducting a literature review on the evidence regarding the use of vacuum
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
dressings on stage IV pressure ulcers. After locating a recent study that appears to be r
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
elevant, which of the following questions would the nurse consider first when critically
QW QW QW QW QW QW QW QW QW QW QW QW QW
appraising the study? QW QW
A) “Are the findings of this study cost-effective in our clinical context?”
QW QW QW QW QW QW QW QW QW QW
B) "How would the implementation of this intervention affect our staffing needs?"
QW QW QW QW QW QW QW QW QW QW
C) “Were the patients in the study similar to the patients on my unit?”
QW QW QW QW QW QW QW QW QW QW QW QW
D) “Are the findings of the study significantly different from what we are currently
QW QW QW QW QW QW QW QW QW QW QW QW
doing on the unit? QW QW QW QW
12. The primary care provider of a 49-year-
QW QW QW QW QW QW
old male patient has examined and briefly explained the evidence that supports begin
QW QW QW QW QW QW QW QW QW QW QW QW
ning regular digital- QW QW
rectal exams. Which of the following factors would justify not performing digital-
QW QW QW QW QW QW QW QW QW QW QW
rectal examinations in this patient's care?
QW QW QW QW QW
A) The patient is vehemently opposed to undergoing a digital-rectal exam.
QW QW QW QW QW QW QW QW QW
B) Clinical practice guidelines for prostate care have not been published.
QW QW QW QW QW QW QW QW QW
C) The clinician has been unable to find any large RCTs in a literature review.
QW QW QW QW QW QW QW QW QW QW QW QW QW
D) The clinician has previously waited until patients are 55 to begin regular
QW QW QW QW QW QW QW QW QW QW QW Q
digital-rectal exams.
W QW
Guide to Best Practice 5th Edition
by Bernadette Mazurek Melnyk, Ellen Fineout-Overholt
Chapter 1 - 23 Complete
,Chapter 1 Making the Case for Evidence-
QW QW QW QW QW QW
Based Practice and Cultivating a Spirit of Inqui QW QWQW QW QW QW QW QW
ry
In the hospital where Nurse L. provides care, tradition dictates that oral temperatures be
QW QW QW QW QW QW QW QW QW QW QW QW QW
included in every set of patient vital signs, regardless of patient diagnosis or acuity. Thi
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
s is most likely an example of which of the following phenomena?
QW QW QW QW QW QW QW QW QW QW QW
A) The prioritization of internal evidence over external evidence
QW QW QW QW QW QW QW
B) Practice that lacks evidence to support its application QW QW QW QW QW QW QW
C) The integration of personal expertise into nursing care
QW QW QW QW QW QW QW
D) Evidence-based practice QW
2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a pat
QW QW QW QW QW QW QW QW QW QW QW QW QW
ient chart review after the implementation of a pilot program aimed at promoting earl
QW QW QW QW QW QW QW QW QW QW QW QW QW
y ambulation following surgery. Which of the following components of EBP is the nu
QW QW QW QW QW QW QW QW QW QW QW QW QW
rse putting into practice?
QW QW QW
A) Patient preferences QW
B) Research utilization QW
C) Experience
D) Internal evidence QW
3. Nurse R. has observed that reorienting demented patients as frequently as possible tends
QW QW QW QW QW QW QW QW QW QW QW QW Q
to minimize the patients' level of agitation in the evening. The nurse has shared this ob
W QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
servation with a colleague, who is skeptical, stating that, “It's best to stick to evidence-
QW QW QW QW QW QW QW QW QW QW QW QW QW QW
based practice.” How can Nurse R. best respond?
QW QW QW QW QW QW QW
A) “EBP can include clinicians' personal expertise.”
QW QW QW QW QW
B) “Personal experience is often more sound than formal evidence-based practice.”
QW QW QW QW QW QW QW QW QW
C) “Traditional practice and EBP are usually shown to be the same.” QW QW QW QW QW QW QW QW QW QW
D) “My years of experience can be just as valuable as any literature review or
QW QW QW QW QW QW QW QW QW QW QW QW QW
randomized trial.” QW QW
4. Which of the following factors provides the most important rationale for the consistent
QW QW QW QW QW QW QW QW QW QW QW QW Q
implementation of EBP?
W QW QW
A) EBP provides for the most cost-effective patient care.
QW QW QW QW QW QW QW
B) EBP is accessible to all healthcare clinicians.
QW QW QW QW QW QW
C) EBP provides consistency in care across healthcare settings.
QW QW QW QW QW QW QW
D) EBP improves patient outcomes. QW QW QW
,5. The Institute of Medicine's Roundtable on Evidence-
QW QW QW QW QW QW
Based Medicine has been established to address EBP. Which of the followin
QW QW QW QW QW QW QW QW QW QW QW
g issues is the Roundtable emphasizing?
QW QW QW QW QW
A) Ensuring that external evidence, rather than internal evidence, is integrated into
QW QW QW QW QW QW QW QW QW QW Q
care W
B) Fostering the level of learning that exists in the American healthcare system
QW QW QW QW QW QW QW QW QW QW QW
C) Issuing clinical guidelines to ensure best nursing practice
QW QW QW QW QW QW QW
D) Comparing the implementation of EBP in the United States with that of other QW QW QW QW QW QW QW QW QW QW QW QW
Western countries
QW QW
6. You have become frustrated with some aspects of patient care that you believe are out
QW QW QW QW QW QW QW QW QW QW QW QW QW QW
dated and ineffective at the long-
QW QW QW QW QW
term care facility where you have recently begun practicing. Consequently, you have r
QW QW QW QW QW QW QW QW QW QW QW QW
esolved to examine some of these practices in light of evidence. Which of the followin
QW QW QW QW QW QW QW QW QW QW QW QW QW QW
g should occur first in the steps of EBP?
QW QW QW QW QW QW QW QW
A) Conducting an electronic search of the literature and ranking individual sources QW QW QW QW QW QW QW QW QW QW
B) Creating “buy-in” from the other clinicians who provide care at the facility
QW QW QW QW QW QW QW QW QW QW QW
C) Developing an inquisitive and curious mindset QW QW QW QW QW
D) Assessing whether the practices in question may, in fact, be evidence-based
QW QW QW QW QW QW QW QW QW QW
7. Which of the following clinical questions best exemplifies the PICOT format?
QW QW QW QW QW QW QW QW QW QW
A) What effect does parents' smoking have on the smoking habits of their children,
QW QW QW QW QW QW QW QW QW QW QW QW Q
ages 13 to 16?
W QW QW QW
B) Among cancer patients, what role does meditation, rather than benzodiazepines,
QW QW QW QW QW QW QW QW QW Q
have on anxiety levels during the 7 days following hospital admission?
W QW QW QW QW QW QW QW QW QW QW
C) Among undergraduate college students, what is the effectiveness of a sexual health
QW QW QW QW QW QW QW QW QW QW QW
campaign undertaken during the first 4 weeks of the fall semester as measured b
QW QW QW QW QW QW QW QW QW QW QW QW QW QW
y incidence of new gonorrheal and chlamydial infections reported to the campus
QW QW QW QW QW QW QW QW QW QW QW QW
medical center? QW
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
a numeric rating scale in the emergency room context?
QW QW QW QW QW QW QW QW
8. After formulating a clinical question, a nurse has proceeded to search for evidence for
QW QW QW QW QW QW QW QW QW QW QW QW QW QW
ways to foster restful sleep in patients who are receiving care in the intensive care unit
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW Q
(ICU). The nurse has identified a relevant meta-
W QW QW QW QW QW QW QW
analysis in an electronic database. What will this source of evidence consist of?
QW QW QW QW QW QW QW QW QW QW QW QW
A) A statistical summary of the results from several different studies
QW QW QW QW QW QW QW QW QW
B) An examination of the theoretical and conceptual underpinnings of the issue
QW QW QW QW QW QW QW QW QW QW
C) An interdisciplinary analysis of the clinical question
QW QW QW QW QW QW
D) A qualitative study of different interventions related to the clinical question
QW QW QW QW QW QW QW QW QW QW
, 9. The nurses on a postpartum unit have noted that many primiparous (first-
QW QW QW QW QW QW QW QW QW QW QW
time) mothers are giving up on breastfeeding within the 24 hours following delivery, a
QW QW QW QW QW QW QW QW QW QW QW QW QW
nd the nurses want to create uniform guidelines for promoting breastfeeding on the unit
QW QW QW QW QW QW QW QW QW QW QW QW QW
. Which of the following sources is most likely to provide the best evidence in their qu
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
est for an intervention?
QW QW QW
A) Evidence from a randomized control trial that had more than 2500 participants
QW QW QW QW QW QW QW QW QW QW QW
B) Evidence from a study that is widely regarded as a classic within the obstetrical
QW QW QW QW QW QW QW QW QW QW QW QW QW
nursing community QW QW
C) Evidence from a systematic review of breastfeeding- QW QW QW QW QW QW
promotion studies that one of the nurses identified in an electronic database
QW QW QW QW QW QW QW QW QW QW QW
D) The consensus opinion of the most senior nurses on the unit
QW QW QW QW QW QW QW QW QW QW
10. The nurse educator on an acute medicine unit is advocating for the use of
QW QW QW QW QW QW QW QW QW QW QW QW QW
evidence-
based clinical practice guidelines on wound care in order to standardize and optimize
QW QW QW QW QW QW QW QW QW QW QW QW Q
the practice of the nurses on the unit. Which of the following statements best describe
W QW QW QW QW QW QW QW QW QW QW QW QW QW QW
s clinical practice guidelines?
QW QW QW
A) The result of replication studies of existing research by an impartial third party
QW QW QW QW QW QW QW QW QW QW QW QW
B) A collection of authorized interventions that are required by law
QW QW QW QW QW QW QW QW QW
C) A number of interventions that are the result of a large, publically-funded RCT
QW QW QW QW QW QW QW QW QW QW QW QW
D) A group of practice recommendations that result from a rigorous review of the
QW QW QW QW QW QW QW QW QW QW QW QW Q
literature W
11. A nurse is conducting a literature review on the evidence regarding the use of vacuum
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
dressings on stage IV pressure ulcers. After locating a recent study that appears to be r
QW QW QW QW QW QW QW QW QW QW QW QW QW QW QW
elevant, which of the following questions would the nurse consider first when critically
QW QW QW QW QW QW QW QW QW QW QW QW QW
appraising the study? QW QW
A) “Are the findings of this study cost-effective in our clinical context?”
QW QW QW QW QW QW QW QW QW QW
B) "How would the implementation of this intervention affect our staffing needs?"
QW QW QW QW QW QW QW QW QW QW
C) “Were the patients in the study similar to the patients on my unit?”
QW QW QW QW QW QW QW QW QW QW QW QW
D) “Are the findings of the study significantly different from what we are currently
QW QW QW QW QW QW QW QW QW QW QW QW
doing on the unit? QW QW QW QW
12. The primary care provider of a 49-year-
QW QW QW QW QW QW
old male patient has examined and briefly explained the evidence that supports begin
QW QW QW QW QW QW QW QW QW QW QW QW
ning regular digital- QW QW
rectal exams. Which of the following factors would justify not performing digital-
QW QW QW QW QW QW QW QW QW QW QW
rectal examinations in this patient's care?
QW QW QW QW QW
A) The patient is vehemently opposed to undergoing a digital-rectal exam.
QW QW QW QW QW QW QW QW QW
B) Clinical practice guidelines for prostate care have not been published.
QW QW QW QW QW QW QW QW QW
C) The clinician has been unable to find any large RCTs in a literature review.
QW QW QW QW QW QW QW QW QW QW QW QW QW
D) The clinician has previously waited until patients are 55 to begin regular
QW QW QW QW QW QW QW QW QW QW QW Q
digital-rectal exams.
W QW
