EVIDENCE-BASED PRACTICE IN NURSING
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1) Making the case for EBP amid “we have always done it this
way”
Reference: Ch. 1 — Making the Case for EBP — Practice
Standardization and Outcomes
Stem: A nurse on a medical-surgical unit notices that
preoperative patient teaching varies widely by provider, and
postoperative patients keep asking different questions
,depending on who taught them. The unit manager says the
current approach has “worked for years,” but readmissions
related to poor discharge understanding remain a concern.
What is the best EBP-based response?
Options:
A. Continue the current approach because long-standing
practice is usually reliable.
B. Collect anecdotal feedback from staff and assume that is
sufficient evidence for change.
C. Use the pattern of inconsistent teaching and outcome
concerns to justify a focused EBP inquiry.
D. Wait until a randomized controlled trial is completed on the
unit’s exact teaching format.
Correct Answer: C
Rationale — Correct Answer:
The pattern suggests a practice gap, and EBP begins when
clinicians recognize variation, uncertainty, or suboptimal
outcomes. A focused inquiry can then determine whether
evidence supports a more consistent patient-teaching
approach. This aligns with the chapter’s emphasis on making
the case for EBP through outcome improvement and reducing
unwarranted variation.
Rationales — Incorrect Options:
A. Tradition does not establish effectiveness; unchanged
practice may perpetuate poor outcomes.
B. Anecdotal impressions are not strong enough to guide
,practice change when outcomes suggest a problem.
D. EBP does not require waiting for the perfect study before
beginning inquiry and evidence synthesis.
Teaching Point: Tradition is not evidence; outcome gaps justify
inquiry.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
2) Spirit of inquiry versus routine task completion
Reference: Ch. 1 — Cultivating a Spirit of Inquiry — Clinical
Curiosity
Stem: A new graduate nurse follows the unit checklist
accurately but notices frequent delays in pain reassessment
after IV opioid administration. Several patients report their pain
control is inconsistent, yet staff accept this as a normal
workflow issue. Which response best reflects a spirit of inquiry?
Options:
A. Assume the workflow is acceptable because medication is
still being given.
B. Ask why reassessment is delayed and whether the process
affects pain outcomes.
C. Report the issue only if a patient files a formal complaint.
D. Reassess pain only in patients who appear visibly
uncomfortable.
Correct Answer: B
, Rationale — Correct Answer:
A spirit of inquiry begins with questioning routine practice and
asking whether it produces the intended outcome. Linking the
delay to patient pain outcomes transforms a task problem into a
potential EBP question. That curiosity is the foundation for
clinical improvement.
Rationales — Incorrect Options:
A. Completing the task does not ensure the process is effective
or timely.
C. Waiting for complaints delays identification of a preventable
care problem.
D. Pain should not be assessed only by visible cues; that
approach misses many patients.
Teaching Point: Inquiry asks whether routine care truly
improves outcomes.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
3) Identifying a practice gap from outcome data
Reference: Ch. 1 — Making the Case for EBP — Outcome
Monitoring
Stem: A telemetry unit reviews quarterly data and finds a
persistent rise in patient falls during night shifts, despite
mandatory hourly rounding. Leadership asks the staff nurse to
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1) Making the case for EBP amid “we have always done it this
way”
Reference: Ch. 1 — Making the Case for EBP — Practice
Standardization and Outcomes
Stem: A nurse on a medical-surgical unit notices that
preoperative patient teaching varies widely by provider, and
postoperative patients keep asking different questions
,depending on who taught them. The unit manager says the
current approach has “worked for years,” but readmissions
related to poor discharge understanding remain a concern.
What is the best EBP-based response?
Options:
A. Continue the current approach because long-standing
practice is usually reliable.
B. Collect anecdotal feedback from staff and assume that is
sufficient evidence for change.
C. Use the pattern of inconsistent teaching and outcome
concerns to justify a focused EBP inquiry.
D. Wait until a randomized controlled trial is completed on the
unit’s exact teaching format.
Correct Answer: C
Rationale — Correct Answer:
The pattern suggests a practice gap, and EBP begins when
clinicians recognize variation, uncertainty, or suboptimal
outcomes. A focused inquiry can then determine whether
evidence supports a more consistent patient-teaching
approach. This aligns with the chapter’s emphasis on making
the case for EBP through outcome improvement and reducing
unwarranted variation.
Rationales — Incorrect Options:
A. Tradition does not establish effectiveness; unchanged
practice may perpetuate poor outcomes.
B. Anecdotal impressions are not strong enough to guide
,practice change when outcomes suggest a problem.
D. EBP does not require waiting for the perfect study before
beginning inquiry and evidence synthesis.
Teaching Point: Tradition is not evidence; outcome gaps justify
inquiry.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
2) Spirit of inquiry versus routine task completion
Reference: Ch. 1 — Cultivating a Spirit of Inquiry — Clinical
Curiosity
Stem: A new graduate nurse follows the unit checklist
accurately but notices frequent delays in pain reassessment
after IV opioid administration. Several patients report their pain
control is inconsistent, yet staff accept this as a normal
workflow issue. Which response best reflects a spirit of inquiry?
Options:
A. Assume the workflow is acceptable because medication is
still being given.
B. Ask why reassessment is delayed and whether the process
affects pain outcomes.
C. Report the issue only if a patient files a formal complaint.
D. Reassess pain only in patients who appear visibly
uncomfortable.
Correct Answer: B
, Rationale — Correct Answer:
A spirit of inquiry begins with questioning routine practice and
asking whether it produces the intended outcome. Linking the
delay to patient pain outcomes transforms a task problem into a
potential EBP question. That curiosity is the foundation for
clinical improvement.
Rationales — Incorrect Options:
A. Completing the task does not ensure the process is effective
or timely.
C. Waiting for complaints delays identification of a preventable
care problem.
D. Pain should not be assessed only by visible cues; that
approach misses many patients.
Teaching Point: Inquiry asks whether routine care truly
improves outcomes.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
3) Identifying a practice gap from outcome data
Reference: Ch. 1 — Making the Case for EBP — Outcome
Monitoring
Stem: A telemetry unit reviews quarterly data and finds a
persistent rise in patient falls during night shifts, despite
mandatory hourly rounding. Leadership asks the staff nurse to
