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 when practice is based on habit
Reference: Ch. 1 — Making the Case for Evidence-Based
Practice — Clinical Decision-Making Culture
Stem:
A medical-surgical unit continues using an outdated turning
schedule for pressure injury prevention because “that is how
we have always done it.” A new nurse notices that current
outcomes are poor and wants the team to consider recent
,evidence. Which response best reflects evidence-based
practice?
A. Continue the schedule until a sentinel event occurs
B. Replace the current schedule immediately without reviewing
unit data
C. Compare the best available evidence, clinical expertise, and
patient preferences before changing practice
D. Ask only the most senior nurse how the schedule should be
changed
Correct Answer: C
Rationale — Correct Answer:
EBP is the integration of best evidence, clinical expertise, and
patient values/preferences. A practice change should be
informed by evidence and local outcomes rather than habit
alone. This approach supports safe, defensible, and patient-
centered care.
Rationale — Incorrect Options:
A. Waiting for harm before acting is reactive and unsafe. It
ignores preventable risk and evidence review.
B. Immediate change without appraisal can create unintended
consequences and bypasses clinical reasoning.
D. Seniority is not a substitute for evidence; expertise matters,
but it should be integrated with current best evidence.
,Teaching Point:
EBP replaces tradition with evidence, expertise, and patient
preferences.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare: A Guide to Best Practice (5th
ed.). Ch. 1.
2) Spirit of inquiry in daily practice
Reference: Ch. 1 — Cultivating a Spirit of Inquiry — Step 0
Stem:
A pediatric nurse notices that children seem less anxious when
parents stay during procedures, but some staff still separate
parents “to keep the room calm.” The nurse wonders whether
this routine really helps children. What action best
demonstrates a spirit of inquiry?
A. Accept the unit norm because it reduces staff conflict
B. Ask a focused question about the effect of parent presence
on child anxiety
C. Wait until a manager orders a practice change
D. Rely on personal experience from one successful case
Correct Answer: B
Rationale — Correct Answer:
A spirit of inquiry begins with curiosity about whether current
, practice is the best one. Asking a focused clinical question is the
first step toward investigating the issue using evidence. This
mindset moves practice from routine to purposeful inquiry.
Rationale — Incorrect Options:
A. Unit norm alone does not establish best practice.
C. Waiting for authority delays improvement and does not
reflect professional inquiry.
D. One experience is anecdotal and cannot establish
effectiveness.
Teaching Point:
Inquiry starts when a nurse questions whether current practice
is truly best.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare: A Guide to Best Practice (5th
ed.). Ch. 1.
3) Identifying a practice gap
Reference: Ch. 1 — Recognizing Clinical Uncertainty — Step 0
Stem:
An oncology unit reports repeated delays in pain reassessment
after IV opioid administration. Staff members believe the
current workflow is “good enough” because no formal
complaint has been filed. Which finding best indicates a
practice gap worthy of EBP inquiry?
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1) Making the case for EBP when practice is based on habit
Reference: Ch. 1 — Making the Case for Evidence-Based
Practice — Clinical Decision-Making Culture
Stem:
A medical-surgical unit continues using an outdated turning
schedule for pressure injury prevention because “that is how
we have always done it.” A new nurse notices that current
outcomes are poor and wants the team to consider recent
,evidence. Which response best reflects evidence-based
practice?
A. Continue the schedule until a sentinel event occurs
B. Replace the current schedule immediately without reviewing
unit data
C. Compare the best available evidence, clinical expertise, and
patient preferences before changing practice
D. Ask only the most senior nurse how the schedule should be
changed
Correct Answer: C
Rationale — Correct Answer:
EBP is the integration of best evidence, clinical expertise, and
patient values/preferences. A practice change should be
informed by evidence and local outcomes rather than habit
alone. This approach supports safe, defensible, and patient-
centered care.
Rationale — Incorrect Options:
A. Waiting for harm before acting is reactive and unsafe. It
ignores preventable risk and evidence review.
B. Immediate change without appraisal can create unintended
consequences and bypasses clinical reasoning.
D. Seniority is not a substitute for evidence; expertise matters,
but it should be integrated with current best evidence.
,Teaching Point:
EBP replaces tradition with evidence, expertise, and patient
preferences.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare: A Guide to Best Practice (5th
ed.). Ch. 1.
2) Spirit of inquiry in daily practice
Reference: Ch. 1 — Cultivating a Spirit of Inquiry — Step 0
Stem:
A pediatric nurse notices that children seem less anxious when
parents stay during procedures, but some staff still separate
parents “to keep the room calm.” The nurse wonders whether
this routine really helps children. What action best
demonstrates a spirit of inquiry?
A. Accept the unit norm because it reduces staff conflict
B. Ask a focused question about the effect of parent presence
on child anxiety
C. Wait until a manager orders a practice change
D. Rely on personal experience from one successful case
Correct Answer: B
Rationale — Correct Answer:
A spirit of inquiry begins with curiosity about whether current
, practice is the best one. Asking a focused clinical question is the
first step toward investigating the issue using evidence. This
mindset moves practice from routine to purposeful inquiry.
Rationale — Incorrect Options:
A. Unit norm alone does not establish best practice.
C. Waiting for authority delays improvement and does not
reflect professional inquiry.
D. One experience is anecdotal and cannot establish
effectiveness.
Teaching Point:
Inquiry starts when a nurse questions whether current practice
is truly best.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare: A Guide to Best Practice (5th
ed.). Ch. 1.
3) Identifying a practice gap
Reference: Ch. 1 — Recognizing Clinical Uncertainty — Step 0
Stem:
An oncology unit reports repeated delays in pain reassessment
after IV opioid administration. Staff members believe the
current workflow is “good enough” because no formal
complaint has been filed. Which finding best indicates a
practice gap worthy of EBP inquiry?
