EVIDENCE-BASED PRACTICE IN NURSING
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1) Spirit of inquiry in day-to-day practice
Reference: Ch. 1 — Spirit of Inquiry — Recognizing Practice
Variation
Stem:
A medical-surgical nurse notices that two experienced nurses
use different approaches to prevent pressure injuries for similar
immobile patients, yet both insist their method is “best.” The
,nurse wants to respond in a way that supports EBP rather than
personal opinion. What is the nurse’s best first action?
Options:
A. Implement the approach used by the most senior nurse
because experience is a reliable evidence source
B. Ask a focused clinical question about which prevention
strategy produces the best patient outcomes
C. Wait until a pressure injury occurs, then report the event
through quality improvement
D. Request that both nurses stop using their approaches until a
new policy is written
Correct Answer: B
Rationale — Correct Answer:
A spirit of inquiry begins with noticing variation and asking why
the variation exists. The best first step is to convert uncertainty
into a focused clinical question that can guide evidence
searching and appraisal. This aligns with the chapter’s emphasis
on questioning practice rather than accepting tradition or
hierarchy alone.
Rationale — Incorrect Options:
A. Experience matters, but seniority is not evidence and should
not replace systematic inquiry.
C. Waiting for harm is reactive and does not reflect proactive
EBP thinking.
D. Policy changes may come later, but the first step is asking the
question, not immediately rewriting practice.
,Teaching Point:
Question practice variation before accepting it as “normal.”
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
2) Identifying a true practice gap
Reference: Ch. 1 — Practice Gap — From Habit to Inquiry
Stem:
On a telemetry unit, nurses routinely delay oral care until the
end of the shift because “everyone is too busy earlier.” The
educator suspects this habit may be affecting patient comfort
and outcomes. Which statement best reflects a practice gap
that warrants EBP inquiry?
Options:
A. “The current practice is efficient because it fits the
workflow.”
B. “We should continue the routine because oral care is a low-
priority task.”
C. “There may be a better time or method for oral care, and we
should examine whether the current routine achieves desired
outcomes.”
D. “If no one has complained, the practice does not need to
change.”
Correct Answer: C
, Rationale — Correct Answer:
A practice gap exists when current practice may not be
producing the best outcomes or may not be supported by
evidence. This option recognizes uncertainty and frames the
issue in outcome-based terms, which is the foundation of EBP
inquiry.
Rationale — Incorrect Options:
A. Efficiency does not prove effectiveness.
B. Prioritization based on habit can overlook patient outcomes
and evidence.
D. Absence of complaints is not proof that care is optimal.
Teaching Point:
A practice gap is about outcomes, not convenience.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
3) EBP versus tradition
Reference: Ch. 1 — EBP vs Tradition — Evidence Over Routine
Stem:
A new graduate asks why the unit continues using a routine that
has never been evaluated formally but is defended because “it
has always worked for us.” Which response by the preceptor
best reflects evidence-based thinking?
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1) Spirit of inquiry in day-to-day practice
Reference: Ch. 1 — Spirit of Inquiry — Recognizing Practice
Variation
Stem:
A medical-surgical nurse notices that two experienced nurses
use different approaches to prevent pressure injuries for similar
immobile patients, yet both insist their method is “best.” The
,nurse wants to respond in a way that supports EBP rather than
personal opinion. What is the nurse’s best first action?
Options:
A. Implement the approach used by the most senior nurse
because experience is a reliable evidence source
B. Ask a focused clinical question about which prevention
strategy produces the best patient outcomes
C. Wait until a pressure injury occurs, then report the event
through quality improvement
D. Request that both nurses stop using their approaches until a
new policy is written
Correct Answer: B
Rationale — Correct Answer:
A spirit of inquiry begins with noticing variation and asking why
the variation exists. The best first step is to convert uncertainty
into a focused clinical question that can guide evidence
searching and appraisal. This aligns with the chapter’s emphasis
on questioning practice rather than accepting tradition or
hierarchy alone.
Rationale — Incorrect Options:
A. Experience matters, but seniority is not evidence and should
not replace systematic inquiry.
C. Waiting for harm is reactive and does not reflect proactive
EBP thinking.
D. Policy changes may come later, but the first step is asking the
question, not immediately rewriting practice.
,Teaching Point:
Question practice variation before accepting it as “normal.”
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
2) Identifying a true practice gap
Reference: Ch. 1 — Practice Gap — From Habit to Inquiry
Stem:
On a telemetry unit, nurses routinely delay oral care until the
end of the shift because “everyone is too busy earlier.” The
educator suspects this habit may be affecting patient comfort
and outcomes. Which statement best reflects a practice gap
that warrants EBP inquiry?
Options:
A. “The current practice is efficient because it fits the
workflow.”
B. “We should continue the routine because oral care is a low-
priority task.”
C. “There may be a better time or method for oral care, and we
should examine whether the current routine achieves desired
outcomes.”
D. “If no one has complained, the practice does not need to
change.”
Correct Answer: C
, Rationale — Correct Answer:
A practice gap exists when current practice may not be
producing the best outcomes or may not be supported by
evidence. This option recognizes uncertainty and frames the
issue in outcome-based terms, which is the foundation of EBP
inquiry.
Rationale — Incorrect Options:
A. Efficiency does not prove effectiveness.
B. Prioritization based on habit can overlook patient outcomes
and evidence.
D. Absence of complaints is not proof that care is optimal.
Teaching Point:
A practice gap is about outcomes, not convenience.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
3) EBP versus tradition
Reference: Ch. 1 — EBP vs Tradition — Evidence Over Routine
Stem:
A new graduate asks why the unit continues using a routine that
has never been evaluated formally but is defended because “it
has always worked for us.” Which response by the preceptor
best reflects evidence-based thinking?
