EVIDENCE-BASED PRACTICE IN NURSING
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1. Reference: Ch. 1 — Making the Case for EBP — Spirit of
Inquiry
Stem: A medical-surgical unit has used the same wound-care
dressing protocol for years, even though healing times vary
widely among similar patients. A new nurse notices that some
staff members are not sure why the protocol was chosen, but
they continue using it because “that is how we have always
done it.” What is the best EBP-oriented response?
,Options:
A. Accept the protocol because long-standing practice is usually
the safest option.
B. Ask what evidence supports the protocol and whether
patient outcomes are being monitored.
C. Change the protocol immediately based on the nurse’s
clinical intuition.
D. Wait until a national guideline is published before
questioning the current practice.
Correct Answer: B
Rationales:
B. This reflects a spirit of inquiry by questioning the basis
for practice and linking it to outcomes. EBP begins by identifying
whether current care is supported by the best evidence rather
than tradition alone.
A. Longevity of a practice does not prove it is effective.
Habit without evidence can preserve outdated care.
C. Clinical intuition is valuable, but it should not replace
evidence and outcome data for a practice change.
D. A national guideline is helpful, but nurses do not need to
wait passively before evaluating an existing practice gap.
Teaching Point: Tradition is not evidence; ask what data support
the current practice.
,Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
2. Reference: Ch. 1 — Making the Case for EBP — Identifying
Practice Gaps
Stem: On a telemetry unit, several nurses report that early
ambulation after surgery seems to reduce complications, but
the unit’s current routine delays ambulation until the next
morning. The charge nurse wants to know whether the practice
delay is based on evidence, safety concerns, or simple custom.
What is the most appropriate first step?
Options:
A. Implement early ambulation for all patients immediately.
B. Formulate a focused clinical question about early ambulation
and outcomes.
C. Ask the staff to vote on which practice they prefer.
D. Keep the current approach because no patient harm has
been reported.
Correct Answer: B
Rationales:
B. A focused question is the first step in moving from
uncertainty to evidence-based decision making. It creates a
clear target for searching and appraising the literature.
A. Immediate implementation without evidence appraisal
, risks adopting an ineffective or unsafe practice.
C. Preference alone is not a substitute for evidence. Staff
opinions may help identify concerns, but they do not establish
best practice.
D. The absence of reported harm does not mean the
practice is optimal or evidence-based.
Teaching Point: A good EBP change starts with a focused clinical
question.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
3. Reference: Ch. 1 — Making the Case for EBP —
Questioning Tradition
Stem: A nurse educator hears a preceptor tell students, “We do
not need research; experienced nurses already know what
works.” The educator wants to respond in a way that supports a
culture of inquiry without dismissing the preceptor’s
experience. Which response is best?
Options:
A. “Experience is more reliable than research because it is
based on real patients.”
B. “Experience matters, but the best practice combines
evidence, expertise, and patient preferences.”
C. “Research should always replace clinical judgment in every
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1. Reference: Ch. 1 — Making the Case for EBP — Spirit of
Inquiry
Stem: A medical-surgical unit has used the same wound-care
dressing protocol for years, even though healing times vary
widely among similar patients. A new nurse notices that some
staff members are not sure why the protocol was chosen, but
they continue using it because “that is how we have always
done it.” What is the best EBP-oriented response?
,Options:
A. Accept the protocol because long-standing practice is usually
the safest option.
B. Ask what evidence supports the protocol and whether
patient outcomes are being monitored.
C. Change the protocol immediately based on the nurse’s
clinical intuition.
D. Wait until a national guideline is published before
questioning the current practice.
Correct Answer: B
Rationales:
B. This reflects a spirit of inquiry by questioning the basis
for practice and linking it to outcomes. EBP begins by identifying
whether current care is supported by the best evidence rather
than tradition alone.
A. Longevity of a practice does not prove it is effective.
Habit without evidence can preserve outdated care.
C. Clinical intuition is valuable, but it should not replace
evidence and outcome data for a practice change.
D. A national guideline is helpful, but nurses do not need to
wait passively before evaluating an existing practice gap.
Teaching Point: Tradition is not evidence; ask what data support
the current practice.
,Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
2. Reference: Ch. 1 — Making the Case for EBP — Identifying
Practice Gaps
Stem: On a telemetry unit, several nurses report that early
ambulation after surgery seems to reduce complications, but
the unit’s current routine delays ambulation until the next
morning. The charge nurse wants to know whether the practice
delay is based on evidence, safety concerns, or simple custom.
What is the most appropriate first step?
Options:
A. Implement early ambulation for all patients immediately.
B. Formulate a focused clinical question about early ambulation
and outcomes.
C. Ask the staff to vote on which practice they prefer.
D. Keep the current approach because no patient harm has
been reported.
Correct Answer: B
Rationales:
B. A focused question is the first step in moving from
uncertainty to evidence-based decision making. It creates a
clear target for searching and appraising the literature.
A. Immediate implementation without evidence appraisal
, risks adopting an ineffective or unsafe practice.
C. Preference alone is not a substitute for evidence. Staff
opinions may help identify concerns, but they do not establish
best practice.
D. The absence of reported harm does not mean the
practice is optimal or evidence-based.
Teaching Point: A good EBP change starts with a focused clinical
question.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
3. Reference: Ch. 1 — Making the Case for EBP —
Questioning Tradition
Stem: A nurse educator hears a preceptor tell students, “We do
not need research; experienced nurses already know what
works.” The educator wants to respond in a way that supports a
culture of inquiry without dismissing the preceptor’s
experience. Which response is best?
Options:
A. “Experience is more reliable than research because it is
based on real patients.”
B. “Experience matters, but the best practice combines
evidence, expertise, and patient preferences.”
C. “Research should always replace clinical judgment in every
