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 — EBP Rationale — Quadruple Aim and
Practice Improvement
Stem:
A med-surg unit has persistently higher-than-benchmark fall
rates despite using the same fall-prevention bundle for years.
Several nurses say the bundle is “good enough,” but the
manager notes that patient satisfaction scores, staff burnout,
,and cost of injury-related care are also worsening. Which
interpretation best supports making the case for EBP in this
situation?
Options:
A. The current bundle should remain unchanged because long-
standing practice is inherently reliable.
B. EBP is justified because it can improve outcomes, costs, and
clinician work life while reducing variation in care.
C. This is primarily a research problem because the unit needs a
new randomized trial before changing practice.
D. This should be treated as a quality assurance audit only,
because patient outcomes are already being measured.
Correct Answer: B
Rationales:
Correct: EBP is appropriate when current practice is not
producing desired outcomes and there is a better evidence-
based approach that may improve patient outcomes, costs, and
clinician well-being. That logic reflects the chapter’s emphasis
on the case for EBP and the Quadruple Aim.
A: Tradition does not equal effectiveness. Persisting with a
familiar bundle despite poor outcomes is exactly the kind of
pattern EBP is meant to challenge.
C: Nurses do not need to generate new primary research before
improving practice; they should locate and appraise existing
evidence first.
D: Measuring outcomes alone is not enough. A quality review
,without evidence appraisal does not address whether the
intervention is the best available option.
Teaching Point:
EBP changes practice when outcomes, cost, and staff
experience all signal a better approach is needed.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
2)
Reference: Ch. 1 — Spirit of Inquiry — Recognizing Clinical
Uncertainty
Stem:
During handoff, a new graduate nurse notices that two
experienced nurses use different methods to prevent pressure
injuries in the same high-risk population. One says, “We’ve
always done it this way,” while the other says, “That’s just my
preference.” The novice wonders what should guide the unit’s
approach. What action best reflects a spirit of inquiry?
Options:
A. Accept the most senior nurse’s preference as the unit
standard.
B. Ask what evidence supports each method and whether
outcomes differ.
C. Wait until a national guideline is issued before discussing the
, issue.
D. Avoid raising the issue because disagreement among staff is
disruptive.
Correct Answer: B
Rationales:
Correct: A spirit of inquiry begins with noticing variation and
asking evidence-focused questions rather than defaulting to
habit or rank. That is the first move toward EBP culture.
A: Seniority does not validate practice. EBP requires evidence,
not authority, to justify care decisions.
C: Waiting passively delays improvement. Nurses can begin
examining current evidence immediately.
D: Professional disagreement should be handled constructively,
not avoided when patient care may improve.
Teaching Point:
A spirit of inquiry starts when nurses question variation instead
of normalizing it.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
3)
Reference: Ch. 1 — EBP vs. Research vs. QI — Practice Decision-
Making
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1)
Reference: Ch. 1 — EBP Rationale — Quadruple Aim and
Practice Improvement
Stem:
A med-surg unit has persistently higher-than-benchmark fall
rates despite using the same fall-prevention bundle for years.
Several nurses say the bundle is “good enough,” but the
manager notes that patient satisfaction scores, staff burnout,
,and cost of injury-related care are also worsening. Which
interpretation best supports making the case for EBP in this
situation?
Options:
A. The current bundle should remain unchanged because long-
standing practice is inherently reliable.
B. EBP is justified because it can improve outcomes, costs, and
clinician work life while reducing variation in care.
C. This is primarily a research problem because the unit needs a
new randomized trial before changing practice.
D. This should be treated as a quality assurance audit only,
because patient outcomes are already being measured.
Correct Answer: B
Rationales:
Correct: EBP is appropriate when current practice is not
producing desired outcomes and there is a better evidence-
based approach that may improve patient outcomes, costs, and
clinician well-being. That logic reflects the chapter’s emphasis
on the case for EBP and the Quadruple Aim.
A: Tradition does not equal effectiveness. Persisting with a
familiar bundle despite poor outcomes is exactly the kind of
pattern EBP is meant to challenge.
C: Nurses do not need to generate new primary research before
improving practice; they should locate and appraise existing
evidence first.
D: Measuring outcomes alone is not enough. A quality review
,without evidence appraisal does not address whether the
intervention is the best available option.
Teaching Point:
EBP changes practice when outcomes, cost, and staff
experience all signal a better approach is needed.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
2)
Reference: Ch. 1 — Spirit of Inquiry — Recognizing Clinical
Uncertainty
Stem:
During handoff, a new graduate nurse notices that two
experienced nurses use different methods to prevent pressure
injuries in the same high-risk population. One says, “We’ve
always done it this way,” while the other says, “That’s just my
preference.” The novice wonders what should guide the unit’s
approach. What action best reflects a spirit of inquiry?
Options:
A. Accept the most senior nurse’s preference as the unit
standard.
B. Ask what evidence supports each method and whether
outcomes differ.
C. Wait until a national guideline is issued before discussing the
, issue.
D. Avoid raising the issue because disagreement among staff is
disruptive.
Correct Answer: B
Rationales:
Correct: A spirit of inquiry begins with noticing variation and
asking evidence-focused questions rather than defaulting to
habit or rank. That is the first move toward EBP culture.
A: Seniority does not validate practice. EBP requires evidence,
not authority, to justify care decisions.
C: Waiting passively delays improvement. Nurses can begin
examining current evidence immediately.
D: Professional disagreement should be handled constructively,
not avoided when patient care may improve.
Teaching Point:
A spirit of inquiry starts when nurses question variation instead
of normalizing it.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
3)
Reference: Ch. 1 — EBP vs. Research vs. QI — Practice Decision-
Making
