NR 449 EVIDENCE-BASED PRACTICE EXAMINATION
COMPREHENSIVE 9. REFOREE EXAM 2026
COMPLETE EXAM QUESTIONS AND VERIFIED
ANSWERS | 2026–2027 LATEST UPDATE |
GUARANTEED PASS | DETAILED RATIONALES |
FULL STUDY GUIDE | EXAM PREP | PRACTICE TEST |
CERTIFICATION PREPARATION
1. A nurse is beginning an evidence-based practice (EBP) project to reduce patient falls on
a medical-surgical unit. What should be the first step in the EBP process?
A. Implement a fall-prevention protocol
B. Review published literature
C. Identify a clinical problem
D. Evaluate project outcomes
Correct Answer: C. Identify a clinical problem
Rationale: The EBP process begins with recognizing and clearly defining a clinical issue that
requires improvement. Literature review, implementation, and evaluation occur after the
problem has been identified and refined into a focused question.
2. Which component of the PICOT framework identifies the desired measurable result?
A. Population
B. Outcome
C. Intervention
D. Time
Correct Answer: B. Outcome
Rationale: The Outcome component specifies the expected result or effect of the intervention.
Population identifies the patient group, Intervention identifies the action, and Time indicates the
duration for measurement.
3. A nurse researcher is reviewing several studies on pressure injury prevention. Which
source provides the highest level of evidence?
A. Expert opinion article
B. Case study
C. Cohort study
D. Systematic review with meta-analysis
,Correct Answer: D. Systematic review with meta-analysis
Rationale: Systematic reviews and meta-analyses synthesize findings from multiple high-quality
studies, providing the strongest level of evidence for clinical decision-making.
4. Which statement best describes evidence-based practice?
A. Following physician preferences exclusively
B. Using hospital policies without question
C. Combining research evidence, clinical expertise, and patient preferences
D. Relying primarily on personal experience
Correct Answer: C. Combining research evidence, clinical expertise, and patient
preferences
Rationale: EBP integrates the best available research, clinician expertise, and patient values to
support optimal healthcare decisions.
5. A nurse develops the PICOT question: "In hospitalized older adults, does hourly
rounding compared with routine care reduce fall rates within three months?" Which
element represents the comparison?
A. Hospitalized older adults
B. Hourly rounding
C. Reduce fall rates
D. Routine care
Correct Answer: D. Routine care
Rationale: The Comparison identifies the alternative intervention or standard practice against
which the intervention is evaluated.
6. Which database is commonly used to locate nursing and allied health research studies?
A. CINAHL
B. QuickBooks
C. Blackboard
D. Canvas
Correct Answer: A. CINAHL
Rationale: CINAHL is a major database for nursing and allied health literature. The other
options are not research databases.
7. A nurse manager wants to improve hand hygiene compliance. Which outcome measure
would be most appropriate?
, A. Number of staff meetings held
B. Percentage of hand hygiene adherence observed
C. Number of nursing shifts scheduled
D. Employee satisfaction score only
Correct Answer: B. Percentage of hand hygiene adherence observed
Rationale: Compliance rates directly measure hand hygiene behavior and are appropriate
indicators of intervention effectiveness.
8. What is the primary purpose of critically appraising research evidence?
A. To increase publication rates
B. To identify study authors
C. To determine the quality and applicability of findings
D. To replace clinical judgment
Correct Answer: C. To determine the quality and applicability of findings
Rationale: Critical appraisal evaluates validity, reliability, relevance, and applicability before
findings are integrated into practice.
9. A nurse reviews a randomized controlled trial (RCT). What characteristic is a major
strength of this study design?
A. Low cost
B. Ability to establish stronger cause-and-effect relationships
C. Reliance on expert opinion
D. Small sample size
Correct Answer: B. Ability to establish stronger cause-and-effect relationships
Rationale: Randomization helps reduce bias and improves the ability to determine whether an
intervention caused an outcome.
10. Which action best demonstrates patient-centered care during an EBP project?
A. Ignoring patient concerns
B. Implementing interventions without explanation
C. Including patient preferences in care decisions
D. Limiting communication
Correct Answer: C. Including patient preferences in care decisions
Rationale: Patient-centered care requires incorporating individual values, preferences, and
goals into decision-making.
COMPREHENSIVE 9. REFOREE EXAM 2026
COMPLETE EXAM QUESTIONS AND VERIFIED
ANSWERS | 2026–2027 LATEST UPDATE |
GUARANTEED PASS | DETAILED RATIONALES |
FULL STUDY GUIDE | EXAM PREP | PRACTICE TEST |
CERTIFICATION PREPARATION
1. A nurse is beginning an evidence-based practice (EBP) project to reduce patient falls on
a medical-surgical unit. What should be the first step in the EBP process?
A. Implement a fall-prevention protocol
B. Review published literature
C. Identify a clinical problem
D. Evaluate project outcomes
Correct Answer: C. Identify a clinical problem
Rationale: The EBP process begins with recognizing and clearly defining a clinical issue that
requires improvement. Literature review, implementation, and evaluation occur after the
problem has been identified and refined into a focused question.
2. Which component of the PICOT framework identifies the desired measurable result?
A. Population
B. Outcome
C. Intervention
D. Time
Correct Answer: B. Outcome
Rationale: The Outcome component specifies the expected result or effect of the intervention.
Population identifies the patient group, Intervention identifies the action, and Time indicates the
duration for measurement.
3. A nurse researcher is reviewing several studies on pressure injury prevention. Which
source provides the highest level of evidence?
A. Expert opinion article
B. Case study
C. Cohort study
D. Systematic review with meta-analysis
,Correct Answer: D. Systematic review with meta-analysis
Rationale: Systematic reviews and meta-analyses synthesize findings from multiple high-quality
studies, providing the strongest level of evidence for clinical decision-making.
4. Which statement best describes evidence-based practice?
A. Following physician preferences exclusively
B. Using hospital policies without question
C. Combining research evidence, clinical expertise, and patient preferences
D. Relying primarily on personal experience
Correct Answer: C. Combining research evidence, clinical expertise, and patient
preferences
Rationale: EBP integrates the best available research, clinician expertise, and patient values to
support optimal healthcare decisions.
5. A nurse develops the PICOT question: "In hospitalized older adults, does hourly
rounding compared with routine care reduce fall rates within three months?" Which
element represents the comparison?
A. Hospitalized older adults
B. Hourly rounding
C. Reduce fall rates
D. Routine care
Correct Answer: D. Routine care
Rationale: The Comparison identifies the alternative intervention or standard practice against
which the intervention is evaluated.
6. Which database is commonly used to locate nursing and allied health research studies?
A. CINAHL
B. QuickBooks
C. Blackboard
D. Canvas
Correct Answer: A. CINAHL
Rationale: CINAHL is a major database for nursing and allied health literature. The other
options are not research databases.
7. A nurse manager wants to improve hand hygiene compliance. Which outcome measure
would be most appropriate?
, A. Number of staff meetings held
B. Percentage of hand hygiene adherence observed
C. Number of nursing shifts scheduled
D. Employee satisfaction score only
Correct Answer: B. Percentage of hand hygiene adherence observed
Rationale: Compliance rates directly measure hand hygiene behavior and are appropriate
indicators of intervention effectiveness.
8. What is the primary purpose of critically appraising research evidence?
A. To increase publication rates
B. To identify study authors
C. To determine the quality and applicability of findings
D. To replace clinical judgment
Correct Answer: C. To determine the quality and applicability of findings
Rationale: Critical appraisal evaluates validity, reliability, relevance, and applicability before
findings are integrated into practice.
9. A nurse reviews a randomized controlled trial (RCT). What characteristic is a major
strength of this study design?
A. Low cost
B. Ability to establish stronger cause-and-effect relationships
C. Reliance on expert opinion
D. Small sample size
Correct Answer: B. Ability to establish stronger cause-and-effect relationships
Rationale: Randomization helps reduce bias and improves the ability to determine whether an
intervention caused an outcome.
10. Which action best demonstrates patient-centered care during an EBP project?
A. Ignoring patient concerns
B. Implementing interventions without explanation
C. Including patient preferences in care decisions
D. Limiting communication
Correct Answer: C. Including patient preferences in care decisions
Rationale: Patient-centered care requires incorporating individual values, preferences, and
goals into decision-making.
