Evidence-Based Practice in Nursing Test Bank 5th Edition |
Melnyk & Fineout-Overholt EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
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EXAM COVERAGE - 1. Introduction to Evidence-Based Practice - 2.
Asking the Clinical Question (PICO) - 3. Searching for Evidence - 4.
Critically Appraising Evidence for Intervention - 5. Critically
Appraising Evidence for Meaning - 6. Evidence-Based Practice
Implementation and Sustainability - 7. Barriers and Facilitators to EBP
- 8. Leadership and Organizational Change - 9. Ethical Considerations
in EBP - 10. Dissemination of EBP Findings
1. A nurse manager is implementing a new fall prevention protocol based on a recent meta-
analysis. Several senior staff members resist, stating, "We have always done it this way, and it
works." Which leadership strategy best addresses this barrier to evidence-based practice (EBP)?
A. Mandate the immediate adoption of the new protocol for all staff.
B. Engage the senior staff in the critical appraisal of the meta-analysis.
C. Dismiss the feedback as resistance to change and proceed with implementation.
D. Provide a brief summary of the research findings in the breakroom.
CORRECT ANSWER : B
Rationale: Engaging staff in critical appraisal fosters ownership and understanding of the
evidence, which is a key strategy for overcoming resistance. Mandating change (A) often leads to
low compliance, while dismissing feedback (C) damages team cohesion. Simply providing a
summary (D) lacks the interactive element necessary to change clinical culture.
2. A clinical nurse specialist (CNS) is forming a team to address rising rates of catheter-associated
urinary tract infections (CAUTI). Which step should the CNS take first when transitioning from
a problem to a clinical question?
A. Perform a comprehensive literature search on PubMed.
B. Develop a PICO(T) question to guide the inquiry.
C. Identify the specific clinical population and the outcome of interest.
, D. Draft a policy change proposal for the nursing administration.
CORRECT ANSWER : C
Rationale: Before a PICO question (B) can be effectively formed, the team must clearly define
the patient population and the specific desired outcome. Literature searching (A) is premature
without a defined question, and policy changes (D) occur after the evidence is synthesized and
appraised.
3. When evaluating the strength of evidence for a nursing intervention, which study design provides
the highest level of rigor?
A. A single qualitative phenomenological study.
B. A non-randomized controlled trial.
C. A systematic review of multiple randomized controlled trials (RCTs).
D. An observational cohort study.
CORRECT ANSWER : C
Rationale: Systematic reviews of multiple RCTs are considered the gold standard in EBP
because they minimize bias and provide a synthesized view of the evidence. Single qualitative
studies (A) and non-randomized trials (B) provide lower levels of evidence regarding causality.
Observational studies (D) are valuable but prone to confounding variables.
4. A nurse researcher is appraising a quantitative study. The p-value for the intervention is reported
as 0.03. How should the nurse interpret this result?
A. The result is clinically significant but not statistically significant.
B. The result is statistically significant at the conventional alpha level of 0.05.
C. The intervention has a high effect size regardless of the sample size.
D. The result indicates that the intervention failed to produce a measurable change.
CORRECT ANSWER : B
Rationale: A p-value of 0.03 is less than the standard threshold of 0.05, meaning the result is
statistically significant. It does not automatically guarantee clinical significance (A). Effect size
(C) is a separate metric, and a p-value of 0.03 specifically indicates a rejection of the null
hypothesis (D).
,5. When utilizing the Iowa Model of Evidence-Based Practice, what is the primary focus during the
"Pilot" phase?
A. Identifying the trigger for the practice change.
B. Determining the feasibility and effectiveness of the change on a small scale.
C. Conducting a full-scale rollout across the entire hospital system.
D. Evaluating the long-term organizational cost-benefit ratio.
CORRECT ANSWER : B
Rationale: The pilot phase allows for testing the intervention in a controlled, smaller
environment to identify potential issues before full-scale implementation (C). Triggers (A) are
identified in the early stages of the model, and long-term evaluation (D) occurs after
implementation is sustained.
6. A nurse is conducting a search for evidence regarding wound care and uses the search string
"wound care AND silver dressing AND healing rate". The search yields zero results. What is the
most appropriate next step for the nurse?
A. Conclude that there is no evidence to support the use of silver dressings.
B. Change the research topic to a more common clinical issue.
C. Broaden the search terms and use controlled vocabulary (MeSH) terms.
D. Search only in clinical nursing textbooks rather than databases.
CORRECT ANSWER : C
Rationale: Zero results often indicate that the search string is too narrow or uses non-standard
terminology. Broadening search terms or using controlled vocabulary like MeSH ensures the
search captures relevant indexed literature. Option A is premature, B changes the focus
unnecessarily, and D limits access to current empirical research.
7. A team is critically appraising a qualitative study on the experience of living with chronic pain.
Which question should the nurse prioritize to determine the study's trustworthiness?
A. Did the study use a large, randomized sample of patients?
B. Was the research method congruent with the study's stated purpose?
C. Was there a high statistical power to detect differences?
, D. Did the study provide numerical data on pain scale improvement?
CORRECT ANSWER : B
Rationale: Trustworthiness in qualitative research is based on methodological rigor and
alignment between the purpose and the method used. Randomized samples (A) and statistical
power (C) are quantitative metrics irrelevant to qualitative inquiry. Numerical data (D) is not
the focus of a qualitative investigation.
8. When calculating the Number Needed to Treat (NNT), a nurse finds the result is 5. How should
this be interpreted for clinical practice?
A. The intervention is ineffective for 5 out of 100 patients.
B. For every 5 patients treated with the intervention, one additional positive outcome is
achieved.
C. The intervention should be avoided because 5 is a high number.
D. The hospital will save money for every 5 patients treated.
CORRECT ANSWER : B
Rationale: The NNT represents the number of patients who need to receive the treatment for one
additional patient to achieve the desired outcome. Lower NNTs are generally better, and A, C,
and D misinterpret the clinical utility and mathematical definition of the statistic.
9. A staff nurse wants to advocate for a change in shift-change reporting based on EBP. Which
organizational strategy best ensures long-term sustainability of this change?
A. Writing a one-time policy update for the unit manual.
B. Integrating the new process into the standard orientation and performance evaluation.
C. Relying on unit managers to remind nurses of the protocol during meetings.
D. Displaying posters with the new guidelines in the nursing station.
CORRECT ANSWER : B
Rationale: Sustainability is achieved when the change becomes part of the organizational
infrastructure, such as training and appraisals. Policy updates (A) and posters (D) are passive,
and reliance on verbal reminders (C) is inconsistent and prone to degradation over time.
10. A nurse researcher is using a forest plot to interpret a systematic review. What does the central
vertical line in a forest plot represent?
Melnyk & Fineout-Overholt EXAM with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE - 1. Introduction to Evidence-Based Practice - 2.
Asking the Clinical Question (PICO) - 3. Searching for Evidence - 4.
Critically Appraising Evidence for Intervention - 5. Critically
Appraising Evidence for Meaning - 6. Evidence-Based Practice
Implementation and Sustainability - 7. Barriers and Facilitators to EBP
- 8. Leadership and Organizational Change - 9. Ethical Considerations
in EBP - 10. Dissemination of EBP Findings
1. A nurse manager is implementing a new fall prevention protocol based on a recent meta-
analysis. Several senior staff members resist, stating, "We have always done it this way, and it
works." Which leadership strategy best addresses this barrier to evidence-based practice (EBP)?
A. Mandate the immediate adoption of the new protocol for all staff.
B. Engage the senior staff in the critical appraisal of the meta-analysis.
C. Dismiss the feedback as resistance to change and proceed with implementation.
D. Provide a brief summary of the research findings in the breakroom.
CORRECT ANSWER : B
Rationale: Engaging staff in critical appraisal fosters ownership and understanding of the
evidence, which is a key strategy for overcoming resistance. Mandating change (A) often leads to
low compliance, while dismissing feedback (C) damages team cohesion. Simply providing a
summary (D) lacks the interactive element necessary to change clinical culture.
2. A clinical nurse specialist (CNS) is forming a team to address rising rates of catheter-associated
urinary tract infections (CAUTI). Which step should the CNS take first when transitioning from
a problem to a clinical question?
A. Perform a comprehensive literature search on PubMed.
B. Develop a PICO(T) question to guide the inquiry.
C. Identify the specific clinical population and the outcome of interest.
, D. Draft a policy change proposal for the nursing administration.
CORRECT ANSWER : C
Rationale: Before a PICO question (B) can be effectively formed, the team must clearly define
the patient population and the specific desired outcome. Literature searching (A) is premature
without a defined question, and policy changes (D) occur after the evidence is synthesized and
appraised.
3. When evaluating the strength of evidence for a nursing intervention, which study design provides
the highest level of rigor?
A. A single qualitative phenomenological study.
B. A non-randomized controlled trial.
C. A systematic review of multiple randomized controlled trials (RCTs).
D. An observational cohort study.
CORRECT ANSWER : C
Rationale: Systematic reviews of multiple RCTs are considered the gold standard in EBP
because they minimize bias and provide a synthesized view of the evidence. Single qualitative
studies (A) and non-randomized trials (B) provide lower levels of evidence regarding causality.
Observational studies (D) are valuable but prone to confounding variables.
4. A nurse researcher is appraising a quantitative study. The p-value for the intervention is reported
as 0.03. How should the nurse interpret this result?
A. The result is clinically significant but not statistically significant.
B. The result is statistically significant at the conventional alpha level of 0.05.
C. The intervention has a high effect size regardless of the sample size.
D. The result indicates that the intervention failed to produce a measurable change.
CORRECT ANSWER : B
Rationale: A p-value of 0.03 is less than the standard threshold of 0.05, meaning the result is
statistically significant. It does not automatically guarantee clinical significance (A). Effect size
(C) is a separate metric, and a p-value of 0.03 specifically indicates a rejection of the null
hypothesis (D).
,5. When utilizing the Iowa Model of Evidence-Based Practice, what is the primary focus during the
"Pilot" phase?
A. Identifying the trigger for the practice change.
B. Determining the feasibility and effectiveness of the change on a small scale.
C. Conducting a full-scale rollout across the entire hospital system.
D. Evaluating the long-term organizational cost-benefit ratio.
CORRECT ANSWER : B
Rationale: The pilot phase allows for testing the intervention in a controlled, smaller
environment to identify potential issues before full-scale implementation (C). Triggers (A) are
identified in the early stages of the model, and long-term evaluation (D) occurs after
implementation is sustained.
6. A nurse is conducting a search for evidence regarding wound care and uses the search string
"wound care AND silver dressing AND healing rate". The search yields zero results. What is the
most appropriate next step for the nurse?
A. Conclude that there is no evidence to support the use of silver dressings.
B. Change the research topic to a more common clinical issue.
C. Broaden the search terms and use controlled vocabulary (MeSH) terms.
D. Search only in clinical nursing textbooks rather than databases.
CORRECT ANSWER : C
Rationale: Zero results often indicate that the search string is too narrow or uses non-standard
terminology. Broadening search terms or using controlled vocabulary like MeSH ensures the
search captures relevant indexed literature. Option A is premature, B changes the focus
unnecessarily, and D limits access to current empirical research.
7. A team is critically appraising a qualitative study on the experience of living with chronic pain.
Which question should the nurse prioritize to determine the study's trustworthiness?
A. Did the study use a large, randomized sample of patients?
B. Was the research method congruent with the study's stated purpose?
C. Was there a high statistical power to detect differences?
, D. Did the study provide numerical data on pain scale improvement?
CORRECT ANSWER : B
Rationale: Trustworthiness in qualitative research is based on methodological rigor and
alignment between the purpose and the method used. Randomized samples (A) and statistical
power (C) are quantitative metrics irrelevant to qualitative inquiry. Numerical data (D) is not
the focus of a qualitative investigation.
8. When calculating the Number Needed to Treat (NNT), a nurse finds the result is 5. How should
this be interpreted for clinical practice?
A. The intervention is ineffective for 5 out of 100 patients.
B. For every 5 patients treated with the intervention, one additional positive outcome is
achieved.
C. The intervention should be avoided because 5 is a high number.
D. The hospital will save money for every 5 patients treated.
CORRECT ANSWER : B
Rationale: The NNT represents the number of patients who need to receive the treatment for one
additional patient to achieve the desired outcome. Lower NNTs are generally better, and A, C,
and D misinterpret the clinical utility and mathematical definition of the statistic.
9. A staff nurse wants to advocate for a change in shift-change reporting based on EBP. Which
organizational strategy best ensures long-term sustainability of this change?
A. Writing a one-time policy update for the unit manual.
B. Integrating the new process into the standard orientation and performance evaluation.
C. Relying on unit managers to remind nurses of the protocol during meetings.
D. Displaying posters with the new guidelines in the nursing station.
CORRECT ANSWER : B
Rationale: Sustainability is achieved when the change becomes part of the organizational
infrastructure, such as training and appraisals. Policy updates (A) and posters (D) are passive,
and reliance on verbal reminders (C) is inconsistent and prone to degradation over time.
10. A nurse researcher is using a forest plot to interpret a systematic review. What does the central
vertical line in a forest plot represent?
