Test Bank For Evidence-Based Practice in Nursing & Healthcare A Guide to Best Practice 5th
Edition by Melnyk, Ellen Fineout-Overholt Chapter 1 - 23 Complete
Chapter 1 Making the Case for Evidence-
ry ry ry ry ry ry
Based Practice and Cultivating a Spirit of Inquiry
ry ry ry ry ry ry ry
, In the hospital where Nurse L. provides care, tradition dictates that oral temperatur
ry ry ry ry ry ry ry ry ry ry ry ry
es be included in every set of patient vital signs, regardless of patient diagnosis or a
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
cuity. Thisis most likely an example of which of the following phenomena?
ry ry ry ry ry ry ry ry ry ry ry ry
A) The prioritization of internal evidence over external evidence
ry ry ry ry ry ry ry
B) Practice that lacks evidence to support its application ry ry ry ry ry ry ry
C) The integration of personal expertise into nursing care
ry ry ry ry ry ry ry
D) Evidence-based practice ry
2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed
ry ry ry ry ry ry ry ry ry ry ry ry
a patient chart review after the implementation of a pilot program aimed at prom
ry ry ry ry ry ry ry ry ry ry ry ry ry
oting early ambulation following surgery. Which of the following components of
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EBP is thenurse putting into practice?
y ry ry ry ry ry ry
A) Patient preferences ry
B) Research utilization ry
C) Experience
D) Internal evidence ry
3. Nurse R. has observed that reorienting demented patients as frequently as possible
ry ry ry ry ry ry ry ry ry ry ry ry
tendsto minimize the patients' level of agitation in the evening. The nurse has share
ry ry ry ry ry ry ry ry ry ry ry ry ry ry
d this observation with a colleague, who is skeptical, stating that, “It's best to stick
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
to evidence-based practice.” How can Nurse R. best respond?
ry ry ry ry ry ry ry ry
A) “EBP can include clinicians' personal expertise.” ry ry ry ry ry
B) “Personal experience is often more sound than formal evidence-based practice.” ry ry ry ry ry ry ry ry ry
C) “Traditional practice and EBP are usually shown to be the same.” ry ry ry ry ry ry ry ry ry ry
D) “My years of experience can be just as valuable as any literature revie
ry ry ry ry ry ry ry ry ry ry ry ry
w orrandomized trial.” ry ry ry
4. Which of the following factors provides the most important rationale for the cons
ry ry ry ry ry ry ry ry ry ry ry ry
istentimplementation of EBP?
ry ry ry
A) EBP provides for the most cost-effective patient care.
ry ry ry ry ry ry ry
B) EBP is accessible to all healthcare clinicians. ry ry ry ry ry ry
C) EBP provides consistency in care across healthcare settings.
ry ry ry ry ry ry ry
D) EBP improves patient outcomes. ry ry ry
,5. The Institute of Medicine's Roundtable on Evidence-
ry ry ry ry ry ry
Based Medicine has beenestablished to address EBP. Which of the follo
ry ry ry ry ry ry ry ry ry ry ry
wing issues is the Roundtable emphasizing?
ry ry ry ry ry
A) Ensuring that external evidence, rather than internal evidence, is integrate ry ry ry ry ry ry ry ry ry
d intocare ry ry
B) Fostering the level of learning that exists in the American healthcare system ry ry ry ry ry ry ry ry ry ry ry
C) Issuing clinical guidelines to ensure best nursing practice ry ry ry ry ry ry ry
D) Comparing the implementation of EBP in the United States with that of ry ry ry ry ry ry ry ry ry ry ry ry
otherWestern countries ry ry
6. You have become frustrated with some aspects of patient care that you believe are
ry ry ry ry ry ry ry ry ry ry ry ry ry ry
outdated and ineffective at the long- ry ry ry ry ry
term care facility where you have recently begun practicing. Consequently, you ha
ry ry ry ry ry ry ry ry ry ry ry
ve resolved to examine some of these practices in lightof evidence. Which of the f
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
ollowing should occur first in the steps of EBP? ry ry ry ry ry ry ry ry
A) Conducting an electronic search of the literature and ranking individual sources ry ry ry ry ry ry ry ry ry ry
B) Creating “buy-in” from the other clinicians who provide care at the facility ry ry ry ry ry ry ry ry ry ry ry
C) Developing an inquisitive and curious mindset ry ry ry ry ry
D) Assessing whether the practices in question may, in fact, be evidence-based ry ry ry ry ry ry ry ry ry ry
7. Which of the following clinical questions best exemplifies the PICOT format?
ry ry ry ry ry ry ry ry ry ry
A) What effect does parents' smoking have on the smoking habits of their chil
ry ry ry ry ry ry ry ry ry ry ry ry
dren,ages 13 to 16? ry ry ry ry
B) Among cancer patients, what role does meditation, rather than benzodiazep ry ry ry ry ry ry ry ry ry
ines,have on anxiety levels during the 7 days following hospital admission
ry ry ry ry ry ry ry ry ry ry ry
?
C) Among undergraduate college students, what is the effectiveness of a sexual h ry ry ry ry ry ry ry ry ry ry ry
ealthcampaign undertaken during the first 4 weeks of the fall semester as mea
ry ry ry ry ry ry ry ry ry ry ry ry ry
sured by incidence of new gonorrheal and chlamydial infections reported to t
ry ry ry ry ry ry ry ry ry ry ry
he campus medical center? ry ry ry
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
to anumeric rating scale in the emergency room context?
ry ry ry ry ry ry ry ry ry ry
8. After formulating a clinical question, a nurse has proceeded to search for evidence
ry ry ry ry ry ry ry ry ry ry ry ry ry
for ways to foster restful sleep in patients who are receiving care in the intensive ca
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
re unit (ICU). The nurse has identified a relevant meta-
ry ry ry ry ry ry ry ry ry
analysis in an electronic database. Whatwill this source of evidence consist of?
ry ry ry ry ry ry ry ry ry ry ry ry
A) A statistical summary of the results from several different studies
ry ry ry ry ry ry ry ry ry
B) An examination of the theoretical and conceptual underpinnings of the issue
ry ry ry ry ry ry ry ry ry ry
C) An interdisciplinary analysis of the clinical question
ry ry ry ry ry ry
D) A qualitative study of different interventions related to the clinical question
ry ry ry ry ry ry ry ry ry ry
, 9. The nurses on a postpartum unit have noted that many primiparous (first-
ry ry ry ry ry ry ry ry ry ry ry
time) mothers are giving up on breastfeeding within the 24 hours following delive
ry ry ry ry ry ry ry ry ry ry ry ry
ry, and the nurses want to create uniform guidelines for promoting breastfeeding o
ry ry ry ry ry ry ry ry ry ry ry ry
n the unit. Which of thefollowing sources is most likely to provide the best eviden
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
ce in their quest for an intervention?
ry ry ry ry ry ry
A) Evidence from a randomized control trial that had more than 2500 participants ry ry ry ry ry ry ry ry ry ry ry
B) Evidence from a study that is widely regarded as a classic within the obstet ry ry ry ry ry ry ry ry ry ry ry ry ry
ricalnursing community ry ry
C) Evidence from a systematic review of breastfeeding- ry ry ry ry ry ry
promotion studies that one ofthe nurses identified in an electronic database ry ry ry ry ry ry ry ry ry ry ry
D) The consensus opinion of the most senior nurses on the unit
ry ry ry ry ry ry ry ry ry ry
10. The nurse educator on an acute medicine unit is advocating for the use of
ry ry ry ry ry ry ry ry ry ry ry ry ry
evidence-
based clinical practice guidelines on wound care in order to standardize and opti
ry ry ry ry ry ry ry ry ry ry ry ry
mize the practice of the nurses on the unit. Which of the following statements bes
ry ry ry ry ry ry ry ry ry ry ry ry ry ry
tdescribes clinical practice guidelines?
ry ry ry ry
A) The result of replication studies of existing research by an impartial third party
ry ry ry ry ry ry ry ry ry ry ry ry
B) A collection of authorized interventions that are required by law
ry ry ry ry ry ry ry ry ry
C) A number of interventions that are the result of a large, publically-funded RCT
ry ry ry ry ry ry ry ry ry ry ry ry
D) A group of practice recommendations that result from a rigorous review o
ry ry ry ry ry ry ry ry ry ry ry
f theliterature ry ry
11. A nurse is conducting a literature review on the evidence regarding the use of vacu
ry ry ry ry ry ry ry ry ry ry ry ry ry ry
um dressings on stage IV pressure ulcers. After locating a recent study that appears
ry ry ry ry ry ry ry ry ry ry ry ry ry
to be relevant, which of the following questions would the nurse consider first wh
ry ry ry ry ry ry ry ry ry ry ry ry ry ry
en criticallyappraising the study?
ry ry ry ry
A) “Are the findings of this study cost-effective in our clinical context?”
ry ry ry ry ry ry ry ry ry ry
B) "How would the implementation of this intervention affect our staffing needs?"
ry ry ry ry ry ry ry ry ry ry
C) “Were the patients in the study similar to the patients on my unit?” ry ry ry ry ry ry ry ry ry ry ry ry
D) “Are the findings of the study significantly different from what we are curr
ry ry ry ry ry ry ry ry ry ry ry ry
entlydoing on the unit? ry ry ry ry
12. The primary care provider of a 49-year-
ry ry ry ry ry ry
old male patient has examined and briefly explained the evidence that supports b
ry ry ry ry ry ry ry ry ry ry ry ry
eginning regular digital- ry ry
rectal exams. Which ofthe following factors would justify not performing digital
ry ry ry ry ry ry ry ry ry ry ry
-rectal examinations in this patient's care? ry ry ry ry ry
A) The patient is vehemently opposed to undergoing a digital-rectal exam.
ry ry ry ry ry ry ry ry ry
B) Clinical practice guidelines for prostate care have not been published. ry ry ry ry ry ry ry ry ry
C) The clinician has been unable to find any large RCTs in a literature review.
ry ry ry ry ry ry ry ry ry ry ry ry ry
D) The clinician has previously waited until patients are 55 to begin reg
ry ry ry ry ry ry ry ry ry ry ry
Edition by Melnyk, Ellen Fineout-Overholt Chapter 1 - 23 Complete
Chapter 1 Making the Case for Evidence-
ry ry ry ry ry ry
Based Practice and Cultivating a Spirit of Inquiry
ry ry ry ry ry ry ry
, In the hospital where Nurse L. provides care, tradition dictates that oral temperatur
ry ry ry ry ry ry ry ry ry ry ry ry
es be included in every set of patient vital signs, regardless of patient diagnosis or a
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
cuity. Thisis most likely an example of which of the following phenomena?
ry ry ry ry ry ry ry ry ry ry ry ry
A) The prioritization of internal evidence over external evidence
ry ry ry ry ry ry ry
B) Practice that lacks evidence to support its application ry ry ry ry ry ry ry
C) The integration of personal expertise into nursing care
ry ry ry ry ry ry ry
D) Evidence-based practice ry
2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed
ry ry ry ry ry ry ry ry ry ry ry ry
a patient chart review after the implementation of a pilot program aimed at prom
ry ry ry ry ry ry ry ry ry ry ry ry ry
oting early ambulation following surgery. Which of the following components of
ry ry ry ry ry ry ry ry ry ry r
EBP is thenurse putting into practice?
y ry ry ry ry ry ry
A) Patient preferences ry
B) Research utilization ry
C) Experience
D) Internal evidence ry
3. Nurse R. has observed that reorienting demented patients as frequently as possible
ry ry ry ry ry ry ry ry ry ry ry ry
tendsto minimize the patients' level of agitation in the evening. The nurse has share
ry ry ry ry ry ry ry ry ry ry ry ry ry ry
d this observation with a colleague, who is skeptical, stating that, “It's best to stick
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
to evidence-based practice.” How can Nurse R. best respond?
ry ry ry ry ry ry ry ry
A) “EBP can include clinicians' personal expertise.” ry ry ry ry ry
B) “Personal experience is often more sound than formal evidence-based practice.” ry ry ry ry ry ry ry ry ry
C) “Traditional practice and EBP are usually shown to be the same.” ry ry ry ry ry ry ry ry ry ry
D) “My years of experience can be just as valuable as any literature revie
ry ry ry ry ry ry ry ry ry ry ry ry
w orrandomized trial.” ry ry ry
4. Which of the following factors provides the most important rationale for the cons
ry ry ry ry ry ry ry ry ry ry ry ry
istentimplementation of EBP?
ry ry ry
A) EBP provides for the most cost-effective patient care.
ry ry ry ry ry ry ry
B) EBP is accessible to all healthcare clinicians. ry ry ry ry ry ry
C) EBP provides consistency in care across healthcare settings.
ry ry ry ry ry ry ry
D) EBP improves patient outcomes. ry ry ry
,5. The Institute of Medicine's Roundtable on Evidence-
ry ry ry ry ry ry
Based Medicine has beenestablished to address EBP. Which of the follo
ry ry ry ry ry ry ry ry ry ry ry
wing issues is the Roundtable emphasizing?
ry ry ry ry ry
A) Ensuring that external evidence, rather than internal evidence, is integrate ry ry ry ry ry ry ry ry ry
d intocare ry ry
B) Fostering the level of learning that exists in the American healthcare system ry ry ry ry ry ry ry ry ry ry ry
C) Issuing clinical guidelines to ensure best nursing practice ry ry ry ry ry ry ry
D) Comparing the implementation of EBP in the United States with that of ry ry ry ry ry ry ry ry ry ry ry ry
otherWestern countries ry ry
6. You have become frustrated with some aspects of patient care that you believe are
ry ry ry ry ry ry ry ry ry ry ry ry ry ry
outdated and ineffective at the long- ry ry ry ry ry
term care facility where you have recently begun practicing. Consequently, you ha
ry ry ry ry ry ry ry ry ry ry ry
ve resolved to examine some of these practices in lightof evidence. Which of the f
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
ollowing should occur first in the steps of EBP? ry ry ry ry ry ry ry ry
A) Conducting an electronic search of the literature and ranking individual sources ry ry ry ry ry ry ry ry ry ry
B) Creating “buy-in” from the other clinicians who provide care at the facility ry ry ry ry ry ry ry ry ry ry ry
C) Developing an inquisitive and curious mindset ry ry ry ry ry
D) Assessing whether the practices in question may, in fact, be evidence-based ry ry ry ry ry ry ry ry ry ry
7. Which of the following clinical questions best exemplifies the PICOT format?
ry ry ry ry ry ry ry ry ry ry
A) What effect does parents' smoking have on the smoking habits of their chil
ry ry ry ry ry ry ry ry ry ry ry ry
dren,ages 13 to 16? ry ry ry ry
B) Among cancer patients, what role does meditation, rather than benzodiazep ry ry ry ry ry ry ry ry ry
ines,have on anxiety levels during the 7 days following hospital admission
ry ry ry ry ry ry ry ry ry ry ry
?
C) Among undergraduate college students, what is the effectiveness of a sexual h ry ry ry ry ry ry ry ry ry ry ry
ealthcampaign undertaken during the first 4 weeks of the fall semester as mea
ry ry ry ry ry ry ry ry ry ry ry ry ry
sured by incidence of new gonorrheal and chlamydial infections reported to t
ry ry ry ry ry ry ry ry ry ry ry
he campus medical center? ry ry ry
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
to anumeric rating scale in the emergency room context?
ry ry ry ry ry ry ry ry ry ry
8. After formulating a clinical question, a nurse has proceeded to search for evidence
ry ry ry ry ry ry ry ry ry ry ry ry ry
for ways to foster restful sleep in patients who are receiving care in the intensive ca
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
re unit (ICU). The nurse has identified a relevant meta-
ry ry ry ry ry ry ry ry ry
analysis in an electronic database. Whatwill this source of evidence consist of?
ry ry ry ry ry ry ry ry ry ry ry ry
A) A statistical summary of the results from several different studies
ry ry ry ry ry ry ry ry ry
B) An examination of the theoretical and conceptual underpinnings of the issue
ry ry ry ry ry ry ry ry ry ry
C) An interdisciplinary analysis of the clinical question
ry ry ry ry ry ry
D) A qualitative study of different interventions related to the clinical question
ry ry ry ry ry ry ry ry ry ry
, 9. The nurses on a postpartum unit have noted that many primiparous (first-
ry ry ry ry ry ry ry ry ry ry ry
time) mothers are giving up on breastfeeding within the 24 hours following delive
ry ry ry ry ry ry ry ry ry ry ry ry
ry, and the nurses want to create uniform guidelines for promoting breastfeeding o
ry ry ry ry ry ry ry ry ry ry ry ry
n the unit. Which of thefollowing sources is most likely to provide the best eviden
ry ry ry ry ry ry ry ry ry ry ry ry ry ry ry
ce in their quest for an intervention?
ry ry ry ry ry ry
A) Evidence from a randomized control trial that had more than 2500 participants ry ry ry ry ry ry ry ry ry ry ry
B) Evidence from a study that is widely regarded as a classic within the obstet ry ry ry ry ry ry ry ry ry ry ry ry ry
ricalnursing community ry ry
C) Evidence from a systematic review of breastfeeding- ry ry ry ry ry ry
promotion studies that one ofthe nurses identified in an electronic database ry ry ry ry ry ry ry ry ry ry ry
D) The consensus opinion of the most senior nurses on the unit
ry ry ry ry ry ry ry ry ry ry
10. The nurse educator on an acute medicine unit is advocating for the use of
ry ry ry ry ry ry ry ry ry ry ry ry ry
evidence-
based clinical practice guidelines on wound care in order to standardize and opti
ry ry ry ry ry ry ry ry ry ry ry ry
mize the practice of the nurses on the unit. Which of the following statements bes
ry ry ry ry ry ry ry ry ry ry ry ry ry ry
tdescribes clinical practice guidelines?
ry ry ry ry
A) The result of replication studies of existing research by an impartial third party
ry ry ry ry ry ry ry ry ry ry ry ry
B) A collection of authorized interventions that are required by law
ry ry ry ry ry ry ry ry ry
C) A number of interventions that are the result of a large, publically-funded RCT
ry ry ry ry ry ry ry ry ry ry ry ry
D) A group of practice recommendations that result from a rigorous review o
ry ry ry ry ry ry ry ry ry ry ry
f theliterature ry ry
11. A nurse is conducting a literature review on the evidence regarding the use of vacu
ry ry ry ry ry ry ry ry ry ry ry ry ry ry
um dressings on stage IV pressure ulcers. After locating a recent study that appears
ry ry ry ry ry ry ry ry ry ry ry ry ry
to be relevant, which of the following questions would the nurse consider first wh
ry ry ry ry ry ry ry ry ry ry ry ry ry ry
en criticallyappraising the study?
ry ry ry ry
A) “Are the findings of this study cost-effective in our clinical context?”
ry ry ry ry ry ry ry ry ry ry
B) "How would the implementation of this intervention affect our staffing needs?"
ry ry ry ry ry ry ry ry ry ry
C) “Were the patients in the study similar to the patients on my unit?” ry ry ry ry ry ry ry ry ry ry ry ry
D) “Are the findings of the study significantly different from what we are curr
ry ry ry ry ry ry ry ry ry ry ry ry
entlydoing on the unit? ry ry ry ry
12. The primary care provider of a 49-year-
ry ry ry ry ry ry
old male patient has examined and briefly explained the evidence that supports b
ry ry ry ry ry ry ry ry ry ry ry ry
eginning regular digital- ry ry
rectal exams. Which ofthe following factors would justify not performing digital
ry ry ry ry ry ry ry ry ry ry ry
-rectal examinations in this patient's care? ry ry ry ry ry
A) The patient is vehemently opposed to undergoing a digital-rectal exam.
ry ry ry ry ry ry ry ry ry
B) Clinical practice guidelines for prostate care have not been published. ry ry ry ry ry ry ry ry ry
C) The clinician has been unable to find any large RCTs in a literature review.
ry ry ry ry ry ry ry ry ry ry ry ry ry
D) The clinician has previously waited until patients are 55 to begin reg
ry ry ry ry ry ry ry ry ry ry ry
