Evidence-Based Practice in Nursing & Healthcare (4th Edition, Bernadette Mazurek Melnyk & Ellen Fineout-Overholt) – Complete Test Bank Chapters 1–23 | A+ Guide

Test Bank For Evidence-Based Practice in Nursing & Healthcare A Guide to
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e Best Practice 5th Edition
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by Bernadette Mazurek Melnyk, Ellen Fineout-Overholt
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Chapter 1 - 23 Complet
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,Chapter1 Making the Case for Evidence-Based Practice and
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Cultivating a Spirit of Inquiry e e e e e




In the hospital where Nurse L. provides care, tradition dictates that oral temperatures be
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included in every set of patient vital signs, regardless of patient diagnosis or acuity. Thisis
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most likely an example of which of the following phenomena? e e e e e e e e e e




A) The prioritization of internal evidence over external evidence
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B) Practice that lacks evidence to support its application e e e e e e e




C) The integration of personal expertise into nursing care
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D) Evidence-based practice e




2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a patient
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chart review after the implementation of a pilot program aimed at promoting early
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ambulation following surgery. Which of the following components of EBP is thenurse
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putting into practice?
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A) Patientpreferences e




B) Research utilization e




C) Experience
D) Internal evidence e




3. Nurse R. has observed that reorienting demented patients as frequently as possible tendsto
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minimize the patients' level of agitation in the evening. The nurse has shared this
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observation with a colleague, who is skeptical, stating that, “It's best to stick to evidence-
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based practice.” How can Nurse R. best respond?
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A) “EBP can include clinicians' personal expertise.”e e e e e




B) “Personal experience is often more sound than formal evidence-based practice.” e e e e e e e e e




C) “Traditional practice and EBP are usually shown to be the same.” e e e e e e e e e e




D) “My years of experience can be just as valuable as any literature review or
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randomized trial.”
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4. Which of the following factors provides the most important rationale for the consistent
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implementation of EBP?
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A) EBP provides for the most cost-effective patient care.
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B) EBP is accessible to all healthcare clinicians.
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C) EBP provides consistency in care across healthcare settings.
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D) EBP improves patient outcomes. e e e

,5. The Institute of Medicine's Roundtable on Evidence-Based Medicine has been
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established to address EBP. Which of the following issues is the Roundtable
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emphasizing?
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A) Ensuring that external evidence, rather than internal evidence, is integrated into e e e e e e e e e e




care e




B) Fostering the level of learning that exists in the American healthcare system e e e e e e e e e e e




C) Issuing clinical guidelines to ensure best nursing practice e e e e e e e




D) Comparing the implementation of EBP in the United States with that of other e e e e e e e e e e e e




Western countries
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6. You have become frustrated with some aspects of patient care that you believe are
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outdated and ineffective at the long-term care facility where you have recently begun
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practicing. Consequently, you have resolved to examine some of these practices in lightof
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evidence. Which of the following should occur first in the steps of EBP?
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A) Conducting an electronic search of the literature and ranking individual sources e e e e e e e e e e




B) Creating “buy-in” from the other clinicians who provide care at the facility e e e e e e e e e e e




C) Developing an inquisitive and curious mindset e e e e e




D) Assessing whether the practices in question may, in fact, be evidence-based e e e e e e e e e e




7. Which of the following clinical questions best exemplifies the PICOT format?
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A) What effect does parents' smoking have on the smoking habits of their children,
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ages 13 to 16?
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B) Among cancer patients, what role does meditation, rather than benzodiazepines, e e e e e e e e e




have on anxiety levels during the 7 days following hospital admission?
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C) Among undergraduate college students, what is the effectiveness of a sexual health
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campaign undertaken during the first 4 weeks of the fall semester as measured by
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incidence of new gonorrheal and chlamydial infections reported to the campus
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medical center?
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D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to a
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numeric rating scale in the emergency room context?
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8. After formulating a clinical question, a nurse has proceeded to search for evidence for ways
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to foster restful sleep in patients who are receiving care in the intensive care unit (ICU). The
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nurse has identified a relevant meta-analysis in an electronic database. Whatwill this
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source of evidence consist of?
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A) Astatistical summaryof the results from severaldifferent studies
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B) An examination of the theoretical and conceptual underpinnings of the issue
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C) An interdisciplinary analysis of the clinical question
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D) A qualitative study of different interventions related to the clinical question
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, 9. The nurses on a postpartum unit have noted that many primiparous (first-time) mothers
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are giving up on breastfeeding within the 24 hours following delivery, and the nurses want
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to create uniform guidelines for promoting breastfeeding on the unit. Which of the
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following sources is most likely to provide the best evidence in their quest for an
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intervention?
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A) Evidence from a randomized control trial that had more than 2500 participants e e e e e e e e e e e




B) Evidence from a study that is widely regarded as a classic within the obstetrical e e e e e e e e e e e e e




nursing community
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C) Evidence from a systematic review of breastfeeding-promotion studies that one of e e e e e e e e e e




the nurses identified in an electronic database
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D) The consensus opinion of the most senior nurses on the unit
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10. The nurse educator on an acute medicine unit is advocating for the use of
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evidence-based clinical practice guidelines on wound care in order to standardize and e e e e e e e e e e e




optimize the practice of the nurses on the unit. Which of the following statements best
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describes clinical practice guidelines?
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A) The result of replication studies of existing research by an impartial third party
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B) A collection of authorized interventions that are required by law
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C) A number of interventions that are the result of a large, publically-funded RCT
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D) A group of practice recommendations that result from a rigorous review of the
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literature e




11. A nurse is conducting a literature review on the evidence regarding the use of vacuum
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dressings on stage IV pressure ulcers. After locating a recent study that appears to be
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relevant, which of the following questions would the nurse consider first when critically
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appraising the study?
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A) “Are the findings of this study cost-effective in our clinical context?”
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B) "How would the implementation of this intervention affect our staffing needs?"
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C) “Were the patients in the study similar to the patients on my unit?” e e e e e e e e e e e e




D) “Are the findings of the study significantly different from what we are currently
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doing on the unit?
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12. The primary care provider of a 49-year-old male patient has examined and briefly
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explained the evidence that supports beginning regular digital-rectal exams. Which of
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the following factors would justify not performing digital-rectal examinations in this
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patient's care?
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A) The patient is vehemently opposed to undergoing a digital-rectal exam.
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B) Clinical practice guidelines for prostate care have not been published. e e e e e e e e e




C) The clinician has been unable to find any large RCTs in a literature review.
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D) The clinician has previously waited until patients are 55 to begin regular
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digital-rectal exams.
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