Evidence Based Practice Moodle Quiz Questions and Complete Solutions

Evidence Practice Exam Questions with Complete Solutions When formulating the plan of care for a new admission, the nurse recognizes that evidence-based practice is most helpful to the nurse when: The nurse determines the client's nursing diagnoses. Determining the client's dietary needs Evaluating the client's outcomes of care Collecting data regarding the client's current medications - Ans: Evaluating the client's outcomes of care Rationale: A goal of evidence-based practice is to improve client care, and the best way to justify care is by evaluating the client's response to care by examining outcomes. Nursing diagnoses are formulated after the client has been assessed and are not necessarily found in nursing research. Collecting data about the client's medication is not enhanced by evidence-based practice. The client's dietary needs are usually determined by the physician. Nursing Process: Evaluation Client Need: Physiological Integrity Cognitive Level: Understanding A nurse preceptor explains to a graduate nurse that the hospital uses evidence-based practice (EBP) because: EBP helps determine the client's preferences of care. EBP assists in the evaluation of nurses' performance. Care cannot be given unless it is backed by research. EBP provides credibility to the profession. - Ans: EBP provides credibility to the profession. Feedback Rationale: Evidence-based care provides credibility for the profession because the profession can demonstrate through research that client outcomes are positive. Some agencies do not use EBP but deliver care based on experience or trial and error. EBP is not designed to evaluate a nurse's performance. EBP will not determine a client's preferences; a nursing assessment will. Nursing Process: Implementation Client Need: Physiological Integrity Cognitive Level: Understanding In order to overcome some of the barriers to evidence- based practice (EBP), the nurse manager plans to: Have the nurses petition the administration for support. Ask the nurses on the unit to go back to school. Buy computers for the nursing staff. Ask the nurses to read articles and report to the unit. - Ans: Ask the nurses to read articles and report to the unit. Feedback Rationale: There is a wealth of knowledge and research in nursing journals. The manager could ask each nurse to read an article and then report a summary during staff meetings. It would not be reasonable to ask nurses to go back to school although supporting nurses who do is good practice. Most hospitals have computers available that the nurses can use to access information during down time. It would not be necessary to have administrative support if the nurses read articles. Nursing Process: Planning Client Need: Health Promotion and Maintenance Cognitive Level: Applying The nurse preceptor tells the nursing student that participation in nursing research will most likely help the student: Improve daily practice. Develop a better attitude about work. Improve communication with clients. Improve the development of skills. - Ans: Improve daily practice. Rationale: Nursing research aims to help nurses improve daily practice by increasing nursing knowledge. Research will not necessarily help nurses have a better attitude, improve skills, or improve communication. Nursing Process: Assessment Client Need: Safe, Effective Care Environment Cognitive Level: Remembering The new nurse is interested in learning more about nursing research. The nurse preceptor would describe a literature review as all except: A non-essential part of the research process A means for the student nurse to identify past research findings on the research topic Is part of the evidence retrieval process of the research process A way to look for clinical evidence from research sources - Ans: A non-essential part of the research process Rationale: Looking for clinical evidence from research sources usually includes a review of the pertinent literature related to the subject. It provides a means to identify past research finding on the research topic, is a part of the evidence retrieval process of the research, and is an essential part of the research process. Nursing Process: Implementation Client Need: Health Promotion and Maintenance Cognitive Level: Remembering The nurse is caring for a client who continues to develop pressure sores despite the trial and error measures the nurses have taken to protect the client's skin. What can the nurse do to provide evidence-based care ? Call the physician for advice on wound care. Incorporate research to improve client's outcome. Mandate the client change his own dressing. Use the most expensive wound care supplies to improve client's outcome. - Ans: Incorporate research to improve client's outcome. Feedback Rationale: Trial and error is a means of attempting to gain knowledge. It is not necessarily based on research because it is not a systematic or scientific approach to the problem. Evidence-based nursing is based on research to improved client outcomes. While the nurse may call the physician regarding the client's condition, this action is not evidence-based. Using the most expensive wound care supplies and mandating the client change the wound dressing is not appropriate. Nursing Process: Evaluation Client Need: Physiological Integrity Cognitive Level: Understanding Regarding research and nursing care, the ANA expects that all nurses will: Integrate research findings into care. Improve assessment skills. Create research questions. Report findings to clients. - Ans: Integrate research findings into care. Rationale: The ANA established research standards with the goal that nurses will integrate findings into improved care for the client. Individual nurses would not be responsible for reporting findings to clients. Assessment skills are gained through education and experience. Some nurses will participate in research by designing questions, but not all nurses will. Nursing Process: Implementation Client Need: Safe, Effective Care Environment Cognitive Level: Understanding To provide optimized individual clinical care to clients, the nurse understands that the components of evidence-based care include all except: Managerial expertise Current strong evidence Clinical expertise Client perspectives - Ans: Managerial expertise Rationale: To provide optimized individual clinical care to clients, nurses use three components that provide the framework for evidence-based practice: current strong evidence, client perspectives, and clinical expertise. Managerial expertise, while important to nursing care, is not a component to the framework of evidence-based practice. Nursing Process: Planning Client Need: Health Promotion and Maintenance Cognitive Level: Applying To impact cost containment in the delivery of health care, the nurse suggests the need for future research studies. The nurse would look to studies that would: Examine end-of-life care. Promote healthy lifestyles. Evaluate the emergency response to disaster. Improve client safety. - Ans: Promote healthy lifestyles. Feedback Rationale: Nurses can help with health cost containment by concentrating on wellness, healthy lifestyles, and disease prevention. It is more cost effective to prevent illness than to treat illness. Improving client safety would not have much impact on cost containment. End-of-life care is a study need but would not produce cost containing results. Evaluating emergency response is more appropriate at the government level. Nursing Process: Assessment Client Need: Safe, Effective Care Environment Cognitive Level: Analyzing When performing a literature review for evidence, nurses look for scientific elements in the journal article, including all except: The abstract Names of patients involved in the data collection A written conclusion An overview of the study conducted - Ans: Names of patients involved in the data collection Rationale: Looking for clinical evidence from research sources usually includes a review of the pertinent literature. When doing a literature review for evidence, nurses look for scientific elements in the journal article including the abstract, an overview or summary of the study conducted, a written conclusion. Revealing the names of patients involved in the data collection is a violation of HIPAA laws and does not occur. Nursing Process: Assessment Client Need: Safe, Effective Care Environment Cognitive Level: Understanding A graduate nurse is instructed to use the mnemonic PICOT to define and formulate a clinical question that will contribute to Evidenced Based Practice (EBP). The nurse understands that this question will include all except: Implementation of hypothesis Comparison of interventions Outcomes Population of clients - Ans: Implementation of hypothesis Feedback Rationale: The nurse utilizing the PICOT format to formulate a clinical question understands that the mnemonic includes: Population of clients, Issue of interest, Comparison of interventions, Outcomes, and Time frame. Implementation of hypothesis is not a part of the PICOT format. Nursing Process: Implementation Client Need: Safe, Effective Care Environment Cognitive Level: Applying According to research design, once the research problem is defined, what is the next step in the process? Formulate a hypothesis. Review the literature. Define variables. Select a design. - Ans: Review the literature. Rationale: Before progressing with the research design, the researcher determines what is known and not known about the problem. A thorough review of the literature provides the foundation on which to build new knowledge. Next, a hypothesis is formulated, variables are defined, and the research design is selected. Nursing Process: Implementation Client Need: Safe, Effective Care Environment Cognitive Level: Applying The nursing instructor is explaining evidence-based practice (EBP) to nursing students. Which statements are appropriate to include in the explanation? (Select all that apply.) EBP considers the client's needs, values, and choices. EBP is reflective of the best evidence from current research. EBP promotes generalization of client care. EBP tests hypotheses about health-related conditions. EBP incorporates the nurse's clinical expertise. - Ans: EBP considers the client's needs, values, and choices. EBP is reflective of the best evidence from current research. EBP incorporates the nurse's clinical expertise. Learning Objective Describe the expected benefits of utilizing three components of evidence-based practice. Rationale Evidence-based practice (EBP) combines the best evidence from the most current research available, the nurse's clinical expertise, and the client's preferences, including needs, values, and choices. EBP promotes individualization of client care. Nursing research tests hypotheses about health-related conditions and nursing care. The nursing student is giving a presentation about nursing research. Which statement is most appropriate for the student to include in the presentation? Nursing research is illustrated by the client's choice to use an alternative treatment. Nursing research tests hypotheses about health-related conditions and nursing care. Nursing research is clinical knowledge, expert opinion, or information resulting from research. Nursing research combines the best evidence from current studies, clinical nursing expertise, and client preferences - Ans: Nursing research tests hypotheses about health-related conditions and nursing care. Learning Objective Describe the expected benefits of utilizing three components of evidence-based practice. Rationale Nursing research tests hypotheses about health-related conditions and nursing care. Evidence-based practice (EBP) combines the best evidence from the most current research studies available, the nurse's clinical expertise, and the client's preferences, including needs, values, and choices. Choosing an alternative treatment is an example of a client preference. Evidence is clinical knowledge, expert opinion, or information resulting from research. The nurse is critically appraising a research study. Which statement is reflective of an appraisal of the study's reliability? "Although the study was supposed to measure the client's wound healing, it really measured the client's satisfaction with care." "The study's results are not applicable to clinical practice." "The study's results are applicable to clinical practice." "The original study was repeated three times, but it did not produce consistent results." - Ans: "The original study was repeated three times, but it did not produce consistent results." Learning Objective Summarize four steps of planning and implementing evidence-based nursing practice. Rationale Reliability is the study's ability to produce consistent results with each use. Validity is the degree to which the study measured what it intended to measure. Usefulness is reflective of the study's application to clinical practice. The nurse is participating in conducting a research study and needs to determine if an individual qualifies to be a participant. Which criteria must be met for inclusion in a research study? (Select all that apply.) The individual is informed of all aspects of the study. . The individual meets all the inclusion criteria. The individual receives payment for participation. The individual has given informed consent. The individual must waive the right to anonymity. - Ans: The individual is informed of all aspects of the study. . The individual meets all the inclusion criteria. The individual has given informed consent. Learning Objective Explain processes of nursing clinical research used when developing evidence-based practice. Rationale Research participants are defined as volunteers for a specific study project who meet all the inclusion criteria, have been informed of all aspects of the study, and have given informed consent. Adherence to the ethical principle of justice requires protection of the research participant's anonymity. Payment is not a mandatory condition of participation in research. During a class about research methods, a nursing student asks the instructor, open double quote"What is the difference between qualitative and quantitative research?close double quote" Which response by the instructor is the most appropriate? Qualitative research does not use the scientific method Quantitative research uses precise measurement to collect data and analyze it statistically. Qualitative research is used to test relationships between variables. Quantitative research explores individuals' subjective experiences. - Ans: Quantitative research uses precise measurement to collect data and analyze it statistically. Learning Objective Explain processes of nursing clinical research used when developing evidence-based practice. Rationale Quantitative research uses precise measurement to collect data and to analyze it statistically; this method is used to test relationships between variables. Qualitative research investigates a question through narrative data to explore the subjective experiences of human beings; this method is used to clarify the nurse's understanding of the client's perspective. The scientific method may be applied to both the qualitative method and the quantitative method of research. A group of nursing students are discussing clinical research questions. In describing the difference between background questions and foreground questions, which student's statement is the most appropriate? The answer to a foreground question addresses multiple clinical issues. Foreground questions are knowledge-based Answers to background questions may be found in drug guides. Background questions address a range of clinical issues - Ans: Answers to background questions may be found in drug guides. Learning Objective Summarize four steps of planning and implementing evidence-based nursing practice. Rationale Background questions are knowledge-based and seek more information about a topic, such as medications or diseases. Answers to background questions can be found in textbooks, drug guides, medical dictionaries, and other education resources. Foreground questions are practice-based and, compared to background questions, they are narrower in scope. Foreground questions focus on a specific clinical issue and their answers identify useful information about direct client care that may guide the formulation of nursing interventions that improve client outcomes. A nursing student is giving a classroom presentation about evidence-based practice (EBP). Which statement best reflects the student's correct understanding of EBP? EBP involves combining quality research, clinical expertise, and client preferences to achieve the best client outcomes. EBP is the gathering of objective facts and information to advance knowledge about a specific topic EBP incorporates clinical knowledge, expert opinion, or information resulting from research EBP uses a systematic and strict scientific process to test hypotheses about health-related conditions and nursing care. - Ans: EBP involves combining quality research, clinical expertise, and client preferences to achieve the best client outcomes. Evidence-based practice (EBP) seeks to achieve optimal client outcomes through combining the best evidence from the most current research available, the nurse's clinical expertise, and the client's preferences, including needs, values, and choices. Research involves gathering objective facts and information to advance knowledge about a specific topic. Nursing research is a systematic and strict scientific process that tests hypotheses about health-related conditions and nursing care. Evidence can be defined as clinical knowledge, expert opinion, or information resulting from research. Which statements most accurately describe potential barriers to implementation of evidence-based practice (EBP)? (Select all that apply.) Ensuring credibility of the nursing profession Providing accountability for nursing care Client workload demands Lack of access to continuing education programs Nursing misperceptions about EBP - Ans: Client workload demands Lack of access to continuing education programs Nursing misperceptions about EBP Potential barriers to implementation of evidence-based practice (EBP) include lack of access to continuing education programs, nursing misperceptions about EBP, and client workload demands. Benefits of EBP include providing accountability for nursing care and ensuring credibility of the nursing profession. In the context of nursing, which statement best describes qualitative research? It is used to clarify the nurse's understanding of the client's perspective. It is used to test relationships between variables. An example of a qualitative question is "Are there differences in skin breakdown between premature infants who are bathed with plain water and those who are bathed with bacteriostatic soap? It uses precise measurement to statistically analyze data. - Ans: It is used to clarify the nurse's understanding of the client's perspective. Qualitative research investigates a question through narrative data to explore the subjective experiences of human beings. This form of research is used to clarify the nurse's understanding of the client's perspective. An example of a qualitative question is open double quote"What is the nature of coping and adjustment after a radical mastectomy?close double quote" Quantitative research uses precise measurement to collect and statistically analyze data. This form of research is used to test relationships between variables. An example of a quantitative question is open double quote"Are there differences in skin breakdown between premature infants who are bathed with plain water and those who are bathed with bacteriostatic soap?close double quote As part of a class project, the nursing student is designing a research study. Which consideration best reflects adherence to the principle of justice? Requiring that the study be conducted for the benefit of others Preventing exploitation of participants during or as a result of the study Protecting participants' anonymity Ensuring that participation is not coerced - Ans: Protecting participants' anonymity Protecting participants' anonymity is reflective of the principle of justice. Adhering to beneficence includes requiring that the study be conducted for the benefit of others and preventing exploitation of participants during or as a result of the study. Ensuring that participation is not coerced is reflective of the principle of dignity. What should the nurse expect a meta-analysis study to offer? A study that uses a control group and an experimental group to illustrate a cause-and-effect relationship A study that follows two groups over a period of time measures the outcomes of an exposure group with those of a nonexposure group Examination of a group of studies on a given topic, followed by combination and analysis of the results as if they were from one large study A detailed description that is specific to one individual, issue, or event - Ans: Examination of a group of studies on a given topic, followed by combination and analysis of the results as if they were from one large study A meta-analysis examines a group of studies on a given topic, and combines and analyzes the results as if they were from one large study. Case studies are specific to one individual, issue, or event. Cohort studies are longitudinal studies that follow two groups and measure the outcomes of an exposure group with those of a nonexposure group. Case-control studies compare individuals with and without a specific condition to identify predictive variables. Randomized Control Trials (RCTs) are designed to illustrate a cause-and-effect relationship by using a control group and an experimental group. In consideration of the evaluation of research evidence, which statement best describes validity? It is the degree to which the study measured what it intended to measure. It is used to determine the strengths and weaknesses of a study and its resulting evidence. It is reflective of the study's application to clinical practice. It is the study's ability to produce consistent results with each use. - Ans: It is the degree to which the study measured what it intended to measure. Validity is the degree to which the study measured what it intended to measure. Reliability is the study's ability to produce consistent results with each use. Usefulness is reflective of the study's application to clinical practice. Critical appraisal is used to identify strengths and weaknesses of a study and its resulting evidence. Which questions are most appropriate for the nurse to consider during the evaluation of the impact of evidence-based practice on client outcomes? (Select all that apply.) Does the change in practice yield the intended results? Is the new practice beneficial to the nurse? Does the practice adhere to the American Nurses Association (ANA) standards of nursing care? Is the new practice being implemented correctly? Is the practice in accordance with the state's nurse practice act? - Ans: Does the change in practice yield the intended results? Is the new practice being implemented correctly? Evaluation seeks to answer questions including, Is the new practice being implemented correctly?Does the change in practice yield the intended results?Nurses are legally bound to practice in accordance with their state's nurse practice act and to provide care that adheres to the ANA standards of nursing care; these concerns must be addressed before implementing care. The practice is intended to be beneficial to the client. The nursing instructor asks students to develop examples of background questions. Which student responses are the most accurate? (Select all that apply.) Why isn't long-acting insulin administered via the IV route? What is the pathophysiology of left ventricular heart failure? How does incentive spirometry help prevent collapse of the small airways in the lungs? What is the link between care providers' stethoscopes and healthcare-acquired infections? How does acupuncture compare to pain medication for treating chronic knee pain? - Ans: Why isn't long-acting insulin administered via the IV route? What is the pathophysiology of left ventricular heart failure? How does incentive spirometry help prevent collapse of the small airways in the lungs? Learning Objective Summarize four steps of planning and implementing evidence-based nursing practice. Rationale Background questions are knowledge-based and seek more information about a topic, such as medications or diseases. Answers to background questions can be found in textbooks, drug guides, medical dictionaries, and other education resources. Foreground questions are practice-based and, compared to background questions, they are narrower in scope. Foreground questions focus on a specific clinical issue and their answers identify useful information about direct client care that may guide the formulation of nursing interventions that improve client outcomes. The critical care nurse is developing a clinical question that explores the etiology of adult respiratory distress syndrome (ARDS). Which clinical question is the most appropriate? How does ARDS affect arterial blood gas values? What are some potential complications of ARDS? Which medications lead to best outcomes for clients with ARDS? What are the causes of ARDS? - Ans: What are the causes of ARDS? Learning Objective Summarize four steps of planning and implementing evidence-based nursing practice. Rationale Etiology-related clinical questions investigate the causes of a condition or disease. Diagnosis-related clinical questions explore selection and interpretation of diagnostic tests, and evaluate a test's accuracy, safety, and cost effectiveness. Therapy-related clinical questions involve identifying treatments that lead to best outcomes and for which the benefits outweigh the risks. Prognosis-related clinical questions examine the prediction of a condition or disease's clinical course and possible complications. The nurse is designing a quantitative research study about the relationship between yoga and wellness. Which research question is the most appropriate for this study? How do individuals who engage in yoga perceive the link between exercise and hypertension? What is the nature of the relationship between engaging in yoga and experiencing wellness? What is the relationship between engaging in yoga and the incidence of hypertension? How do health beliefs about hypertension influence an individual's choice to practice yoga? - Ans: What is the relationship between engaging in yoga and the incidence of hypertension? Learning Objective Explain processes of nursing clinical research used when developing evidence-based practice. Rationale Quantitative research uses precise measurement to collect data and to analyze it statistically; this method is used to test relationships between variables. Qualitative research investigates a question through narrative data to explore the subjective experiences of human beings; this method is used to clarify the nurse's understanding of the client's perspective. A study of the incidence of hypertension among individuals who practice yoga would yield results that can be statistically analyzed to test the relationship between variables (i.e., practicing yoga and the incidence of hypertension). The clinical nursing instructor is designing a presentation about evidence-based practice (EBP). Which example best illustrates evidence derived from research? Studies suggest medical massage effectively reduces lower back pain. In certain cultures, male clients accept massage treatment only from male therapists. A nurse reads studies about the effects of massage on back pain. The client may refuse to have back surgery. - Ans: Studies suggest medical massage effectively reduces lower back pain. Learning Objective Describe the expected benefits of utilizing three components of evidence-based practice. Rationale Evidence is clinical knowledge, expert opinion, or information resulting from research; this is best illustrated by the study-based conclusion that medical massage reduces lower back pain. Research is gathering objective facts and information to advance knowledge about a specific topic, as illustrated by a nurse reading studies about the effects of massage on back pain. Male clients who accept massage treatments only from male therapists and consent for surgery illustrate client preferences. Which statements best reflect the nurse's correct understanding of principles related to evidence-based practice (EBP)? (Select all that apply.) "Evidence-based practice requires application of all research evidence about a given topic." "Client choices do not affect evidence-based practice." "The nurse's level of expertise influences evidence-based practice." "Evidence-based practice promotes individualization of client care." "Client-centered care is an outcome of evidence-based practice." - Ans: The nurse's level of expertise influences evidence-based practice." "Evidence-based practice promotes individualization of client care." "Client-centered care is an outcome of evidence-based practice." Learning Objective Describe the expected benefits of utilizing three components of evidence-based practice. Rationale Evidence-based practice (EBP) combines the best evidence from the most current research available, the nurse's clinical expertise, and the client's preferences, including needs, values, and choices. EBP promotes individualization of client care and provides best practice for client-centered care. The nurse is designing a nursing clinical research study. Which research questions are most appropriate for this type of study? (Select all that apply.) What is the relationship between the duration of nurse-client interaction and the client's level of satisfaction with nursing care? What factors influence an individual's choice to enroll in online nursing education? Is there a relationship between acupressure and incidence of nausea in clients who are receiving chemotherapy medications? How do communication styles influence the nurse's perception of nurse educators? How do environmental noise levels affect the client's pain perception postanesthesia? - Ans: What is the relationship between the duration of nurse-client interaction and the client's level of satisfaction with nursing care? Is there a relationship between acupressure and incidence of nausea in clients who are receiving chemotherapy medications?. How do environmental noise levels affect the client's pain perception postanesthesia? Learning Objective Explain processes of nursing clinical research used when developing evidence-based practice. Rationale Nursing research is a systematic and strict scientific process that tests hypotheses about health-related conditions and nursing care; as an extension of nursing research, nursing clinical research seeks answers that will ultimately improve client care.