TEST BANK FOR
EVIDENCE BASED Chapter 1 Making the Case for Evidence-Based
Practice and Cultivating a Spirit of Inquiry
PRACTICE IN NURSING
AND HEALTHCARE 4TH
EDITION BY MELNYK
All chapters
,1. In the hospital where Nurse L. provides care, tradition dictates that oral temperatures be 5. The Institute of Medicine's Roundtable on Evidence-Based Medicine has been
included in every set of patient vital signs, regardless of patient diagnosis or acuity. This established to address EBP. Which of the following issues is the Roundtable
is most likely an example of which of the following phenomena? emphasizing?
A) The prioritization of internal evidence over external evidence A) Ensuring that external evidence, rather than internal evidence, is integrated into
B) Practice that lacks evidence to support its application care
C) The integration of personal expertise into nursing care B) Fostering the level of learning that exists in the American healthcare system
D) Evidence-based practice C) Issuing clinical guidelines to ensure best nursing practice
D) Comparing the implementation of EBP in the United States with that of other
Western countries
2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a
patient chart review after the implementation of a pilot program aimed at promoting
early ambulation following surgery. Which of the following components of EBP is the 6. You have become frustrated with some aspects of patient care that you believe are
nurse putting into practice? outdated and ineffective at the long-term care facility where you have recently begun
A) Patient preferences practicing. Consequently, you have resolved to examine some of these practices in light
B) Research utilization of evidence. Which of the following should occur first in the steps of EBP?
C) Experience A) Conducting an electronic search of the literature and ranking individual sources
D) Internal evidence B) Creating “buy-in” from the other clinicians who provide care at the facility
C) Developing an inquisitive and curious mindset
D) Assessing whether the practices in question may, in fact, be evidence-based
3. Nurse R. has observed that reorienting demented patients as frequently as possible tends
to minimize the patients' level of agitation in the evening. The nurse has shared this
observation with a colleague, who is skeptical, stating that, “It's best to stick to 7. Which of the following clinical questions best exemplifies the PICOT format?
evidence-based practice.” How can Nurse R. best respond? A) What effect does parents' smoking have on the smoking habits of their children,
A) “EBP can include clinicians' personal expertise.” ages 13 to 16?
B) “Personal experience is often more sound than formal evidence-based practice.” B) Among cancer patients, what role does meditation, rather than benzodiazepines,
C) “Traditional practice and EBP are usually shown to be the same.” have on anxiety levels during the 7 days following hospital admission?
D) “My years of experience can be just as valuable as any literature review or C) Among undergraduate college students, what is the effectiveness of a sexual health
randomized trial.” campaign undertaken during the first 4 weeks of the fall semester as measured by
incidence of new gonorrheal and chlamydial infections reported to the campus
medical center?
4. Which of the following factors provides the most important rationale for the consistent D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to a
implementation of EBP? numeric rating scale in the emergency room context?
A) EBP provides for the most cost-effective patient care.
B) EBP is accessible to all healthcare clinicians.
C) EBP provides consistency in care across healthcare settings. 8. After formulating a clinical question, a nurse has proceeded to search for evidence for
D) EBP improves patient outcomes. ways to foster restful sleep in patients who are receiving care in the intensive care unit
(ICU). The nurse has identified a relevant meta-analysis in an electronic database. What
will this source of evidence consist of?
A) A statistical summary of the results from several different studies
B) An examination of the theoretical and conceptual underpinnings of the issue
C) An interdisciplinary analysis of the clinical question
D) A qualitative study of different interventions related to the clinical question
Page 1 Page 2
WWW.TESTBANKTANK.COM WWW.TESTBANKTANK.COM
, 9. The nurses on a postpartum unit have noted that many primiparous (first-time) mothers 13. The implementation of a new, evidence-based infection-control regimen in a community
are giving up on breastfeeding within the 24 hours following delivery, and the nurses hospital has resulted in a significant reduction in the incidence of nosocomial
want to create uniform guidelines for promoting breastfeeding on the unit. Which of the (hospital-acquired) infections. What should constitute the final step in the nurses'
following sources is most likely to provide the best evidence in their quest for an evidence-based practice?
intervention? A) Calculating the cost-savings that will be realized by using the new regimen
A) Evidence from a randomized control trial that had more than 2500 participants B) Sharing their experience with other healthcare professionals
B) Evidence from a study that is widely regarded as a classic within the obstetrical C) Implementing enforcement measures to ensure compliance with the new regimen
nursing community D) Conducting a meta-analysis of other infection-control measures
C) Evidence from a systematic review of breastfeeding-promotion studies that one of
the nurses identified in an electronic database
D) The consensus opinion of the most senior nurses on the unit 14. Frustrated by the lack of follow-up provided to patients who are newly diagnosed with
type 2 diabetes, a community health nurse has begun the process of identifying evidence
for the best interventions for this patient population. Which of the following factors is
10. The nurse educator on an acute medicine unit is advocating for the use of most likely to promote the use of EBP in this nurse's workplace?
evidence-based clinical practice guidelines on wound care in order to standardize and A) Bringing in nurses who have been educated at a baccalaureate (bachelor's degree)
optimize the practice of the nurses on the unit. Which of the following statements best level
describes clinical practice guidelines? B) Increasing nurses' accountability for patient outcomes
A) The result of replication studies of existing research by an impartial third party C) Increased funding
B) A collection of authorized interventions that are required by law D) Support from the practice leaders and administration
C) A number of interventions that are the result of a large, publically-funded RCT
D) A group of practice recommendations that result from a rigorous review of the
literature 15. In the process of advocating for EBP in the unit guidelines around the management of
increased intracranial pressure, a nurse has met with skepticism from other members of
the nursing staff, with several stating, “Evidence-based practice is good in theory, but
11. A nurse is conducting a literature review on the evidence regarding the use of vacuum it's almost impossible to actually search hundreds of journals and find the evidence.”
dressings on stage IV pressure ulcers. After locating a recent study that appears to be What could the nurse recommend?
relevant, which of the following questions would the nurse consider first when critically A) Self-reflection on the nurses' current practices
appraising the study? B) Accessing the Cochrane Library
A) “Are the findings of this study cost-effective in our clinical context?” C) Contacting the clinical nurse educator on the unit
B) "How would the implementation of this intervention affect our staffing needs?" D) Beginning with lay publications before progressing to peer-reviewed journals
C) “Were the patients in the study similar to the patients on my unit?”
D) “Are the findings of the study significantly different from what we are currently
doing on the unit?
12. The primary care provider of a 49-year-old male patient has examined and briefly
explained the evidence that supports beginning regular digital-rectal exams. Which of
the following factors would justify not performing digital-rectal examinations in this
patient's care?
A) The patient is vehemently opposed to undergoing a digital-rectal exam.
B) Clinical practice guidelines for prostate care have not been published.
C) The clinician has been unable to find any large RCTs in a literature review.
D) The clinician has previously waited until patients are 55 to begin regular
digital-rectal exams.
Page 3 Page 4
WWW.TESTBANKTANK.COM WWW.TESTBANKTANK.COM
, Answer Key
1. B
2. D
3. A
4. D
5. B
6. C
7. B
8. A
9. C
10.
11.
D
C
Chapter 2 Asking Compelling Clinical Questions
12. A
13. B
14. D
15. B
Page 5
WWW.TESTBANKTANK.COM
EVIDENCE BASED Chapter 1 Making the Case for Evidence-Based
Practice and Cultivating a Spirit of Inquiry
PRACTICE IN NURSING
AND HEALTHCARE 4TH
EDITION BY MELNYK
All chapters
,1. In the hospital where Nurse L. provides care, tradition dictates that oral temperatures be 5. The Institute of Medicine's Roundtable on Evidence-Based Medicine has been
included in every set of patient vital signs, regardless of patient diagnosis or acuity. This established to address EBP. Which of the following issues is the Roundtable
is most likely an example of which of the following phenomena? emphasizing?
A) The prioritization of internal evidence over external evidence A) Ensuring that external evidence, rather than internal evidence, is integrated into
B) Practice that lacks evidence to support its application care
C) The integration of personal expertise into nursing care B) Fostering the level of learning that exists in the American healthcare system
D) Evidence-based practice C) Issuing clinical guidelines to ensure best nursing practice
D) Comparing the implementation of EBP in the United States with that of other
Western countries
2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a
patient chart review after the implementation of a pilot program aimed at promoting
early ambulation following surgery. Which of the following components of EBP is the 6. You have become frustrated with some aspects of patient care that you believe are
nurse putting into practice? outdated and ineffective at the long-term care facility where you have recently begun
A) Patient preferences practicing. Consequently, you have resolved to examine some of these practices in light
B) Research utilization of evidence. Which of the following should occur first in the steps of EBP?
C) Experience A) Conducting an electronic search of the literature and ranking individual sources
D) Internal evidence B) Creating “buy-in” from the other clinicians who provide care at the facility
C) Developing an inquisitive and curious mindset
D) Assessing whether the practices in question may, in fact, be evidence-based
3. Nurse R. has observed that reorienting demented patients as frequently as possible tends
to minimize the patients' level of agitation in the evening. The nurse has shared this
observation with a colleague, who is skeptical, stating that, “It's best to stick to 7. Which of the following clinical questions best exemplifies the PICOT format?
evidence-based practice.” How can Nurse R. best respond? A) What effect does parents' smoking have on the smoking habits of their children,
A) “EBP can include clinicians' personal expertise.” ages 13 to 16?
B) “Personal experience is often more sound than formal evidence-based practice.” B) Among cancer patients, what role does meditation, rather than benzodiazepines,
C) “Traditional practice and EBP are usually shown to be the same.” have on anxiety levels during the 7 days following hospital admission?
D) “My years of experience can be just as valuable as any literature review or C) Among undergraduate college students, what is the effectiveness of a sexual health
randomized trial.” campaign undertaken during the first 4 weeks of the fall semester as measured by
incidence of new gonorrheal and chlamydial infections reported to the campus
medical center?
4. Which of the following factors provides the most important rationale for the consistent D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to a
implementation of EBP? numeric rating scale in the emergency room context?
A) EBP provides for the most cost-effective patient care.
B) EBP is accessible to all healthcare clinicians.
C) EBP provides consistency in care across healthcare settings. 8. After formulating a clinical question, a nurse has proceeded to search for evidence for
D) EBP improves patient outcomes. ways to foster restful sleep in patients who are receiving care in the intensive care unit
(ICU). The nurse has identified a relevant meta-analysis in an electronic database. What
will this source of evidence consist of?
A) A statistical summary of the results from several different studies
B) An examination of the theoretical and conceptual underpinnings of the issue
C) An interdisciplinary analysis of the clinical question
D) A qualitative study of different interventions related to the clinical question
Page 1 Page 2
WWW.TESTBANKTANK.COM WWW.TESTBANKTANK.COM
, 9. The nurses on a postpartum unit have noted that many primiparous (first-time) mothers 13. The implementation of a new, evidence-based infection-control regimen in a community
are giving up on breastfeeding within the 24 hours following delivery, and the nurses hospital has resulted in a significant reduction in the incidence of nosocomial
want to create uniform guidelines for promoting breastfeeding on the unit. Which of the (hospital-acquired) infections. What should constitute the final step in the nurses'
following sources is most likely to provide the best evidence in their quest for an evidence-based practice?
intervention? A) Calculating the cost-savings that will be realized by using the new regimen
A) Evidence from a randomized control trial that had more than 2500 participants B) Sharing their experience with other healthcare professionals
B) Evidence from a study that is widely regarded as a classic within the obstetrical C) Implementing enforcement measures to ensure compliance with the new regimen
nursing community D) Conducting a meta-analysis of other infection-control measures
C) Evidence from a systematic review of breastfeeding-promotion studies that one of
the nurses identified in an electronic database
D) The consensus opinion of the most senior nurses on the unit 14. Frustrated by the lack of follow-up provided to patients who are newly diagnosed with
type 2 diabetes, a community health nurse has begun the process of identifying evidence
for the best interventions for this patient population. Which of the following factors is
10. The nurse educator on an acute medicine unit is advocating for the use of most likely to promote the use of EBP in this nurse's workplace?
evidence-based clinical practice guidelines on wound care in order to standardize and A) Bringing in nurses who have been educated at a baccalaureate (bachelor's degree)
optimize the practice of the nurses on the unit. Which of the following statements best level
describes clinical practice guidelines? B) Increasing nurses' accountability for patient outcomes
A) The result of replication studies of existing research by an impartial third party C) Increased funding
B) A collection of authorized interventions that are required by law D) Support from the practice leaders and administration
C) A number of interventions that are the result of a large, publically-funded RCT
D) A group of practice recommendations that result from a rigorous review of the
literature 15. In the process of advocating for EBP in the unit guidelines around the management of
increased intracranial pressure, a nurse has met with skepticism from other members of
the nursing staff, with several stating, “Evidence-based practice is good in theory, but
11. A nurse is conducting a literature review on the evidence regarding the use of vacuum it's almost impossible to actually search hundreds of journals and find the evidence.”
dressings on stage IV pressure ulcers. After locating a recent study that appears to be What could the nurse recommend?
relevant, which of the following questions would the nurse consider first when critically A) Self-reflection on the nurses' current practices
appraising the study? B) Accessing the Cochrane Library
A) “Are the findings of this study cost-effective in our clinical context?” C) Contacting the clinical nurse educator on the unit
B) "How would the implementation of this intervention affect our staffing needs?" D) Beginning with lay publications before progressing to peer-reviewed journals
C) “Were the patients in the study similar to the patients on my unit?”
D) “Are the findings of the study significantly different from what we are currently
doing on the unit?
12. The primary care provider of a 49-year-old male patient has examined and briefly
explained the evidence that supports beginning regular digital-rectal exams. Which of
the following factors would justify not performing digital-rectal examinations in this
patient's care?
A) The patient is vehemently opposed to undergoing a digital-rectal exam.
B) Clinical practice guidelines for prostate care have not been published.
C) The clinician has been unable to find any large RCTs in a literature review.
D) The clinician has previously waited until patients are 55 to begin regular
digital-rectal exams.
Page 3 Page 4
WWW.TESTBANKTANK.COM WWW.TESTBANKTANK.COM
, Answer Key
1. B
2. D
3. A
4. D
5. B
6. C
7. B
8. A
9. C
10.
11.
D
C
Chapter 2 Asking Compelling Clinical Questions
12. A
13. B
14. D
15. B
Page 5
WWW.TESTBANKTANK.COM
