82|LATEST
Chapter 1.Primary Care inthe Twenty-First Century: A Circle of Caring ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
incidence of nosocomial (hospital-acquired) infections in acute care settings. An article presented
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
findings at a level of significance of <0.01. This indicates that
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
A) thecontrol group andtheexperimental groupweremore than99% similar.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
B) thefindings ofthe studyhave lessthan1%chance ofbeing attributable to chance.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
C) theeffects oftheintervention werenearlyzero.
,i ,i ,i ,i ,i ,i ,i
D) theclinical significance ofthefindings waslessthan 1:100.
,i ,i ,i ,i ,i ,i ,i ,i ,i
Ans: B ,i
Feedback: Thelevelofsignificance isthelevelatwhichtheresearcher believes thatthestudyresults most
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
likelyrepresent a nonchance event. A level of significance of <0.01 indicates that there is less than 1%
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
probability that the result is due to chance.
,i ,i ,i ,i ,i ,i ,i ,i
2. Anursehasreadaqualitativeresearchstudyinordertounderstandthelivedexperienceofparents who
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
have a neonatal loss. Which of the following questions should the nurse prioritize when appraising the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
results of this study?
,i ,i ,i ,i
A) Howwell didthe authorscapture thepersonalexperiencesofthese parents?
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
B) Howwell didthe authorscontrolfor confoundingvariables thatmay have affected thefindings?
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
C) Didthe authorsusestatisticalmeasures thatwere appropriatetothephenomenon in question?
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
D) Weretheinstrumentsthattheresearchers usedstatisticallyvalidandreliable?
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
Ans: A ,i
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
subjective experiences of individuals. Statistical measures and variables are not dimensions of a
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
qualitative methodology.
,i ,i
3. Anursehasexpressedskepticismtoacolleagueaboutthevalueofnursingresearch,claimingthat
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
nursing research has little relevance to practice. How can the nurses colleague best defend the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
importance of nursing research?
,i ,i ,i ,i
,A) Theexistenceofnursingresearchmeansthatnursesarenowabletoaccessfederalgrantmoney,
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
something that didnt use to be the case.
,i ,i ,i ,i ,i ,i ,i ,i
B) Nursingresearchhasallowedthedevelopmentofmastersanddoctoralprogramsandhasgreatly ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
increased the credibility of the profession.
,i ,i ,i ,i ,i ,i
C) Thegrowthofnursingresearchhascausednursingtobeviewedasatrueprofession,ratherthan simply
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
as a trade or a skill.
,i ,i ,i ,i ,i ,i
D) Theapplicationofnursingresearchhasthepotentialtoimprovenursingpracticeandpatient
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
outcomes.
,i
Ans: D ,i
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimately,to
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
improvepatientoutcomes.Thissupersedesthecontributionsofnursingresearchto education programs,
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
grant funding, or the public view of the profession.
,i ,i ,i ,i ,i ,i ,i ,i ,i
4. Tracyisanursewithabaccalaureate degree who worksinthelabor and deliveryunit of abusy urban
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
hospital.Shehasnoticedthatmanynewmothers abandonbreast-feedingtheirbabieswhen they
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
experience early challenges and wonders what could be done to encourage more women to continue
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
breast-feeding. What role is Tracy most likely to play in a research project that tests an intervention
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
aimed at promoting breast-feeding?
,i ,i ,i ,i
A) Applyingforgrant funding fortheresearch project ,i ,i ,i ,i ,i ,i ,i
B) Posingthe clinical problemtooneormorenursing researchers ,i ,i ,i ,i ,i ,i ,i ,i ,i
C) Planningthemethodology oftheresearch project ,i ,i ,i ,i ,i ,i
D) Carryingouttheinterventionand submittingtheresultsforpublication ,i ,i ,i ,i tx ,i ,i ,i ,i
,i Ans: B ,i
Feedback: A major role for staff nurses is to identify questions or problems for research. Grant
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
applications, methodological planning, and publication submission are normally carried out by
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
nurses who have advanced degrees in nursing.
,i ,i ,i ,i ,i ,i ,i
5. A patient signed the informed consent form for a drug trial that was explained to patient bya research
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
assistant. Later, the patient admitted to his nurse that he did not understand the research assistants
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
explanation orhis own rolein the study. Howshould this patients nurse respond to this revelation?
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
A) Explaintheresearchprocessto thepatientingreater detail. ,i ,i ,i ,i ,i ,i ,i ,i ,i
B) Describethedetailsofa randomized controlledtrialforthe patient. ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
,C) Informtheresearch assistantthatthepatientsconsentislikelyinvalid. ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
D) Explaintothe patientthat hiswrittenconsentis nowlegallybinding. ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
Ans: C ,i
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsible for
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
research consent. If patients who have agreed to participate exhibit ambivalence or uncertaintyabout
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
participating, do not tryto convince them to participate. Ask the person from the researchteamwhois
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
managingconsentstospeakwithconcernedpatientsaboutthestudy,evenafter a patient has signed the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
consent forms.
,i ,i
MultipleSelection ,i
6. A nurse leader is attempting to increase the awareness of evidence-based practice (EBP) among the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
nursesonaunit.AnursewhoisimplementingEBPintegrateswhichofthefollowing?(Selectall that apply.)
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
A) Interdisciplinary consensus , i
B) Nursingtradition ,i
C) Researchstudies ,i
D) Patientpreferencesandvalues ,i ,i ,i
E) Clinicalexpertise
Ans: C, D, E
,i ,i ,i ,i
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-solving ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
approach to the delivery of healthcare that integrates the best evidence from studies and patient care data
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
with clinician expertise and patient preferences and values.
,i ,i ,i ,i ,i ,i ,i ,i
MultipleChoice ,i
7. Mrs. Mayes is a 73-year-old woman who has a diabetic foot ulcer that has been extremelyslow to heal and
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
which now poses a threat of osteomyelitis. The wound care nurse who has been working withMrs.Mayes
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
appliesevidence-basedpractice(EBP)wheneverpossibleandhasproposedtheuse of maggot therapy to
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
debride necrotic tissue. Mrs. Mayes, however, finds the suggestion repugnant andadamantlyopposes this
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
treatment despitethesizablebodyofevidencesupportingit.Howshould the nurse reconcile Mrs. Mayes
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
views with the principles of EBP?
,i ,i ,i ,i ,i ,i
A) Thenurseshouldexplainthatreliable andvalidresearch evidenceoverrides thepatients opinion.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
B) Thenurse should explaintheevidencetothepatient ingreater detail.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
, C) Thenurse shouldintegratethe patientspreferences intotheplanofcare.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
D) Thenurseshould involvethepatientsfamilymembersin thedecision-making process.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
Ans: C ,i
Feedback: Patient preferences should be integrated into EBP and considered alongside research evidence ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
andthe nursesclinicalexpertise; evidence does nottrumpthe patients preferences. The familyshould be
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
involved, butthisisnot an explicit dimension ofEBP. Similarly, explaining the evidence in more detail is
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i tx ,i ,i ,i ,i ,i ,i
not a demonstration of EBP.
,i ,i ,i ,i ,i
8. The administrators of a long-term care facility are considered the use of specialized, pressure-
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
reducingmattressesinordertoreducetheincidenceofpressureulcersamongresidents.Theyhave
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
sought input from the nurses on the unit, all of whom are aware of the need to implement the principles of
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
evidence-based practice (EBP) in this decision. Which of the following evidence sources should the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
nurses prioritize?
,i ,i
A) Aqualitativestudythat explorestheexperienceoflivingwith apressure ulcer
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
B) Acasestudythatdescribesthemeasuresthat nursesonageriatricunittooktoreducepressure ulcers
,i ,i ,i ,i ,i ,i ,i tx , i ,i ,i ,i ,i ,i ,i ,i ,i ,i
among patients
,i ,i
C) Testimonialsfromexperiencedcliniciansabouttheeffectiveness ofthemattressinquestion ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
D) Arandomizedcontrolledtrialthatcomparedthepressure-reducingmattresswithstandard
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
mattresses
,i
Ans: D ,i
Feedback:ThemostreliableevidenceisconsideredRCTs.Qualitativestudies,casestudies,and expert ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
opinion are low on the hierarchy of evidence.
,i ,i ,i ,i ,i ,i ,i ,i
9. Hospital administrators are applying the principles of evidence-based practice (EBP) in their attempt ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
toascertainthemostefficientandeffectivewaytocommunicatebetweennurseswhoareon different units,
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
a project that will consider many types of evidence. Which of the following information sources should
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
the administrators prioritize?
,i ,i ,i
A) Asystematicreviewaboutcommunicationin nursing contexts
,i ,i ,i ,i ,i ,i ,i
B) Nursesideasaboutcommunicationmethods ,i ,i ,i ,i
C) The resultsof a chart review ,i ,i ,i ,i ,i
D) Thehospitalsaccreditation status tx
Ans: A
,i ,i
Chapter 1.Primary Care inthe Twenty-First Century: A Circle of Caring ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
incidence of nosocomial (hospital-acquired) infections in acute care settings. An article presented
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
findings at a level of significance of <0.01. This indicates that
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
A) thecontrol group andtheexperimental groupweremore than99% similar.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
B) thefindings ofthe studyhave lessthan1%chance ofbeing attributable to chance.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
C) theeffects oftheintervention werenearlyzero.
,i ,i ,i ,i ,i ,i ,i
D) theclinical significance ofthefindings waslessthan 1:100.
,i ,i ,i ,i ,i ,i ,i ,i ,i
Ans: B ,i
Feedback: Thelevelofsignificance isthelevelatwhichtheresearcher believes thatthestudyresults most
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
likelyrepresent a nonchance event. A level of significance of <0.01 indicates that there is less than 1%
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
probability that the result is due to chance.
,i ,i ,i ,i ,i ,i ,i ,i
2. Anursehasreadaqualitativeresearchstudyinordertounderstandthelivedexperienceofparents who
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
have a neonatal loss. Which of the following questions should the nurse prioritize when appraising the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
results of this study?
,i ,i ,i ,i
A) Howwell didthe authorscapture thepersonalexperiencesofthese parents?
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
B) Howwell didthe authorscontrolfor confoundingvariables thatmay have affected thefindings?
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
C) Didthe authorsusestatisticalmeasures thatwere appropriatetothephenomenon in question?
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
D) Weretheinstrumentsthattheresearchers usedstatisticallyvalidandreliable?
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
Ans: A ,i
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
subjective experiences of individuals. Statistical measures and variables are not dimensions of a
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
qualitative methodology.
,i ,i
3. Anursehasexpressedskepticismtoacolleagueaboutthevalueofnursingresearch,claimingthat
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
nursing research has little relevance to practice. How can the nurses colleague best defend the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
importance of nursing research?
,i ,i ,i ,i
,A) Theexistenceofnursingresearchmeansthatnursesarenowabletoaccessfederalgrantmoney,
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
something that didnt use to be the case.
,i ,i ,i ,i ,i ,i ,i ,i
B) Nursingresearchhasallowedthedevelopmentofmastersanddoctoralprogramsandhasgreatly ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
increased the credibility of the profession.
,i ,i ,i ,i ,i ,i
C) Thegrowthofnursingresearchhascausednursingtobeviewedasatrueprofession,ratherthan simply
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
as a trade or a skill.
,i ,i ,i ,i ,i ,i
D) Theapplicationofnursingresearchhasthepotentialtoimprovenursingpracticeandpatient
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
outcomes.
,i
Ans: D ,i
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimately,to
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
improvepatientoutcomes.Thissupersedesthecontributionsofnursingresearchto education programs,
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
grant funding, or the public view of the profession.
,i ,i ,i ,i ,i ,i ,i ,i ,i
4. Tracyisanursewithabaccalaureate degree who worksinthelabor and deliveryunit of abusy urban
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
hospital.Shehasnoticedthatmanynewmothers abandonbreast-feedingtheirbabieswhen they
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
experience early challenges and wonders what could be done to encourage more women to continue
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
breast-feeding. What role is Tracy most likely to play in a research project that tests an intervention
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
aimed at promoting breast-feeding?
,i ,i ,i ,i
A) Applyingforgrant funding fortheresearch project ,i ,i ,i ,i ,i ,i ,i
B) Posingthe clinical problemtooneormorenursing researchers ,i ,i ,i ,i ,i ,i ,i ,i ,i
C) Planningthemethodology oftheresearch project ,i ,i ,i ,i ,i ,i
D) Carryingouttheinterventionand submittingtheresultsforpublication ,i ,i ,i ,i tx ,i ,i ,i ,i
,i Ans: B ,i
Feedback: A major role for staff nurses is to identify questions or problems for research. Grant
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
applications, methodological planning, and publication submission are normally carried out by
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
nurses who have advanced degrees in nursing.
,i ,i ,i ,i ,i ,i ,i
5. A patient signed the informed consent form for a drug trial that was explained to patient bya research
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
assistant. Later, the patient admitted to his nurse that he did not understand the research assistants
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
explanation orhis own rolein the study. Howshould this patients nurse respond to this revelation?
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
A) Explaintheresearchprocessto thepatientingreater detail. ,i ,i ,i ,i ,i ,i ,i ,i ,i
B) Describethedetailsofa randomized controlledtrialforthe patient. ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
,C) Informtheresearch assistantthatthepatientsconsentislikelyinvalid. ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
D) Explaintothe patientthat hiswrittenconsentis nowlegallybinding. ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
Ans: C ,i
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsible for
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
research consent. If patients who have agreed to participate exhibit ambivalence or uncertaintyabout
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
participating, do not tryto convince them to participate. Ask the person from the researchteamwhois
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
managingconsentstospeakwithconcernedpatientsaboutthestudy,evenafter a patient has signed the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
consent forms.
,i ,i
MultipleSelection ,i
6. A nurse leader is attempting to increase the awareness of evidence-based practice (EBP) among the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
nursesonaunit.AnursewhoisimplementingEBPintegrateswhichofthefollowing?(Selectall that apply.)
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
A) Interdisciplinary consensus , i
B) Nursingtradition ,i
C) Researchstudies ,i
D) Patientpreferencesandvalues ,i ,i ,i
E) Clinicalexpertise
Ans: C, D, E
,i ,i ,i ,i
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-solving ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
approach to the delivery of healthcare that integrates the best evidence from studies and patient care data
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
with clinician expertise and patient preferences and values.
,i ,i ,i ,i ,i ,i ,i ,i
MultipleChoice ,i
7. Mrs. Mayes is a 73-year-old woman who has a diabetic foot ulcer that has been extremelyslow to heal and
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
which now poses a threat of osteomyelitis. The wound care nurse who has been working withMrs.Mayes
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
appliesevidence-basedpractice(EBP)wheneverpossibleandhasproposedtheuse of maggot therapy to
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
debride necrotic tissue. Mrs. Mayes, however, finds the suggestion repugnant andadamantlyopposes this
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
treatment despitethesizablebodyofevidencesupportingit.Howshould the nurse reconcile Mrs. Mayes
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
views with the principles of EBP?
,i ,i ,i ,i ,i ,i
A) Thenurseshouldexplainthatreliable andvalidresearch evidenceoverrides thepatients opinion.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
B) Thenurse should explaintheevidencetothepatient ingreater detail.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
, C) Thenurse shouldintegratethe patientspreferences intotheplanofcare.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
D) Thenurseshould involvethepatientsfamilymembersin thedecision-making process.
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
Ans: C ,i
Feedback: Patient preferences should be integrated into EBP and considered alongside research evidence ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
andthe nursesclinicalexpertise; evidence does nottrumpthe patients preferences. The familyshould be
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
involved, butthisisnot an explicit dimension ofEBP. Similarly, explaining the evidence in more detail is
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i tx ,i ,i ,i ,i ,i ,i
not a demonstration of EBP.
,i ,i ,i ,i ,i
8. The administrators of a long-term care facility are considered the use of specialized, pressure-
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
reducingmattressesinordertoreducetheincidenceofpressureulcersamongresidents.Theyhave
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
sought input from the nurses on the unit, all of whom are aware of the need to implement the principles of
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
evidence-based practice (EBP) in this decision. Which of the following evidence sources should the
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
nurses prioritize?
,i ,i
A) Aqualitativestudythat explorestheexperienceoflivingwith apressure ulcer
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
B) Acasestudythatdescribesthemeasuresthat nursesonageriatricunittooktoreducepressure ulcers
,i ,i ,i ,i ,i ,i ,i tx , i ,i ,i ,i ,i ,i ,i ,i ,i ,i
among patients
,i ,i
C) Testimonialsfromexperiencedcliniciansabouttheeffectiveness ofthemattressinquestion ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
D) Arandomizedcontrolledtrialthatcomparedthepressure-reducingmattresswithstandard
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
mattresses
,i
Ans: D ,i
Feedback:ThemostreliableevidenceisconsideredRCTs.Qualitativestudies,casestudies,and expert ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
opinion are low on the hierarchy of evidence.
,i ,i ,i ,i ,i ,i ,i ,i
9. Hospital administrators are applying the principles of evidence-based practice (EBP) in their attempt ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
toascertainthemostefficientandeffectivewaytocommunicatebetweennurseswhoareon different units,
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
a project that will consider many types of evidence. Which of the following information sources should
,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i ,i
the administrators prioritize?
,i ,i ,i
A) Asystematicreviewaboutcommunicationin nursing contexts
,i ,i ,i ,i ,i ,i ,i
B) Nursesideasaboutcommunicationmethods ,i ,i ,i ,i
C) The resultsof a chart review ,i ,i ,i ,i ,i
D) Thehospitalsaccreditation status tx
Ans: A
,i ,i
