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