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