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