Clinical Nursing Skills and Techniques 9th Edition Test Bank by Perry,|Updated

,Chapter 01: Using Evidence in Practice
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Perry et al.: Clinical Nursing Skills & Techniques, 9th Edition
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MULTIPLE CHOICE v




1. Evidence-based practice is a problem-solving approach to making decisions about patient v v v v v v v v v v


care that is grounded in:
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a. the latest information found in textbooks.
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b. systematically conducted research studies. v v v


c. tradition in clinical practice. v v v


d. quality improvement and risk-management data. v v v v




ANS: B v


The best evidence comes from well-designed, systematically conducted research studies
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described in scientific journals. Portions of a textbook often become outdated by the time it
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is published. Many health care settings do not have a process to help staff adopt new
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evidence in practice, and nurses in practice settings lack easy access to risk-management
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data, relying instead on tradition or convenience. Some sources of evidence do not originate
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from research. These include quality improvement and risk-management data; infection
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control data; retrospective or concurrent chart reviews; and clinicians’ expertise. Although
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non–research-based evidence is often very valuable, it is important that you learn to rely
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more on research-based evidence.
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DIF: Cognitive Level: Comprehension REF: Text reference: p. 2 v v v v v


OBJ:
v Discuss the benefits of evidence-based practice.v v v v v


TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment v v v v v


MSC:
v v NCLEX: Safe and Effective Care Environment (management of care)
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2. When evidence-based practice is used, patient care will be:
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a. standardized for all. v v


b. unhampered by patient culture. v v v


c. variable according to the situation. v v v v


d. safe from the hazards of critical thinking.
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ANS: C v


Using your clinical expertise and considering patients’ cultures, values, and preferences
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ensures that you will apply available evidence in practice ethically and appropriately. Even
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when you use the best evidence available, application and outcomes will differ; as a nurse,
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you will develop critical thinking skills to determine whether evidence is relevant and
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appropriate.
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DIF: Cognitive Level: Application REF: Text reference: p. 2 v v v v v


OBJ:
v Discuss the benefits of evidence-based practice.v v v v v


TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment v v v v v


MSC:
v v NCLEX: Safe and Effective Care Environment (management of care)
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3. When a PICOT question is developed, the letter that corresponds with the usual standard of
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care is:
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a. P.

, b. I.
c. C.
d. O.
ANS: C v


C = Comparison of interest. What standard of care or current intervention do you usually
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use now in practice?
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P = Patient population of interest. Identify your patient by age, gender, ethnicity, disease, or
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health problem.
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I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and
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prognostic factor) do you think is worthwhile to use in practice?
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O = Outcome. What result (e.g., change in patient’s behavior, physical finding, and change
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in patient’s perception) do you wish to achieve or observe as the result of an intervention?
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DIF: Cognitive Level: Knowledge REF: Text reference: p. 3
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OBJ:
v Develop a PICO question. TOP: PICOv v v


KEY: v Nursing Process Step: Implementation v v v


MSC: v NCLEX: Safe and Effective Care Environment (management of care)
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4. A well-developed PICOT question helps the nurse:
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a. search for evidence. v v


b. include all five elements of the sequence. v v v v v v


c. find as many articles as possible in a literature search.
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d. accept standard clinical routines. v v v




ANS: A v


The more focused a question that you ask is, the easier it is to search for evidence in the
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scientific literature. A well-designed PICOT question does not have to include all five
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elements, nor does it have to follow the PICOT sequence. Do not be satisfied with clinical
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routines. Always question and use critical thinking to consider better ways to provide patient
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care.
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DIF: Cognitive Level: Analysis REF: Text reference: p. 3
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OBJ:
v Describe the six steps of evidence-based practice.
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TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation v v v v v


MSC:
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5. The nurse is not sure that the procedure the patient requires is the best possible for the
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situation. Utilizing which of the following resources would be the quickest way to review
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research on the topic?
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a. CINAHL
b. PubMed
c. MEDLINE
d. The Cochrane Database v v




vANS: D v




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, The Cochrane Community Database of Systematic Reviews is a valuable source of
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synthesized evidence (i.e., pre-appraised evidence). The Cochrane Database includes the full
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text of regularly updated systematic reviews and protocols for reviews currently happening.
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MEDLINE, CINAHL, and PubMed are among the most comprehensive databases and
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represent the scientific knowledge base of health care.
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DIF: Cognitive Level: Synthesis REF: Text reference: p. 4 v v v v v


OBJ:
v Describe the six steps of evidence-based practice. v v v v v v


TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation v v v v v


MSC:
v v NCLEX: Safe and Effective Care Environment (management of care)
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6. The nurse is getting ready to develop a plan of care for a patient who has a specific need.
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The best source for developing this plan of care would probably be:
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a. The Cochrane Database.
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b. MEDLINE.
c. NGC.
d. CINAHL.
ANS: C v


The National Guidelines Clearinghouse (NGC) is a database supported by the Agency for
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Healthcare Research and Quality (AHRQ). It contains clinical guidelines—systematically
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developed statements about a plan of care for a specific set of clinical circumstances
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involving a specific patient population. The NGC is a valuable source when you want to
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develop a plan of care for a patient. The Cochrane Community Database of Systematic
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Reviews, MEDLINE, and CINAHL are all valuable sources of synthesized evidence (i.e.,
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pre-appraised evidence).
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DIF: Cognitive Level: Synthesis REF: Text reference: p. 4 v v v v v


OBJ:
v Describe the six steps of evidence-based practice. v v v v v v


TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation v v v v v


MSC:
v v NCLEX: Safe and Effective Care Environment (management of care)
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7. The nurse has done a literature search and found 25 possible articles on the topic that she is
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studying. To determine which of those 25 best fit her inquiry, the nurse first should look at:
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a. the abstracts. v


b. the literature reviews.
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c. the “Methods” sections.
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d. the narrative sections.
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ANS: A v


An abstract is a brief summary of an article that quickly tells you whether the article is
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research based or clinically based. An abstract summarizes the purpose of the study or
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clinical query, the major themes or findings, and the implications for nursing practice. The
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literature review usually gives you a good idea of how past research led to the researcher’s
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question. The “Methods” or “Design” section explains how a research study is organized
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and conducted to answer the research question or to test the hypothesis. The narrative of a
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manuscript differs according to the type of evidence-based article—clinical or research.
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DIF: Cognitive Level: Application REF: Text reference: p. 7 v v v v v


OBJ: Discuss elements to review when critiquing the scientific literature.
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