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