Chapter 05: Evidence-Based Practice
ra ra ra
MULTIPLE CHOICE ra
1. A nursing attendant uses evidence-
ra ra ra ra
based practice (EBP) to provide nursing care. What is the
ra ra ra ra ra ra ra ra ra
best rationale for the nursing attendant ’s behavior?
ra ra ra ra ra ra ra
a. EBP is a guide for nursing attendant s in making clinical decisions.
ra ra ra ra ra ra ra ra ra ra ra
b. EBP is based on the latest textbook information.
ra ra ra ra ra ra ra
c. EBP is easily attained at the bedside. ra ra ra ra ra ra
d. EBP is always right for all situations. ra ra ra ra ra ra
ACCURATE ar
ANSWER:-A
Evidence-
based practice (EBP) is a guide for nursing attendant s to structure how to make appropriate,
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra r
timely, and effective clinical decisions. A textbook relies on the scientific literature, which m
a ra ra ra ra ra ra ra ra ra ra ra ra ra
ay be outdated by the time the book is published. Unfortunately, much of the best evidence ne
ra ra ra ra ra ra ra ra ra ra ra ra ar ra ra ra
ver reaches the bedside. EBP is not to be blindly applied without using good judgment and cri
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
tical thinking skills. ra ra
DIF:Understand (comprehension) OBJ:Discuss the benefits of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar
Evaluation MSC: Management of Care ra ra ra
2. In caring for hospital client s, what must the nursing attendant remember about evid
ra ra ra ra ra ra ra ra ra ra ra ra ra
encebased practice (EBP)? ar ra
a. EBP is the only valid source of knowledge that should be used.
ra ra ra ra ra ra ra ra ra ra ra
b. EBP is secondary to traditional or convenient care knowledge.
ra ra ra ra ra ra ra ra
c. EBP is dependent on hospital client values and expectations.
ra ra ra ra ra ra ra ra
d. EBP is not shown to provide better hospital client outcomes.
ra ra ra ra ra ra ra ra ra
ACCURATE ANSWER:-C ra
Even when the best evidence available is used, application and outcomes will differ based on h
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
ospital client values, preferences, concerns, and/or expectations. Nursing attendant s often c
ra ra ra ra ra ra ra ra ra ra ra
are for hospital client s on the basis of tradition or convenience. Although these sources have
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra r
value, it is important to learn to rely more on research evidence than on nonresearch evidence. Ev
a ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
idencebased care improves quality, safety, hospital client outcomes, and nursing attendant satisf
ra ra ra ra ra ra ra ra ra ra ra
ac tion while reducing costs. ra ra ra
DIF:Understand (comprehension) OBJ:Discuss the benefits of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar
Implementation MSC: Management of Care ra ra ra
3. A nursing attendant wants to change a hospital client procedure. Which action will t
ra ra ra ra ra ra ra ra ra ra ra ra ra
h e nursing attendant take to easily find research evidence to support this change? a.
ar ra ra ra ra ra ra ra ra ra ra ra
Read all the articles found on the Internet.
ra ra ra ra ra ra ra
b. Make a general search of the Internet. ra ra ra ra ra ra
c. Use a PICOT format for the search. ra ra ra ra ra ra
d. Start with a broad question. ra ra ra ra
ACCURATE ANSWER:-C ra
, The more focused the question is, the easier it becomes to search for evidence in the scientific l
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
iterature. The PICO format allows the nursing attendant to ask focused questions that are int
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
ervention based. Inappropriately formed questions (general search or broad question) will lik
ra ra ra ra ra ra ra ra ra ra ra
ely lead to irrelevant sources of information. It is not beneficial to read hundreds of articles. It is
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra
more beneficial to read the best four to six articles that specifically address the question.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Apply (application) OBJ:Explain the steps of evidence-based practice. TOPIC:-Implementation
ra ra ra ra ra ra
MSC: Management of Care ra ra ra
4. A nursing attendant has collected several research findings for evidencebased practic
ra ra ra ra ra ra ra ra ra ra
e. Which article will be the best for the nursing attendant to use? a.
ar ra ra ra ra ra ra ra ra ra ra ra
An article that uses randomized controlled trials (RCT).
ra ra ra ra ra ra ra
b. An article that is an opinion of expert committees.
ra ra ra ra ra ra ra ra
c. An article that uses qualitative research.
ra ra ra ra ra
d. An article that is peer-reviewed.
ra ra ra ra
ACCURATE ANSWER:-A ra
Individual RCTs are the highest level of evidence or ―gold standard‖ for research. A pe
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
er-
reviewed article means that a panel of experts has reviewed the article; this is not a resea
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
rch method. Qualitative research is valuable in identifying information about how
ra ra ra ra ra ra ra ra ra ra
hospital client s cope with or manage various health problems and their perceptions of illness.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
It does not usually have the robustness of an RCT. Expert opinion is on the bottom of the hie
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
rarchical pyramid of evidence. ra ra ra
DIF:Understand (comprehension) ra
OBJ:Summarize the levels of evidence available in the literature. T ra ra ra ra ra ra ra ra ar
OPIC:-Assessment MSC: Management of Care ra ra ra ra
5. The nursing attendant is reviewing a research article on a hospital client care topic. Which
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
area should entice the nursing attendant to read the article? a. Literature review
ra ra ra ra ra ra ra ra ra ra
b. Introduction
c. Methods
d. Results
ACCURATE ANSWER:-B ra
The introduction contains information about its purpose and the importance of the topic to th
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
e audience who reads the article. The literature review or background offers a detailed backgr
ar ra ra ra ra ra ra ra ra ra ra ra ra ra
ound of the level of science or clinical information about the topic of the article. The methods
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
or design section explains how a research study was organized and conducted. The results or
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
conclusion section details the results of the study and explains whether a hypothesis is suppor
ra ra ra ra ra ra ra ra ra ra ra ra ar ra
ted.
DIF:Understand (comprehension) OBJ:Explain the steps of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar
Communication and Documentation ra ra
MSC: Management of Care ra ra ra
6. The nursing attendant is caring for a hospital client with chronic low back pain. The nursing
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra a
r
attendant wants to determine the best evidencebased practice regarding clinical guidelines f
ra ra ra ra ra ra ra ra ra ra ra
or low back pain. What is the best database for the nursing attendant to access?
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
a. MEDLINE
b. EMBASE
, c. PsycINFO
d. Agency for Healthcare Research and Quality (AHRQ) ra ra ra ra ra ra
ACCURATE ANSWER:-D ra
The Agency for Healthcare Research and Quality (AHRQ) includes clinical guidelines and ev
ra ra ra ra ra ra ra ra ra ra ra ra
idence summaries. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry, veter
ra ra ra ra ra ra ra ra ra ar
inary medicine, and allied health. EMBASE includes biomedical and pharmaceutical studies.
ra ra ra ra ra ra ra ra ra ra ra
PsycINFO deals with psychology and related health care disciplines.
ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) OBJ:Explain the steps of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar
Implementation MSC: Management of Care ra ra ra
7. A nursing attendant writes the following PICOT question: How do hospital client s wit
ra ra ra ra ra ra ra ra ra ra ra ra ra
h breast cancer rate their quality of life? How should the nursing attendant evaluate this
ar ra ra ra ra ra ra ra ra ra ra ra ra ra
question?
ra
a. A true PICOT question regardless of the number of elements
ra ra ra ra ra ra ra ra ra
b. A true PICOT question because the intervention comes before the control
ra ra ra ra ra ra ra ra ra ra
c. Not a true PICOT question because the comparison comes after the intervention
ra ra ra ra ra ra ra ra ra ra ra
d. Not a true PICOT question because the time is not designated
ra ra ra ra ra ra ra ra ra ra
ACCURATE ANSWER:-A ra
A meaningful PICOT question can contain only a P and O: How do hospital client s with bre
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
ast cancer (P) rate their quality of life (O)? Note that a welldesigned PICOT question does not ha
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
ve to follow the sequence of P, I, C, O, and T. The aim is
ra ra ra ra ra ra ra ra ra ra ra ra ra ra r
to ask a question that contains as many of the PICOT elements as possible.
a ra ra ra ra ar ra ra ra ra ra ra ra ra
DIF:Analyze (analysis) ra
OBJ:Develop a PICOT question. TOPIC:-Evaluation ra ra ra ar
MSC: Management of Care ra ra ra
8. A nursing attendant is reviewing literature for an evidencebased practice study. Which stud
ra ra ra ra ra ra ra ra ra ra ra ar
y should the nursing attendant use for the most relia
ra ra ra ra ra ra ra ra ra
ble level of evidence that uses statistics to show effectiveness? a. Meta-analysis
ra ra ra ra ra ra ra ra ra
b. Systematic review ra
c. Single random controlled trial ra ra ra
d. Control trial without randomization ra ra ra
ACCURATE ANSWER:-A ra
The main difference is that in a metaanalysis the researcher uses statistics to show the effect of a
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
n intervention on an outcome. In
ra ra ra ra ra ra
a systematic review, no statistics are used to draw conclusions about the evidence. A single ra
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
ndom controlled trial (RCT) is not as conclusive as a review of several RCTs on the same quest
ra ra ra ra ra ra ra ra ar ra ra ra ra ra ra ra ra
ion. Control trials without randomization may involve bias in how the study is conducted.
ra ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Analyze (analysis) ra
OBJ:Summarize the levels of evidence available in the literature. T ra ra ra ra ra ra ra ra ar
OPIC:-Planning MSC: Management of Care ra ra ra
9. A nursing attendant is reviewing research studies for evidencebased practice. Which article
ra ra ra ra ra ra ra ra ra ra ra ra
should the nursing attendant use for qualitative nursin g research?
ra ra ra ra ra ra ra ra
a. An article about the number of falls after use of no side rails
ra ra ra ra ra ra ra ra ra ra ra ra
b. An article about infection rates after use of a new wound dressing
ra ra ra ra ra ra ra ra ra ra ra
ra ra ra
MULTIPLE CHOICE ra
1. A nursing attendant uses evidence-
ra ra ra ra
based practice (EBP) to provide nursing care. What is the
ra ra ra ra ra ra ra ra ra
best rationale for the nursing attendant ’s behavior?
ra ra ra ra ra ra ra
a. EBP is a guide for nursing attendant s in making clinical decisions.
ra ra ra ra ra ra ra ra ra ra ra
b. EBP is based on the latest textbook information.
ra ra ra ra ra ra ra
c. EBP is easily attained at the bedside. ra ra ra ra ra ra
d. EBP is always right for all situations. ra ra ra ra ra ra
ACCURATE ar
ANSWER:-A
Evidence-
based practice (EBP) is a guide for nursing attendant s to structure how to make appropriate,
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra r
timely, and effective clinical decisions. A textbook relies on the scientific literature, which m
a ra ra ra ra ra ra ra ra ra ra ra ra ra
ay be outdated by the time the book is published. Unfortunately, much of the best evidence ne
ra ra ra ra ra ra ra ra ra ra ra ra ar ra ra ra
ver reaches the bedside. EBP is not to be blindly applied without using good judgment and cri
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
tical thinking skills. ra ra
DIF:Understand (comprehension) OBJ:Discuss the benefits of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar
Evaluation MSC: Management of Care ra ra ra
2. In caring for hospital client s, what must the nursing attendant remember about evid
ra ra ra ra ra ra ra ra ra ra ra ra ra
encebased practice (EBP)? ar ra
a. EBP is the only valid source of knowledge that should be used.
ra ra ra ra ra ra ra ra ra ra ra
b. EBP is secondary to traditional or convenient care knowledge.
ra ra ra ra ra ra ra ra
c. EBP is dependent on hospital client values and expectations.
ra ra ra ra ra ra ra ra
d. EBP is not shown to provide better hospital client outcomes.
ra ra ra ra ra ra ra ra ra
ACCURATE ANSWER:-C ra
Even when the best evidence available is used, application and outcomes will differ based on h
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
ospital client values, preferences, concerns, and/or expectations. Nursing attendant s often c
ra ra ra ra ra ra ra ra ra ra ra
are for hospital client s on the basis of tradition or convenience. Although these sources have
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra r
value, it is important to learn to rely more on research evidence than on nonresearch evidence. Ev
a ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
idencebased care improves quality, safety, hospital client outcomes, and nursing attendant satisf
ra ra ra ra ra ra ra ra ra ra ra
ac tion while reducing costs. ra ra ra
DIF:Understand (comprehension) OBJ:Discuss the benefits of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar
Implementation MSC: Management of Care ra ra ra
3. A nursing attendant wants to change a hospital client procedure. Which action will t
ra ra ra ra ra ra ra ra ra ra ra ra ra
h e nursing attendant take to easily find research evidence to support this change? a.
ar ra ra ra ra ra ra ra ra ra ra ra
Read all the articles found on the Internet.
ra ra ra ra ra ra ra
b. Make a general search of the Internet. ra ra ra ra ra ra
c. Use a PICOT format for the search. ra ra ra ra ra ra
d. Start with a broad question. ra ra ra ra
ACCURATE ANSWER:-C ra
, The more focused the question is, the easier it becomes to search for evidence in the scientific l
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
iterature. The PICO format allows the nursing attendant to ask focused questions that are int
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
ervention based. Inappropriately formed questions (general search or broad question) will lik
ra ra ra ra ra ra ra ra ra ra ra
ely lead to irrelevant sources of information. It is not beneficial to read hundreds of articles. It is
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar ra
more beneficial to read the best four to six articles that specifically address the question.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Apply (application) OBJ:Explain the steps of evidence-based practice. TOPIC:-Implementation
ra ra ra ra ra ra
MSC: Management of Care ra ra ra
4. A nursing attendant has collected several research findings for evidencebased practic
ra ra ra ra ra ra ra ra ra ra
e. Which article will be the best for the nursing attendant to use? a.
ar ra ra ra ra ra ra ra ra ra ra ra
An article that uses randomized controlled trials (RCT).
ra ra ra ra ra ra ra
b. An article that is an opinion of expert committees.
ra ra ra ra ra ra ra ra
c. An article that uses qualitative research.
ra ra ra ra ra
d. An article that is peer-reviewed.
ra ra ra ra
ACCURATE ANSWER:-A ra
Individual RCTs are the highest level of evidence or ―gold standard‖ for research. A pe
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
er-
reviewed article means that a panel of experts has reviewed the article; this is not a resea
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
rch method. Qualitative research is valuable in identifying information about how
ra ra ra ra ra ra ra ra ra ra
hospital client s cope with or manage various health problems and their perceptions of illness.
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
It does not usually have the robustness of an RCT. Expert opinion is on the bottom of the hie
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
rarchical pyramid of evidence. ra ra ra
DIF:Understand (comprehension) ra
OBJ:Summarize the levels of evidence available in the literature. T ra ra ra ra ra ra ra ra ar
OPIC:-Assessment MSC: Management of Care ra ra ra ra
5. The nursing attendant is reviewing a research article on a hospital client care topic. Which
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ar
area should entice the nursing attendant to read the article? a. Literature review
ra ra ra ra ra ra ra ra ra ra
b. Introduction
c. Methods
d. Results
ACCURATE ANSWER:-B ra
The introduction contains information about its purpose and the importance of the topic to th
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
e audience who reads the article. The literature review or background offers a detailed backgr
ar ra ra ra ra ra ra ra ra ra ra ra ra ra
ound of the level of science or clinical information about the topic of the article. The methods
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
or design section explains how a research study was organized and conducted. The results or
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
conclusion section details the results of the study and explains whether a hypothesis is suppor
ra ra ra ra ra ra ra ra ra ra ra ra ar ra
ted.
DIF:Understand (comprehension) OBJ:Explain the steps of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar
Communication and Documentation ra ra
MSC: Management of Care ra ra ra
6. The nursing attendant is caring for a hospital client with chronic low back pain. The nursing
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra a
r
attendant wants to determine the best evidencebased practice regarding clinical guidelines f
ra ra ra ra ra ra ra ra ra ra ra
or low back pain. What is the best database for the nursing attendant to access?
ra ra ra ra ra ra ra ra ra ra ra ra ra ra
a. MEDLINE
b. EMBASE
, c. PsycINFO
d. Agency for Healthcare Research and Quality (AHRQ) ra ra ra ra ra ra
ACCURATE ANSWER:-D ra
The Agency for Healthcare Research and Quality (AHRQ) includes clinical guidelines and ev
ra ra ra ra ra ra ra ra ra ra ra ra
idence summaries. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry, veter
ra ra ra ra ra ra ra ra ra ar
inary medicine, and allied health. EMBASE includes biomedical and pharmaceutical studies.
ra ra ra ra ra ra ra ra ra ra ra
PsycINFO deals with psychology and related health care disciplines.
ra ra ra ra ra ra ra ra
DIF:Understand (comprehension) OBJ:Explain the steps of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar
Implementation MSC: Management of Care ra ra ra
7. A nursing attendant writes the following PICOT question: How do hospital client s wit
ra ra ra ra ra ra ra ra ra ra ra ra ra
h breast cancer rate their quality of life? How should the nursing attendant evaluate this
ar ra ra ra ra ra ra ra ra ra ra ra ra ra
question?
ra
a. A true PICOT question regardless of the number of elements
ra ra ra ra ra ra ra ra ra
b. A true PICOT question because the intervention comes before the control
ra ra ra ra ra ra ra ra ra ra
c. Not a true PICOT question because the comparison comes after the intervention
ra ra ra ra ra ra ra ra ra ra ra
d. Not a true PICOT question because the time is not designated
ra ra ra ra ra ra ra ra ra ra
ACCURATE ANSWER:-A ra
A meaningful PICOT question can contain only a P and O: How do hospital client s with bre
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
ast cancer (P) rate their quality of life (O)? Note that a welldesigned PICOT question does not ha
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
ve to follow the sequence of P, I, C, O, and T. The aim is
ra ra ra ra ra ra ra ra ra ra ra ra ra ra r
to ask a question that contains as many of the PICOT elements as possible.
a ra ra ra ra ar ra ra ra ra ra ra ra ra
DIF:Analyze (analysis) ra
OBJ:Develop a PICOT question. TOPIC:-Evaluation ra ra ra ar
MSC: Management of Care ra ra ra
8. A nursing attendant is reviewing literature for an evidencebased practice study. Which stud
ra ra ra ra ra ra ra ra ra ra ra ar
y should the nursing attendant use for the most relia
ra ra ra ra ra ra ra ra ra
ble level of evidence that uses statistics to show effectiveness? a. Meta-analysis
ra ra ra ra ra ra ra ra ra
b. Systematic review ra
c. Single random controlled trial ra ra ra
d. Control trial without randomization ra ra ra
ACCURATE ANSWER:-A ra
The main difference is that in a metaanalysis the researcher uses statistics to show the effect of a
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
n intervention on an outcome. In
ra ra ra ra ra ra
a systematic review, no statistics are used to draw conclusions about the evidence. A single ra
ra ra ra ra ra ra ra ra ra ra ra ra ra ra ra
ndom controlled trial (RCT) is not as conclusive as a review of several RCTs on the same quest
ra ra ra ra ra ra ra ra ar ra ra ra ra ra ra ra ra
ion. Control trials without randomization may involve bias in how the study is conducted.
ra ra ra ra ra ra ra ra ra ra ra ra ra
DIF:Analyze (analysis) ra
OBJ:Summarize the levels of evidence available in the literature. T ra ra ra ra ra ra ra ra ar
OPIC:-Planning MSC: Management of Care ra ra ra
9. A nursing attendant is reviewing research studies for evidencebased practice. Which article
ra ra ra ra ra ra ra ra ra ra ra ra
should the nursing attendant use for qualitative nursin g research?
ra ra ra ra ra ra ra ra
a. An article about the number of falls after use of no side rails
ra ra ra ra ra ra ra ra ra ra ra ra
b. An article about infection rates after use of a new wound dressing
ra ra ra ra ra ra ra ra ra ra ra
