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Chapter 1. Using Evidence in Nursing Practice
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Chapter 2. Communication and Collaboration
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Chapter 3. Admitting, Transfer, and Discharge
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Chapter 4. Documentation and Informatics
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Chapter 5. Vital Signs
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Chapter 6. Health Assessment
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Chapter 7. Specimen Collection
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Chapter 8. Diagnostic Procedures
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Chapter 9. Medical Asepsis
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Chapter 10. Sterile Technique
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Chapter 11. Safe Patient Handling and Mobility (SPHM)
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Chapter 12. Exercise and Mobility
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Chapter 13. Support Surfaces and Special Beds
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Chapter 14. Patient Safety
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Chapter 15. Disaster Preparedness
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Chapter 16. Pain Management
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Chapter 17. End-of-Life Care
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Chapter 18. Personal Hygiene and Bed Making
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Chapter 19. Care of the Eye and Ear
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Chapter 20. Safe Medication Preparation
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Chapter 21. Nonparenteral Medications
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Chapter 22. Parenteral Medications
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Chapter 23. Oxygen Therapy
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Chapter 24. Performing Chest Physiotherapy
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Chapter 25. Airway Management
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Chapter 26. Cardiac Care
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Chapter 27. Closed Chest Drainage Systems
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Chapter 28. Emergency Measures for Life Support
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Chapter 29. Intravenous and Vascular Access Therapy Chapter
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30. Blood Therapy
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Chapter 31. Oral Nutrition
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Chapter 32. Enteral Nutrition
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Chapter 33. Parenteral Nutrition
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Chapter 34. Urinary Elimination
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Chapter 35. Bowel Elimination and Gastric Intubation Chapter
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36. Ostomy Care
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Chapter 37. Preoperative and Postoperative Care
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Chapter 38. Intraoperative Care
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Chapter 39. Wound Care and Irrigations
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Chapter 40. Impaired Skin Integrity Prevention and Care
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Chapter 41. Dressings, Bandages, and Binders
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Chapter 42. Home Care Safety
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Chapter 43. Home Care Teaching
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,Chapter 01: Using Evidence in Nursing Practice
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Perry et al.: Clinical Nursing Skills & Techniques, 11th Edition
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MULTIPLE CHOICE m
1. Evidence-based practice is a problem-solving approach to making decisions about patient care m m m m m m m m m m m
that is grounded in:
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a. the latest information found in textbooks.
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b. systematically conducted research studies. m m m
c. tradition in clinical practice. m m m
d. quality improvement and risk-management data. m m m m
ANSWER: B m
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 is
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published. Many health care settings do not have a process to help staff adopt new evidence in
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practice, and nurses in practice settings lack easy access to risk-management data, relying
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instead on tradition or convenience. Some sources of evidence do not originate from research.
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These include quality improvement and risk-management data; infection control data;
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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 more on m m m m m m m m m m m m m m m
research-based evidence.
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DIF: CognitiveLevel: Comprehension OBJ: Discuss the benefits of evidence-based practice. m m m m m m m
TOP: Evidence-Based Practice
m m KEY: Nursing Process Step: Assessment m m m m m
MSC: 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. m m
b. unhampered by patient culture. m m m
c. variable according to the situation. m m m m
d. safe from the hazards of critical thinking.
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ANSWER: C m
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: CognitiveLevel: Application OBJ: Discuss the benefits of evidence-based practice. m m m m m m m
TOP: Evidence-Based Practice
m m KEY: Nursing Process Step: Assessment m m m m m
MSC: 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. CHOICE BLANK m
d. O.
ANSWER: C m
C = Comparison of interest. What standard of care or current intervention do you usually use now
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in practice?
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P = Patient population of interest. Identify your patient by age, gender, ethnicity, disease, or health
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problem.
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I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and prognostic
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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 in
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patient‘s perception) do you wish to achieve or observe as the result of an intervention?
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DIF: CognitiveLevel: Knowledge OBJ: Develop a PICO question. m m m m m
TOP: PICO
m KEY: Nursing Process Step: Implementation
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MSC: 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. m m
b. include all five elements of the sequence. m m m m m m
c. find as many articles as possible in a literature search.
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d. accept standard clinical routines. m m m
ANSWER: A m
The more focused a question that you ask is, the easier it is to search for evidence in the scientific
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literature. A well-designed PICOT question does not have to include all five elements, nor does
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it have to follow the PICOT sequence. Do not be satisfied with clinical routines. Always
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question and use critical thinking to consider better ways to provide patient care.
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DIF: CognitiveLevel: Analysis OBJ: Describe the six steps of evidence-based practice. m m m m m m m m
TOP: Evidence-Based Practice
m m KEY: Nursing Process Step: Implementation m m m m m
MSC: NCLEX: Safe and Effective Care Environment (management of care)
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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 m m
ANSWER: D m
The Cochrane Community Database of Systematic Reviews is a valuable source of synthesized
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evidence (i.e., pre-appraised evidence). The Cochrane Database includes the full text of regularly
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updated systematic reviews and protocols for reviews currently happening. MEDLINE,
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CINAHL, and PubMed are among the most comprehensive databases and represent the
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scientific knowledge base of health care.
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DIF: CognitiveLevel: Synthesis OBJ: Describe the six steps of evidence-based practice. m m m m m m m m
TOP: Evidence-Based Practice
m m KEY: Nursing Process Step: Implementation m m m m m
MSC: NCLEX: Safe and Effective Care Environment (management of care)
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