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