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