Module 45 Evidence-Based Practice Exam Questions and Complete Solutions

Module 45 Evidence-Based Practice Exam Questions and Complete Solutions The nurse is caring for a client who requires extensive wound care. The client has consented to participate in a nursing research study regarding the wound care. Which client statement indicates understanding of the research goal? A) "This research will not influence my care." B) "Nursing care is based solely on research." C) "I will be paid to participate in the research project." D) "I will be helping to validate nursing care." Ans: D Improving nursing care and establishing the profession's credibility are two goals of nursing research. Participation in this research project will probably change the normal routine of the client's care. Clients do not receive pay for participating in research. Nursing care is based on intuition and the experience of the nurse as well as research. Page Ref: 2765 A nurse researcher is preparing to give a presentation about evidence-based practice (EBP) to a group of nursing students. Which of the following statements would be appropriate for the nurse researcher to include in this presentation? A) "EBP focuses solely on research-based evidence, and it assumes that best practices for nursing care exist independent of client preferences." B) "EBP involves integrating research evidence, the nurse's own clinical expertise, and client values and preferences." C) "EBP is sometimes also referred to as translational research." D) "EBP is typically only associated with complex nursing tasks, such as preparing clients for surgery and monitoring for adverse effects." Ans: B The nurse researcher should be sure to tell students that EBP involves integrating research evidence, the nurse's own clinical expertise, and client values and preferences. Although translational research helps in the development of EBP, the two terms are not synonymous. EBP informs nursing procedures of all types, from simple to complex Page Ref: 2761 The nurse working in a community hospital is caring for a client who does not seem to be responding well to the current plan of care that has been implemented by the nursing team. Given this information, which actions by the nurse are appropriate? Select all that apply. A) Accessing research journals for evidence that would support a change in the plan of care B) Proposing a nursing research project to the unit manager C) Networking online with other nurses who are giving similar care D) Asking the doctor for a new nursing approach to care E) Trying a different approach to care even though it breaches hospital policy Ans: A, C A nurse in a community hospital may not have immediate access to the latest in nursing research. In order to improve care, this nurse might access research journals or network with other nurses to determine whether there is any evidence that would support changes in the client's nursing care. The nurse should not breach hospital policy even if the client were to benefit. Proposing a research project is an excellent way to improve client care, but this nurse needs a more immediate solution to the client's problems. The physician is not involved in solving nursing problems Page Ref: 2763 A client in the clinic is being asked to participate in a research study. The client asks why a nursing research study is necessary given that research on this subject has already been published by the American Medical Association (AMA). Which of the following responses should the nurse offer in reply to the client's question? A) "This study is useful because it supports the medical profession." B) "This study is useful because it validates nursing through medical research." C) "This study is useful because it supports products used in nursing care." D) "This study is useful because it validates nursing care, not medical care." Ans: D Many people do not understand that nursing is a separate profession from the medical profession. One reason that nursing research is undertaken is to ensure the credibility of the nursing profession as separate from medicine with the potential to make valuable contributions to client care. Nursing research validates nursing, not medicine. Nursing research is not established to support products but to improve client care. Nursing research does not seek to support the medical profession but the nursing profession. Page Ref: The nurse manager for a medical-surgical nursing unit is talking to a group of nursing students. The nurse manager is explaining the types of nursing research studies that are conducted on the unit. Which statement by the students indicates understanding of the nature of nursing research? A) "Nursing research does not include nursing education or nursing leadership." B) "Nursing research does not include the study of nurses themselves." C) "Nursing research impacts nursing by adding knowledge and changing nursing practice." D) "Nursing research is used to enhance medical treatment." Ans: C The student who states that nursing research impacts the profession by adding knowledge and changing nursing practice understands what nursing research is. Nursing research includes the study of nurses themselves. Nursing research does not enhance medical treatment but enhances nursing care. Research also includes the educational aspects of nursing and nursing leadership Page Ref: 2763 A nursing preceptor is working with a novice nurse on a medical-surgical unit. During client care, the novice nurse shares an evidence-based wound care technique that is being used with much success. Which of the following is being encouraged when the novice nurse shares this information with the preceptor? A) Use of trial and error to gain knowledge B) Use of existing unit modes of care C) Use of new knowledge gained through research D) Use of medical knowledge to perform care Ans: C The novice nurse is sharing evidence learned through research that may enhance client care. The novice nurse is not encouraging the preceptor to use existing modes of care, medical knowledge, or trial and error in this example Page Ref: The head nurse in a pediatrician's office is interested in incorporating more aspects of evidence-based practice (EBP) into the facility's regular nursing procedures and protocols. Which of the following resources would be most useful in helping the nurse achieve this goal? A) An American Nurses Association (ANA) report about best practices for reducing the incidence of pressure ulcers B) Documentation from the Centers for Disease Control and Prevention regarding recommended vaccinations for individuals who plan to travel abroad C) A report from the National Institutes of Health (NIH) describing a new sickle cell screening protocol D) A journal article discussing the perceived versus actual effectiveness of various approaches to smoking cessation Ans: C Of the resources listed, the NIH report about a new sickle cell screening protocol would be of greatest use to a nurse in a pediatrician's office. Screening for conditions that often become apparent during childhood, such as sickle cell disease, is an important responsibility of healthcare providers who work with infants, children, and adolescents, and it directly supports the Healthy People 2020 goal of reducing child mortality. Although all of the other resources listed above could be used in support of EBP, they would be more appropriate for nurses who work with older populations Page Ref: 2763 Which of the following resources would be of least value to a nurse who hopes to employ evidence-based practice (EBP) in support of the Healthy People 2020 objectives for pregnant women? A) A research study linking regular exercise during pregnancy with a reduced likelihood of cesarean section B) A report from the American Congress of Obstetricians and Gynecologists describing best practices for screening for gestational diabetes C) A document from the National Institutes of Health describing newly identified benefits of receiving vaccines during pregnancy D) A report from the American Cancer Society regarding changes in the recommended schedule for mammograms Ans: D Healthy People 2020 objectives for pregnant women include reducing mortality rates among this population, reducing the rate of pregnancy-related complications, and reducing the occurrence of cesarean births among women who are at low risk for complications. Of the listed resources, the only one that doesn't directly support these objectives is the report about changes in mammogram screening recommendations. This resource would be appropriate for a nurse who is interested in using EBP to support Healthy People 2020 objectives for older adult populations, however. Page Ref: 2772 A nurse educator is interacting with a group of nurses who are working toward their graduate degrees. The members of the group are interested in replication studies. Which of the following replication studies would be most appropriate given the changing demographics in the United States? A) A study examining the ability of families to adapt to acute health problems B) A study examining how effective use of supplies affects the cost of care C) A study examining the ability of an aging population to care for itself D) A study examining how new technology affects client care Ans: C The U.S. population is aging as the baby boomers begin to retire. In light of this demographic shift, an important replication study would be to examine how well the aging population is able to care for itself, in hopes of identifying cost-effective measures that can be instituted to provide care for this expanding group. Studying how effective use of supplies affects the cost of care is usually an ongoing project conducted in most hospitals as healthcare costs increase. Studying a family's ability to adapt to acute health problems is not a demographic issue. New technology is not a demographic issue Page Ref: 2770 The nurse is caring for a client with a chronic disease process. The client tells the nurse he recently read an article about funding for the National Institute of Nursing Research (NINR). He then asks the nurse why the U.S. Congress would fund such an organization. Which response by the nurse is most appropriate? A) "The government is looking to the NINR for information about promoting health." B) "Funding the NINR is one cause of health cost increases in the country." C) "The government is interested in preventing chronic disease." D) "Nursing research is focused on prevention and health promotion, which will decrease healthcare costs." Ans: D The U.S. government's goal in funding organizations like the NINR is to help contain healthcare costs while also increasing the quality of care. Nursing research frequently focuses on prevention and health promotion, which means it directly supports these two goals. Funding the NINR does not increase healthcare costs but rather seeks to reduce costs. The government does know how to promote healthcare; the purpose of partnering with the NINR is to further that goal from a nursing perspective. Chronic disease cannot always be prevented, but research can help improve care and reduce costs. Page Ref: 2765 The nurse is working with a client who has agreed to participate in a research study. Which actions would constitute a violation of the client's right to full disclosure? Select all that apply. A) Giving the client false information about his or her participation in the study B) Telling a mutual friend about the client's involvement in the study C) Withholding information about the study from the client D) Providing the client's name as a participant in the study E) Suggesting that participating in the study would greatly benefit the client's financial situation Ans: A, C Withholding information and giving false information would both violate the client's right to full disclosure. Telling a mutual friend about the client's involvement would violate the client's right to confidentiality, as would providing the client's name as a study participant, but neither of these actions would affect the client's right to full disclosure. Suggesting that study participation would benefit the client financially could be viewed as a form of coercion or undue influence and thus be considered unethical, but it would not affect the client's right to full disclosure. Page Ref: 2765 A nurse working in a home health agency is asked to participate on a committee that is looking to incorporate evidence-based nursing care. What should be the committee's first step in implementing evidence-based practice (EBP)? A) Compile a list of questions. B) Research evidence-based practices that can be implemented. C) Evaluate the results of different research projects. D) Suggest that individual staff members try new means of delivering care Ans: A Following committee formation, the next step in the EBP implementation process would be to compile a list of clinical questions that are relevant to nursing practice within the agency. Suggesting that staff nurses try new methods of care may violate the agency's policies; also, new care methods should be tried and evaluated in an orderly fashion. It is not appropriate to research specific nursing practices until pertinent clinical questions have been asked. Results cannot be evaluated until research has been reviewed and practice has been changed. Page Ref: 2766 A nurse is planning a research project comparing the use of fingerstick blood glucose testing with the use of alternative sites for adult male clients. Which elements of the PICOT formulation of the clinical question still need to be defined? Select all that apply. A) People B) Issue C) Comparison D) Outcome E) Time Ans: D, E The people in this study are adult men with diabetes. The issue is effective testing for blood glucose levels. The comparison is between adult men using different testing sites. According to the PICOT formulation, the clinical question still needs to specify an outcome (i.e., it needs to state a hypothesis about the two groups) and a time frame for the study. Page Ref: 2767 A nurse is preparing to conduct a research study and wants to do a literature search for relevant articles. Which of the following sections should the nurse expect to find in each search result? Select all that apply. A) Abstract B) Methods C) Funding D) Results E) References Ans: A, B, D, E The abstract provides a summary of the entire content of the journal article. The methods section describes in detail all aspects and methods of the study. The results section reports statistical data. The references section lists source materials and other resources for additional information. Funding information is not a necessary element of a research article. Page Ref: 2768 A nursing student who is providing care for an assigned client knows that the information documented in the client's nursing care plan could potentially be used in research to optimize client care. Which type of research is used to convert research knowledge into healthcare applications for improved outcomes? A) Translational research B) Transformational research C) Quantitative research D) Qualitative research Ans: A Translational research is a systematic approach of converting research knowledge into applications of healthcare for improved client outcomes. When scientific evidence is translated into practical applications, human health can be improved. Information can flow back and forth between researchers and clinicians to further investigate diseases and human response to them. Page Ref: 2762 A nurse manager is encouraging staff on the unit to go back to school and "become professionals, not just workers" by "increasing" their knowledge through education and networking. Which criteria for nursing to be recognized as a profession is the nurse manager highlighting? Select all that apply. A) Joining professional organizations B) Following a code of ethics C) Having specialized education requirements D) Conducting ongoing research E) Having autonomy Ans: A, C, E Although all of the answer choices are criteria for nursing to be recognized as a profession, in this situation, the nurse manager is highlighting the importance of specialized education and joining professional organizations through networking. Having autonomy is implied, because more education leads to more autonomy. Page Ref: A home health nurse who is visiting a client to complete a wound dressing notes that the client has a flat affect and is not as responsive as during previous visits. The nurse calls the client's primary healthcare provider for a psychiatric referral. By recognizing the signs and symptoms of possible depression, the nurse is exhibiting which concept associated with evidence-based practice? A) Clinical decision making B) Advocacy C) Professional behaviors D) Accountability Ans: A Here, the nurse is engaging in clinical decision making informed by evidence from the research. The nurse's decision to seek a psychiatric referral reflects familiarity with the signs and symptoms of depression, as widely documented in the literature. It also reflects an understanding that psychiatric care may be necessary to achieve the best possible outcomes for this client. Page Ref: 2763 Which type of research investigates a question through narrative data that explores the subjective experiences of human beings and can provide nursing with a better understanding of clients' perspectives? A) Quantitative research B) Thematic research C) Qualitative research D) Clinical research Ans: C Qualitative research investigates a question through narrative data that explores the subjective experiences of human beings and can provide nursing with a better understanding of the subjects' perspective. Goals of qualitative research include the identification of patterns and themes. In comparison, quantitative research uses precise measurement to collect data and analyze the data statistically for a summary and a description of the resulting findings or to test relationships among variables. Clinical research refers to any type of research (qualitative or quantitative) that seeks answers to questions that will ultimately improve patient care. Page Ref: 2764 Prior to conducting research, nurse researchers must have their research protocols approved by which of the following bodies? A) The American Nurses Association B) The U.S. Department of Health and Human Services C) The journal in which the researchers plan to publish their results D) An institutional review board Ans: D Prior to undertaking research, nurse researchers must have their protocols reviewed and approved by an institutional review board (IRB). The IRB is responsible for ensuring that the research protocols adhere to ethical standards. Although an IRB's decision may be influenced by ANA recommendations or Department of Health and Human Services policies and regulations, neither of these groups is required to review research protocols. Journals are interested in research after it has been conducted, not before. Page Ref: 2765 Which of the following measures would be most directly aimed at upholding the principle of respect for persons? A) A policy requiring that any research involving pediatric subjects undergo an extra level of ethical scrutiny prior to approval B) A policy stating that all data gathered during research must be stripped of information that links it to individual research subjects C) A policy stating that a research project must be immediately suspended should any of the participants experience an unexpected adverse event D) A policy requiring that all participants in a research effort receive financial compensation Ans: A The principle of respect for persons involves acknowledging and protecting the autonomy of all individuals, including individuals whose capacity to exercise autonomy is diminished because of disability, illness, circumstances that restrict liberty, or immaturity. Thus, this principle would underlie a policy providing extra protection for pediatric research subjects. A policy requiring the removal of personally identifying information would be more closely linked to the concept of justice, and a policy requiring the suspension of a research project following unforeseen adverse effects would be more closely linked to the principle of beneficence. It is unlikely that an organization would have a policy requiring financial compensation for all research subjects, as this might be considered a form of undue influence. Page Ref: 2765