Advanced Practice Nursing in the Care of Older Adults
2nd Edition Chapter 1-19 Complete Guide|Q&A|2025
Brand
_____________________________________________________________________________________
A nurse leader is attempting to increase the awareness of evidence-based practice (EBP) among the
nurses on a unit. A nurse who is implementing EBP integrates which of the following? (Select all that
apply.)
A) Interdisciplinary consensus
B) Nursing tradition
C) Research studies
D) Patient preferences and values
E) Clinical expertise
C) Research studies
D) Patient preferences and values
E) Clinical expertise
Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-solving approach to
the delivery of healthcare that integrates the best evidence from studies and patient care data
with clinician expertise and patient preferences and values.
Mrs. Mayes is a 73-year-old woman who has a diabetic foot ulcer that has been extremely slow to
heal and which now poses a threat of osteomyelitis. The wound care nurse who has been working
with Mrs. Mayes applies evidence-based practice (EBP) whenever possible and has proposed the use
of maggot therapy to debride necrotic tissue. Mrs. Mayes, however, finds the suggestion repugnant
and adamantly opposes this treatment despite the sizable body of evidence supporting it. How should
the nurse reconcile Mrs. Mayes views with the principles of EBP?
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
B) The nurse should explain the evidence to the patient in greater detail.
C) The nurse should integrate the patients preferences into the plan of care. D) The nurse should
involve the patients family members in the decision-making process.
C) The nurse should integrate the patients preferences into the plan of care.
Patient preferences should be integrated into EBP and considered alongside research evidence
and the nurses clinical expertise; evidence does not trump the patients preferences. The family
should be involved, but this is not an explicit dimension of EBP. Similarly, explaining the
evidence in more detail is not a demonstration of EBP.
,The administrators of a long-term care facility are considered the use of specialized, pressure reducing
mattresses in order to reduce the incidence of pressure ulcers among residents. They have sought
input from the nurses on the unit, all of whom are aware of the need to implement the principles of
evidence-based practice (EBP) in this decision. Which of the following evidence sources should the
nurses prioritize?
A) A qualitative study that explores the experience of living with a pressure ulcer
B) A case study that describes the measures that nurses on a geriatric unit took to reduce pressure
ulcers among patients
C) Testimonials from experienced clinicians about the effectiveness of the mattress in question
D) A randomized controlled trial that compared the pressure-reducing mattress with standard
mattresses
D) A randomized controlled trial that compared the pressure-reducing mattress with standard
mattresses
The most reliable evidence is considered RCTs. Qualitative studies, case studies, and expert
opinion are low on the hierarchy of evidence.
Hospital administrators are applying the principles of evidence-based practice (EBP) in their attempt
to ascertain the most efficient and effective way to communicate between nurses who are on
different units, a project that will consider many types of evidence. Which of the following
information sources should the administrators prioritize?
A) A systematic review about communication in nursing contexts
B) Nurses ideas about communication methods
C) The results of a chart review
D) The hospitals accreditation status
A systematic review about communication in nursing contexts
Systematic reviews are assigned a high value in EBP. Reviews would be prioritized over nurses
ideas or a chart review, though both are potential considerations. The hospitals accreditation
status is not a relevant consideration.
10. A nurse has resolved to apply the evidence-based practice (EBP) process to the way that admission
assessments are conducted and documented on a unit. How should the nurse begin the process of
establishing EBP?
A) Gather evidence showing the shortcomings of current practices
B) Formulate a clear and concise question to be addressed
C) Elicit support from the nurses who are most often responsible for admissions
D) Search the literature for evidence that is potentially relevant to the practice need
B) Formulate a clear and concise question to be addressed
The first step in applying EBP is to ask a clear, focused question. This should precede a search of
, the literature or the recruitment of participants. An assessment of the shortcomings of the
current system is not an explicit component of the EBP process.
Which of the following questions best exemplifies the PICOT format for asking evidence-based
questions?
A) What affect does parents alcohol use have on the alcohol use of their teenage children?
B) Among postsurgical patients, what role does meditation rather than benzodiazepines have on
anxiety levels during the 48 hours following surgery?
C) Among high school students, what is the effectiveness of a sexual health campaign undertaken
during the first 4 weeks of the fall semester as measured by incidence of new sexually transmitted
infections?
D) In children aged 68, is the effectiveness of a descriptive pain scale superior to a numeric rating scale
in the emergency room context?
B) Among postsurgical patients, what role does meditation rather than benzodiazepines have on
anxiety levels during the 48 hours following surgery?
The correct answer includes a population (postsurgical patients), intervention (meditation),
comparison (benzodiazepines), outcome (anxiety levels), and a time frame (48 hours). No other
option contains each of the five elements of a PICOT question.
A nurse has made plans to implement the University of North Carolina (UNC) model of 5 As during the
process of applying evidence-based practice (EBP) to a practice problem. What is the final step that
the nurse will take in applying this model?
A) Analyze the results of the EBP process
B) Advocate for others to embrace the identified change
C) Adopt the changes identified in the review process
D) Assess the outcomes of the new practice
D) Assess the outcomes of the new practice
The final step in the UNC rubric is to Assess the change using the quality improvement process
in place in the institution.
A nurse has been asked to make a presentation to a group of high school students on the subject of
sexual health. However, the nurse does not have a background in this practice area and requires rapid
access to evidence-based guidelines. Which of the following strategies is most likely to provide the
nurse with valid and reliable evidence in a time-efficient manner?
A) Search the Cochrane Library of Systematic Reviews
B) Google search terms such as sexual health teens and sexual education C) Search Medline using
PubMed and order relevant articles
D) Scan the most recent issues of nursing journals that address this area of practice
, Search the Cochrane Library of Systematic Reviews
For some problems, a systematic review may be available from a source such as the Cochrane
Library. Often this review is done by an expert panel providing excellent information on which to
base decisions. This approach is more likely to produce valid and reliable results than a Google
search and is more efficient than searching journal manually or ordering articles through
PubMed.
The nurses at a university hospital have been informed that a computerized record system will be
implemented over the next 12 months. The nurses should be aware that such as system presents
particular challenges in the area of
A) vulnerability to errors in charting and the inability to make changes.
B) patient privacy and confidentiality of records.
C) enforcing compliance with the system on the part of nurses.
D) ensuring compatibility with different computer operating systems.
B) patient privacy and confidentiality of records.
Concerns about privacy become magnified when information is available to many people in
many sites far removed from where the patient is located, a situation that exists when
computerized records are used. This is usually considered a more important concern than issues
of compliance, compatibility, or vulnerability to errors.
A nurse is nervous about the impeding introduction of computerized nursing care records at the
hospital because he does not consider himself to be technologically adept. How should this nurse best
respond to this situation?
A) Take courses in advanced practice nursing to build his knowledge.
B) Explore employment opportunities in settings that use written documentation systems.
C) Advocate for a delay in the introduction of the proposed system.
D) Seek out opportunities to learn the relevant knowledge and practice the necessary skills
D) Seek out opportunities to learn the relevant knowledge and practice the necessary skills
A nurse who lacks technological knowledge or skills should seek out opportunities to expand
these. This is preferable to finding a job elsewhere, studying advanced practice nursing, or
attempting to delay the change.
The major impact of the physiological changes that occur with aging is:
A. Reduced physiological reserve
B. Reduced homeostatic mechanisms
C. Impaired immunological response
D. All of the above
2nd Edition Chapter 1-19 Complete Guide|Q&A|2025
Brand
_____________________________________________________________________________________
A nurse leader is attempting to increase the awareness of evidence-based practice (EBP) among the
nurses on a unit. A nurse who is implementing EBP integrates which of the following? (Select all that
apply.)
A) Interdisciplinary consensus
B) Nursing tradition
C) Research studies
D) Patient preferences and values
E) Clinical expertise
C) Research studies
D) Patient preferences and values
E) Clinical expertise
Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-solving approach to
the delivery of healthcare that integrates the best evidence from studies and patient care data
with clinician expertise and patient preferences and values.
Mrs. Mayes is a 73-year-old woman who has a diabetic foot ulcer that has been extremely slow to
heal and which now poses a threat of osteomyelitis. The wound care nurse who has been working
with Mrs. Mayes applies evidence-based practice (EBP) whenever possible and has proposed the use
of maggot therapy to debride necrotic tissue. Mrs. Mayes, however, finds the suggestion repugnant
and adamantly opposes this treatment despite the sizable body of evidence supporting it. How should
the nurse reconcile Mrs. Mayes views with the principles of EBP?
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
B) The nurse should explain the evidence to the patient in greater detail.
C) The nurse should integrate the patients preferences into the plan of care. D) The nurse should
involve the patients family members in the decision-making process.
C) The nurse should integrate the patients preferences into the plan of care.
Patient preferences should be integrated into EBP and considered alongside research evidence
and the nurses clinical expertise; evidence does not trump the patients preferences. The family
should be involved, but this is not an explicit dimension of EBP. Similarly, explaining the
evidence in more detail is not a demonstration of EBP.
,The administrators of a long-term care facility are considered the use of specialized, pressure reducing
mattresses in order to reduce the incidence of pressure ulcers among residents. They have sought
input from the nurses on the unit, all of whom are aware of the need to implement the principles of
evidence-based practice (EBP) in this decision. Which of the following evidence sources should the
nurses prioritize?
A) A qualitative study that explores the experience of living with a pressure ulcer
B) A case study that describes the measures that nurses on a geriatric unit took to reduce pressure
ulcers among patients
C) Testimonials from experienced clinicians about the effectiveness of the mattress in question
D) A randomized controlled trial that compared the pressure-reducing mattress with standard
mattresses
D) A randomized controlled trial that compared the pressure-reducing mattress with standard
mattresses
The most reliable evidence is considered RCTs. Qualitative studies, case studies, and expert
opinion are low on the hierarchy of evidence.
Hospital administrators are applying the principles of evidence-based practice (EBP) in their attempt
to ascertain the most efficient and effective way to communicate between nurses who are on
different units, a project that will consider many types of evidence. Which of the following
information sources should the administrators prioritize?
A) A systematic review about communication in nursing contexts
B) Nurses ideas about communication methods
C) The results of a chart review
D) The hospitals accreditation status
A systematic review about communication in nursing contexts
Systematic reviews are assigned a high value in EBP. Reviews would be prioritized over nurses
ideas or a chart review, though both are potential considerations. The hospitals accreditation
status is not a relevant consideration.
10. A nurse has resolved to apply the evidence-based practice (EBP) process to the way that admission
assessments are conducted and documented on a unit. How should the nurse begin the process of
establishing EBP?
A) Gather evidence showing the shortcomings of current practices
B) Formulate a clear and concise question to be addressed
C) Elicit support from the nurses who are most often responsible for admissions
D) Search the literature for evidence that is potentially relevant to the practice need
B) Formulate a clear and concise question to be addressed
The first step in applying EBP is to ask a clear, focused question. This should precede a search of
, the literature or the recruitment of participants. An assessment of the shortcomings of the
current system is not an explicit component of the EBP process.
Which of the following questions best exemplifies the PICOT format for asking evidence-based
questions?
A) What affect does parents alcohol use have on the alcohol use of their teenage children?
B) Among postsurgical patients, what role does meditation rather than benzodiazepines have on
anxiety levels during the 48 hours following surgery?
C) Among high school students, what is the effectiveness of a sexual health campaign undertaken
during the first 4 weeks of the fall semester as measured by incidence of new sexually transmitted
infections?
D) In children aged 68, is the effectiveness of a descriptive pain scale superior to a numeric rating scale
in the emergency room context?
B) Among postsurgical patients, what role does meditation rather than benzodiazepines have on
anxiety levels during the 48 hours following surgery?
The correct answer includes a population (postsurgical patients), intervention (meditation),
comparison (benzodiazepines), outcome (anxiety levels), and a time frame (48 hours). No other
option contains each of the five elements of a PICOT question.
A nurse has made plans to implement the University of North Carolina (UNC) model of 5 As during the
process of applying evidence-based practice (EBP) to a practice problem. What is the final step that
the nurse will take in applying this model?
A) Analyze the results of the EBP process
B) Advocate for others to embrace the identified change
C) Adopt the changes identified in the review process
D) Assess the outcomes of the new practice
D) Assess the outcomes of the new practice
The final step in the UNC rubric is to Assess the change using the quality improvement process
in place in the institution.
A nurse has been asked to make a presentation to a group of high school students on the subject of
sexual health. However, the nurse does not have a background in this practice area and requires rapid
access to evidence-based guidelines. Which of the following strategies is most likely to provide the
nurse with valid and reliable evidence in a time-efficient manner?
A) Search the Cochrane Library of Systematic Reviews
B) Google search terms such as sexual health teens and sexual education C) Search Medline using
PubMed and order relevant articles
D) Scan the most recent issues of nursing journals that address this area of practice
, Search the Cochrane Library of Systematic Reviews
For some problems, a systematic review may be available from a source such as the Cochrane
Library. Often this review is done by an expert panel providing excellent information on which to
base decisions. This approach is more likely to produce valid and reliable results than a Google
search and is more efficient than searching journal manually or ordering articles through
PubMed.
The nurses at a university hospital have been informed that a computerized record system will be
implemented over the next 12 months. The nurses should be aware that such as system presents
particular challenges in the area of
A) vulnerability to errors in charting and the inability to make changes.
B) patient privacy and confidentiality of records.
C) enforcing compliance with the system on the part of nurses.
D) ensuring compatibility with different computer operating systems.
B) patient privacy and confidentiality of records.
Concerns about privacy become magnified when information is available to many people in
many sites far removed from where the patient is located, a situation that exists when
computerized records are used. This is usually considered a more important concern than issues
of compliance, compatibility, or vulnerability to errors.
A nurse is nervous about the impeding introduction of computerized nursing care records at the
hospital because he does not consider himself to be technologically adept. How should this nurse best
respond to this situation?
A) Take courses in advanced practice nursing to build his knowledge.
B) Explore employment opportunities in settings that use written documentation systems.
C) Advocate for a delay in the introduction of the proposed system.
D) Seek out opportunities to learn the relevant knowledge and practice the necessary skills
D) Seek out opportunities to learn the relevant knowledge and practice the necessary skills
A nurse who lacks technological knowledge or skills should seek out opportunities to expand
these. This is preferable to finding a job elsewhere, studying advanced practice nursing, or
attempting to delay the change.
The major impact of the physiological changes that occur with aging is:
A. Reduced physiological reserve
B. Reduced homeostatic mechanisms
C. Impaired immunological response
D. All of the above
