Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
TEST BANK
Clinical Nursing Skills and Techniques
Anne Griffin Perry, Patricia A. Potter & Wendy Ostendorf
9th Edition
Page 1
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
Table of Contents
Unit: Supporting the Patient Through the Health Care System
1 Using Evidence in Practice
2 Admitting, Transfer, and Discharge
3 Communication and Collaboration
4 Documentation and Informatics
Unit II: Vital Signs and Physical Assessment
5 Vital Signs
6 Health Assessment
Unit III: Special Procedures
7 Specimen Collection
8 Diagnostic Procedures
Unit IV: Infection Control
9 Medical Asepsis
10 Sterile Technique
Unit V: Activity and Mobility
11 Safe Patient Handling, Transfer and Positioning
12 Exercise and Mobility
13 Support Surfaces and Special Beds
Unit VI: Safety and Comfort
14 Patient Safety
15 Disaster Preparedness
16 Pain Management
17 Palliative Care
Unit VII: Hygiene
18 Personal Hygiene and Bed Making
19 Care of the Eye and Ear
Unit VIII: Medications
20 Safe Medicine Preparation
21 Administration of Nonparenteral Medications
22 Administration of Parenteral Medications
Unit IX: Oxygenation
23 Oxygen Therapy
24 Performing Chest Physiotherapy
25 Airway Management
26 Cardiac Care (NEW CHAPTER)
27 Closed Chest Drainage Systems
28 Emergency Measures for Life Support
Unit X: Fluid Balance
29 Intravenous and Vascular Access Therapy
30 Blood Therapy
Page 2
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
Unit XI: Nutrition
31 Oral Nutrition
32 Enteral Nutrition
33 Parenteral Nutrition
Unit XII: Elimination
34 Urinary Elimination
35 Bowel Elimination and Gastric Intubation
36 Ostomy Care
Unit XIII: Care of the Surgical Patient
37 Preoperative and Postoperative Care
38 Intraoperative Care
Unit XIV: Dressings and Wound Care
39 Impaired Skin Integrity Prevention and Care
40 Wound Care and Irrigations
41 Dressings, Bandages, and Binders
42 Warm and Cold Therapy
Unit XV: Home Care
43 Home Care Safety
44 Home Care Teaching
Page 3
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
Chapter 01: Using Evidence in Practice
M U LT I P L E C H O I C E
1. Evidence-based practice is a problem-solving approach to making decisions about patient
care that is grounded in:
a. the latest information found in textbooks.
b. systematically conducted research studies.
c. tradition in clinical practice.
d. quality improvement and risk-management data.
ANS: B
The best evidence comes from well-designed, systematically conducted research studies
described in scientific journals. Portions of a textbook often become outdated by the time it is
published. Many health care settings do not have a process to help staff adopt new evidence in
practice, and nurses in practice settings lack easy access to risk-management data, relying
instead on tradition or convenience. Some sources of evidence do not originate from research.
These include quality improvement and risk-management data; infection control data;
retrospective or concurrent chart reviews; and clinicians’ expertise. Although non–research-
based evidence is often very valuable, it is important that you learn to rely more on research-
based evidence.
DIF: Cognitive Level: Comprehension REF: Text reference: p. 2
OBJ: Discuss the benefits of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Assessment MSC: N C LE X : Safe and Effective Care Environment (management of
care)
2. When evidence-based practice is used, patient care will be:
a. standardized for all.
b. unhampered by patient culture.
c. variable according to the situation.
d. safe from the hazards of critical thinking.
ANS: C
Using your clinical expertise and considering patients’ cultures, values, and preferences
ensures that you will apply available evidence in practice ethically and appropriately. Even
when you use the best evidence available, application and outcomes will differ; as a nurse,
you will develop critical thinking skills to determine whether evidence is relevant and
appropriate.
DIF: Cognitive Level: Application REF: Text reference: p. 2
OBJ: Discuss the benefits of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Assessment MSC: N C LE X : Safe and Effective Care Environment (management of
care)
3. When a PICOT question is developed, the letter that corresponds with the usual standard of
care is:
a. P.
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
b. I.
c. C.
d. O.
ANS: C
C = Comparison of interest. What standard of care or current intervention do you usually
use now in practice?
P = Patient population of interest. Identify your patient by age, gender, ethnicity, disease, or
health problem.
I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and
prognostic factor) do you think is worthwhile to use in practice?
O = Outcome. What result (e.g., change in patient’s behavior, physical finding, and change
in patient’s perception) do you wish to achieve or observe as the result of an intervention?
DIF: Cognitive Level: Knowledge REF: Text reference: p. 3
OBJ: Develop a PICO question. TOP: PICO
K E Y: Nursing Process Step: Implementation
MSC: N C LE X : Safe and Effective Care Environment (management of care)
4. A well-developed PICOT question helps the
nurse:
a. search for evidence.
b. include all five elements of the sequence.
c. find as many articles as possible in a literature search.
d. accept standard clinical routines.
ANS: A
The more focused a question that you ask is, the easier it is to search for evidence in the
scientific literature. A well-designed PICOT question does not have to include all five
elements, nor does it have to follow the PICOT sequence. Do not be satisfied with clinical
routines. Always question and use critical thinking to consider better ways to provide patient
care.
DIF: Cognitive Level: Analysis REF: Text reference: p. 3
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
5. The nurse is not sure that the procedure the patient requires is the best possible for the
situation. Utilizing which of the following resources would be the quickest way to review
research on the topic?
a. C INAH L
b. PubMed
c. MEDLINE
d. The Cochrane Database
ANS: D
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
The Cochrane Community Database of Systematic Reviews is a valuable source of
synthesized evidence (i.e., pre-appraised evidence). The Cochrane Database includes the full
text of regularly updated systematic reviews and protocols for reviews currently happening.
MEDLINE, CINAHL, and PubMed are among the most comprehensive databases and
represent the scientific knowledge base of health care.
DIF: Cognitive Level: Synthesis REF: Text reference: p. 4
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
6. The nurse is getting ready to develop a plan of care for a patient who has a specific need.
The best source for developing this plan of care would probably be:
a. The Cochrane Database.
b. MEDLINE.
c. NGC.
d. CINAHL.
ANS : C
The National Guidelines Clearinghouse (NGC) is a database supported by the Agency
for Healthcare Research and Quality (AHRQ). It contains clinical guidelines—
systematically developed statements about a plan of care for a specific set of clinical
circumstances involving a specific patient population. The NGC is a valuable source
when you want to develop a plan of care for a patient. The Cochrane Community Database
of Systematic Reviews, MEDLINE, and C IN AHL are all valuable sources of
synthesized evidence (i.e., pre-appraised evidence).
DIF: Cognitive Level: Synthesis REF: Text reference: p. 4
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
7. The nurse has done a literature search and found 25 possible articles on the topic that she is
studying. To determine which of those 25 best fit her inquiry, the nurse first should look at:
a. the abstracts.
b. the literature reviews.
c. the “Methods” sections.
d. the narrative sections.
ANS: A
An abstract is a brief summary of an article that quickly tells you whether the article is
research based or clinically based. An abstract summarizes the purpose of the study or
clinical query, the major themes or findings, and the implications for nursing practice. The
literature review usually gives you a good idea of how past research led to the researcher’s
question. The “Methods” or “Design” section explains how a research study is organized
and conducted to answer the research question or to test the hypothesis. The narrative of a
manuscript differs according to the type of evidence-based article—clinical or research.
DIF: Cognitive Level: Application REF: Text reference: p. 7
OBJ: Discuss elements to review when critiquing the scientific literature.
.
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
TOP: Randomized Controlled Trials K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
8. The nurse wants to determine the effects of cardiac rehabilitation program attendance on the
level of postmyocardial depression for individuals who have had a myocardial infarction.
The type of study that would best capture this information would be a:
a. randomized controlled trial.
b. qualitative study.
c. case control study.
d. descriptive study.
ANS: B
Qualitative studies examine individuals’ experiences with health problems and the contexts in
which these experiences occur. A qualitative study is best in this case of an individual nurse
who wants to examine the effectiveness of a local program. Randomized controlled trials
involve close monitoring of control groups and treatment groups to test an intervention against
the usual standard of care. Case control studies typically compare one group of subjects with a
certain condition against another group without the condition, to look for associations between
the condition and predictor variables. Descriptive studies focus mainly on describing the
concepts under study.
DIF: Cognitive Level: Synthesis REF: Text reference: p. 6
OBJ: Discuss ways to apply evidence in nursing practice.
TOP: Randomized Controlled Trials K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
9. Six months after an early mobility protocol was implemented, the incidence of deep vein
thrombosis in patients was decreased. This is an example of what stage in the EBP process?
a. Asking a clinical question
b. Applying the evidence
c. Evaluating the practice decision
d. Communicating your results
ANS: C
After implementing a practice change, your next step is to evaluate the effect. You do this by
analyzing the outcomes data that you collected during the pilot project. Outcomes evaluation
tells you whether your practice change improved conditions, created no change, or worsened
conditions.
DIF: Cognitive Level: Application REF: Text reference: p. 9
OBJ: Discuss ways to apply evidence in nursing practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Evaluation MSC: N C LE X : Safe and Effective Care Environment (safety and
infection control)
M U LT I P L E RESPONSE
1. To use evidence-based practice appropriately, you need to collect the most relevant and best
evidence and to critically appraise the evidence you gather. This process also includes:
(Select all that apply.)
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
a. asking a clinical question.
b. applying the evidence.
c. evaluating the practice decision.
d. communicating your results.
ANS: A, B, C, D
EBP comprises six steps (Melnyk and Fineout-Overholt,
2010):
1. Ask a clinical question.
2. Search for the most relevant and best evidence that applies to the question.
3. Critically appraise the evidence you gather.
4. Apply or integrate evidence along with one’s clinical expertise and patient preferences
and values in making a practice decision or change.
5. Evaluate the practice decision or change.
6. Communicate your results.
DIF: Cognitive Level: Analysis REF: Text reference: p. 3
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
2. In a clinical environment, evidence-based practice has the ability to improve: (Select all that
apply.)
a. the quality of care provided.
b. patient outcomes.
c. clinician satisfaction.
d. patients’ perceptions.
ANS: A, B, C, D
EBP has the potential to improve the quality of care that nurses provide, patient outcomes,
and clinicians’ satisfaction with their practice. Your patients expect nursing professionals to
be informed and to use the safest and most appropriate interventions. Use of evidence
enhances nursing, thereby improving patients’ perceptions of excellent nursing care.
DIF: Cognitive Level: Application REF: Text reference: p. 2
OBJ: Discuss the benefits of evidence-based practice.
TOP: Randomized Controlled Trials K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
3. During the application stage of evidence-based practice change, it is important to consider:
(Select all that apply.)
a. cost.
b. the need for new equipment.
c. management support.
d. adequate staff.
ANS: A, B, C, D
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
One important step for an individual or an interdisciplinary EBP committee is to consider
the resources needed for a practice change project. Are added costs or new equipment
involved with a practice change? Do you have adequate staff to make the practice change
work as planned? Do management and medical staff support you in the change? If the
barriers to practice change are excessive, adopting a practice change can be difficult, if not
impossible.
DIF: Cognitive Level: Application REF: Text reference: p. 8
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
COMPLETION
1. _________________ is a guide for making accurate, timely, and appropriate clinical
decisions.
ANS:
Evidence-based practice
Evidence-based practice is a guide for making accurate, timely, and appropriate clinical
decisions.
DIF: Cognitive Level: Knowledge REF: Text reference: p. 2
OBJ: Define the key terms listed. TOP: Evidence-Based Practice
K E Y: Nursing Process Step: Assessment
MSC: N C L E X : Safe and Effective Care Environment (management of care)
2. Evidence-based practice requires good ______________.
ANS:
nursing judgment
Evidence-based practice requires good nursing judgment; it does not consist of finding
research evidence and blindly applying it.
DIF: Cognitive Level: Comprehension REF: Text reference: p. 2
OBJ: Discuss the benefits of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step: Assessment
MSC: N C L E X : Safe and Effective Care Environment (management of care)
3. While caring for patients, the professional nurse must question ________________.
ANS:
what does not make sense
Always think about your practice when caring for patients. Question what does not make
sense to you, and question what you think needs clarification.
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
DIF: Cognitive Level: Analysis REF: Text reference: p. 3
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step: Implementation
MSC: N C L E X : Safe and Effective Care Environment (management of care)
4. A systematic review explains whether the evidence that you are searching for exists and
whether there is good cause to change practice. In _____________, all entries include
information on systematic reviews. Individual randomized controlled trials (RCTs) are the
gold standard for research.
ANS:
The Cochrane Database
A systematic review explains whether the evidence that you are searching for exists and
whether there is good cause to change practice. In The Cochrane Database, all entries
include information on systematic reviews. Individual randomized controlled trials (RCTs)
are the gold standard for research.
DIF: Cognitive Level: Analysis REF: Text reference: p. 5
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step: Implementation
MSC: N C L E X : Safe and Effective Care Environment (management of care)
5. __________________ are the gold standard for research.
ANS:
Randomized controlled trials
Individual randomized controlled trials (RCTs) are the gold standard for research (Titler and
others, 2001). An R C T establishes cause and effect and is excellent for testing therapies.
DIF: Cognitive Level: Knowledge REF: Text reference: p. 5
OBJ: Explain the levels of evidence in the literature.
TOP: Randomized Controlled Trials K E Y: Nursing Process Step: Implementation
MSC: N C L E X : Safe and Effective Care Environment (management of care)
6. The researcher explains how to apply findings in a practice setting for the types of subjects
studied in the _________________ section of a research article.
ANS:
“Clinical Implications”
Clinical Implications
A research article includes a section that explains whether the findings from the study have
“clinical implications.” The researcher explains how to apply findings in a practice setting
for the types of subjects studied.
DIF: Cognitive Level: Application REF: Text reference: p. 8
OBJ: Discuss elements to review when critiquing the scientific literature.
.
TEST BANK
Clinical Nursing Skills and Techniques
Anne Griffin Perry, Patricia A. Potter & Wendy Ostendorf
9th Edition
Page 1
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
Table of Contents
Unit: Supporting the Patient Through the Health Care System
1 Using Evidence in Practice
2 Admitting, Transfer, and Discharge
3 Communication and Collaboration
4 Documentation and Informatics
Unit II: Vital Signs and Physical Assessment
5 Vital Signs
6 Health Assessment
Unit III: Special Procedures
7 Specimen Collection
8 Diagnostic Procedures
Unit IV: Infection Control
9 Medical Asepsis
10 Sterile Technique
Unit V: Activity and Mobility
11 Safe Patient Handling, Transfer and Positioning
12 Exercise and Mobility
13 Support Surfaces and Special Beds
Unit VI: Safety and Comfort
14 Patient Safety
15 Disaster Preparedness
16 Pain Management
17 Palliative Care
Unit VII: Hygiene
18 Personal Hygiene and Bed Making
19 Care of the Eye and Ear
Unit VIII: Medications
20 Safe Medicine Preparation
21 Administration of Nonparenteral Medications
22 Administration of Parenteral Medications
Unit IX: Oxygenation
23 Oxygen Therapy
24 Performing Chest Physiotherapy
25 Airway Management
26 Cardiac Care (NEW CHAPTER)
27 Closed Chest Drainage Systems
28 Emergency Measures for Life Support
Unit X: Fluid Balance
29 Intravenous and Vascular Access Therapy
30 Blood Therapy
Page 2
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
Unit XI: Nutrition
31 Oral Nutrition
32 Enteral Nutrition
33 Parenteral Nutrition
Unit XII: Elimination
34 Urinary Elimination
35 Bowel Elimination and Gastric Intubation
36 Ostomy Care
Unit XIII: Care of the Surgical Patient
37 Preoperative and Postoperative Care
38 Intraoperative Care
Unit XIV: Dressings and Wound Care
39 Impaired Skin Integrity Prevention and Care
40 Wound Care and Irrigations
41 Dressings, Bandages, and Binders
42 Warm and Cold Therapy
Unit XV: Home Care
43 Home Care Safety
44 Home Care Teaching
Page 3
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
Chapter 01: Using Evidence in Practice
M U LT I P L E C H O I C E
1. Evidence-based practice is a problem-solving approach to making decisions about patient
care that is grounded in:
a. the latest information found in textbooks.
b. systematically conducted research studies.
c. tradition in clinical practice.
d. quality improvement and risk-management data.
ANS: B
The best evidence comes from well-designed, systematically conducted research studies
described in scientific journals. Portions of a textbook often become outdated by the time it is
published. Many health care settings do not have a process to help staff adopt new evidence in
practice, and nurses in practice settings lack easy access to risk-management data, relying
instead on tradition or convenience. Some sources of evidence do not originate from research.
These include quality improvement and risk-management data; infection control data;
retrospective or concurrent chart reviews; and clinicians’ expertise. Although non–research-
based evidence is often very valuable, it is important that you learn to rely more on research-
based evidence.
DIF: Cognitive Level: Comprehension REF: Text reference: p. 2
OBJ: Discuss the benefits of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Assessment MSC: N C LE X : Safe and Effective Care Environment (management of
care)
2. When evidence-based practice is used, patient care will be:
a. standardized for all.
b. unhampered by patient culture.
c. variable according to the situation.
d. safe from the hazards of critical thinking.
ANS: C
Using your clinical expertise and considering patients’ cultures, values, and preferences
ensures that you will apply available evidence in practice ethically and appropriately. Even
when you use the best evidence available, application and outcomes will differ; as a nurse,
you will develop critical thinking skills to determine whether evidence is relevant and
appropriate.
DIF: Cognitive Level: Application REF: Text reference: p. 2
OBJ: Discuss the benefits of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Assessment MSC: N C LE X : Safe and Effective Care Environment (management of
care)
3. When a PICOT question is developed, the letter that corresponds with the usual standard of
care is:
a. P.
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
b. I.
c. C.
d. O.
ANS: C
C = Comparison of interest. What standard of care or current intervention do you usually
use now in practice?
P = Patient population of interest. Identify your patient by age, gender, ethnicity, disease, or
health problem.
I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and
prognostic factor) do you think is worthwhile to use in practice?
O = Outcome. What result (e.g., change in patient’s behavior, physical finding, and change
in patient’s perception) do you wish to achieve or observe as the result of an intervention?
DIF: Cognitive Level: Knowledge REF: Text reference: p. 3
OBJ: Develop a PICO question. TOP: PICO
K E Y: Nursing Process Step: Implementation
MSC: N C LE X : Safe and Effective Care Environment (management of care)
4. A well-developed PICOT question helps the
nurse:
a. search for evidence.
b. include all five elements of the sequence.
c. find as many articles as possible in a literature search.
d. accept standard clinical routines.
ANS: A
The more focused a question that you ask is, the easier it is to search for evidence in the
scientific literature. A well-designed PICOT question does not have to include all five
elements, nor does it have to follow the PICOT sequence. Do not be satisfied with clinical
routines. Always question and use critical thinking to consider better ways to provide patient
care.
DIF: Cognitive Level: Analysis REF: Text reference: p. 3
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
5. The nurse is not sure that the procedure the patient requires is the best possible for the
situation. Utilizing which of the following resources would be the quickest way to review
research on the topic?
a. C INAH L
b. PubMed
c. MEDLINE
d. The Cochrane Database
ANS: D
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
The Cochrane Community Database of Systematic Reviews is a valuable source of
synthesized evidence (i.e., pre-appraised evidence). The Cochrane Database includes the full
text of regularly updated systematic reviews and protocols for reviews currently happening.
MEDLINE, CINAHL, and PubMed are among the most comprehensive databases and
represent the scientific knowledge base of health care.
DIF: Cognitive Level: Synthesis REF: Text reference: p. 4
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
6. The nurse is getting ready to develop a plan of care for a patient who has a specific need.
The best source for developing this plan of care would probably be:
a. The Cochrane Database.
b. MEDLINE.
c. NGC.
d. CINAHL.
ANS : C
The National Guidelines Clearinghouse (NGC) is a database supported by the Agency
for Healthcare Research and Quality (AHRQ). It contains clinical guidelines—
systematically developed statements about a plan of care for a specific set of clinical
circumstances involving a specific patient population. The NGC is a valuable source
when you want to develop a plan of care for a patient. The Cochrane Community Database
of Systematic Reviews, MEDLINE, and C IN AHL are all valuable sources of
synthesized evidence (i.e., pre-appraised evidence).
DIF: Cognitive Level: Synthesis REF: Text reference: p. 4
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
7. The nurse has done a literature search and found 25 possible articles on the topic that she is
studying. To determine which of those 25 best fit her inquiry, the nurse first should look at:
a. the abstracts.
b. the literature reviews.
c. the “Methods” sections.
d. the narrative sections.
ANS: A
An abstract is a brief summary of an article that quickly tells you whether the article is
research based or clinically based. An abstract summarizes the purpose of the study or
clinical query, the major themes or findings, and the implications for nursing practice. The
literature review usually gives you a good idea of how past research led to the researcher’s
question. The “Methods” or “Design” section explains how a research study is organized
and conducted to answer the research question or to test the hypothesis. The narrative of a
manuscript differs according to the type of evidence-based article—clinical or research.
DIF: Cognitive Level: Application REF: Text reference: p. 7
OBJ: Discuss elements to review when critiquing the scientific literature.
.
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
TOP: Randomized Controlled Trials K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
8. The nurse wants to determine the effects of cardiac rehabilitation program attendance on the
level of postmyocardial depression for individuals who have had a myocardial infarction.
The type of study that would best capture this information would be a:
a. randomized controlled trial.
b. qualitative study.
c. case control study.
d. descriptive study.
ANS: B
Qualitative studies examine individuals’ experiences with health problems and the contexts in
which these experiences occur. A qualitative study is best in this case of an individual nurse
who wants to examine the effectiveness of a local program. Randomized controlled trials
involve close monitoring of control groups and treatment groups to test an intervention against
the usual standard of care. Case control studies typically compare one group of subjects with a
certain condition against another group without the condition, to look for associations between
the condition and predictor variables. Descriptive studies focus mainly on describing the
concepts under study.
DIF: Cognitive Level: Synthesis REF: Text reference: p. 6
OBJ: Discuss ways to apply evidence in nursing practice.
TOP: Randomized Controlled Trials K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
9. Six months after an early mobility protocol was implemented, the incidence of deep vein
thrombosis in patients was decreased. This is an example of what stage in the EBP process?
a. Asking a clinical question
b. Applying the evidence
c. Evaluating the practice decision
d. Communicating your results
ANS: C
After implementing a practice change, your next step is to evaluate the effect. You do this by
analyzing the outcomes data that you collected during the pilot project. Outcomes evaluation
tells you whether your practice change improved conditions, created no change, or worsened
conditions.
DIF: Cognitive Level: Application REF: Text reference: p. 9
OBJ: Discuss ways to apply evidence in nursing practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Evaluation MSC: N C LE X : Safe and Effective Care Environment (safety and
infection control)
M U LT I P L E RESPONSE
1. To use evidence-based practice appropriately, you need to collect the most relevant and best
evidence and to critically appraise the evidence you gather. This process also includes:
(Select all that apply.)
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
a. asking a clinical question.
b. applying the evidence.
c. evaluating the practice decision.
d. communicating your results.
ANS: A, B, C, D
EBP comprises six steps (Melnyk and Fineout-Overholt,
2010):
1. Ask a clinical question.
2. Search for the most relevant and best evidence that applies to the question.
3. Critically appraise the evidence you gather.
4. Apply or integrate evidence along with one’s clinical expertise and patient preferences
and values in making a practice decision or change.
5. Evaluate the practice decision or change.
6. Communicate your results.
DIF: Cognitive Level: Analysis REF: Text reference: p. 3
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
2. In a clinical environment, evidence-based practice has the ability to improve: (Select all that
apply.)
a. the quality of care provided.
b. patient outcomes.
c. clinician satisfaction.
d. patients’ perceptions.
ANS: A, B, C, D
EBP has the potential to improve the quality of care that nurses provide, patient outcomes,
and clinicians’ satisfaction with their practice. Your patients expect nursing professionals to
be informed and to use the safest and most appropriate interventions. Use of evidence
enhances nursing, thereby improving patients’ perceptions of excellent nursing care.
DIF: Cognitive Level: Application REF: Text reference: p. 2
OBJ: Discuss the benefits of evidence-based practice.
TOP: Randomized Controlled Trials K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
3. During the application stage of evidence-based practice change, it is important to consider:
(Select all that apply.)
a. cost.
b. the need for new equipment.
c. management support.
d. adequate staff.
ANS: A, B, C, D
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
One important step for an individual or an interdisciplinary EBP committee is to consider
the resources needed for a practice change project. Are added costs or new equipment
involved with a practice change? Do you have adequate staff to make the practice change
work as planned? Do management and medical staff support you in the change? If the
barriers to practice change are excessive, adopting a practice change can be difficult, if not
impossible.
DIF: Cognitive Level: Application REF: Text reference: p. 8
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step:
Implementation MSC: N C LE X : Safe and Effective Care Environment (management of
care)
COMPLETION
1. _________________ is a guide for making accurate, timely, and appropriate clinical
decisions.
ANS:
Evidence-based practice
Evidence-based practice is a guide for making accurate, timely, and appropriate clinical
decisions.
DIF: Cognitive Level: Knowledge REF: Text reference: p. 2
OBJ: Define the key terms listed. TOP: Evidence-Based Practice
K E Y: Nursing Process Step: Assessment
MSC: N C L E X : Safe and Effective Care Environment (management of care)
2. Evidence-based practice requires good ______________.
ANS:
nursing judgment
Evidence-based practice requires good nursing judgment; it does not consist of finding
research evidence and blindly applying it.
DIF: Cognitive Level: Comprehension REF: Text reference: p. 2
OBJ: Discuss the benefits of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step: Assessment
MSC: N C L E X : Safe and Effective Care Environment (management of care)
3. While caring for patients, the professional nurse must question ________________.
ANS:
what does not make sense
Always think about your practice when caring for patients. Question what does not make
sense to you, and question what you think needs clarification.
.
, Test Bank - Clinical Nursing Skills and Techniques 9th Edition (Perry, 2018)
.
DIF: Cognitive Level: Analysis REF: Text reference: p. 3
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step: Implementation
MSC: N C L E X : Safe and Effective Care Environment (management of care)
4. A systematic review explains whether the evidence that you are searching for exists and
whether there is good cause to change practice. In _____________, all entries include
information on systematic reviews. Individual randomized controlled trials (RCTs) are the
gold standard for research.
ANS:
The Cochrane Database
A systematic review explains whether the evidence that you are searching for exists and
whether there is good cause to change practice. In The Cochrane Database, all entries
include information on systematic reviews. Individual randomized controlled trials (RCTs)
are the gold standard for research.
DIF: Cognitive Level: Analysis REF: Text reference: p. 5
OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice K E Y: Nursing Process Step: Implementation
MSC: N C L E X : Safe and Effective Care Environment (management of care)
5. __________________ are the gold standard for research.
ANS:
Randomized controlled trials
Individual randomized controlled trials (RCTs) are the gold standard for research (Titler and
others, 2001). An R C T establishes cause and effect and is excellent for testing therapies.
DIF: Cognitive Level: Knowledge REF: Text reference: p. 5
OBJ: Explain the levels of evidence in the literature.
TOP: Randomized Controlled Trials K E Y: Nursing Process Step: Implementation
MSC: N C L E X : Safe and Effective Care Environment (management of care)
6. The researcher explains how to apply findings in a practice setting for the types of subjects
studied in the _________________ section of a research article.
ANS:
“Clinical Implications”
Clinical Implications
A research article includes a section that explains whether the findings from the study have
“clinical implications.” The researcher explains how to apply findings in a practice setting
for the types of subjects studied.
DIF: Cognitive Level: Application REF: Text reference: p. 8
OBJ: Discuss elements to review when critiquing the scientific literature.
.
