EVIDENCE-BASED PRACTICE IN NURSING
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1) Making the case for EBP in a unit with variable practice
Reference: Chapter 1 — Making the Case for Evidence-Based
Practice and Cultivating a Spirit of Inquiry
Stem: A medical-surgical unit has three different approaches to
preventing pressure injuries during repositioning. New nurses
are confused because each preceptor teaches a different
method, and the unit’s current rates are trending upward. The
nurse manager wants to build support for an evidence-based
,change. Which action best reflects the first step in making the
case for EBP?
A. Implement the most commonly used method immediately to
reduce variation
B. Identify a focused practice problem and gather the best
available evidence
C. Wait for a large randomized trial to be published before
changing practice
D. Ask each nurse to continue using the method they were
taught
Correct Answer: B
Rationale — Correct Answer:
Identifying a clear practice problem and gathering the best
available evidence is the foundation for making the case for
EBP. It moves the unit from opinion-based variation to a
structured inquiry about what should be done and why. This
approach aligns with EBP’s emphasis on using evidence, clinical
expertise, and patient preferences together.
Rationale — Incorrect Options:
A. Common practice is not the same as best practice, so
popularity alone does not justify implementation.
C. EBP does not require waiting for perfect evidence before
action; strong existing evidence is often sufficient.
D. Continuing inconsistent practice preserves variation and does
not address the quality gap.
,Teaching Point:
A problem statement plus evidence search starts the EBP case.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
2) Cultivating a spirit of inquiry
Reference: Chapter 1 — Making the Case for Evidence-Based
Practice and Cultivating a Spirit of Inquiry
Stem: During report, a bedside nurse notices that one patient
was mobilized within 12 hours of surgery while another similar
patient was kept on bed rest until postoperative day 2. The
nurse wonders whether the difference is necessary and safe.
Which behavior best demonstrates a spirit of inquiry?
A. Accepting that practice differences are normal and should
not be questioned
B. Asking whether evidence supports early mobility for
comparable patients
C. Reporting the inconsistency only if an adverse event occurs
D. Changing the policy independently without discussing it with
the team
Correct Answer: B
Rationale — Correct Answer:
A spirit of inquiry begins with noticing variation and asking
, whether a better evidence-based approach exists. The nurse is
questioning routine practice in a constructive way rather than
assuming current habits are optimal. That question is the
starting point for EBP.
Rationale — Incorrect Options:
A. Routine variation is exactly what should trigger inquiry when
safety or outcomes may be affected.
C. Waiting for harm delays improvement and misses prevention
opportunities.
D. Independent policy changes bypass collaboration and can
create unsafe implementation.
Teaching Point:
Inquiry starts when nurses question routine variation in
practice.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
3) Best example of a clinical practice gap
Reference: Chapter 1 — Making the Case for Evidence-Based
Practice and Cultivating a Spirit of Inquiry
Stem: A unit is reviewing its oral-care protocol for ventilated
patients. Staff report that some nurses perform oral care every
2 hours, while others do it once per shift, and the incidence of
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1) Making the case for EBP in a unit with variable practice
Reference: Chapter 1 — Making the Case for Evidence-Based
Practice and Cultivating a Spirit of Inquiry
Stem: A medical-surgical unit has three different approaches to
preventing pressure injuries during repositioning. New nurses
are confused because each preceptor teaches a different
method, and the unit’s current rates are trending upward. The
nurse manager wants to build support for an evidence-based
,change. Which action best reflects the first step in making the
case for EBP?
A. Implement the most commonly used method immediately to
reduce variation
B. Identify a focused practice problem and gather the best
available evidence
C. Wait for a large randomized trial to be published before
changing practice
D. Ask each nurse to continue using the method they were
taught
Correct Answer: B
Rationale — Correct Answer:
Identifying a clear practice problem and gathering the best
available evidence is the foundation for making the case for
EBP. It moves the unit from opinion-based variation to a
structured inquiry about what should be done and why. This
approach aligns with EBP’s emphasis on using evidence, clinical
expertise, and patient preferences together.
Rationale — Incorrect Options:
A. Common practice is not the same as best practice, so
popularity alone does not justify implementation.
C. EBP does not require waiting for perfect evidence before
action; strong existing evidence is often sufficient.
D. Continuing inconsistent practice preserves variation and does
not address the quality gap.
,Teaching Point:
A problem statement plus evidence search starts the EBP case.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
2) Cultivating a spirit of inquiry
Reference: Chapter 1 — Making the Case for Evidence-Based
Practice and Cultivating a Spirit of Inquiry
Stem: During report, a bedside nurse notices that one patient
was mobilized within 12 hours of surgery while another similar
patient was kept on bed rest until postoperative day 2. The
nurse wonders whether the difference is necessary and safe.
Which behavior best demonstrates a spirit of inquiry?
A. Accepting that practice differences are normal and should
not be questioned
B. Asking whether evidence supports early mobility for
comparable patients
C. Reporting the inconsistency only if an adverse event occurs
D. Changing the policy independently without discussing it with
the team
Correct Answer: B
Rationale — Correct Answer:
A spirit of inquiry begins with noticing variation and asking
, whether a better evidence-based approach exists. The nurse is
questioning routine practice in a constructive way rather than
assuming current habits are optimal. That question is the
starting point for EBP.
Rationale — Incorrect Options:
A. Routine variation is exactly what should trigger inquiry when
safety or outcomes may be affected.
C. Waiting for harm delays improvement and misses prevention
opportunities.
D. Independent policy changes bypass collaboration and can
create unsafe implementation.
Teaching Point:
Inquiry starts when nurses question routine variation in
practice.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
3) Best example of a clinical practice gap
Reference: Chapter 1 — Making the Case for Evidence-Based
Practice and Cultivating a Spirit of Inquiry
Stem: A unit is reviewing its oral-care protocol for ventilated
patients. Staff report that some nurses perform oral care every
2 hours, while others do it once per shift, and the incidence of
