EVIDENCE-BASED PRACTICE IN NURSING
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
Reference: Ch. 1 — Making the Case for EBP —
Organizational Outcomes and Quality of Care
Stem: A nurse leader notices that postoperative patients on one
unit have a higher-than-expected rate of mobility delays and
longer lengths of stay than similar patients on a sister unit. Staff
members believe the difference is due to “patient factors,” but
the leader wants a stronger case for changing practice. Which
action best reflects an evidence-based approach to building the
case for change?
,Options:
A. Implement the sister unit’s mobility protocol immediately
because it appears more effective.
B. Review local outcome data, compare current practice with
best evidence, and identify the practice gap.
C. Survey staff opinions to determine whether the current
approach is acceptable.
D. Wait until a large randomized trial is published before
changing anything.
Correct Answer: B
Rationale — Correct Answer: Evidence-based practice begins
with recognizing a clinical problem, examining the current state,
and identifying a measurable practice gap. Comparing local data
with best evidence helps determine whether the issue is a
systems problem, a practice problem, or both.
Rationale — Incorrect Options:
A. This skips appraisal and local evaluation; an intervention
should not be adopted solely because it appears better
elsewhere.
C. Staff opinion is useful, but it does not establish evidence of
effectiveness or define the gap.
D. EBP does not require perfect evidence before action; it
requires the best available evidence integrated with clinical
expertise and patient preferences.
Teaching Point: Start with the gap, not the guess.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
,Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
Reference: Ch. 1 — Spirit of Inquiry — Questioning Current
Practice
Stem: During handoff, a student asks why one unit still uses an
older pain reassessment routine when recent patients report
delayed relief. The preceptor says, “That is just how we have
always done it.” Which response by the student best reflects a
spirit of inquiry?
Options:
A. “If everyone is doing it, it is probably correct.”
B. “I will look for current evidence and ask whether the routine
improves outcomes.”
C. “It is best not to question established practices on busy
units.”
D. “I will ask the charge nurse to make a quick decision without
reviewing evidence.”
Correct Answer: B
Rationale — Correct Answer: A spirit of inquiry involves
curiosity, asking why a practice exists, and seeking evidence to
evaluate whether it produces desired outcomes. This is the first
mindset needed for EBP implementation.
Rationale — Incorrect Options:
A. Popularity does not establish effectiveness.
C. Unquestioned tradition can perpetuate ineffective or
outdated care.
D. Evidence-based decisions should not be made without
, reviewing the relevant data and literature.
Teaching Point: Inquiry starts with “Why do we do it this way?”
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
Reference: Ch. 1 — EBP vs. Tradition — Replacing Habit With
Evidence
Stem: A medical-surgical unit continues to use a practice
because several senior nurses are confident it “worked in the
past,” although no one has reviewed outcome data in years. The
manager wants to know what makes the practice vulnerable to
change. Which concern is most relevant?
Options:
A. The practice may be supported by strong evidence, so no
change is needed.
B. Tradition alone does not demonstrate current effectiveness
or safety.
C. The practice cannot be evaluated unless it is expensive.
D. Only physicians can decide whether a nursing practice should
change.
Correct Answer: B
Rationale — Correct Answer: Practices based only on tradition
may persist even when better evidence or safer alternatives
exist. EBP requires evaluation of current evidence rather than
reliance on habit.
Rationale — Incorrect Options:
A. Tradition does not equal evidence and may not reflect
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
Reference: Ch. 1 — Making the Case for EBP —
Organizational Outcomes and Quality of Care
Stem: A nurse leader notices that postoperative patients on one
unit have a higher-than-expected rate of mobility delays and
longer lengths of stay than similar patients on a sister unit. Staff
members believe the difference is due to “patient factors,” but
the leader wants a stronger case for changing practice. Which
action best reflects an evidence-based approach to building the
case for change?
,Options:
A. Implement the sister unit’s mobility protocol immediately
because it appears more effective.
B. Review local outcome data, compare current practice with
best evidence, and identify the practice gap.
C. Survey staff opinions to determine whether the current
approach is acceptable.
D. Wait until a large randomized trial is published before
changing anything.
Correct Answer: B
Rationale — Correct Answer: Evidence-based practice begins
with recognizing a clinical problem, examining the current state,
and identifying a measurable practice gap. Comparing local data
with best evidence helps determine whether the issue is a
systems problem, a practice problem, or both.
Rationale — Incorrect Options:
A. This skips appraisal and local evaluation; an intervention
should not be adopted solely because it appears better
elsewhere.
C. Staff opinion is useful, but it does not establish evidence of
effectiveness or define the gap.
D. EBP does not require perfect evidence before action; it
requires the best available evidence integrated with clinical
expertise and patient preferences.
Teaching Point: Start with the gap, not the guess.
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
,Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
Reference: Ch. 1 — Spirit of Inquiry — Questioning Current
Practice
Stem: During handoff, a student asks why one unit still uses an
older pain reassessment routine when recent patients report
delayed relief. The preceptor says, “That is just how we have
always done it.” Which response by the student best reflects a
spirit of inquiry?
Options:
A. “If everyone is doing it, it is probably correct.”
B. “I will look for current evidence and ask whether the routine
improves outcomes.”
C. “It is best not to question established practices on busy
units.”
D. “I will ask the charge nurse to make a quick decision without
reviewing evidence.”
Correct Answer: B
Rationale — Correct Answer: A spirit of inquiry involves
curiosity, asking why a practice exists, and seeking evidence to
evaluate whether it produces desired outcomes. This is the first
mindset needed for EBP implementation.
Rationale — Incorrect Options:
A. Popularity does not establish effectiveness.
C. Unquestioned tradition can perpetuate ineffective or
outdated care.
D. Evidence-based decisions should not be made without
, reviewing the relevant data and literature.
Teaching Point: Inquiry starts with “Why do we do it this way?”
Citation: Melnyk, B. M., & Fineout-Overholt, E. (2023).
Evidence-Based Practice in Nursing & Healthcare (5th ed.). Ch.
1.
Reference: Ch. 1 — EBP vs. Tradition — Replacing Habit With
Evidence
Stem: A medical-surgical unit continues to use a practice
because several senior nurses are confident it “worked in the
past,” although no one has reviewed outcome data in years. The
manager wants to know what makes the practice vulnerable to
change. Which concern is most relevant?
Options:
A. The practice may be supported by strong evidence, so no
change is needed.
B. Tradition alone does not demonstrate current effectiveness
or safety.
C. The practice cannot be evaluated unless it is expensive.
D. Only physicians can decide whether a nursing practice should
change.
Correct Answer: B
Rationale — Correct Answer: Practices based only on tradition
may persist even when better evidence or safer alternatives
exist. EBP requires evaluation of current evidence rather than
reliance on habit.
Rationale — Incorrect Options:
A. Tradition does not equal evidence and may not reflect
