EVIDENCE-BASED PRACTICE IN NURSING
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1. Reference
Ch. 1 — Making the Case for Evidence-Based Practice —
Organizational Priorities
Stem:
A medical-surgical unit has high catheter-associated urinary
tract infection rates, but staff members believe the current
insertion routine is “good enough” because no one has
complained. The nurse manager wants to introduce an
,evidence-based bundle, but some nurses argue that changing
practice without a major budget increase is unnecessary. Which
response best reflects the strongest case for EBP in this
situation?
Options:
A. Continue the current routine because absence of complaints
suggests acceptable care quality.
B. Implement the bundle only after waiting for a physician-led
directive.
C. Use the best available evidence to reduce preventable harm
and improve outcomes.
D. Replace the current routine only if a randomized trial has
been conducted in the exact unit.
Correct Answer:
C
Rationale — Correct Answer:
EBP is used to improve outcomes, reduce unnecessary
variation, and decrease preventable harm by integrating the
best evidence with clinical expertise and patient needs. A
preventable infection problem is exactly the kind of clinical gap
EBP is meant to address. The absence of complaints does not
equal quality, and waiting for perfect local evidence delays safer
care.
Rationale — Incorrect Options:
A. Lack of complaints is not a valid quality indicator and may
mask preventable harm.
,B. EBP is not dependent on physician initiation; nursing practice
should also be evidence-driven.
D. EBP rarely requires evidence from the exact unit before
action; high-quality external evidence is often used first.
Teaching Point:
EBP targets preventable harm, not just obvious complaints.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
2. Reference
Ch. 1 — Making the Case for Evidence-Based Practice — Best
Available Evidence
Stem:
A nurse practitioner is deciding whether to adopt a new wound-
care approach. One article is a single expert opinion piece,
another is a well-conducted systematic review, and a third is a
small descriptive study. The clinician has limited time and must
choose the strongest basis for change. Which source should
carry the most weight?
Options:
A. The expert opinion piece, because experts understand
practice realities best.
B. The systematic review, because it synthesizes multiple studies
using a rigorous method.
, C. The descriptive study, because it reflects current patient
experiences.
D. All three should be weighted equally to avoid bias.
Correct Answer:
B
Rationale — Correct Answer:
Systematic reviews generally provide stronger evidence than
expert opinion or descriptive studies because they synthesize
and critically appraise multiple studies using a transparent
method. In EBP, evidence hierarchy matters when deciding what
to adopt. The strongest available evidence should guide
practice changes when relevant.
Rationale — Incorrect Options:
A. Expert opinion may be useful, but it is lower on the evidence
hierarchy than systematic review evidence.
C. Descriptive studies can inform understanding, but they do
not establish effectiveness as strongly as systematic reviews.
D. EBP does not weight all evidence equally; quality and design
matter.
Teaching Point:
Higher-level evidence usually deserves greater influence on
practice decisions.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
& HEALTHCARE
A GUIDE TO BEST PRACTICE
5TH EDITION
• AUTHOR(S)BERNADETTE MAZUREK
MELNYK; ELLEN FINEOUT-OVERHOLT
TEST BANK
1. Reference
Ch. 1 — Making the Case for Evidence-Based Practice —
Organizational Priorities
Stem:
A medical-surgical unit has high catheter-associated urinary
tract infection rates, but staff members believe the current
insertion routine is “good enough” because no one has
complained. The nurse manager wants to introduce an
,evidence-based bundle, but some nurses argue that changing
practice without a major budget increase is unnecessary. Which
response best reflects the strongest case for EBP in this
situation?
Options:
A. Continue the current routine because absence of complaints
suggests acceptable care quality.
B. Implement the bundle only after waiting for a physician-led
directive.
C. Use the best available evidence to reduce preventable harm
and improve outcomes.
D. Replace the current routine only if a randomized trial has
been conducted in the exact unit.
Correct Answer:
C
Rationale — Correct Answer:
EBP is used to improve outcomes, reduce unnecessary
variation, and decrease preventable harm by integrating the
best evidence with clinical expertise and patient needs. A
preventable infection problem is exactly the kind of clinical gap
EBP is meant to address. The absence of complaints does not
equal quality, and waiting for perfect local evidence delays safer
care.
Rationale — Incorrect Options:
A. Lack of complaints is not a valid quality indicator and may
mask preventable harm.
,B. EBP is not dependent on physician initiation; nursing practice
should also be evidence-driven.
D. EBP rarely requires evidence from the exact unit before
action; high-quality external evidence is often used first.
Teaching Point:
EBP targets preventable harm, not just obvious complaints.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
2. Reference
Ch. 1 — Making the Case for Evidence-Based Practice — Best
Available Evidence
Stem:
A nurse practitioner is deciding whether to adopt a new wound-
care approach. One article is a single expert opinion piece,
another is a well-conducted systematic review, and a third is a
small descriptive study. The clinician has limited time and must
choose the strongest basis for change. Which source should
carry the most weight?
Options:
A. The expert opinion piece, because experts understand
practice realities best.
B. The systematic review, because it synthesizes multiple studies
using a rigorous method.
, C. The descriptive study, because it reflects current patient
experiences.
D. All three should be weighted equally to avoid bias.
Correct Answer:
B
Rationale — Correct Answer:
Systematic reviews generally provide stronger evidence than
expert opinion or descriptive studies because they synthesize
and critically appraise multiple studies using a transparent
method. In EBP, evidence hierarchy matters when deciding what
to adopt. The strongest available evidence should guide
practice changes when relevant.
Rationale — Incorrect Options:
A. Expert opinion may be useful, but it is lower on the evidence
hierarchy than systematic review evidence.
C. Descriptive studies can inform understanding, but they do
not establish effectiveness as strongly as systematic reviews.
D. EBP does not weight all evidence equally; quality and design
matter.
Teaching Point:
Higher-level evidence usually deserves greater influence on
practice decisions.
Citation:
Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-Based
Practice in Nursing & Healthcare (5th ed.). Ch. 1.
