NURS 6052 – Essentials of Evidence-Based
Practice
1. Foundations of Evidence-Based Practice
1. A nurse researcher is evaluating a new intervention for post-surgical pain
management. The researcher's primary goal is to minimize bias and ensure the
findings are directly applicable to the patient population on their unit. Which
model of EBP is best suited for this purpose, as it focuses on both the evidence
and the environment's readiness for change?
A. The Iowa Model of Evidence-Based Practice
B. The Johns Hopkins Nursing Evidence-Based Practice Model
C. The Stetler Model of Evidence-Based Practice
D. The Advancing Research and Clinical Practice through Close Collaboration
(ARCC) Model
2. A clinical nurse is frustrated by the delay in implementing a new, evidence-
based pressure ulcer prevention protocol. She notes that unit culture and a lack
of administrative support are major barriers. Her mentor suggests using a model
that specifically addresses organizational change and the adoption of
innovations. Which model is her mentor most likely referring to?
A. The ACE Star Model of Knowledge Transformation
B. The Promoting Action on Research Implementation in Health Services (PARIHS)
Framework
C. The Iowa Model of Evidence-Based Practice
D. The Rosswurm and Larrabee Model
3. A nursing student asks their preceptor to explain the primary difference
between Evidence-Based Practice (EBP) and Quality Improvement (QI). The
preceptor's best response is:
A. "EBP is for individual patient care, while QI is for system-level changes only."
B. "QI uses internal data to fix a local problem, whereas EBP uses external
research to guide best practice."
C. "Both are the same; QI is just the implementation phase of EBP."
D. "EBP is a rigid process, while QI is a flexible and creative process."
,4. A nurse on an oncology unit is reading a systematic review on the
management of chemotherapy-induced nausea. In evaluating the level of
evidence, which hierarchy does this source represent?
A. Level I
B. Level II
C. Level III
D. Level IV
5. Which of the following best describes the primary goal of EBP?
A. To increase the cost-effectiveness of healthcare delivery.
B. To establish nursing as a purely scientific discipline.
C. To integrate the best current evidence with clinical expertise and patient
preferences to make clinical decisions.
D. To ensure all clinical decisions are based solely on randomized controlled trials.
6. A nursing leader is implementing a new EBP initiative. She identifies that the
unit has a "positive culture for change" but lacks the necessary "skills and
resources." According to the PARIHS framework, which element is present, and
which is weak?
A. Evidence is present; Facilitation is weak.
B. Context is present; Facilitation is weak.
C. Context is present; Evidence is weak.
D. Facilitation is present; Context is weak.
7. A new graduate nurse is learning about the steps of EBP. When placing the
steps in the correct order, which sequence is accurate?
A. Ask, Appraise, Acquire, Apply, Assess.
B. Ask, Acquire, Appraise, Apply, Assess.
C. Acquire, Ask, Appraise, Apply, Assess.
D. Appraise, Ask, Acquire, Apply, Assess.
8. Which of the following is a key component of "clinical expertise" in the EBP
triad?
A. The latest research study published in a peer-reviewed journal.
B. The patient's religious and cultural beliefs.
C. The clinician's cumulative experience, education, and clinical skills.
D. Data collected from the hospital's electronic health records.
,9. In the Johns Hopkins Nursing EBP Model, the "Practice Question" phase
involves a specific process. What is the critical first step in this phase?
A. Conducting a comprehensive literature search.
B. Appraising the evidence for strength and quality.
C. Assembling an interprofessional team.
D. Identifying a stakeholder or patient-care issue.
10. A nurse is reading a meta-analysis on the effect of early ambulation on
length of stay in post-operative patients. In terms of the hierarchy of evidence,
this type of study represents the strongest level because it:
A. Is a carefully controlled experiment.
B. Represents a summary of individual patient data.
C. Combines and analyzes results from multiple independent studies.
D. Is based on a large cohort over a long period.
11. The "Stetler Model" of EBP is unique because it places a strong emphasis on:
A. The creation of new knowledge through primary research.
B. The individual practitioner's critical thinking and internal decision-making
process.
C. Cost-effectiveness as the primary driver for implementation.
D. The application of research findings at the organizational level.
12. A clinical question is derived from a nurse's observation that many patients
with heart failure do not adhere to their dietary restrictions. This is an example
of which type of trigger for EBP?
A. Knowledge-focused trigger
B. Problem-focused trigger
C. Administrative trigger
D. Research-focused trigger
13. An interprofessional team is evaluating the feasibility of implementing a
new fall prevention program. According to the Iowa Model, what is one of the
most critical initial steps to determine if the change is appropriate for their unit?
A. Implement the change on a pilot unit.
B. Critically appraise the available research.
C. Form a team to develop and evaluate the pilot.
D. Identify whether the issue is a priority for the organization.
, 14. A nurse is researching the best practices for preventing catheter-associated
urinary tract infections (CAUTIs). She finds a clinical practice guideline that is
based on a systematic review. This guideline is considered a strong source of
evidence because it:
A. Is published by a professional organization.
B. Is written by experts in the field.
C. Synthesizes the best available evidence and provides actionable
recommendations.
D. Is the most recent publication on the topic.
15. A significant barrier to EBP implementation is often the "culture of the unit."
Which strategy is most effective in addressing this barrier?
A. Providing individual incentives for reading research articles.
B. Mandating that all nurses attend a research lecture.
C. Engaging a clinical champion and facilitating mentorship.
D. Waiting for a new generation of nurses who are more research-focused.
16. Which of the following best describes the primary purpose of a conceptual
framework or model in nursing research?
A. To statistically analyze the collected data.
B. To provide a structured guide for the research design and interpretation.
C. To ensure the study is free from all types of bias.
D. To prove the researcher's hypothesis.
17. An "opinion of an expert committee" is considered what level of evidence in
most EBP hierarchies?
A. Level I
B. Level IV or Level V
C. Level II
D. It is not considered evidence.
18. The nurse is comparing the Johns Hopkins EBP Model to the Iowa Model. A
distinct advantage of the Iowa Model over the Johns Hopkins Model is that the
Iowa Model:
A. Is specifically designed for the nursing profession only.
B. Integrates patient preference as a central component.
C. Includes a strong emphasis on the organizational environment and feedback
Practice
1. Foundations of Evidence-Based Practice
1. A nurse researcher is evaluating a new intervention for post-surgical pain
management. The researcher's primary goal is to minimize bias and ensure the
findings are directly applicable to the patient population on their unit. Which
model of EBP is best suited for this purpose, as it focuses on both the evidence
and the environment's readiness for change?
A. The Iowa Model of Evidence-Based Practice
B. The Johns Hopkins Nursing Evidence-Based Practice Model
C. The Stetler Model of Evidence-Based Practice
D. The Advancing Research and Clinical Practice through Close Collaboration
(ARCC) Model
2. A clinical nurse is frustrated by the delay in implementing a new, evidence-
based pressure ulcer prevention protocol. She notes that unit culture and a lack
of administrative support are major barriers. Her mentor suggests using a model
that specifically addresses organizational change and the adoption of
innovations. Which model is her mentor most likely referring to?
A. The ACE Star Model of Knowledge Transformation
B. The Promoting Action on Research Implementation in Health Services (PARIHS)
Framework
C. The Iowa Model of Evidence-Based Practice
D. The Rosswurm and Larrabee Model
3. A nursing student asks their preceptor to explain the primary difference
between Evidence-Based Practice (EBP) and Quality Improvement (QI). The
preceptor's best response is:
A. "EBP is for individual patient care, while QI is for system-level changes only."
B. "QI uses internal data to fix a local problem, whereas EBP uses external
research to guide best practice."
C. "Both are the same; QI is just the implementation phase of EBP."
D. "EBP is a rigid process, while QI is a flexible and creative process."
,4. A nurse on an oncology unit is reading a systematic review on the
management of chemotherapy-induced nausea. In evaluating the level of
evidence, which hierarchy does this source represent?
A. Level I
B. Level II
C. Level III
D. Level IV
5. Which of the following best describes the primary goal of EBP?
A. To increase the cost-effectiveness of healthcare delivery.
B. To establish nursing as a purely scientific discipline.
C. To integrate the best current evidence with clinical expertise and patient
preferences to make clinical decisions.
D. To ensure all clinical decisions are based solely on randomized controlled trials.
6. A nursing leader is implementing a new EBP initiative. She identifies that the
unit has a "positive culture for change" but lacks the necessary "skills and
resources." According to the PARIHS framework, which element is present, and
which is weak?
A. Evidence is present; Facilitation is weak.
B. Context is present; Facilitation is weak.
C. Context is present; Evidence is weak.
D. Facilitation is present; Context is weak.
7. A new graduate nurse is learning about the steps of EBP. When placing the
steps in the correct order, which sequence is accurate?
A. Ask, Appraise, Acquire, Apply, Assess.
B. Ask, Acquire, Appraise, Apply, Assess.
C. Acquire, Ask, Appraise, Apply, Assess.
D. Appraise, Ask, Acquire, Apply, Assess.
8. Which of the following is a key component of "clinical expertise" in the EBP
triad?
A. The latest research study published in a peer-reviewed journal.
B. The patient's religious and cultural beliefs.
C. The clinician's cumulative experience, education, and clinical skills.
D. Data collected from the hospital's electronic health records.
,9. In the Johns Hopkins Nursing EBP Model, the "Practice Question" phase
involves a specific process. What is the critical first step in this phase?
A. Conducting a comprehensive literature search.
B. Appraising the evidence for strength and quality.
C. Assembling an interprofessional team.
D. Identifying a stakeholder or patient-care issue.
10. A nurse is reading a meta-analysis on the effect of early ambulation on
length of stay in post-operative patients. In terms of the hierarchy of evidence,
this type of study represents the strongest level because it:
A. Is a carefully controlled experiment.
B. Represents a summary of individual patient data.
C. Combines and analyzes results from multiple independent studies.
D. Is based on a large cohort over a long period.
11. The "Stetler Model" of EBP is unique because it places a strong emphasis on:
A. The creation of new knowledge through primary research.
B. The individual practitioner's critical thinking and internal decision-making
process.
C. Cost-effectiveness as the primary driver for implementation.
D. The application of research findings at the organizational level.
12. A clinical question is derived from a nurse's observation that many patients
with heart failure do not adhere to their dietary restrictions. This is an example
of which type of trigger for EBP?
A. Knowledge-focused trigger
B. Problem-focused trigger
C. Administrative trigger
D. Research-focused trigger
13. An interprofessional team is evaluating the feasibility of implementing a
new fall prevention program. According to the Iowa Model, what is one of the
most critical initial steps to determine if the change is appropriate for their unit?
A. Implement the change on a pilot unit.
B. Critically appraise the available research.
C. Form a team to develop and evaluate the pilot.
D. Identify whether the issue is a priority for the organization.
, 14. A nurse is researching the best practices for preventing catheter-associated
urinary tract infections (CAUTIs). She finds a clinical practice guideline that is
based on a systematic review. This guideline is considered a strong source of
evidence because it:
A. Is published by a professional organization.
B. Is written by experts in the field.
C. Synthesizes the best available evidence and provides actionable
recommendations.
D. Is the most recent publication on the topic.
15. A significant barrier to EBP implementation is often the "culture of the unit."
Which strategy is most effective in addressing this barrier?
A. Providing individual incentives for reading research articles.
B. Mandating that all nurses attend a research lecture.
C. Engaging a clinical champion and facilitating mentorship.
D. Waiting for a new generation of nurses who are more research-focused.
16. Which of the following best describes the primary purpose of a conceptual
framework or model in nursing research?
A. To statistically analyze the collected data.
B. To provide a structured guide for the research design and interpretation.
C. To ensure the study is free from all types of bias.
D. To prove the researcher's hypothesis.
17. An "opinion of an expert committee" is considered what level of evidence in
most EBP hierarchies?
A. Level I
B. Level IV or Level V
C. Level II
D. It is not considered evidence.
18. The nurse is comparing the Johns Hopkins EBP Model to the Iowa Model. A
distinct advantage of the Iowa Model over the Johns Hopkins Model is that the
Iowa Model:
A. Is specifically designed for the nursing profession only.
B. Integrates patient preference as a central component.
C. Includes a strong emphasis on the organizational environment and feedback
