Chapter 01: Using Evidence in Nursing Practice
Perry et al.: Nursing Interventions & Clinical Skills, 7th Edition
MULTIPLE CHOICE
1. A nursing educator is explaining how the best clinical practices are determined. Which
statement best explains the purpose of evidence-based practice?
a. It ensures that all patients receive holistic care.
b. It provides a definite reason for providing care in a specific manner.
c. It prevents errors when care is being delivered.
d. It guarantees that care delivered is based on research.
ANS: B
Evidence-based practice is the use of the current best evidence in making patient care decisions. It
applies to all types of health care professionals. Currently there is no method that can ensure that all
patients receive holistic care, that all errors can be prevented, or that a guarantee exists that care given
is based on research.
DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
2. Which question is a problem-focused trigger for initiating the evidence-based practice method
in nursing care?
a. What is known about reduction of urinary tract infections in the older adult with diabetes?
b. How can chronic pain best be described when the patient is nonverbal?
c. How long can an IV catheter remain in place in a patient with obesity?
d. What measures can the nurse take to reduce the rising incidence of urinary tract infections on
the older adult care unit?
ANS: D
Evidence-based practice (EBP) questions tend to arise from two sources: recurrent problems or new
knowledge. In the correct option, the increase in urinary tract infections indicates a trend or recurring
problem in a specific group of patients. The other questions are general information questions, not
,based on what is happening in a specific area or to a group of specific patients in an area or relating to
an observed trend.
DIF: Cognitive Level: Applying OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
3. What does the “I” indicate in a “PICO” question?
a. Intervention of interest
b. Incorporation of concepts
c. Implementation by nursing
d. Interest of personnel
ANS: A
The “I” stands for intervention of interest, meaning what the nurse hopes to use in practice and believes
is worthwhile or valuable. This could be a treatment for a specific type of wound or an approach on how
to teach food preparation for a patient with impaired sight.
DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
4. Who will the clinical research nurse contact to search relevant databases in preparation for an
upcoming study?
a. The physician whose patients may be involved in the study
b. The medical librarian
c. The nurse manager of the unit where the study will be conducted
d. The director of nursing of the facility
ANS: B
The medical librarian is most knowledgeable regarding databases relevant to a study. The other
individuals do not have the knowledge regarding relevant databases.
,DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
5. Which database contains summaries of clinical guidelines and their development?
a. MEDLINE
b. CINAHL
c. Cochrane Database of Systematic Reviews
d. The National Guideline Clearinghouse
ANS: D
The National Guideline Clearinghouse is a database supported by the Agency for Healthcare Research
and Quality. It contains summaries of clinical guidelines for practice. MEDLINE is a database for studies
in medicNine, nursing, dentistry, psychiatry, veterinary medicine, and
allied health. CINAHL (Cumulative Index of Nursing and Allied Health Literature) includes
studies in nursing, allied health, and biomedicine. The Cochrane Database Full text of regularly updated
systematic reviews prepared by the Cochrane Collaboration includes completed reviews and protocols.
DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
6. Which does the nurse researcher identify as the strongest type of research?
a. Randomized controlled trials
b. A qualitative study
c. A descriptive study
d. A case controlled study
ANS: A
Individual randomized controlled trials are close to the top of the research pyramid. Only systematic
reviews and meta-analyses are higher. This type of study tests an intervention against the usual
standard of care. The other types of studies are useful but do not give the same type of information as a
randomized controlled trial provides.
, DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Assessment
7. What is the nurse attempting to determine when critiquing the evidence related to a PICOT
question?
a. The ethical conduct of the research the nurse read
b. The strength of the evidence found in the literature
c. If there are any experts in the clinical question needing to be researched
d. If the study demonstrates cost-effectiveness if a change in practice occurs
ANS: B
Once a literature search is complete and data are gathered about the question, it is time to critique the
evidence. Critiquing the evidence involves a systematic approach to looking at the strength of the work
reviewed and its relevance. The other questions are not applicable to critiquing the evidence.
DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
8. A nurse finds a cohort study comparing one group taking hormone treatment with another
group not taking hormone treatment to determine the incidence of changes in bone density of the
lower spine. What can the nurse imply from this study?
a. Low level of strength makes the study limited in value.
b. Moderate level of strength makes the study probably useful.
c. Opinions of the individuals in the cohort are not research.
d. This could be the basis for a Quality Improvement project.
ANS: B
A cohort study is Level 4 evidence as it is a single, non-experimental study. This moderate level of
evidence makes the study probably useful but the nurse should strive to find stronger
evidence. N
Perry et al.: Nursing Interventions & Clinical Skills, 7th Edition
MULTIPLE CHOICE
1. A nursing educator is explaining how the best clinical practices are determined. Which
statement best explains the purpose of evidence-based practice?
a. It ensures that all patients receive holistic care.
b. It provides a definite reason for providing care in a specific manner.
c. It prevents errors when care is being delivered.
d. It guarantees that care delivered is based on research.
ANS: B
Evidence-based practice is the use of the current best evidence in making patient care decisions. It
applies to all types of health care professionals. Currently there is no method that can ensure that all
patients receive holistic care, that all errors can be prevented, or that a guarantee exists that care given
is based on research.
DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
2. Which question is a problem-focused trigger for initiating the evidence-based practice method
in nursing care?
a. What is known about reduction of urinary tract infections in the older adult with diabetes?
b. How can chronic pain best be described when the patient is nonverbal?
c. How long can an IV catheter remain in place in a patient with obesity?
d. What measures can the nurse take to reduce the rising incidence of urinary tract infections on
the older adult care unit?
ANS: D
Evidence-based practice (EBP) questions tend to arise from two sources: recurrent problems or new
knowledge. In the correct option, the increase in urinary tract infections indicates a trend or recurring
problem in a specific group of patients. The other questions are general information questions, not
,based on what is happening in a specific area or to a group of specific patients in an area or relating to
an observed trend.
DIF: Cognitive Level: Applying OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
3. What does the “I” indicate in a “PICO” question?
a. Intervention of interest
b. Incorporation of concepts
c. Implementation by nursing
d. Interest of personnel
ANS: A
The “I” stands for intervention of interest, meaning what the nurse hopes to use in practice and believes
is worthwhile or valuable. This could be a treatment for a specific type of wound or an approach on how
to teach food preparation for a patient with impaired sight.
DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
4. Who will the clinical research nurse contact to search relevant databases in preparation for an
upcoming study?
a. The physician whose patients may be involved in the study
b. The medical librarian
c. The nurse manager of the unit where the study will be conducted
d. The director of nursing of the facility
ANS: B
The medical librarian is most knowledgeable regarding databases relevant to a study. The other
individuals do not have the knowledge regarding relevant databases.
,DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
5. Which database contains summaries of clinical guidelines and their development?
a. MEDLINE
b. CINAHL
c. Cochrane Database of Systematic Reviews
d. The National Guideline Clearinghouse
ANS: D
The National Guideline Clearinghouse is a database supported by the Agency for Healthcare Research
and Quality. It contains summaries of clinical guidelines for practice. MEDLINE is a database for studies
in medicNine, nursing, dentistry, psychiatry, veterinary medicine, and
allied health. CINAHL (Cumulative Index of Nursing and Allied Health Literature) includes
studies in nursing, allied health, and biomedicine. The Cochrane Database Full text of regularly updated
systematic reviews prepared by the Cochrane Collaboration includes completed reviews and protocols.
DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
6. Which does the nurse researcher identify as the strongest type of research?
a. Randomized controlled trials
b. A qualitative study
c. A descriptive study
d. A case controlled study
ANS: A
Individual randomized controlled trials are close to the top of the research pyramid. Only systematic
reviews and meta-analyses are higher. This type of study tests an intervention against the usual
standard of care. The other types of studies are useful but do not give the same type of information as a
randomized controlled trial provides.
, DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Assessment
7. What is the nurse attempting to determine when critiquing the evidence related to a PICOT
question?
a. The ethical conduct of the research the nurse read
b. The strength of the evidence found in the literature
c. If there are any experts in the clinical question needing to be researched
d. If the study demonstrates cost-effectiveness if a change in practice occurs
ANS: B
Once a literature search is complete and data are gathered about the question, it is time to critique the
evidence. Critiquing the evidence involves a systematic approach to looking at the strength of the work
reviewed and its relevance. The other questions are not applicable to critiquing the evidence.
DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment TOP: Nursing
Process: Implementation
8. A nurse finds a cohort study comparing one group taking hormone treatment with another
group not taking hormone treatment to determine the incidence of changes in bone density of the
lower spine. What can the nurse imply from this study?
a. Low level of strength makes the study limited in value.
b. Moderate level of strength makes the study probably useful.
c. Opinions of the individuals in the cohort are not research.
d. This could be the basis for a Quality Improvement project.
ANS: B
A cohort study is Level 4 evidence as it is a single, non-experimental study. This moderate level of
evidence makes the study probably useful but the nurse should strive to find stronger
evidence. N
