TEST BANK FOR PRIMARY CARE ART AND SCIENCE OF ADVANCED PRACTICE NURSING-AN INTERPROFESSIONAL APPROACH 6TH EDITION - DUNPHY

TEST BANK FOR PRIMARY CARE ART AND SCIENCE OF ADVANCED PRACTICE NURSING-AN INTERPROFESSIONAL APPROACH 6TH EDITION - DUNPHY. A nurse leader is attempting to increase the awareness of evidence-based practice (EBP) among the nurses on a unit. A nurse who is implementing EBP integrates which of the following? (Select all that apply.) A) Interdisciplinary consensus B) Nursing tradition C) Research studies D) Patient preferences and values E) Clinical expertise Ans: C, D, E Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problemsolving approach to the delivery of healthcare that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values. Multiple Choice 7. Mrs. Mayes is a 73-year-old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now poses a threat of osteomyelitis. The wound care nurse who has been working with Mrs. Mayes applies evidence-based practice (EBP) whenever possible and has proposed the use of maggot therapy to debride necrotic tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this treatment despite the sizable body of evidence supporting it. How should the nurse reconcile Mrs. Mayes views with the principles of EBP? A) The nurse should explain that reliable and valid research evidence overrides the patients opinion. B) The nurse should explain the evidence to the patient in greater detail. C) The nurse should integrate the patients preferences into the plan of care. D) The nurse should involve the patients family members in the decision-making process. Ans: C Feedback: Patient preferences should be integrated into EBP and considered alongside research evidence and the nurses clinical expertise; evidence does not trump the patients preferences. The family should be involved, but this is not an explicit dimension of EBP. Similarly, explaining the evidence in more detail is not a demonstration of EBP. 8. The administrators of a long-term care facility are considered the use of specialized, pressure- reducing mattresses in order to reduce the incidence of pressure ulcers among residents. They have sought input from the nurses on the unit, all of whom are aware of the need to implement the principles of evidence-based practice (EBP) in this decision. Which of the following evidence sources should the nurses prioritize? A) A qualitative study that explores the experience of living with a pressure ulcer B) A case study that describes the measures that nurses on a geriatric unit took to reduce pressure ulcers among patients C) Testimonials from experienced clinicians about the effectiveness of the mattress in question D) A randomized controlled trial that compared the pressure-reducing mattress with standard mattresses Ans: D Feedback: The most reliable evidence is considered RCTs. Qualitative studies, case studies, and expert opinion are low on the hierarchy of evidence. 9. Hospital administrators are applying the principles of evidence-based practice (EBP) in their attempt to ascertain the most efficient and effective way to communicate between nurses who are on different units, a project that will consider many types of evidence. Which of the following information sources should the administrators prioritize? A) A systematic review about communication in nursing contexts B) Nurses ideas about communication methods C) The results of a chart review D) The hospitals accreditation status Ans: A Feedback: Systematic reviews are assigned a high value in EBP. Reviews would be prioritized over nurses ideas or a chart review, though both are potential considerations. The hospitals accreditation status is not a relevant consideration. 10. A nurse has resolved to apply the evidence-based practice (EBP) process to the way that admission assessments are conducted and documented on a unit. How should the nurse begin the process of establishing EBP? A) Gather evidence showing the shortcomings of current practices B) Formulate a clear and concise question to be addressed C) Elicit support from the nurses who are most often responsible for admissions D) Search the literature for evidence that is potentially relevant to the practice need Ans: B Feedback: The first step in applying EBP is to ask a clear, focused question. This should precede a search of the literature or the recruitment of participants. An assessment of the shortcomings of the current system is not an explicit component of the EBP process. 11. Which of the following questions best exemplifies the PICOT format for asking evidence-based questions? A) What affect does parents alcohol use have on the alcohol use of their teenage children? B) Among postsurgical patients, what role does meditation rather than benzodiazepines have on anxiety levels during the 48 hours following surgery? C) Among high school students, what is the effectiveness of a sexual health campaign undertaken during the first 4 weeks of the fall semester as measured by incidence of new sexually transmitted infections?