Module 45 - Evidence Based Practice Exam Questions and Complete Solutions

Module 45 - Evidence Based Practice Exam Questions and Complete Solutions The nurse researcher is explaining evidence-based practice (EBP) to a group of nurses. Which statement is appropriate to include in the explanation? (Select all that apply.) A. "EBP promotes generalization of client care." B. "EBP incorporates the nurse's clinical expertise." C. "EBP considers the client's needs, values, and choices." D. "EBP tests hypotheses about health-related conditions." E. "EBP is reflective of the best evidence from current research." - Ans: B. "EBP incorporates the nurse's clinical expertise." C. "EBP considers the client's needs, values, and choices." D. "EBP tests hypotheses about health-related conditions." Rationale: Evidence-based practice (EBP) combines the best evidence from the most current research available, the nurse's clinical expertise, and the client's preferences, including needs, values, and choices. EBP promotes individualization of client care. Nursing research tests hypotheses about health-related conditions and nursing care. The nurse conducting a research study needs to determine if an individual qualifies to be a participant. Which criteria must be met for inclusion? (Select all that apply.) A. he individual meets all the inclusion criteria. B. The individual has been given informed consent. C. The individual receives payment for participation. D. The individual must waive the right to anonymity. E. The individual is informed of all aspects of the study. - Ans: A. he individual meets all the inclusion criteria. B. The individual has been given informed consent. E. The individual is informed of all aspects of the study. Rationale: Research participants are defined as volunteers for a specific study project who meet all the inclusion criteria, have been informed of all aspects of thestudy, and have given informed consent. Adherence to the ethical principle of justice requires protection of the research participant's anonymity. Payment is not a mandatory condition of participation in research. Which statement best reflects the nurse's correct understanding of principles related toevidence-based practice (EBP)? (Select all that apply.) A. "Client choices do not affect evidence-based practice." B. "Client-centered care is an outcome of evidence-based practice." C. "The nurse's level of expertise influences evidence-based practice." D. "Evidence-based practice promotes individualization of client care." E. "Evidence-based practice requires application of all research evidence about a given topic." - Ans: B. "Client-centered care is an outcome of evidence-based practice." C. "The nurse's level of expertise influences evidence-based practice." D. "Evidence-based practice promotes individualization of client care." Rationale: Evidence-based practice (EBP) combines the best evidence from the most current research available, the nurse's clinical expertise, and the client's preferences, including needs, values, and choices. EBP promotes individualization of client care and provides best practice for client-centered care. The nurse is designing a nursing clinical research study. Which research question is most appropriate for this type of study?(Select all that apply.) A. What factors influence an individual's choice to enroll in online nursing education? B. How do communication styles influence the nurse's perception of nurse educators? C. How do environmental noise levels affect the client's pain perception postanesthesia? D. Is there a relationship between acupressure and incidence of nausea in clients who are receiving chemotherapy medications? E. What is the relationship between the duration of nurse-client interaction and the client's level of satisfaction with nursing care? - Ans: C. How do environmental noise levels affect the client's pain perception postanesthesia? D. Is there a relationship between acupressure and incidence of nausea in clients who are receiving chemotherapy medications? E. What is the relationship between the duration of nurse-client interaction and the client's level of satisfaction with nursing care? Rationale: Nursing research is a systematic and strict scientific process that tests hypotheses about health-related conditions and nursing care; as an extension of nursing research, nursing clinical research seeks answers that will ultimately improve client care. The nurse is delivering a presentation about evidence-based practice (EBP). Which statement best reflects the nurse's correct understanding of EBP? A. "EBP incorporates clinical knowledge, expert opinion, or information resulting from research." B. "EBP is the gathering of objective facts and information to advance knowledge about a specific topic." C. "EBP uses a systematic and strict scientific process to test hypotheses about health-related conditions and nursing care." D. "EBP involves combining quality research, clinical expertise, and client preferences to achieve the best client outcomes." - Ans: A. "EBP incorporates clinical knowledge, expert opinion, or information resulting from research." Rationale: Evidence-based practice (EBP) seeks to achieve optimal client outcomes by combining the best evidence from the most current researchavailable, the nurse's clinical expertise, and the client's preferences, includingneeds, values, and choices. Research involves gathering objective facts and information to advance knowledge about a specific topic. Nursing research is a systematic and strict scientific process that tests hypotheses about health-related conditions and nursing care. Evidence can be defined as clinical knowledge, expertopinion, or information resulting from research. The nurse is critically appraising a research study. Which statement is reflective of an appraisal of thestudy's reliability? A. "Although the study was supposed to measure the client's wound healing, it really measured the client's satisfaction with care." B. "The original study was repeated three times, but it did not produce consistent results." C. "The study's results are not applicable to clinical practice." D. "The study's results are applicable to clinical practice." - Ans: B. "The original study was repeated three times, but it did not produce consistent results." Rationale: Reliability is the study's ability to produce consistent results with each use. Validity is the degree to which the study measured what it intended to measure. Usefulness is reflective of the study's application to clinical practice. Which response is an example of a background question? (Select all that apply.) A. Why isn't long-acting insulin administered via the IV route? B. What is the pathophysiology of left ventricular heart failure? C. How does acupuncture compare with pain medication for treating chronic knee pain? D. How does incentive spirometry help prevent collapse of the small airways in the lungs? E. What is the link between healthcare providers' stethoscopes and healthcare-acquired infections? - Ans: A. Why isn't long-acting insulin administered via the IV route? B. What is the pathophysiology of left ventricular heart failure? D. How does incentive spirometry help prevent collapse of the small airways in the lungs? Rationale: Background questions are knowledgebased and seek more information about a topic, such as medications or diseases. Answers to background questions can be found in textbooks, drug guides, medical dictionaries, and other education resources. Foreground questions are practice based and, compared with background questions, they are narrower in scope. Foreground questions focus on a specific clinical issue and their answers identify useful information about direct client care that may guide the formulation of nursing interventions that improve client outcomes. A nurse researcheris designing a study intended to explore how certification exam preparation courses affect nursing students' success rates in passing the exam. Which element best reflects the nurse's use of a randomized control trial (RCT) design? A. Compare graduate nurses who successfully passed the certification exam with graduate nurses who did not pass the exam in order to determine whether or not completing a certification exam preparation course was a variable that contributed to test performance. B. Compare the exam performance of a control group of graduate nurses who did not complete any certification exam preparation course with a group of graduate nurses who completed a specific certification exam preparation course prior to taking the exam. C. Interview five graduate nurses who completed a certification exam preparation course and detail their experiences with the course and then identify the number o - Ans: B. Compare the exam performance of a control group of graduate nurses who did not complete any certification exam preparation course with a group of graduate nurses who completed a specific certification exam preparation course prior to taking the exam. Rationale: Randomized control trials (RCTs) are designed to illustrate acause-and-effect relationship by using a control group and an experimental group. An RCT is best illustrated by comparing the exam performance of a control group of graduate nurses who did not complete any certification exam preparation course with a group of graduate nurses who completed a specific certification exam preparation course prior to taking the exam. A meta-analysis examines a group of studies on a given topic and combines and analyzes the results as if they were from one large study; this design is best reflected by examining a group of studies on graduate nurses who completed certification exam preparation courses and then combining and analyzing the results as if they were from one large study. A case study is specific to one individual, issue, or event; this design is best reflected by interviewing five graduate nurses who completed a certification exam preparation course and detailing their experiences with the course, as well as identifying the number of graduate nurses who successfully complete the certification exam. Case-control studies compare individuals with and without a specific condition to identify predictive variables; this design is best reflected by comparing graduate nurses who successfully passed the certification exam with graduate nurses who did not pass the exam to determine whether or not completing a certification exam preparation course contributed to the success rates. Which statement best describes validity of research evidence? A. It is reflective of the study's application to clinical practice. B. It is the study's ability to produce consistent results with each use. C. It is the degree to which the study measured what it intended to measure. D. It is used to determine the strengths and weaknesses of a study and its resulting evidence. - Ans: C. It is the degree to which the study measured what it intended to measure. Rationale: Validity is the degree to which the study measured what it intended to measure. Reliability is the study's ability to produce consistent results with each use. Usefulness is reflective of the study's application to clinical practice. Critical appraisal is used to identify strengths and weaknesses of a study and its resulting evidence. Which question is most appropriate for the nurse to consider when evaluating the impact ofevidence-based practice (EBP) on client outcomes? (Select all that apply.) A. Is the new practice beneficial to the nurse? B. Is the new practice being implemented correctly? C. Does the change in practice yield the intended results? D. Is the practice in accordance with the state's nurse practice act? E. Does the practice adhere to the American Nurses Association (ANA) standards of nursingcare? - Ans: B. Is the new practice being implemented correctly? C. Does the change in practice yield the intended results? Rationale: Evaluation seeks to answer questions including, "Is the new practice being implemented correctly?" and "Does the change in practice yield the intendedresults?" Nurses are legally bound to practice in accordance with their state's nurse practice act and to provide care that adheres to the ANA standards of nursing care; these concerns must be addressed before implementing care. The practice is intended to be beneficial to the client. A 2-year-old child with cerebral palsy may benefit from the model known as a medical home.Which goal from Healthy People 2020 does the nurse identify for the client? A. Limiting who lives in the home B. Paying for their medication C. Coordinating their healthcare services D. Paying the mortgage for the home - Ans: C. Coordinating their healthcare services Rationale: Healthy People 2020 objectives include reducing child mortality rates as well as decreasing the incidence of transmission of preventable diseases among children. Increasing access to a medical homelong dash—which is a model of care that promotes physician-led, client-centered, coordinated health serviceslong dash—for children with special needs is also an objective. The services do not provide financial backing nor do they limit who lives in the home. Which evidence-based resource would be appropriate for the nurse to integrate into the care of a pregnant client? A. Information on breastfeeding from Healthy People 2020 B. Teaching pamphlets on circumcision C. Safety instructions from a car seat manufacturer D. Consequences of illegal drug use from the local police department - Ans: A. Information on breastfeeding from Healthy People 2020 Rationale: Evidence-based resources use current best evidence in making decisions about the care of individual patients. Healthy People 2020 providesscience-based benchmarks to track and monitor progress towards health to motivate individuals. While there are multiple opportunities for educational topics, only those based in the science can be considered evidence-based. Healthy People 2020 strives to identify nationwide health improvement priorities. As such, breastfeeding information from this source would be considered evidence-based, while other teaching pamphlets or information from local agencies or manufacturers may not. The nurse is doing a case study on a client with long-term cardiovascular disease.Which would be the best way to target health promotion for treatment as it relates to evidence-based practice? A. Examining cultural views B. Following federal regulation C. Genomic standpoint D. Looking at the hospital data - Ans: C. Genomic standpoint Rationale: Targeting health promotion from a genomic standpoint allows for more accurate risk prediction, diagnosis, and treatment of a variety of health alterations, such as heart disease, stroke, cancer, diabetes, and Alzheimer disease (HHS, 2016e). Goals associated with the promotion of global health include protecting the health of the national population as well as limiting the international transmission of infectious diseases during travel. Evidence-based resources related to global health and genomics are emerging. The charge nurse is providing an educational seminar for a group of nurses. Which factor should the nurse expect to be discussed as an evidence-based practice topic for older adults that correlates with Healthy People 2020? A. Screening protocols for sickle cell B. Transmission of infectious disease during travel C. Obesity prevention D. Fall-related injuries - Ans: D. Fall-related injuries Rationale: For older adults, Healthy People 2020 objectives address topics including increasing the number of individuals who are up to date on basic preventive care and decreasing the incidence of health alterations such as pressure ulcers and fall related injuries. For the general care of adults, goals associated with the promotion of global health include protecting the health of the national population as well as limiting the international transmission of infectious diseases during travel. Evidence-based resources related to newborns and infants address topics such as screening protocols for phenylketonuria and sickle cell disease. Evidence-based practice (EBP) is very prescriptive across the lifespan. Which client would be the focus for decreasing the incidence of pressure ulcers as presented in Healthy People 2020? A. A 16-year-old who is hospitalized after knee surgery B. A 65-year-old client who is bedridden in a nursing home C. A 12-year-old whosleeps 10?12 hours a day D. A 35-year-old who is in a rehab facility following neck fusion surgery - Ans: B. A 65-year-old client who is bedridden in a nursing home Rationale: For older adults, Healthy People 2020 objectives address topics including increasing the number of individuals who are up to date on basic preventive care and decreasing the incidence of health alterations such as pressure ulcers and fall related injuries. The older adult who is bedridden would be the focus of pressure ulcer prevention due to thinner skin and no mobility. Lying in the bed put pressure on the bony prominences. In a professional development seminar, the educator shares barriers that they may encounter as they try to implement evidence-based practice (EBP) into their care. Which statement most accurately describes these potential barriers? (Select all that apply.) A. Client workload demands B. Nursing misperceptions about EBP C. Providing accountability for nursing care D. Ensuring credibility of the nursing profession E. Lack of access to continuing education programs - Ans: A. Client workload demands B. Nursing misperceptions about EBP E. Lack of access to continuing education programs Rationale: Potential barriers to implementation of evidence-based practice (EBP) include lack of access to continuing education programs, nursing misperceptions about EBP, and client workload demands. Benefits of EBP include providing accountability for nursing care and ensuring credibility of the nursing profession. The nurse is discussing some barriers that they have encountered with a journal club related to the topic. Which statement by the nurse describes potential barriers? (Select all that apply.) A. I am an administrator." B. "I work in a nursing home." C. "I don't have time to do those trainings." D. "I have been in nursing 20 years; I do not need more training." E. "The hospital I work at stopped professional development based on funds." - Ans: C. "I don't have time to do those trainings." D. "I have been in nursing 20 years; I do not need more training." E. "The hospital I work at stopped professional development based on funds." Rationale: When a healthcare facility makes cuts, it has been seen that educational programs and trainings go by the wayside. The other barrier would be not making time for the staff to attend trainings that are offered. The overconfident, stuck-in-their-ways nurse is a difficult person to educate on change and an alternate way of thinking. Being an administrator or working in a nursing home is not a barrier to promoting evidence-based practice in a healthcare facility. The nurse researcher is encouraging a nurse to incorporate evidence-based practice (EBP) into client care. Which action should the researcher encourage the nurse to do? A. Reviewing a client's record B. Looking at past data C. Participating in a research project D. Speaking with the hospitalist - Ans: C. Participating in a research project Rationale: It would be beneficial for the graduate nurse to participate in a research project to be a part of an EBP process, so they could see firsthand how the process works in action. Reviewing a client's chart may be a way to look at what treatment was performed, but it would not reveal if it was evidence based. Looking at past data will not provide a look at evidence-based practice. A hospitalist may be able to share their opinion of evidence-based practice, but that does not expose the nurse to the process. Which factor that inhibits evidence-based practice would be considered an external factor? A. Personal aversion to the idea B. Lack of support by management C. Resistance to change D. Thoughts that the process doesn't work - Ans: B. Lack of support by management Rationale: Nurses need to assess the obstacles that inhibit them from using EBP more frequently. These may include internal factors, such as beliefs ormisconceptions, or external factors, such as lack of management support. Resistance to change, a personal aversion to the idea, and a thought that the process doesn't work are all examples of internal factors. The nurse is preparing to present the benefits of evidence-based practice (EBP) as it relates to nursing to colleagues. Which benefit should the nurse include? (Select all that apply.) A. Receiving the best clientoutcomes B. Increasing the accuracy of charting C. Contributing to the knowledge of nursing D. Increasing teamwork in healthcare facilities E. Assisting in the delivery of high-quality nursing care - Ans: A. Receiving the best clientoutcomes C. Contributing to the knowledge of nursing E. Assisting in the delivery of high-quality nursing care Rationale: Some basic activities can provide a foundation for implementing EBP. These strategies can spark the necessary stimulus to engage in behaviors that encourage best practice. Participating in EBP contributes to the knowledge of nursing and client care in today's healthcare systems and delivery of high-quality nursing care for best outcomes. Utilizing EBP doesn't increase the accuracy ofcharting, as that is all dependent on the nurse and the knowledge of what they add to the record. EBP governs nursing practice, but teamwork is something that needs to be encouraged by management in each individual healthcare facility. Which factor would help target health promotion in a patient through a genomic standpoint? - Ans: Family History