FULL TEST BANK FOR
EVIDENCE-BASED PRACTICE IN NURSING & HEALTHCARE 4TH EDITION
BY BERNADETTE MAZUREK MELNYK PHD RN CPNP/PMHNP FNAP (AUTHOR), ELLEN FINEOUT-OVERHOLT
PHD RN FNAP FAAN (AUTHOR)
,TABLE OF CONTENTS
CHAPTER 1 MAKING THE CASE FOR EVIDENCE-BASED PRACTICE AND CULTIVATING A SPIRIT OF
INQUIRY..................................................................................................................................................... 3
CHAPTER 2 ASKING COMPELLING CLINICAL QUESTIONS ......................................................................... 8
CHAPTER 3 FINDING RELEVANT EVIDENCE TO ANSWER CLINICAL QUESTIONS ..................................... 14
CHAPTER 4 CRITICALLY APPRAISING KNOWLEDGE FOR CLINICAL DECISION MAKING .......................... 19
CHAPTER 5 CRITICALLY APPRAISING QUANTITATIVE EVIDENCE FOR CLINICAL DECISION MAKING ...... 25
CHAPTER 6 CRITICALLY APPRAISING QUALITATIVE EVIDENCE FOR CLINICAL DECISION MAKING ......... 31
CHAPTER 7 INTEGRATION OF PATIENT PREFERENCES AND VALUES AND CLINICIAN EXPERTISE INTO
EVIDENCE-BASED DECISION MAKING ..................................................................................................... 37
CHAPTER 8 ADVANCING OPTIMAL CARE WITH ROBUST CLINICAL PRACTICE GUIDELINES .................... 42
CHAPTER 9 IMPLEMENTING EVIDENCE IN CLINICAL SETTINGS .............................................................. 48
CHAPTER 10 THE ROLE OF OUTCOMES AND EVIDENCE- BASED QUALITY IMPROVEMENT IN
ENHANCING AND EVALUATING PRACTICE.............................................................................................. 53
CHAPTER 11 IMPLEMENTING THE EVIDENCE-BASED PRACTICE COMPETENCIES IN CLINICAL AND
ACADEMIC SETTINGS TO ENSURE HEALTHCARE QUALITY AND IMPROVED PATIENT OUTCOMES ........ 59
CHAPTER 12 LEADERSHIP STRATEGIES FOR CREATING AND SUSTAINING EVIDENCE-BASED PRACTICE
ORGANIZATIONS ..................................................................................................................................... 65
CHAPTER 13 INNOVATION AND EVIDENCE: A PARTNERSHIP IN ADVANCING BEST PRACTICE AND HIGH
QUALITY CARE ......................................................................................................................................... 71
CHAPTER 14 MODELS TO GUIDE IMPLEMENTATION AND SUSTAINABILITY OF EVIDENCE-BASED
PRACTICE ................................................................................................................................................. 78
CHAPTER 15 CREATING A VISION AND MOTIVATING A CHANGE TO EVIDENCE-BASED PRACTICE IN
INDIVIDUALS, TEAMS, AND ORGANIZATIONS ........................................................................................ 84
CHAPTER 16 TEACHING EVIDENCE-BASED PRACTICE IN ACADEMIC SETTINGS...................................... 89
CHAPTER 17 TEACHING EVIDENCE-BASED PRACTICE IN CLINICAL SETTINGS ......................................... 95
CHAPTER 18 ARCC EVIDENCE-BASED PRACTICE MENTORS: THE KEY TO SUSTAINING EVIDENCE-BASED
PRACTICE ............................................................................................................................................... 100
CHAPTER 19 USING EVIDENCE TO INFLUENCE HEALTH AND ORGANIZATIONAL POLICY..................... 105
CHAPTER 20 DISSEMINATING EVIDENCE THROUGH PRESENTATIONS, PUBLICATIONS, HEALTH POLICY
BRIEFS, AND THE MEDIA ....................................................................................................................... 111
CHAPTER 21 GENERATING EVIDENCE THROUGH QUANTITATIVE AND QUALITATIVE RESEARCH ....... 117
CHAPTER 22 WRITING A SUCCESSFUL GRANT PROPOSAL TO FUND RESEARCH AND EVIDENCE-BASED
PRACTICE IMPLEMENTATION PROJECT ................................................................................................ 122
CHAPTER 23 ETHICAL CONSIDERATIONS FOR EVIDENCE IMPLEMENTATION AND EVIDENCE
GENERATION ......................................................................................................................................... 128
,CHAPTER 1 MAKING THE CASE FOR EVIDENCE-BASED PRACTICE AND CULTIVATING A SPIRIT OF INQUIRY
1. IN THE HOSPITAL WHERE NURSE L. PROVIDES CARE, TRADITION DICTATES THAT ORAL
TEMPERATURES BE INCLUDED IN EVERY SET OF PATIENT VITAL SIGNS, REGARDLESS OF PATIENT
DIAGNOSIS OR ACUITY. THIS IS MOST LIKELY AN EXAMPLE OF WHICH OF THE FOLLOWING
PHENOMENA?
A) THE PRIORITIZATION OF INTERNAL EVIDENCE OVER EXTERNAL EVIDENCE
B) PRACTICE THAT LACKS EVIDENCE TO SUPPORT ITS APPLICATION
C) THE INTEGRATION OF PERSONAL EXPERTISE INTO NURSING CARE
D) EVIDENCE-BASED PRACTICE
2. THE CLINICAL NURSE EDUCATOR (CNE) ON A POSTSURGICAL UNIT HAS RECENTLY COMPLETED A
PATIENT CHART REVIEW AFTER THE IMPLEMENTATION OF A PILOT PROGRAM AIMED AT PROMOTING
EARLY AMBULATION FOLLOWING SURGERY. WHICH OF THE FOLLOWING COMPONENTS OF EBP IS THE
NURSE PUTTING INTO PRACTICE?
A) PATIENT PREFERENCES
B) RESEARCH UTILIZATION
C) EXPERIENCE
D) INTERNAL EVIDENCE
3. NURSE R. HAS OBSERVED THAT REORIENTING DEMENTED PATIENTS AS FREQUENTLY AS
POSSIBLE TENDS TO MINIMIZE THE PATIENTS' LEVEL OF AGITATION IN THE EVENING. THE NURSE HAS
SHARED THIS OBSERVATION WITH A COLLEAGUE, WHO IS SKEPTICAL, STATING THAT, “IT'S BEST TO
STICK TO EVIDENCE-BASED PRACTICE.” HOW CAN NURSE R. BEST RESPOND?
A) “EBP CAN INCLUDE CLINICIANS' PERSONAL EXPERTISE.”
B) “PERSONAL EXPERIENCE IS OFTEN MORE SOUND THAN FORMAL EVIDENCE-BASED PRACTICE.”
C) “TRADITIONAL PRACTICE AND EBP ARE USUALLY SHOWN TO BE THE SAME.”
D) “MY YEARS OF EXPERIENCE CAN BE JUST AS VALUABLE AS ANY LITERATURE REVIEW OR
RANDOMIZED TRIAL.”
, 4. WHICH OF THE FOLLOWING FACTORS PROVIDES THE MOST IMPORTANT RATIONALE FOR THE
CONSISTENT IMPLEMENTATION OF EBP?
A) EBP PROVIDES FOR THE MOST COST-EFFECTIVE PATIENT CARE.
B) EBP IS ACCESSIBLE TO ALL HEALTHCARE CLINICIANS.
C) EBP PROVIDES CONSISTENCY IN CARE ACROSS HEALTHCARE SETTINGS.
D) EBP IMPROVES PATIENT OUTCOMES.
5. THE INSTITUTE OF MEDICINE'S ROUNDTABLE ON EVIDENCE-BASED MEDICINE HAS BEEN
ESTABLISHED TO ADDRESS EBP. WHICH OF THE FOLLOWING ISSUES IS THE ROUNDTABLE EMPHASIZING?
A) ENSURING THAT EXTERNAL EVIDENCE, RATHER THAN INTERNAL EVIDENCE, IS INTEGRATED INTO
CARE
B) FOSTERING THE LEVEL OF LEARNING THAT EXISTS IN THE AMERICAN HEALTHCARE SYSTEM
C) ISSUING CLINICAL GUIDELINES TO ENSURE BEST NURSING PRACTICE
D) COMPARING THE IMPLEMENTATION OF EBP IN THE UNITED STATES WITH THAT OF OTHER
WESTERN COUNTRIES
6. YOU HAVE BECOME FRUSTRATED WITH SOME ASPECTS OF PATIENT CARE THAT YOU BELIEVE
ARE OUTDATED AND INEFFECTIVE AT THE LONG-TERM CARE FACILITY WHERE YOU HAVE RECENTLY
BEGUN PRACTICING. CONSEQUENTLY, YOU HAVE RESOLVED TO EXAMINE SOME OF THESE PRACTICES IN
LIGHT OF EVIDENCE. WHICH OF THE FOLLOWING SHOULD OCCUR FIRST IN THE STEPS OF EBP?
A) CONDUCTING AN ELECTRONIC SEARCH OF THE LITERATURE AND RANKING INDIVIDUAL
SOURCES
B) CREATING “BUY-IN” FROM THE OTHER CLINICIANS WHO PROVIDE CARE AT THE FACILITY
C) DEVELOPING AN INQUISITIVE AND CURIOUS MINDSET
D) ASSESSING WHETHER THE PRACTICES IN QUESTION MAY, IN FACT, BE EVIDENCE-BASED
7. WHICH OF THE FOLLOWING CLINICAL QUESTIONS BEST EXEMPLIFIES THE PICOT FORMAT?
EVIDENCE-BASED PRACTICE IN NURSING & HEALTHCARE 4TH EDITION
BY BERNADETTE MAZUREK MELNYK PHD RN CPNP/PMHNP FNAP (AUTHOR), ELLEN FINEOUT-OVERHOLT
PHD RN FNAP FAAN (AUTHOR)
,TABLE OF CONTENTS
CHAPTER 1 MAKING THE CASE FOR EVIDENCE-BASED PRACTICE AND CULTIVATING A SPIRIT OF
INQUIRY..................................................................................................................................................... 3
CHAPTER 2 ASKING COMPELLING CLINICAL QUESTIONS ......................................................................... 8
CHAPTER 3 FINDING RELEVANT EVIDENCE TO ANSWER CLINICAL QUESTIONS ..................................... 14
CHAPTER 4 CRITICALLY APPRAISING KNOWLEDGE FOR CLINICAL DECISION MAKING .......................... 19
CHAPTER 5 CRITICALLY APPRAISING QUANTITATIVE EVIDENCE FOR CLINICAL DECISION MAKING ...... 25
CHAPTER 6 CRITICALLY APPRAISING QUALITATIVE EVIDENCE FOR CLINICAL DECISION MAKING ......... 31
CHAPTER 7 INTEGRATION OF PATIENT PREFERENCES AND VALUES AND CLINICIAN EXPERTISE INTO
EVIDENCE-BASED DECISION MAKING ..................................................................................................... 37
CHAPTER 8 ADVANCING OPTIMAL CARE WITH ROBUST CLINICAL PRACTICE GUIDELINES .................... 42
CHAPTER 9 IMPLEMENTING EVIDENCE IN CLINICAL SETTINGS .............................................................. 48
CHAPTER 10 THE ROLE OF OUTCOMES AND EVIDENCE- BASED QUALITY IMPROVEMENT IN
ENHANCING AND EVALUATING PRACTICE.............................................................................................. 53
CHAPTER 11 IMPLEMENTING THE EVIDENCE-BASED PRACTICE COMPETENCIES IN CLINICAL AND
ACADEMIC SETTINGS TO ENSURE HEALTHCARE QUALITY AND IMPROVED PATIENT OUTCOMES ........ 59
CHAPTER 12 LEADERSHIP STRATEGIES FOR CREATING AND SUSTAINING EVIDENCE-BASED PRACTICE
ORGANIZATIONS ..................................................................................................................................... 65
CHAPTER 13 INNOVATION AND EVIDENCE: A PARTNERSHIP IN ADVANCING BEST PRACTICE AND HIGH
QUALITY CARE ......................................................................................................................................... 71
CHAPTER 14 MODELS TO GUIDE IMPLEMENTATION AND SUSTAINABILITY OF EVIDENCE-BASED
PRACTICE ................................................................................................................................................. 78
CHAPTER 15 CREATING A VISION AND MOTIVATING A CHANGE TO EVIDENCE-BASED PRACTICE IN
INDIVIDUALS, TEAMS, AND ORGANIZATIONS ........................................................................................ 84
CHAPTER 16 TEACHING EVIDENCE-BASED PRACTICE IN ACADEMIC SETTINGS...................................... 89
CHAPTER 17 TEACHING EVIDENCE-BASED PRACTICE IN CLINICAL SETTINGS ......................................... 95
CHAPTER 18 ARCC EVIDENCE-BASED PRACTICE MENTORS: THE KEY TO SUSTAINING EVIDENCE-BASED
PRACTICE ............................................................................................................................................... 100
CHAPTER 19 USING EVIDENCE TO INFLUENCE HEALTH AND ORGANIZATIONAL POLICY..................... 105
CHAPTER 20 DISSEMINATING EVIDENCE THROUGH PRESENTATIONS, PUBLICATIONS, HEALTH POLICY
BRIEFS, AND THE MEDIA ....................................................................................................................... 111
CHAPTER 21 GENERATING EVIDENCE THROUGH QUANTITATIVE AND QUALITATIVE RESEARCH ....... 117
CHAPTER 22 WRITING A SUCCESSFUL GRANT PROPOSAL TO FUND RESEARCH AND EVIDENCE-BASED
PRACTICE IMPLEMENTATION PROJECT ................................................................................................ 122
CHAPTER 23 ETHICAL CONSIDERATIONS FOR EVIDENCE IMPLEMENTATION AND EVIDENCE
GENERATION ......................................................................................................................................... 128
,CHAPTER 1 MAKING THE CASE FOR EVIDENCE-BASED PRACTICE AND CULTIVATING A SPIRIT OF INQUIRY
1. IN THE HOSPITAL WHERE NURSE L. PROVIDES CARE, TRADITION DICTATES THAT ORAL
TEMPERATURES BE INCLUDED IN EVERY SET OF PATIENT VITAL SIGNS, REGARDLESS OF PATIENT
DIAGNOSIS OR ACUITY. THIS IS MOST LIKELY AN EXAMPLE OF WHICH OF THE FOLLOWING
PHENOMENA?
A) THE PRIORITIZATION OF INTERNAL EVIDENCE OVER EXTERNAL EVIDENCE
B) PRACTICE THAT LACKS EVIDENCE TO SUPPORT ITS APPLICATION
C) THE INTEGRATION OF PERSONAL EXPERTISE INTO NURSING CARE
D) EVIDENCE-BASED PRACTICE
2. THE CLINICAL NURSE EDUCATOR (CNE) ON A POSTSURGICAL UNIT HAS RECENTLY COMPLETED A
PATIENT CHART REVIEW AFTER THE IMPLEMENTATION OF A PILOT PROGRAM AIMED AT PROMOTING
EARLY AMBULATION FOLLOWING SURGERY. WHICH OF THE FOLLOWING COMPONENTS OF EBP IS THE
NURSE PUTTING INTO PRACTICE?
A) PATIENT PREFERENCES
B) RESEARCH UTILIZATION
C) EXPERIENCE
D) INTERNAL EVIDENCE
3. NURSE R. HAS OBSERVED THAT REORIENTING DEMENTED PATIENTS AS FREQUENTLY AS
POSSIBLE TENDS TO MINIMIZE THE PATIENTS' LEVEL OF AGITATION IN THE EVENING. THE NURSE HAS
SHARED THIS OBSERVATION WITH A COLLEAGUE, WHO IS SKEPTICAL, STATING THAT, “IT'S BEST TO
STICK TO EVIDENCE-BASED PRACTICE.” HOW CAN NURSE R. BEST RESPOND?
A) “EBP CAN INCLUDE CLINICIANS' PERSONAL EXPERTISE.”
B) “PERSONAL EXPERIENCE IS OFTEN MORE SOUND THAN FORMAL EVIDENCE-BASED PRACTICE.”
C) “TRADITIONAL PRACTICE AND EBP ARE USUALLY SHOWN TO BE THE SAME.”
D) “MY YEARS OF EXPERIENCE CAN BE JUST AS VALUABLE AS ANY LITERATURE REVIEW OR
RANDOMIZED TRIAL.”
, 4. WHICH OF THE FOLLOWING FACTORS PROVIDES THE MOST IMPORTANT RATIONALE FOR THE
CONSISTENT IMPLEMENTATION OF EBP?
A) EBP PROVIDES FOR THE MOST COST-EFFECTIVE PATIENT CARE.
B) EBP IS ACCESSIBLE TO ALL HEALTHCARE CLINICIANS.
C) EBP PROVIDES CONSISTENCY IN CARE ACROSS HEALTHCARE SETTINGS.
D) EBP IMPROVES PATIENT OUTCOMES.
5. THE INSTITUTE OF MEDICINE'S ROUNDTABLE ON EVIDENCE-BASED MEDICINE HAS BEEN
ESTABLISHED TO ADDRESS EBP. WHICH OF THE FOLLOWING ISSUES IS THE ROUNDTABLE EMPHASIZING?
A) ENSURING THAT EXTERNAL EVIDENCE, RATHER THAN INTERNAL EVIDENCE, IS INTEGRATED INTO
CARE
B) FOSTERING THE LEVEL OF LEARNING THAT EXISTS IN THE AMERICAN HEALTHCARE SYSTEM
C) ISSUING CLINICAL GUIDELINES TO ENSURE BEST NURSING PRACTICE
D) COMPARING THE IMPLEMENTATION OF EBP IN THE UNITED STATES WITH THAT OF OTHER
WESTERN COUNTRIES
6. YOU HAVE BECOME FRUSTRATED WITH SOME ASPECTS OF PATIENT CARE THAT YOU BELIEVE
ARE OUTDATED AND INEFFECTIVE AT THE LONG-TERM CARE FACILITY WHERE YOU HAVE RECENTLY
BEGUN PRACTICING. CONSEQUENTLY, YOU HAVE RESOLVED TO EXAMINE SOME OF THESE PRACTICES IN
LIGHT OF EVIDENCE. WHICH OF THE FOLLOWING SHOULD OCCUR FIRST IN THE STEPS OF EBP?
A) CONDUCTING AN ELECTRONIC SEARCH OF THE LITERATURE AND RANKING INDIVIDUAL
SOURCES
B) CREATING “BUY-IN” FROM THE OTHER CLINICIANS WHO PROVIDE CARE AT THE FACILITY
C) DEVELOPING AN INQUISITIVE AND CURIOUS MINDSET
D) ASSESSING WHETHER THE PRACTICES IN QUESTION MAY, IN FACT, BE EVIDENCE-BASED
7. WHICH OF THE FOLLOWING CLINICAL QUESTIONS BEST EXEMPLIFIES THE PICOT FORMAT?
