Evidence-Based Practice in Nursing & Healthcare
5th Edition by Melnyk, Chapters 1 – 23
TEST BANK
,Contents
CHAPTER 1 Making the Case for Evidence-Based Practice and Cultivating a Spirit of
Inquiry ........................................................................................................................................... 4
CHAPTER 2 Asking Compelling Clinical Questions ............................................................... 13
CHAPTER 3 Finding Relevant Evidence to Answer Clinical Questions............................... 21
CHAPTER 4 Critically Appraising Knowledge for Clinical Decision Making ...................... 29
CHAPTER 5 Critically Appraising Quantitative Evidence for Clinical Decision Making ... 38
CHAPTER 6 Critically Appraising Qualitative Evidence for Clinical Decision Making ...... 44
Chapter 7: Integration Of Patient Preferences And Values And Clinician Expertise Into
Evidence-Based Decision Making ........................................................................................... 53
Chapter 8: Advancing Optimal Care With Robust Clinical Practice Guidelines ............... 63
Chapter 9: Implementing Evidence In Clinical Settings ...................................................... 72
CHAPTER 10 The Role of Outcomes and Evidence-Based Quality Improvement in
Enhancing and Evaluating Practice ........................................................................................ 81
CHAPTER 11 Implementing the Evidence-Based Practice Competencies in Clinical and
Academic Settings ..................................................................................................................... 88
CHAPTER 12 Leadership Strategies for Creating and Sustaining EBP Organizations .... 94
CHAPTER 13 Innovation and Evidence: A Partnership in Advancing Best Practice ...... 100
CHAPTER 14 Models to Guide Implementation and Sustainability of Evidence-Based
Practice...................................................................................................................................... 107
,CHAPTER 15 Creating a Vision and Motivating a Change to Evidence-Based Practice in
Individuals, Teams, and Organizations ................................................................................ 114
CHAPTER 16 Teaching Evidence-Based Practice in Academic Settings .......................... 119
CHAPTER 17 Teaching Evidence-Based Practice in Clinical Settings ............................... 125
CHAPTER 18: ARCC Evidence-Based Practice Mentors: The Key to Sustaining Evidence-
Based Practice .......................................................................................................................... 131
CHAPTER 19: Using Evidence to Influence Health and Organizational Policy ............... 138
CHAPTER 20: Disseminating Evidence Through Presentations, Publications, Health
Policy Briefs, and the Media .................................................................................................. 145
CHAPTER 21: Generating Evidence Through Quantitative and Qualitative Research.. 152
CHAPTER 22 Writing a Successful Grant Proposal to Fund Research and Evidence-
Based Practice Implementation Project .............................................................................. 158
CHAPTER 23 Ethical Considerations for Evidence Implementation and Evidence
Generation................................................................................................................................ 171
,────────────────────────────────────────────────────────────
───────────
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
Answer: B
Expert-Verified Explanation:
• Many facilities continue doing things a certain way simply because it has “always been
done.” When a practice is upheld only by tradition rather than by research studies or up-
to-date clinical data, it is quite likely lacking evidence for its effectiveness.
• Choice B directly states that this is “practice that lacks evidence to support its
application,” which fits the situation.
• Choice A would imply that the clinicians used local hospital data or unanimous
expertise at the expense of external data. However, in this question, it is simply a matter of
doing something out of habit, so it is not truly “prioritizing internal evidence.”
• Choice C would suggest that personal clinical judgment or advanced expertise formed
the basis for a unique modification to care, which is not indicated here.
• Choice D is incorrect because evidence-based practice explicitly integrates current best
evidence with clinical expertise and patient preferences. The scenario mentions no such
process.
,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
Answer: D
Expert-Verified Explanation:
• Internal evidence includes data from your own organization, such as chart reviews, QI
outcomes, and locally gathered information about patient outcomes. The CNE is explicitly
reviewing charts from their unit to assess the impact of the ambulation pilot.
• Choice A (patient preferences) relates more to patient choices and values, which is not
the main focus in this scenario.
• Choice B (research utilization) typically involves applying findings from published
research directly, whereas the question focuses on reviewing unit-generated data.
• Choice C (experience) refers mainly to the clinicians’ personal expertise, rather than a
systematic chart review or outcome data.
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: “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.”
Answer: A
Expert-Verified Explanation:
, • Evidence-based practice consists of three main pillars: (1) the best research evidence,
(2) clinical expertise, and (3) patient preferences. Option A reinforces that point by
clarifying that EBP is not solely about journal articles; it also accommodates the wisdom
gained from real-world practice.
• Choice B is too sweeping: personal experience alone does not necessarily “outweigh”
formal EBP.
• Choice C is incorrect because traditional practice, done without current data, is distinct
from fully adopting EBP.
• Choice D overstates the role of personal experience and suggests it could be equal on
its own to all scientific evidence, which is not how EBP is structured.
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.
Answer: D
Expert-Verified Explanation:
• The primary and overarching goal of EBP is improved patient outcomes. While cost
savings and consistency are benefits, the evidence-based approach aims first and
foremost to ensure that patients receive the safest, most effective care possible.
• Choices A, B, and C do mention important advantages of EBP, but they do not trump
the objective of better outcomes for patients.
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
, Answer: B
Expert-Verified Explanation:
• The Institute of Medicine (IOM) Roundtable focuses on creating a continuously learning
healthcare system—one that readily learns from evidence and applies that knowledge.
This fosters higher skill levels among clinicians and improved patient care.
• Choice A is too narrow; the IOM Roundtable does not specifically exclude internal
evidence; it encourages the use of all relevant evidence.
• Choice C is incorrect because the Roundtable’s role is broader than issuing specific
guidelines.
• Choice D is not the Roundtable’s principal mission; their primary emphasis is on
transforming the U.S. healthcare system from within, not primarily on international
comparisons.
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 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
Answer: C
Expert-Verified Explanation:
• The starting point for EBP is “cultivating a spirit of inquiry,” or developing a
questioning attitude. Nurses must become curious and ask, “Is there a better way to do
this, based on evidence and best practices?”
• Choices A, B, and D are subsequent steps. One must become inquisitive first, and then
form a PICOT question, search literature, and engage colleagues.
7) Which of the following clinical questions best exemplifies the PICOT format?
A) What effect does parents’ smoking have on the smoking habits of their children, ages
13 to 16?
, B) Among cancer patients, what role does meditation, rather than benzodiazepines, have
on anxiety levels during the 7 days following hospital admission?
C) Among undergraduate college 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 gonorrheal and chlamydial infections reported to the campus medical
center?
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to a
numeric rating scale in the emergency room context?
Answer: B
Expert-Verified Explanation:
• A PICOT question should clearly identify the Population, Intervention, Comparison,
Outcome, and Time (PICOT). In Option B:
– P (Population): Cancer patients
– I (Intervention): Meditation
– C (Comparison): Benzodiazepines
– O (Outcome): Anxiety levels
– T (Time): During the 7 days following hospital admission
• Choice A lacks a clear intervention and timeframe.
• Choice C has an intervention (sexual health campaign) and measure (infection rate),
but is less explicit about comparison.
• Choice D does not clearly denote a timeframe or a distinct outcome beyond
“effectiveness.”
8) After formulating a clinical question, a nurse has proceeded to search for evidence on
ways to foster restful sleep in patients receiving care in the ICU. The nurse has identified a
relevant meta-analysis in an electronic database. What will this source of evidence consist
of?
A) A statistical summary of the results from several different studies
B) An examination of the theoretical and conceptual underpinnings of the issue
C) An interdisciplinary analysis of the clinical question
D) A qualitative study of different interventions related to the clinical question
Answer: A
, Expert-Verified Explanation:
• A meta-analysis is a quantitative synthesis that pools data from multiple studies and
then conducts a statistical analysis of their combined results.
• Choice B would be more characteristic of a conceptual paper or theoretical review.
• Choice C (“interdisciplinary analysis”) could describe certain integrative reviews, but
not necessarily a meta-analysis.
• Choice D describes a single qualitative study, whereas meta-analyses usually involve
quantitative data from multiple trials.
9) The nurses on a postpartum unit have noted that many primiparous (first-time)
mothers are giving up on breastfeeding within 24 hours following delivery, and they want
to create uniform guidelines for promoting breastfeeding on the unit. Which of the
following sources is most likely to provide the best evidence in their quest for an
intervention?
A) Evidence from a randomized control trial that had more than 2500 participants
B) Evidence from a study that is widely regarded as a classic within the obstetrical
nursing community
C) Evidence from a systematic review of breastfeeding-promotion studies that one of the
nurses identified in an electronic database
D) The consensus opinion of the most senior nurses on the unit
Answer: C
Expert-Verified Explanation:
• A systematic review synthesizes findings from multiple high-quality studies, providing a
stronger level of evidence than a single study or an expert opinion.
• Choice A can be significant, but one large RCT alone may not encompass all the
research on the subject, whereas a systematic review integrates multiple studies.
• Choice B might be outdated or less comprehensive than a recent systematic review.
• Choice D, while valuable for practical insights, amounts to anecdotal or expert opinion,
which is weaker evidence compared to systematic reviews.
10) The nurse educator on an acute medicine unit is advocating for the use of evidence-
based clinical practice guidelines on wound care in order to standardize and optimize
nurses’ practice. Which of the following statements best describes clinical practice
guidelines?
, A) The result of replication studies of existing research by an impartial third party
B) A collection of authorized interventions that are required by law
C) A number of interventions that are the result of a large, publicly funded RCT
D) A group of practice recommendations that result from a rigorous review of the
literature
Answer: D
Expert-Verified Explanation:
• Clinical practice guidelines are systematically developed statements or
recommendations that incorporate a careful review of the best available evidence in a
given area of healthcare.
• Choice A focuses on replicated research by third parties but does not necessarily
describe guidelines in general.
• Choice B is inaccurate because guidelines are not laws (though some organizations will
strongly recommend them).
• Choice C is too narrow, as guidelines typically arise from multiple studies and analyses,
not solely from one large RCT.
11) A nurse is conducting a literature review on the evidence regarding the use of vacuum
dressings on stage IV pressure ulcers. After locating a recent study that appears to be
relevant, which of the following questions would the nurse consider first when critically
appraising the study?
A) “Are the findings of this study cost-effective in our clinical context?”
B) “How would the implementation of this intervention affect our staffing needs?”
C) “Were the patients in the study similar to the patients on my unit?”
D) “Are the findings of the study significantly different from what we are currently doing
on the unit?”
Answer: C
Expert-Verified Explanation:
• Critical appraisal often starts by determining how well the study population and setting
match your own practice environment. If the patients in the study differ drastically, the
results may not be transferable.
5th Edition by Melnyk, Chapters 1 – 23
TEST BANK
,Contents
CHAPTER 1 Making the Case for Evidence-Based Practice and Cultivating a Spirit of
Inquiry ........................................................................................................................................... 4
CHAPTER 2 Asking Compelling Clinical Questions ............................................................... 13
CHAPTER 3 Finding Relevant Evidence to Answer Clinical Questions............................... 21
CHAPTER 4 Critically Appraising Knowledge for Clinical Decision Making ...................... 29
CHAPTER 5 Critically Appraising Quantitative Evidence for Clinical Decision Making ... 38
CHAPTER 6 Critically Appraising Qualitative Evidence for Clinical Decision Making ...... 44
Chapter 7: Integration Of Patient Preferences And Values And Clinician Expertise Into
Evidence-Based Decision Making ........................................................................................... 53
Chapter 8: Advancing Optimal Care With Robust Clinical Practice Guidelines ............... 63
Chapter 9: Implementing Evidence In Clinical Settings ...................................................... 72
CHAPTER 10 The Role of Outcomes and Evidence-Based Quality Improvement in
Enhancing and Evaluating Practice ........................................................................................ 81
CHAPTER 11 Implementing the Evidence-Based Practice Competencies in Clinical and
Academic Settings ..................................................................................................................... 88
CHAPTER 12 Leadership Strategies for Creating and Sustaining EBP Organizations .... 94
CHAPTER 13 Innovation and Evidence: A Partnership in Advancing Best Practice ...... 100
CHAPTER 14 Models to Guide Implementation and Sustainability of Evidence-Based
Practice...................................................................................................................................... 107
,CHAPTER 15 Creating a Vision and Motivating a Change to Evidence-Based Practice in
Individuals, Teams, and Organizations ................................................................................ 114
CHAPTER 16 Teaching Evidence-Based Practice in Academic Settings .......................... 119
CHAPTER 17 Teaching Evidence-Based Practice in Clinical Settings ............................... 125
CHAPTER 18: ARCC Evidence-Based Practice Mentors: The Key to Sustaining Evidence-
Based Practice .......................................................................................................................... 131
CHAPTER 19: Using Evidence to Influence Health and Organizational Policy ............... 138
CHAPTER 20: Disseminating Evidence Through Presentations, Publications, Health
Policy Briefs, and the Media .................................................................................................. 145
CHAPTER 21: Generating Evidence Through Quantitative and Qualitative Research.. 152
CHAPTER 22 Writing a Successful Grant Proposal to Fund Research and Evidence-
Based Practice Implementation Project .............................................................................. 158
CHAPTER 23 Ethical Considerations for Evidence Implementation and Evidence
Generation................................................................................................................................ 171
,────────────────────────────────────────────────────────────
───────────
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
Answer: B
Expert-Verified Explanation:
• Many facilities continue doing things a certain way simply because it has “always been
done.” When a practice is upheld only by tradition rather than by research studies or up-
to-date clinical data, it is quite likely lacking evidence for its effectiveness.
• Choice B directly states that this is “practice that lacks evidence to support its
application,” which fits the situation.
• Choice A would imply that the clinicians used local hospital data or unanimous
expertise at the expense of external data. However, in this question, it is simply a matter of
doing something out of habit, so it is not truly “prioritizing internal evidence.”
• Choice C would suggest that personal clinical judgment or advanced expertise formed
the basis for a unique modification to care, which is not indicated here.
• Choice D is incorrect because evidence-based practice explicitly integrates current best
evidence with clinical expertise and patient preferences. The scenario mentions no such
process.
,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
Answer: D
Expert-Verified Explanation:
• Internal evidence includes data from your own organization, such as chart reviews, QI
outcomes, and locally gathered information about patient outcomes. The CNE is explicitly
reviewing charts from their unit to assess the impact of the ambulation pilot.
• Choice A (patient preferences) relates more to patient choices and values, which is not
the main focus in this scenario.
• Choice B (research utilization) typically involves applying findings from published
research directly, whereas the question focuses on reviewing unit-generated data.
• Choice C (experience) refers mainly to the clinicians’ personal expertise, rather than a
systematic chart review or outcome data.
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: “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.”
Answer: A
Expert-Verified Explanation:
, • Evidence-based practice consists of three main pillars: (1) the best research evidence,
(2) clinical expertise, and (3) patient preferences. Option A reinforces that point by
clarifying that EBP is not solely about journal articles; it also accommodates the wisdom
gained from real-world practice.
• Choice B is too sweeping: personal experience alone does not necessarily “outweigh”
formal EBP.
• Choice C is incorrect because traditional practice, done without current data, is distinct
from fully adopting EBP.
• Choice D overstates the role of personal experience and suggests it could be equal on
its own to all scientific evidence, which is not how EBP is structured.
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.
Answer: D
Expert-Verified Explanation:
• The primary and overarching goal of EBP is improved patient outcomes. While cost
savings and consistency are benefits, the evidence-based approach aims first and
foremost to ensure that patients receive the safest, most effective care possible.
• Choices A, B, and C do mention important advantages of EBP, but they do not trump
the objective of better outcomes for patients.
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
, Answer: B
Expert-Verified Explanation:
• The Institute of Medicine (IOM) Roundtable focuses on creating a continuously learning
healthcare system—one that readily learns from evidence and applies that knowledge.
This fosters higher skill levels among clinicians and improved patient care.
• Choice A is too narrow; the IOM Roundtable does not specifically exclude internal
evidence; it encourages the use of all relevant evidence.
• Choice C is incorrect because the Roundtable’s role is broader than issuing specific
guidelines.
• Choice D is not the Roundtable’s principal mission; their primary emphasis is on
transforming the U.S. healthcare system from within, not primarily on international
comparisons.
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 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
Answer: C
Expert-Verified Explanation:
• The starting point for EBP is “cultivating a spirit of inquiry,” or developing a
questioning attitude. Nurses must become curious and ask, “Is there a better way to do
this, based on evidence and best practices?”
• Choices A, B, and D are subsequent steps. One must become inquisitive first, and then
form a PICOT question, search literature, and engage colleagues.
7) Which of the following clinical questions best exemplifies the PICOT format?
A) What effect does parents’ smoking have on the smoking habits of their children, ages
13 to 16?
, B) Among cancer patients, what role does meditation, rather than benzodiazepines, have
on anxiety levels during the 7 days following hospital admission?
C) Among undergraduate college 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 gonorrheal and chlamydial infections reported to the campus medical
center?
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to a
numeric rating scale in the emergency room context?
Answer: B
Expert-Verified Explanation:
• A PICOT question should clearly identify the Population, Intervention, Comparison,
Outcome, and Time (PICOT). In Option B:
– P (Population): Cancer patients
– I (Intervention): Meditation
– C (Comparison): Benzodiazepines
– O (Outcome): Anxiety levels
– T (Time): During the 7 days following hospital admission
• Choice A lacks a clear intervention and timeframe.
• Choice C has an intervention (sexual health campaign) and measure (infection rate),
but is less explicit about comparison.
• Choice D does not clearly denote a timeframe or a distinct outcome beyond
“effectiveness.”
8) After formulating a clinical question, a nurse has proceeded to search for evidence on
ways to foster restful sleep in patients receiving care in the ICU. The nurse has identified a
relevant meta-analysis in an electronic database. What will this source of evidence consist
of?
A) A statistical summary of the results from several different studies
B) An examination of the theoretical and conceptual underpinnings of the issue
C) An interdisciplinary analysis of the clinical question
D) A qualitative study of different interventions related to the clinical question
Answer: A
, Expert-Verified Explanation:
• A meta-analysis is a quantitative synthesis that pools data from multiple studies and
then conducts a statistical analysis of their combined results.
• Choice B would be more characteristic of a conceptual paper or theoretical review.
• Choice C (“interdisciplinary analysis”) could describe certain integrative reviews, but
not necessarily a meta-analysis.
• Choice D describes a single qualitative study, whereas meta-analyses usually involve
quantitative data from multiple trials.
9) The nurses on a postpartum unit have noted that many primiparous (first-time)
mothers are giving up on breastfeeding within 24 hours following delivery, and they want
to create uniform guidelines for promoting breastfeeding on the unit. Which of the
following sources is most likely to provide the best evidence in their quest for an
intervention?
A) Evidence from a randomized control trial that had more than 2500 participants
B) Evidence from a study that is widely regarded as a classic within the obstetrical
nursing community
C) Evidence from a systematic review of breastfeeding-promotion studies that one of the
nurses identified in an electronic database
D) The consensus opinion of the most senior nurses on the unit
Answer: C
Expert-Verified Explanation:
• A systematic review synthesizes findings from multiple high-quality studies, providing a
stronger level of evidence than a single study or an expert opinion.
• Choice A can be significant, but one large RCT alone may not encompass all the
research on the subject, whereas a systematic review integrates multiple studies.
• Choice B might be outdated or less comprehensive than a recent systematic review.
• Choice D, while valuable for practical insights, amounts to anecdotal or expert opinion,
which is weaker evidence compared to systematic reviews.
10) The nurse educator on an acute medicine unit is advocating for the use of evidence-
based clinical practice guidelines on wound care in order to standardize and optimize
nurses’ practice. Which of the following statements best describes clinical practice
guidelines?
, A) The result of replication studies of existing research by an impartial third party
B) A collection of authorized interventions that are required by law
C) A number of interventions that are the result of a large, publicly funded RCT
D) A group of practice recommendations that result from a rigorous review of the
literature
Answer: D
Expert-Verified Explanation:
• Clinical practice guidelines are systematically developed statements or
recommendations that incorporate a careful review of the best available evidence in a
given area of healthcare.
• Choice A focuses on replicated research by third parties but does not necessarily
describe guidelines in general.
• Choice B is inaccurate because guidelines are not laws (though some organizations will
strongly recommend them).
• Choice C is too narrow, as guidelines typically arise from multiple studies and analyses,
not solely from one large RCT.
11) A nurse is conducting a literature review on the evidence regarding the use of vacuum
dressings on stage IV pressure ulcers. After locating a recent study that appears to be
relevant, which of the following questions would the nurse consider first when critically
appraising the study?
A) “Are the findings of this study cost-effective in our clinical context?”
B) “How would the implementation of this intervention affect our staffing needs?”
C) “Were the patients in the study similar to the patients on my unit?”
D) “Are the findings of the study significantly different from what we are currently doing
on the unit?”
Answer: C
Expert-Verified Explanation:
• Critical appraisal often starts by determining how well the study population and setting
match your own practice environment. If the patients in the study differ drastically, the
results may not be transferable.
