Test Bank For Evidence-Based Practice in Nursing & Healthcare A
l l l l l l l l l
Guide to Best Practice 5th Edition
l l l l l l
by Bernadette Mazurek Melnyk, Ellen Fineout-Overholt
l l l l l
Chapter 1 - 23 Complete
l l l l
,Chapter 1 Making the Case for Evidence-Based Practice and
l l l l l l l l
Cultivating a Spirit of Inquiry l l l l l
In the hospital where Nurse L. provides care, tradition dictates that oral temperatures be
l l l l l l l l l l l l l
included in every set of patient vital signs, regardless of patient diagnosis or acuity. Thisis
l l l l l l l l l l l l l l l l
most likely an example of which of the following phenomena? l l l l l l l l l l
A) The prioritization of internal evidence over external evidence
l l l l l l l
B) Practice that lacks evidence to support its application l l l l l l l
C) The integration of personal expertise into nursing care
l l l l l l l
D) Evidence-based practice l
2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a
l l l l l l l l l l l l
patient chart review after the implementation of a pilot program aimed at promoting
l l l l l l l l l l l l l
early ambulation following surgery. Which of the following components of EBP is
l l l l l l l l l l l l
thenurse putting into practice?
l l l l l
A) Patient preferences l
B) Research utilization l
C) Experience
D) Internal evidence l
3. Nurse R. has observed that reorienting demented patients as frequently as possible
l l l l l l l l l l l
tendsto minimize the patients' level of agitation in the evening. The nurse has shared this
l l l l l l l l l l l l l l l l
observation with a colleague, who is skeptical, stating that, “It's best to stick to evidence-
l l l l l l l l l l l l l l l
based practice.” How can Nurse R. best respond?
l l l l l l l
A) “EBP can include clinicians' personal expertise.” l l l l l
B) “Personal experience is often more sound than formal evidence-based practice.” l l l l l l l l l
C) “Traditional practice and EBP are usually shown to be the same.” l l l l l l l l l l
D) “My years of experience can be just as valuable as any literature review
l l l l l l l l l l l l
orrandomized trial.”
l l l
4. Which of the following factors provides the most important rationale for the
l l l l l l l l l l l
consistentimplementation of EBP?
l l l l
A) EBP provides for the most cost-effective patient care. l l l l l l l
B) EBP is accessible to all healthcare clinicians. l l l l l l
C) EBP provides consistency in care across healthcare settings. l l l l l l l
D) EBP improves patient outcomes. l l l
,5. The Institute of Medicine's Roundtable on Evidence-Based Medicine has
l l l l l l l l
beenestablished to address EBP. Which of the following issues is the
l l l l l l l l l l l l
Roundtable emphasizing?
l l
A) Ensuring that external evidence, rather than internal evidence, is integrated l l l l l l l l l
intocare
l l
B) Fostering the level of learning that exists in the American healthcare system l l l l l l l l l l l
C) Issuing clinical guidelines to ensure best nursing practice l l l l l l l
D) Comparing the implementation of EBP in the United States with that of l l l l l l l l l l l
otherWestern countries
l l l
6. You have become frustrated with some aspects of patient care that you believe are
l l l l l l l l l l l l l
outdated and ineffective at the long-term care facility where you have recently begun
l l l l l l l l l l l l l
practicing. Consequently, you have resolved to examine some of these practices in
l l l l l l l l l l l l
lightof evidence. Which of the following should occur first in the steps of EBP?
l l l l l l l l l l l l l l l
A) Conducting an electronic search of the literature and ranking individual sources l l l l l l l l l l
B) Creating “buy-in” from the other clinicians who provide care at the facility l l l l l l l l l l l
C) Developing an inquisitive and curious mindset l l l l l
D) Assessing whether the practices in question may, in fact, be evidence-based l l l l l l l l l l
7. Which of the following clinical questions best exemplifies the PICOT format?
l l l l l l l l l l
A) What effect does parents' smoking have on the smoking habits of their
l l l l l l l l l l l
children,ages 13 to 16?
l l l l l
B) Among cancer patients, what role does meditation, rather than l l l l l l l l
benzodiazepines,have on anxiety levels during the 7 days following hospital
l l l l l l l l l l l
admission?
l
C) Among undergraduate college students, what is the effectiveness of a sexual l l l l l l l l l l
healthcampaign undertaken during the first 4 weeks of the fall semester as measured
l l l l l l l l l l l l l l
by incidence of new gonorrheal and chlamydial infections reported to the campus
l l l l l l l l l l l l
medical center?
l l
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to
l l l l l l l l l l l l l l l l
anumeric rating scale in the emergency room context?
l l l l l l l l l
8. After formulating a clinical question, a nurse has proceeded to search for evidence for
l l l l l l l l l l l l l
ways to foster restful sleep in patients who are receiving care in the intensive care unit
l l l l l l l l l l l l l l l l
(ICU). The nurse has identified a relevant meta-analysis in an electronic database.
l l l l l l l l l l l l
Whatwill this source of evidence consist of?
l l l l l l l l
A) A statistical summary of the results from several different studies
l l l l l l l l l
B) An examination of the theoretical and conceptual underpinnings of the issue
l l l l l l l l l l
C) An interdisciplinary analysis of the clinical question
l l l l l l
D) A qualitative study of different interventions related to the clinical question
l l l l l l l l l l
, 9. The nurses on a postpartum unit have noted that many primiparous (first-time) mothers
l l l l l l l l l l l l
are giving up on breastfeeding within the 24 hours following delivery, and the nurses
l l l l l l l l l l l l l l
want to create uniform guidelines for promoting breastfeeding on the unit. Which of
l l l l l l l l l l l l l
thefollowing sources is most likely to provide the best evidence in their quest for an
l l l l l l l l l l l l l l l l
intervention?
l
A) Evidence from a randomized control trial that had more than 2500 participants l l l l l l l l l l l
B) Evidence from a study that is widely regarded as a classic within the l l l l l l l l l l l l
obstetricalnursing community
l l l
C) Evidence from a systematic review of breastfeeding-promotion studies that one l l l l l l l l l
ofthe nurses identified in an electronic database
l l l l l l l l
D) The consensus opinion of the most senior nurses on the unit
l l l l l l l l l l
10. The nurse educator on an acute medicine unit is advocating for the use of
l l l l l l l l l l l l l
evidence-based clinical practice guidelines on wound care in order to standardize and l l l l l l l l l l l
optimize the practice of the nurses on the unit. Which of the following statements
l l l l l l l l l l l l l l
bestdescribes clinical practice guidelines?
l l l l l
A) The result of replication studies of existing research by an impartial third party
l l l l l l l l l l l l
B) A collection of authorized interventions that are required by law
l l l l l l l l l
C) A number of interventions that are the result of a large, publically-funded RCT
l l l l l l l l l l l l
D) A group of practice recommendations that result from a rigorous review of
l l l l l l l l l l l
theliterature l l
11. A nurse is conducting a literature review on the evidence regarding the use of vacuum
l l l l l l l l l l l l l l
dressings on stage IV pressure ulcers. After locating a recent study that appears to be
l l l l l l l l l l l l l l l
relevant, which of the following questions would the nurse consider first when
l l l l l l l l l l l l
criticallyappraising the study?
l l l l
A) “Are the findings of this study cost-effective in our clinical context?”
l l l l l l l l l l
B) "How would the implementation of this intervention affect our staffing needs?"
l l l l l l l l l l
C) “Were the patients in the study similar to the patients on my unit?” l l l l l l l l l l l l
D) “Are the findings of the study significantly different from what we are
l l l l l l l l l l l
currentlydoing on the unit?
l l l l l
12. The primary care provider of a 49-year-old male patient has examined and briefly
l l l l l l l l l l l l
explained the evidence that supports beginning regular digital-rectal exams. Which
l l l l l l l l l l
ofthe following factors would justify not performing digital-rectal examinations in this
l l l l l l l l l l l l
patient's care?
l l
A) The patient is vehemently opposed to undergoing a digital-rectal exam.
l l l l l l l l l
B) Clinical practice guidelines for prostate care have not been published. l l l l l l l l l
C) The clinician has been unable to find any large RCTs in a literature review.
l l l l l l l l l l l l l
D) The clinician has previously waited until patients are 55 to begin
l l l l l l l l l l
regulardigital-rectal exams.
l l l
l l l l l l l l l
Guide to Best Practice 5th Edition
l l l l l l
by Bernadette Mazurek Melnyk, Ellen Fineout-Overholt
l l l l l
Chapter 1 - 23 Complete
l l l l
,Chapter 1 Making the Case for Evidence-Based Practice and
l l l l l l l l
Cultivating a Spirit of Inquiry l l l l l
In the hospital where Nurse L. provides care, tradition dictates that oral temperatures be
l l l l l l l l l l l l l
included in every set of patient vital signs, regardless of patient diagnosis or acuity. Thisis
l l l l l l l l l l l l l l l l
most likely an example of which of the following phenomena? l l l l l l l l l l
A) The prioritization of internal evidence over external evidence
l l l l l l l
B) Practice that lacks evidence to support its application l l l l l l l
C) The integration of personal expertise into nursing care
l l l l l l l
D) Evidence-based practice l
2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a
l l l l l l l l l l l l
patient chart review after the implementation of a pilot program aimed at promoting
l l l l l l l l l l l l l
early ambulation following surgery. Which of the following components of EBP is
l l l l l l l l l l l l
thenurse putting into practice?
l l l l l
A) Patient preferences l
B) Research utilization l
C) Experience
D) Internal evidence l
3. Nurse R. has observed that reorienting demented patients as frequently as possible
l l l l l l l l l l l
tendsto minimize the patients' level of agitation in the evening. The nurse has shared this
l l l l l l l l l l l l l l l l
observation with a colleague, who is skeptical, stating that, “It's best to stick to evidence-
l l l l l l l l l l l l l l l
based practice.” How can Nurse R. best respond?
l l l l l l l
A) “EBP can include clinicians' personal expertise.” l l l l l
B) “Personal experience is often more sound than formal evidence-based practice.” l l l l l l l l l
C) “Traditional practice and EBP are usually shown to be the same.” l l l l l l l l l l
D) “My years of experience can be just as valuable as any literature review
l l l l l l l l l l l l
orrandomized trial.”
l l l
4. Which of the following factors provides the most important rationale for the
l l l l l l l l l l l
consistentimplementation of EBP?
l l l l
A) EBP provides for the most cost-effective patient care. l l l l l l l
B) EBP is accessible to all healthcare clinicians. l l l l l l
C) EBP provides consistency in care across healthcare settings. l l l l l l l
D) EBP improves patient outcomes. l l l
,5. The Institute of Medicine's Roundtable on Evidence-Based Medicine has
l l l l l l l l
beenestablished to address EBP. Which of the following issues is the
l l l l l l l l l l l l
Roundtable emphasizing?
l l
A) Ensuring that external evidence, rather than internal evidence, is integrated l l l l l l l l l
intocare
l l
B) Fostering the level of learning that exists in the American healthcare system l l l l l l l l l l l
C) Issuing clinical guidelines to ensure best nursing practice l l l l l l l
D) Comparing the implementation of EBP in the United States with that of l l l l l l l l l l l
otherWestern countries
l l l
6. You have become frustrated with some aspects of patient care that you believe are
l l l l l l l l l l l l l
outdated and ineffective at the long-term care facility where you have recently begun
l l l l l l l l l l l l l
practicing. Consequently, you have resolved to examine some of these practices in
l l l l l l l l l l l l
lightof evidence. Which of the following should occur first in the steps of EBP?
l l l l l l l l l l l l l l l
A) Conducting an electronic search of the literature and ranking individual sources l l l l l l l l l l
B) Creating “buy-in” from the other clinicians who provide care at the facility l l l l l l l l l l l
C) Developing an inquisitive and curious mindset l l l l l
D) Assessing whether the practices in question may, in fact, be evidence-based l l l l l l l l l l
7. Which of the following clinical questions best exemplifies the PICOT format?
l l l l l l l l l l
A) What effect does parents' smoking have on the smoking habits of their
l l l l l l l l l l l
children,ages 13 to 16?
l l l l l
B) Among cancer patients, what role does meditation, rather than l l l l l l l l
benzodiazepines,have on anxiety levels during the 7 days following hospital
l l l l l l l l l l l
admission?
l
C) Among undergraduate college students, what is the effectiveness of a sexual l l l l l l l l l l
healthcampaign undertaken during the first 4 weeks of the fall semester as measured
l l l l l l l l l l l l l l
by incidence of new gonorrheal and chlamydial infections reported to the campus
l l l l l l l l l l l l
medical center?
l l
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to
l l l l l l l l l l l l l l l l
anumeric rating scale in the emergency room context?
l l l l l l l l l
8. After formulating a clinical question, a nurse has proceeded to search for evidence for
l l l l l l l l l l l l l
ways to foster restful sleep in patients who are receiving care in the intensive care unit
l l l l l l l l l l l l l l l l
(ICU). The nurse has identified a relevant meta-analysis in an electronic database.
l l l l l l l l l l l l
Whatwill this source of evidence consist of?
l l l l l l l l
A) A statistical summary of the results from several different studies
l l l l l l l l l
B) An examination of the theoretical and conceptual underpinnings of the issue
l l l l l l l l l l
C) An interdisciplinary analysis of the clinical question
l l l l l l
D) A qualitative study of different interventions related to the clinical question
l l l l l l l l l l
, 9. The nurses on a postpartum unit have noted that many primiparous (first-time) mothers
l l l l l l l l l l l l
are giving up on breastfeeding within the 24 hours following delivery, and the nurses
l l l l l l l l l l l l l l
want to create uniform guidelines for promoting breastfeeding on the unit. Which of
l l l l l l l l l l l l l
thefollowing sources is most likely to provide the best evidence in their quest for an
l l l l l l l l l l l l l l l l
intervention?
l
A) Evidence from a randomized control trial that had more than 2500 participants l l l l l l l l l l l
B) Evidence from a study that is widely regarded as a classic within the l l l l l l l l l l l l
obstetricalnursing community
l l l
C) Evidence from a systematic review of breastfeeding-promotion studies that one l l l l l l l l l
ofthe nurses identified in an electronic database
l l l l l l l l
D) The consensus opinion of the most senior nurses on the unit
l l l l l l l l l l
10. The nurse educator on an acute medicine unit is advocating for the use of
l l l l l l l l l l l l l
evidence-based clinical practice guidelines on wound care in order to standardize and l l l l l l l l l l l
optimize the practice of the nurses on the unit. Which of the following statements
l l l l l l l l l l l l l l
bestdescribes clinical practice guidelines?
l l l l l
A) The result of replication studies of existing research by an impartial third party
l l l l l l l l l l l l
B) A collection of authorized interventions that are required by law
l l l l l l l l l
C) A number of interventions that are the result of a large, publically-funded RCT
l l l l l l l l l l l l
D) A group of practice recommendations that result from a rigorous review of
l l l l l l l l l l l
theliterature l l
11. A nurse is conducting a literature review on the evidence regarding the use of vacuum
l l l l l l l l l l l l l l
dressings on stage IV pressure ulcers. After locating a recent study that appears to be
l l l l l l l l l l l l l l l
relevant, which of the following questions would the nurse consider first when
l l l l l l l l l l l l
criticallyappraising the study?
l l l l
A) “Are the findings of this study cost-effective in our clinical context?”
l l l l l l l l l l
B) "How would the implementation of this intervention affect our staffing needs?"
l l l l l l l l l l
C) “Were the patients in the study similar to the patients on my unit?” l l l l l l l l l l l l
D) “Are the findings of the study significantly different from what we are
l l l l l l l l l l l
currentlydoing on the unit?
l l l l l
12. The primary care provider of a 49-year-old male patient has examined and briefly
l l l l l l l l l l l l
explained the evidence that supports beginning regular digital-rectal exams. Which
l l l l l l l l l l
ofthe following factors would justify not performing digital-rectal examinations in this
l l l l l l l l l l l l
patient's care?
l l
A) The patient is vehemently opposed to undergoing a digital-rectal exam.
l l l l l l l l l
B) Clinical practice guidelines for prostate care have not been published. l l l l l l l l l
C) The clinician has been unable to find any large RCTs in a literature review.
l l l l l l l l l l l l l
D) The clinician has previously waited until patients are 55 to begin
l l l l l l l l l l
regulardigital-rectal exams.
l l l
