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