Evidence-Based Practice in Nursing & Healthcare – Practice Questions & Rationalized Answers (5th Edition, Melnyk)

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EVIDENCE BASED ix




PRACTICE IN NURSING
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ANDHEALTHCARE4TH
EDITION BY MELNYK
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All chapters
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,Chapter1MakingtheCaseforEvidence-Based Practice
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and Cultivating a Spirit of Inquiry
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,1. In the hospital where Nurse L. provides care, tradition dictates that oral temperatures
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ibe included in every set of patient vital signs, regardless of patient diagnosis or
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iacuity. This is most likely an example of which of the following phenomena?
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A) The prioritization of internal evidence over external evidence
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B) Practice that lacks evidence to support its application i i i i i i i



C) The integration of personal expertise into nursing care
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D) Evidence-based practice i




2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a
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ipatient chart review after the implementation of a pilot program aimed at
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promoting early ambulation following surgery. Which of the following components of
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EBP is the nurse putting into practice?
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A) Patient preferences i



B) Research utilization i



C) Experience
D) Internal evidence i




3. Nurse R. has observed that reorienting demented patients as frequently as possible tends
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to minimize the patients' level of agitation in the evening. The nurse has shared this
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observation with a colleague, who is skeptical, stating that, “It's best to stick to
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ievidence-based practice.” How can Nurse R. best respond? i i i i i i i



A) “EBP can include clinicians' personal expertise.” i i i i i



B) “Personal experience is often more sound than formal evidence-based practice.” i i i i i i i i i



C) “Traditional practice and EBP are usually shown to be the same.” i i i i i i i i i i



D) “My years of experience can be just as valuable as any literature review or
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randomized trial.”
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4. Which of the following factors provides the most important rationale for the
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consistent implementation of EBP?
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A) EBP provides for the most cost-effective patient care.
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B) EBP is accessible to all healthcare clinicians. i i i i i i



C) EBP provides consistency in care across healthcare settings.
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D) EBP improves patient outcomes. i i i




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, 5. The Institute of Medicine's Roundtable on Evidence-Based Medicine has
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been established to address EBP. Which of the following issues is the
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iRoundtable emphasizing? i



A) Ensuring that external evidence, rather than internal evidence, is integrated i i i i i i i i i



into care i i



B) Fostering the level of learning that exists in the American healthcare system i i i i i i i i i i i



C) Issuing clinical guidelines to ensure best nursing practice i i i i i i i



D) Comparing the implementation of EBP in the United States with that of i i i i i i i i i i i



other Western countries
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6. You have become frustrated with some aspects of patient care that you believe are
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ioutdated and ineffective at the long-term care facility where you have recently
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begun practicing. Consequently, you have resolved to examine some of these practices
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in light of evidence. Which of the following should occur first in the steps of EBP?
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A) Conducting an electronic search of the literature and ranking individual sources i i i i i i i i i i



B) Creating “buy-in” from the other clinicians who provide care at the facility i i i i i i i i i i i



C) Developing an inquisitive and curious mindset i i i i i



D) Assessing whether the practices in question may, in fact, be evidence-based i i i i i i i i i i




7. Which of the following clinical questions best exemplifies the PICOT format?
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A) What effect does parents' smoking have on the smoking habits of their
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children, ages 13 to 16?
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B) Among cancer patients, what role does meditation, rather than benzodiazepines,
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have on anxiety levels during the 7 days following hospital admission?
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C) Among undergraduate college students, what is the effectiveness of a sexual health
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campaign undertaken during the first 4 weeks of the fall semester as measured by
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incidence of new gonorrheal and chlamydial infections reported to the campus
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medical center?
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D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to a
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numeric rating scale in the emergency room context?
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8. After formulating a clinical question, a nurse has proceeded to search for evidence for
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ways to foster restful sleep in patients who are receiving care in the intensive care unit
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(ICU). The nurse has identified a relevant meta-analysis in an electronic database.
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What will this source of evidence consist of?
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A) A statistical summary of the results from several different studies
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B) An examination of the theoretical and conceptual underpinnings of the issue
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C) An interdisciplinary analysis of the clinical question
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D) A qualitative study of different interventions related to the clinical question
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