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Healthcare Quality Improvement 1st Edition LoBiondo-Wood
Chapter 02: Models and Evidence
LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality
Improvement, 1st Edition
MULTIPLE CHOICE
1. Which of the following is an example of a problem-focused trigger?
a. How often should a patient ambulate after abdominal surgery to prevent
pneumonia?
b. How often should blood glucose monitoring be recorded for a non-diabetic patient
receiving total parenteral nutrition?
c. How long should a patient be maintained on nothing by mouth status after
endotracheal extubation?
d. Should patients with acute coronary syndrome wear sequential compression hose
to prevent deep vein thrombosis?
ANS: D
Problem-focused triggers are those identified by staff through quality improvement, risk
surveillance, benchmarking and financial data, or recurrent clinical problems.
Knowledge-focused triggers arise when health providers hear scientific presentations, read
research articles, or published evidence-based practice guidelines and question practice.
2. Which of the following are clinical questions derived from the problem?
a. Therapy
b. Harm
c. Diagnosis
d. Prognosis
e. Meaning
f. All of the above
ANS: F
There are five types of clinical questions derived from the problem: therapy—question
focuses on determining the effect of an intervention(s) on patient outcomes; harm—question
focuses on the potential harm of a symptom or group of symptoms, disorder, treatment, or
intervention; diagnosis—question focuses on the establishment of the power of a test to
differentiate between those with the disease or problem and those who do not experience the
problem; prognosis—question focuses on a patient’s likely course for a disease state or factors
that may alter a prognosis; meaning—question focuses on the situation or processes related to
how people experience, cope or adapt to conditions, illnesses, or circumstances.
3. Which of the following questions should be considered when identifying key stakeholders for
an evidence-based practice team?
a. Who is likely to lead and champion implementation of the practice?
b. Who can influence the decision to proceed with implementation of the practice,
either positively or negatively?
c. What type of cooperation is needed from stakeholders for the practice change to be
successful?
d. All of the above
ANS: D
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,DOWNLOAD THE Test Bank for Evidence Based Practice for Nursing and
Healthcare Quality Improvement 1st Edition LoBiondo-Wood
Questions to consider in identification of key stakeholders include: How are decisions made in
the area where the evidence-based practice will be implemented; What types of unit or system
changes will be needed; Who is involved in decision-making; Who is likely to lead and
champion implementation of the practice; Who can influence the decision to proceed with
implementation of the practice, either positively or negatively; What type of cooperation is
needed from stakeholders for the practice change to be successful?
4. Which of the following is not a component of the PICO Model?
a. Population
b. Intervention
c. Cash flow
d. Outcome
ANS: C
Components of the PICO Model include P—patient, population, problem; I—intervention,
prognostic factor, exposure; C—comparison or intervention; and O—outcome you would like
to measure or achieve.
5. In most evidence hierarchies, which of the following study types is considered to be the top of
the pyramid and to be more rigorous and hence more likely to minimize the effect of bias on
the results of the study?
a. Expert opinion
b. Systematic reviews
c. Randomized controlled trials
d. Case controlled studies
ANS: B
Systematic reviews are considered to be at the top of the pyramid in most evidence hierarchies
and are a more rigorous methodology and hence more likely to minimize the effect of bias on
the results of the study. The order then follows randomized controlled studies, case controlled
studies, and expert opinion.
6. Before critically appraising research, it is suggested to read/critique which types of the
following articles first?
a. Clinical and theory articles to understand the state of the practice and theoretical
perspectives and concepts that may be encountered in critiquing studies
b. Meta-analyses, systematic and integrative reviews to understand the state of the
science
c. Evidence-based practice guidelines and evidence reports
d. Research articles
ANS: A
It is helpful to read/critique articles in the following order: (1) clinical and theory articles to
understand the state of the practice and theoretical perspectives and concepts that may be
encountered in critiquing studies; (2) meta-analyses, systematic and integrative reviews to
understand the state of the science; (3) evidence-based practice guidelines and evidence
reports; (4) research articles.
7. A group approach to critical appraisal is recommended because
a. the leader assumes most of the workload.
b. those responsible for implementing the changes have an opportunity to understand
mynursytest.store
, DOWNLOAD THE Test Bank for Evidence Based Practice for Nursing and
Healthcare Quality Improvement 1st Edition LoBiondo-Wood
the scientific base for the practice change.
c. financial-based information is obtained to advocate for the change.
d. the group is composed of experienced individuals which saves valuable time.
ANS: B
A group approach to critical appraisal is recommended because it distributes the workload,
helps those responsible for implementing the changes to understand the scientific base for the
practice change, arms nurses with citations and research-based language to use in advocating
for changes with peers and other disciplines, and provides novices with an environment to
learn critical appraisal and application of research findings.
8. Factors to consider in the synthesis of findings include all of the following except
a. overall scientific merit.
b. relevance of the study to the question topic.
c. incorporation of findings to current policies and procedures.
d. comparison of types of subjects enrolled and their similarity to the patient
population to which the findings will be applied.
ANS: C
Factors that should be considered for inclusion of studies in the synthesis of findings include:
overall scientific merit; type of subjects enrolled (e.g., age, gender, pathology) and the
similarity to the patient population to which the findings will be applied; as well as relevance
of the study to the question topic.
9. Essential information to include in a summary table consists of which of the following?
a. Research questions/hypotheses
b. Independent and dependent variables studied
c. Description of the study sample and setting
d. Type of research design
e. Methods used to measure each variable and outcome
f. All of the above
ANS: F
Essential information to include in a summary table consist of: research questions/hypothesis;
independent and dependent variables studied; description of the study sample and setting; type
of research design; methods used to measure each variable and outcome; study findings as
well as strengths and weaknesses of each study.
TRUE/FALSE
1. The EBP process uses a clinical question to search the published literature for completed
studies in order to bring about improvements in care?
ANS: T
EBP process uses a clinical question to search the published literature for completed studies in
order to bring about improvements in care.
2. Translation science focuses on testing the implementation of interventions to improve uptake
and use of evidence to improve patient outcomes and population health, as well as to clarify
what implementation strategies work for whom, in what settings, and why.
mynursytest.store
Healthcare Quality Improvement 1st Edition LoBiondo-Wood
Chapter 02: Models and Evidence
LoBiondo-wood: Evidence-Based Practice for Nursing and Health Care Quality
Improvement, 1st Edition
MULTIPLE CHOICE
1. Which of the following is an example of a problem-focused trigger?
a. How often should a patient ambulate after abdominal surgery to prevent
pneumonia?
b. How often should blood glucose monitoring be recorded for a non-diabetic patient
receiving total parenteral nutrition?
c. How long should a patient be maintained on nothing by mouth status after
endotracheal extubation?
d. Should patients with acute coronary syndrome wear sequential compression hose
to prevent deep vein thrombosis?
ANS: D
Problem-focused triggers are those identified by staff through quality improvement, risk
surveillance, benchmarking and financial data, or recurrent clinical problems.
Knowledge-focused triggers arise when health providers hear scientific presentations, read
research articles, or published evidence-based practice guidelines and question practice.
2. Which of the following are clinical questions derived from the problem?
a. Therapy
b. Harm
c. Diagnosis
d. Prognosis
e. Meaning
f. All of the above
ANS: F
There are five types of clinical questions derived from the problem: therapy—question
focuses on determining the effect of an intervention(s) on patient outcomes; harm—question
focuses on the potential harm of a symptom or group of symptoms, disorder, treatment, or
intervention; diagnosis—question focuses on the establishment of the power of a test to
differentiate between those with the disease or problem and those who do not experience the
problem; prognosis—question focuses on a patient’s likely course for a disease state or factors
that may alter a prognosis; meaning—question focuses on the situation or processes related to
how people experience, cope or adapt to conditions, illnesses, or circumstances.
3. Which of the following questions should be considered when identifying key stakeholders for
an evidence-based practice team?
a. Who is likely to lead and champion implementation of the practice?
b. Who can influence the decision to proceed with implementation of the practice,
either positively or negatively?
c. What type of cooperation is needed from stakeholders for the practice change to be
successful?
d. All of the above
ANS: D
mynursytest.store
,DOWNLOAD THE Test Bank for Evidence Based Practice for Nursing and
Healthcare Quality Improvement 1st Edition LoBiondo-Wood
Questions to consider in identification of key stakeholders include: How are decisions made in
the area where the evidence-based practice will be implemented; What types of unit or system
changes will be needed; Who is involved in decision-making; Who is likely to lead and
champion implementation of the practice; Who can influence the decision to proceed with
implementation of the practice, either positively or negatively; What type of cooperation is
needed from stakeholders for the practice change to be successful?
4. Which of the following is not a component of the PICO Model?
a. Population
b. Intervention
c. Cash flow
d. Outcome
ANS: C
Components of the PICO Model include P—patient, population, problem; I—intervention,
prognostic factor, exposure; C—comparison or intervention; and O—outcome you would like
to measure or achieve.
5. In most evidence hierarchies, which of the following study types is considered to be the top of
the pyramid and to be more rigorous and hence more likely to minimize the effect of bias on
the results of the study?
a. Expert opinion
b. Systematic reviews
c. Randomized controlled trials
d. Case controlled studies
ANS: B
Systematic reviews are considered to be at the top of the pyramid in most evidence hierarchies
and are a more rigorous methodology and hence more likely to minimize the effect of bias on
the results of the study. The order then follows randomized controlled studies, case controlled
studies, and expert opinion.
6. Before critically appraising research, it is suggested to read/critique which types of the
following articles first?
a. Clinical and theory articles to understand the state of the practice and theoretical
perspectives and concepts that may be encountered in critiquing studies
b. Meta-analyses, systematic and integrative reviews to understand the state of the
science
c. Evidence-based practice guidelines and evidence reports
d. Research articles
ANS: A
It is helpful to read/critique articles in the following order: (1) clinical and theory articles to
understand the state of the practice and theoretical perspectives and concepts that may be
encountered in critiquing studies; (2) meta-analyses, systematic and integrative reviews to
understand the state of the science; (3) evidence-based practice guidelines and evidence
reports; (4) research articles.
7. A group approach to critical appraisal is recommended because
a. the leader assumes most of the workload.
b. those responsible for implementing the changes have an opportunity to understand
mynursytest.store
, DOWNLOAD THE Test Bank for Evidence Based Practice for Nursing and
Healthcare Quality Improvement 1st Edition LoBiondo-Wood
the scientific base for the practice change.
c. financial-based information is obtained to advocate for the change.
d. the group is composed of experienced individuals which saves valuable time.
ANS: B
A group approach to critical appraisal is recommended because it distributes the workload,
helps those responsible for implementing the changes to understand the scientific base for the
practice change, arms nurses with citations and research-based language to use in advocating
for changes with peers and other disciplines, and provides novices with an environment to
learn critical appraisal and application of research findings.
8. Factors to consider in the synthesis of findings include all of the following except
a. overall scientific merit.
b. relevance of the study to the question topic.
c. incorporation of findings to current policies and procedures.
d. comparison of types of subjects enrolled and their similarity to the patient
population to which the findings will be applied.
ANS: C
Factors that should be considered for inclusion of studies in the synthesis of findings include:
overall scientific merit; type of subjects enrolled (e.g., age, gender, pathology) and the
similarity to the patient population to which the findings will be applied; as well as relevance
of the study to the question topic.
9. Essential information to include in a summary table consists of which of the following?
a. Research questions/hypotheses
b. Independent and dependent variables studied
c. Description of the study sample and setting
d. Type of research design
e. Methods used to measure each variable and outcome
f. All of the above
ANS: F
Essential information to include in a summary table consist of: research questions/hypothesis;
independent and dependent variables studied; description of the study sample and setting; type
of research design; methods used to measure each variable and outcome; study findings as
well as strengths and weaknesses of each study.
TRUE/FALSE
1. The EBP process uses a clinical question to search the published literature for completed
studies in order to bring about improvements in care?
ANS: T
EBP process uses a clinical question to search the published literature for completed studies in
order to bring about improvements in care.
2. Translation science focuses on testing the implementation of interventions to improve uptake
and use of evidence to improve patient outcomes and population health, as well as to clarify
what implementation strategies work for whom, in what settings, and why.
mynursytest.store
