TEST BANK
EVIDENCE-BASED PRACTICE IN NURSING & HEALTHCARE
Page 1 of 147
, TABLE OF CONTENTS
Chapter 1 Making The Case For Evidence-Based Practice And Cultivating A Spirit Of Inquiry
Chapter 2 Asking Compelling Clinical Questions
Chapter 3 Finding Relevant Evidence To Answer Clinical Questions
Chapter 4 Critically Appraising Knowledge For Clinical Decision Making
Chapter 5 Critically Appraising Quantitative Evidence For Clinical Decision Making
Chapter 6 Critically Appraising Qualitative Evidence For Clinical Decision Making
Chapter 7 Integration Of Patient Preferences And Values And Clinician Expertise
Into Evidence-Based Decision Making
Chapter 8 Advancing Optimal Care With Robust Clinical Practice Guidelines
Chapter 9 Implementing Evidence In Clinical Settings
Chapter 10 The Role Of Outcomes And Evidence- Based Quality Improvement In Enhancing
And Evaluating Practice
Chapter 11 Implementing The Evidence-Based Practice Competencies In Clinical
And Academic Settings To Ensure Healthcare Quality And Improved Patient
Outcomes
Chapter 12 Leadership Strategies For Creating And Sustaining Evidence-Based Practice
Organizations
Chapter 13 Innovation And Evidence: A Partnership In Advancing Best Practice And High
Quality Care
Chapter 14 Models To Guide Implementation And Sustainability Of Evidence-Based Practice
Chapter 15 Creating A Vision And Motivating A Change To Evidence-Based Practice In
Individuals, Teams, And Organizations
Chapter 16 Teaching Evidence-Based Practice In Academic Settings
Chapter 17 Teaching Evidence-Based Practice In Clinical Settings
Chapter 18 ARCC Evidence-Based Practice Mentors: The Key To Sustaining Evidence-Based
Practice
Chapter 19 Using Evidence To Influence Health And Organizational Policy
Page 2 of 147
,Chapter 20 Disseminating Evidence Through Presentations, Publications, Health Policy
Briefs, And The Media
Chapter 21 Generating Evidence Through Quantitative And Qualitative Research
Chapter 22 Writing A Successful Grant Proposal To Fund Research And Evidence-Based
Practice Implementation Project
Chapter 23 Ethical Considerations For Evidence Implementation And Evidence Generation
Page 3 of 147
, 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
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
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, Stating That, “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.”
4. Which Of The Following Factors Provides The Most Important Rationale For The Consistent
Implementation Of EBP?
Page 4 of 147
,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.
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
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 Some Of 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
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?
Page 5 of 147
,8. After Formulating A Clinical Question, A Nurse Has Proceeded To Search For Evidence For Ways To
Foster Restful Sleep In Patients Who Are Receiving Care In The Intensive Care Unit (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
9. The Nurses On A Postpartum Unit Have Noted That Many Primiparous (First-Time) Mothers Are
Giving Up On Breastfeeding Within The 24 Hours Following Delivery, And The Nurses 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
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 The Practice Of
The Nurses On The Unit. 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, Publically-Funded RCT
D) A Group Of Practice Recommendations That Result From A Rigorous Review Of The Literature
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,
Page 6 of 147
,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?
12. The Primary Care Provider Of A 49-Year-Old Male Patient Has Examined And Briefly
Explained The Evidence That Supports Beginning Regular Digital-Rectal Exams. Which Of The
Following Factors Would Justify Not Performing Digital-Rectal Examinations In This Patient's
Care?
A) The Patient Is Vehemently Opposed To Undergoing A Digital-Rectal Exam.
B) Clinical Practice Guidelines For Prostate Care Have Not Been Published.
C) The Clinician Has Been Unable To Find Any Large Rcts In A Literature Review.
D) The Clinician Has Previously Waited Until Patients Are 55 To Begin Regular Digital-Rectal Exams.
13. The Implementation Of A New, Evidence-Based Infection-Control Regimen In A Community
Hospital Has Resulted In A Significant Reduction In The Incidence Of Nosocomial (Hospital-Acquired)
Infections. What Should Constitute The Final Step In The Nurses' Evidence-Based Practice?
A) Calculating The Cost-Savings That Will Be Realized By Using The New Regimen
B) Sharing Their Experience With Other Healthcare Professionals
C) Implementing Enforcement Measures To Ensure Compliance With The New Regimen
D) Conducting A Meta-Analysis Of Other Infection-Control Measures
14. Frustrated By The Lack Of Follow-Up Provided To Patients Who Are Newly Diagnosed With Type
2 Diabetes, A Community Health Nurse Has Begun The Process Of Identifying Evidence For The Best
Interventions For This Patient Population. Which Of The Following Factors Is Most Likely To Promote
The Use Of EBP In This Nurse's Workplace?
A) Bringing In Nurses Who Have Been Educated At A Baccalaureate (Bachelor's Degree) Level
B) Increasing Nurses' Accountability For Patient Outcomes
Page 7 of 147
,C) Increased Funding
D) Support From The Practice Leaders And Administration
15. In The Process Of Advocating For EBP In The Unit Guidelines Around The Management Of
Increased Intracranial Pressure, A Nurse Has Met With Skepticism From Other Members Of The
Nursing Staff, With Several Stating, “Evidence-Based Practice Is Good In Theory, But It's Almost
Impossible To Actually Search Hundreds Of Journals And Find The Evidence.” What Could The
Nurse Recommend?
A) Self-Reflection On The Nurses' Current Practices
B) Accessing The Cochrane Library
C) Contacting The Clinical Nurse Educator On The Unit
D) Beginning With Lay Publications Before Progressing To Peer-Reviewed Journals
Answer Key
1. B
2. D
3. A
4. D
5. B
6. C
7. B
8. A
9. C
10. D
11. C
12. A
13. B
14. D
15. B
Page 8 of 147
, Chapter 2 Asking Compelling Clinical Questions
1. Which Of The Following Components Of A Clinical Question Represents The “P” In The PICOT Format
For
Asking Clinical Questions?
A) The Nurse's Preparation For Patient Teaching Prior To Surgery
B) Early Ambulation Versus Aggressive Anticoagulant Therapy
C) Individuals Who Require Peritoneal Dialysis
D) Deep Vein Thrombosis
2. An Unacceptably High Number Of Patients On A Geriatric, Subacute Medicine Unit Have Developed
Pressure Ulcers During Their Period Of Care. The Nurses On The Unit Have Agreed On A Goal Of
Reducing The Incidence Of These Wounds By 50% Over The Next 10 Weeks. This Goal Represents
Which Component Of The PICOT Format For Asking Clinical Questions?
A) O
B) P
C) I
D) C
3. Which Of The Following Scenarios Represents The Most Common Obstacle That Nurses
Encounter When Attempting To Gain The Knowledge Necessary For EBP?
A) A Nurse Identifies Several Articles Relevant To A Clinical Question, But The Methodology Of
Each Is Significantly Flawed.
B) A Nurse Is Overwhelmed By The Number Of Hits During A CINAHL Search.
C) Current Research That Relates To The Nurse's Clinical Question Does Not Exist.
D) The Research That The Nurse Locates Is Rooted In A Medical, Not Nursing, Perspective.
Page 9 of 147
, 4. A Nurse Has Attempted To Begin The Process Of Implementing EBP In The Area Of Falls Prevention
But Has Become Disillusioned By The Possibility Of Having To Read A Vast Number Of Publications.
Which Of The Following Strategies Should The Nurse Implement In Response To This Problem?
A) Narrow The Scope Of The Clinical Question
B) Restrict The Information Search To Publications From The Past 24 Months
C) Seek Recommendations For Information Sources From Trusted Colleagues
D) Limit The Search To Articles That Relate The Findings Of Randomized Control Trials (Rcts)
5. A Pediatric Nurse Provides Care For Many Children Who Present To The Emergency Department
(ED) With Signs And Symptoms Of Asthma. Which Of The Following Questions Is A Background
Question That The Nurse Can Utilize In The Process Of Providing EBP?
A) What Evidence Exists To Recommend The Use Of Nebulizers Over Metered-Dose Inhalers (Mdis)?
B) What Patient Populations Respond Best To Nebulized Bronchodilators?
C) How Effective Are Nebulizers Compared To Metered-Dose Inhalers At Reducing Bronchospasm?
D) Are Nebulizers Provided To Patients In The ED More Often Than Metered-Dose Inhalers?
6. Which Of The Following Statements Is True Of Foreground Questions?
A) They Focus On Issues That Can Be Addressed By Applying Scientific Evidence.
B) They Have A Broad, Rather Than Narrow, Scope.
C) They Can Be Answered By Examining Electronic Information Sources Instead Of Print Sources.
D) They Are Rooted In The Current Practices Of A Nurse's Clinical Setting.
7. An Oncology Nurse Is Engaged In Increasing The Quality Of EBP That Is Provided On The Cancer
Unit Of The Local Hospital. Which Of The Following Questions Would The Nurse Consider To Be
An Adequate And Useful Foreground Question?
A) “Are Benzodiazepines And Analgesics Provided Before Patients Have A Bone Marrow Biopsy?”
B) “What Is The Clinical Rationale For Using Bone Marrow Biopsy To Gauge And Predict The Course
Of A
Patient's Cancer?”
C) “Does Guided Imagery Reduce The Anxiety Of Patients Who Undergo Bone Marrow Biopsy?”
Page 10 of 147
EVIDENCE-BASED PRACTICE IN NURSING & HEALTHCARE
Page 1 of 147
, TABLE OF CONTENTS
Chapter 1 Making The Case For Evidence-Based Practice And Cultivating A Spirit Of Inquiry
Chapter 2 Asking Compelling Clinical Questions
Chapter 3 Finding Relevant Evidence To Answer Clinical Questions
Chapter 4 Critically Appraising Knowledge For Clinical Decision Making
Chapter 5 Critically Appraising Quantitative Evidence For Clinical Decision Making
Chapter 6 Critically Appraising Qualitative Evidence For Clinical Decision Making
Chapter 7 Integration Of Patient Preferences And Values And Clinician Expertise
Into Evidence-Based Decision Making
Chapter 8 Advancing Optimal Care With Robust Clinical Practice Guidelines
Chapter 9 Implementing Evidence In Clinical Settings
Chapter 10 The Role Of Outcomes And Evidence- Based Quality Improvement In Enhancing
And Evaluating Practice
Chapter 11 Implementing The Evidence-Based Practice Competencies In Clinical
And Academic Settings To Ensure Healthcare Quality And Improved Patient
Outcomes
Chapter 12 Leadership Strategies For Creating And Sustaining Evidence-Based Practice
Organizations
Chapter 13 Innovation And Evidence: A Partnership In Advancing Best Practice And High
Quality Care
Chapter 14 Models To Guide Implementation And Sustainability Of Evidence-Based Practice
Chapter 15 Creating A Vision And Motivating A Change To Evidence-Based Practice In
Individuals, Teams, And Organizations
Chapter 16 Teaching Evidence-Based Practice In Academic Settings
Chapter 17 Teaching Evidence-Based Practice In Clinical Settings
Chapter 18 ARCC Evidence-Based Practice Mentors: The Key To Sustaining Evidence-Based
Practice
Chapter 19 Using Evidence To Influence Health And Organizational Policy
Page 2 of 147
,Chapter 20 Disseminating Evidence Through Presentations, Publications, Health Policy
Briefs, And The Media
Chapter 21 Generating Evidence Through Quantitative And Qualitative Research
Chapter 22 Writing A Successful Grant Proposal To Fund Research And Evidence-Based
Practice Implementation Project
Chapter 23 Ethical Considerations For Evidence Implementation And Evidence Generation
Page 3 of 147
, 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
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
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, Stating That, “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.”
4. Which Of The Following Factors Provides The Most Important Rationale For The Consistent
Implementation Of EBP?
Page 4 of 147
,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.
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
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 Some Of 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
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?
Page 5 of 147
,8. After Formulating A Clinical Question, A Nurse Has Proceeded To Search For Evidence For Ways To
Foster Restful Sleep In Patients Who Are Receiving Care In The Intensive Care Unit (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
9. The Nurses On A Postpartum Unit Have Noted That Many Primiparous (First-Time) Mothers Are
Giving Up On Breastfeeding Within The 24 Hours Following Delivery, And The Nurses 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
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 The Practice Of
The Nurses On The Unit. 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, Publically-Funded RCT
D) A Group Of Practice Recommendations That Result From A Rigorous Review Of The Literature
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,
Page 6 of 147
,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?
12. The Primary Care Provider Of A 49-Year-Old Male Patient Has Examined And Briefly
Explained The Evidence That Supports Beginning Regular Digital-Rectal Exams. Which Of The
Following Factors Would Justify Not Performing Digital-Rectal Examinations In This Patient's
Care?
A) The Patient Is Vehemently Opposed To Undergoing A Digital-Rectal Exam.
B) Clinical Practice Guidelines For Prostate Care Have Not Been Published.
C) The Clinician Has Been Unable To Find Any Large Rcts In A Literature Review.
D) The Clinician Has Previously Waited Until Patients Are 55 To Begin Regular Digital-Rectal Exams.
13. The Implementation Of A New, Evidence-Based Infection-Control Regimen In A Community
Hospital Has Resulted In A Significant Reduction In The Incidence Of Nosocomial (Hospital-Acquired)
Infections. What Should Constitute The Final Step In The Nurses' Evidence-Based Practice?
A) Calculating The Cost-Savings That Will Be Realized By Using The New Regimen
B) Sharing Their Experience With Other Healthcare Professionals
C) Implementing Enforcement Measures To Ensure Compliance With The New Regimen
D) Conducting A Meta-Analysis Of Other Infection-Control Measures
14. Frustrated By The Lack Of Follow-Up Provided To Patients Who Are Newly Diagnosed With Type
2 Diabetes, A Community Health Nurse Has Begun The Process Of Identifying Evidence For The Best
Interventions For This Patient Population. Which Of The Following Factors Is Most Likely To Promote
The Use Of EBP In This Nurse's Workplace?
A) Bringing In Nurses Who Have Been Educated At A Baccalaureate (Bachelor's Degree) Level
B) Increasing Nurses' Accountability For Patient Outcomes
Page 7 of 147
,C) Increased Funding
D) Support From The Practice Leaders And Administration
15. In The Process Of Advocating For EBP In The Unit Guidelines Around The Management Of
Increased Intracranial Pressure, A Nurse Has Met With Skepticism From Other Members Of The
Nursing Staff, With Several Stating, “Evidence-Based Practice Is Good In Theory, But It's Almost
Impossible To Actually Search Hundreds Of Journals And Find The Evidence.” What Could The
Nurse Recommend?
A) Self-Reflection On The Nurses' Current Practices
B) Accessing The Cochrane Library
C) Contacting The Clinical Nurse Educator On The Unit
D) Beginning With Lay Publications Before Progressing To Peer-Reviewed Journals
Answer Key
1. B
2. D
3. A
4. D
5. B
6. C
7. B
8. A
9. C
10. D
11. C
12. A
13. B
14. D
15. B
Page 8 of 147
, Chapter 2 Asking Compelling Clinical Questions
1. Which Of The Following Components Of A Clinical Question Represents The “P” In The PICOT Format
For
Asking Clinical Questions?
A) The Nurse's Preparation For Patient Teaching Prior To Surgery
B) Early Ambulation Versus Aggressive Anticoagulant Therapy
C) Individuals Who Require Peritoneal Dialysis
D) Deep Vein Thrombosis
2. An Unacceptably High Number Of Patients On A Geriatric, Subacute Medicine Unit Have Developed
Pressure Ulcers During Their Period Of Care. The Nurses On The Unit Have Agreed On A Goal Of
Reducing The Incidence Of These Wounds By 50% Over The Next 10 Weeks. This Goal Represents
Which Component Of The PICOT Format For Asking Clinical Questions?
A) O
B) P
C) I
D) C
3. Which Of The Following Scenarios Represents The Most Common Obstacle That Nurses
Encounter When Attempting To Gain The Knowledge Necessary For EBP?
A) A Nurse Identifies Several Articles Relevant To A Clinical Question, But The Methodology Of
Each Is Significantly Flawed.
B) A Nurse Is Overwhelmed By The Number Of Hits During A CINAHL Search.
C) Current Research That Relates To The Nurse's Clinical Question Does Not Exist.
D) The Research That The Nurse Locates Is Rooted In A Medical, Not Nursing, Perspective.
Page 9 of 147
, 4. A Nurse Has Attempted To Begin The Process Of Implementing EBP In The Area Of Falls Prevention
But Has Become Disillusioned By The Possibility Of Having To Read A Vast Number Of Publications.
Which Of The Following Strategies Should The Nurse Implement In Response To This Problem?
A) Narrow The Scope Of The Clinical Question
B) Restrict The Information Search To Publications From The Past 24 Months
C) Seek Recommendations For Information Sources From Trusted Colleagues
D) Limit The Search To Articles That Relate The Findings Of Randomized Control Trials (Rcts)
5. A Pediatric Nurse Provides Care For Many Children Who Present To The Emergency Department
(ED) With Signs And Symptoms Of Asthma. Which Of The Following Questions Is A Background
Question That The Nurse Can Utilize In The Process Of Providing EBP?
A) What Evidence Exists To Recommend The Use Of Nebulizers Over Metered-Dose Inhalers (Mdis)?
B) What Patient Populations Respond Best To Nebulized Bronchodilators?
C) How Effective Are Nebulizers Compared To Metered-Dose Inhalers At Reducing Bronchospasm?
D) Are Nebulizers Provided To Patients In The ED More Often Than Metered-Dose Inhalers?
6. Which Of The Following Statements Is True Of Foreground Questions?
A) They Focus On Issues That Can Be Addressed By Applying Scientific Evidence.
B) They Have A Broad, Rather Than Narrow, Scope.
C) They Can Be Answered By Examining Electronic Information Sources Instead Of Print Sources.
D) They Are Rooted In The Current Practices Of A Nurse's Clinical Setting.
7. An Oncology Nurse Is Engaged In Increasing The Quality Of EBP That Is Provided On The Cancer
Unit Of The Local Hospital. Which Of The Following Questions Would The Nurse Consider To Be
An Adequate And Useful Foreground Question?
A) “Are Benzodiazepines And Analgesics Provided Before Patients Have A Bone Marrow Biopsy?”
B) “What Is The Clinical Rationale For Using Bone Marrow Biopsy To Gauge And Predict The Course
Of A
Patient's Cancer?”
C) “Does Guided Imagery Reduce The Anxiety Of Patients Who Undergo Bone Marrow Biopsy?”
Page 10 of 147
