Test Bank For Evidence-Based Practice in Nursing & Healthcare A
Guide to Best Practice 5th Edition
by Bernadette Mazurek Melnyk, Ellen Fineout-Overholt
Chapter 1 - 23 Complet
,Chapter 1 Making the Case for Evidence-Based Practice
and Cultivating a Spirit of Inquiry
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.
Thisis 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
tendsto 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
orrandomized trial.”
4. Which of the following factors provides the most important rationale for the
consistentimplementation of EBP?
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
beenestablished to address EBP. Which of the following issues is the
Roundtable emphasizing?
A) Ensuring that external evidence, rather than internal evidence, is integrated
intocare
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
otherWestern 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
lightof 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
healthcampaign 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
anumeric rating scale in the emergency room context?
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.
Whatwill 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 thefollowing 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
obstetricalnursing community
C) Evidence from a systematic review of breastfeeding-promotion studies that one
ofthe nurses identified in an electronic database
D) The consensus opinion of the most senior nurses on the unit
10. The fnurse feducator fon fan facute fmedicine funit fis fadvocating ffor fthe fuse fof
evidence-based fclinical fpractice fguidelines fon fwound fcare fin forder fto fstandardize
fand foptimize fthe fpractice fof fthe fnurses fon fthe funit. fWhich fof fthe ffollowing
fstatements fbestfdescribes fclinical fpractice fguidelines?
A) The fresult fof freplication fstudies fof fexisting fresearch fby fan fimpartial fthird fparty
B) A fcollection fof fauthorized finterventions fthat fare frequired fby flaw
C) A fnumber fof finterventions fthat fare fthe fresult fof fa flarge, fpublically-funded fRCT
D) A fgroup fof fpractice frecommendations fthat fresult ffrom fa frigorous freview
fof fthefliterature
11. A fnurse fis fconducting fa fliterature freview fon fthe fevidence fregarding fthe fuse fof
fvacuum fdressings fon fstage fIV fpressure fulcers. fAfter flocating fa frecent fstudy fthat
fappears fto fbe frelevant, fwhich fof fthe ffollowing fquestions fwould fthe fnurse fconsider
ffirst fwhen fcriticallyfappraising fthe fstudy?
A) “Are fthe ffindings fof fthis fstudy fcost-effective fin four fclinical fcontext?”
B) "How fwould fthe fimplementation fof fthis fintervention faffect four fstaffing fneeds?"
C) “Were fthe fpatients fin fthe fstudy fsimilar fto fthe fpatients fon fmy funit?”
D) “Are fthe ffindings fof fthe fstudy fsignificantly fdifferent ffrom fwhat fwe fare
fcurrentlyfdoing fon fthe funit?
12. The fprimary fcare fprovider fof fa f49-year-old fmale fpatient fhas fexamined fand
fbriefly fexplained fthe fevidence fthat fsupports fbeginning fregular fdigital-rectal
fexams. fWhich foffthe ffollowing ffactors fwould fjustify fnot fperforming fdigital-rectal
fexaminations fin fthis fpatient's fcare?
A) The fpatient fis fvehemently fopposed fto fundergoing fa fdigital-rectal fexam.
B) Clinical fpractice fguidelines ffor fprostate fcare fhave fnot fbeen fpublished.
C) The fclinician fhas fbeen funable fto ffind fany flarge fRCTs fin fa fliterature freview.
D) The fclinician fhas fpreviously fwaited funtil fpatients fare f55 fto fbegin
fregularfdigital-rectal fexams.
Guide to Best Practice 5th Edition
by Bernadette Mazurek Melnyk, Ellen Fineout-Overholt
Chapter 1 - 23 Complet
,Chapter 1 Making the Case for Evidence-Based Practice
and Cultivating a Spirit of Inquiry
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.
Thisis 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
tendsto 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
orrandomized trial.”
4. Which of the following factors provides the most important rationale for the
consistentimplementation of EBP?
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
beenestablished to address EBP. Which of the following issues is the
Roundtable emphasizing?
A) Ensuring that external evidence, rather than internal evidence, is integrated
intocare
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
otherWestern 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
lightof 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
healthcampaign 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
anumeric rating scale in the emergency room context?
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.
Whatwill 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 thefollowing 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
obstetricalnursing community
C) Evidence from a systematic review of breastfeeding-promotion studies that one
ofthe nurses identified in an electronic database
D) The consensus opinion of the most senior nurses on the unit
10. The fnurse feducator fon fan facute fmedicine funit fis fadvocating ffor fthe fuse fof
evidence-based fclinical fpractice fguidelines fon fwound fcare fin forder fto fstandardize
fand foptimize fthe fpractice fof fthe fnurses fon fthe funit. fWhich fof fthe ffollowing
fstatements fbestfdescribes fclinical fpractice fguidelines?
A) The fresult fof freplication fstudies fof fexisting fresearch fby fan fimpartial fthird fparty
B) A fcollection fof fauthorized finterventions fthat fare frequired fby flaw
C) A fnumber fof finterventions fthat fare fthe fresult fof fa flarge, fpublically-funded fRCT
D) A fgroup fof fpractice frecommendations fthat fresult ffrom fa frigorous freview
fof fthefliterature
11. A fnurse fis fconducting fa fliterature freview fon fthe fevidence fregarding fthe fuse fof
fvacuum fdressings fon fstage fIV fpressure fulcers. fAfter flocating fa frecent fstudy fthat
fappears fto fbe frelevant, fwhich fof fthe ffollowing fquestions fwould fthe fnurse fconsider
ffirst fwhen fcriticallyfappraising fthe fstudy?
A) “Are fthe ffindings fof fthis fstudy fcost-effective fin four fclinical fcontext?”
B) "How fwould fthe fimplementation fof fthis fintervention faffect four fstaffing fneeds?"
C) “Were fthe fpatients fin fthe fstudy fsimilar fto fthe fpatients fon fmy funit?”
D) “Are fthe ffindings fof fthe fstudy fsignificantly fdifferent ffrom fwhat fwe fare
fcurrentlyfdoing fon fthe funit?
12. The fprimary fcare fprovider fof fa f49-year-old fmale fpatient fhas fexamined fand
fbriefly fexplained fthe fevidence fthat fsupports fbeginning fregular fdigital-rectal
fexams. fWhich foffthe ffollowing ffactors fwould fjustify fnot fperforming fdigital-rectal
fexaminations fin fthis fpatient's fcare?
A) The fpatient fis fvehemently fopposed fto fundergoing fa fdigital-rectal fexam.
B) Clinical fpractice fguidelines ffor fprostate fcare fhave fnot fbeen fpublished.
C) The fclinician fhas fbeen funable fto ffind fany flarge fRCTs fin fa fliterature freview.
D) The fclinician fhas fpreviously fwaited funtil fpatients fare f55 fto fbegin
fregularfdigital-rectal fexams.
