Chapter 5 Evidence-Based Practice-Fundamentals of Nursing

Chapter 05: Evidence-Based Practice
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MULTIPLE CHOICE ra




1. A nursing attendant uses evidence-
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based practice (EBP) to provide nursing care. What is the
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best rationale for the nursing attendant ’s behavior?
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a. EBP is a guide for nursing attendant s in making clinical decisions.
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b. EBP is based on the latest textbook information.
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c. EBP is easily attained at the bedside. ra ra ra ra ra ra




d. EBP is always right for all situations. ra ra ra ra ra ra




ACCURATE ar



ANSWER:-A
Evidence-
based practice (EBP) is a guide for nursing attendant s to structure how to make appropriate,
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timely, and effective clinical decisions. A textbook relies on the scientific literature, which m
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ay be outdated by the time the book is published. Unfortunately, much of the best evidence ne
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ver reaches the bedside. EBP is not to be blindly applied without using good judgment and cri
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tical thinking skills. ra ra




DIF:Understand (comprehension) OBJ:Discuss the benefits of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar



Evaluation MSC: Management of Care ra ra ra




2. In caring for hospital client s, what must the nursing attendant remember about evid
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encebased practice (EBP)? ar ra




a. EBP is the only valid source of knowledge that should be used.
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b. EBP is secondary to traditional or convenient care knowledge.
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c. EBP is dependent on hospital client values and expectations.
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d. EBP is not shown to provide better hospital client outcomes.
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ACCURATE ANSWER:-C ra



Even when the best evidence available is used, application and outcomes will differ based on h
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ospital client values, preferences, concerns, and/or expectations. Nursing attendant s often c
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are for hospital client s on the basis of tradition or convenience. Although these sources have
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value, it is important to learn to rely more on research evidence than on nonresearch evidence. Ev
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idencebased care improves quality, safety, hospital client outcomes, and nursing attendant satisf
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ac tion while reducing costs. ra ra ra




DIF:Understand (comprehension) OBJ:Discuss the benefits of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar



Implementation MSC: Management of Care ra ra ra




3. A nursing attendant wants to change a hospital client procedure. Which action will t
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h e nursing attendant take to easily find research evidence to support this change? a.
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Read all the articles found on the Internet.
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b. Make a general search of the Internet. ra ra ra ra ra ra




c. Use a PICOT format for the search. ra ra ra ra ra ra




d. Start with a broad question. ra ra ra ra




ACCURATE ANSWER:-C ra

, The more focused the question is, the easier it becomes to search for evidence in the scientific l
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iterature. The PICO format allows the nursing attendant to ask focused questions that are int
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ervention based. Inappropriately formed questions (general search or broad question) will lik
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ely lead to irrelevant sources of information. It is not beneficial to read hundreds of articles. It is
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more beneficial to read the best four to six articles that specifically address the question.
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DIF:Apply (application) OBJ:Explain the steps of evidence-based practice. TOPIC:-Implementation
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MSC: Management of Care ra ra ra




4. A nursing attendant has collected several research findings for evidencebased practic
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e. Which article will be the best for the nursing attendant to use? a.
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An article that uses randomized controlled trials (RCT).
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b. An article that is an opinion of expert committees.
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c. An article that uses qualitative research.
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d. An article that is peer-reviewed.
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ACCURATE ANSWER:-A ra




Individual RCTs are the highest level of evidence or ―gold standard‖ for research. A pe
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er-
reviewed article means that a panel of experts has reviewed the article; this is not a resea
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rch method. Qualitative research is valuable in identifying information about how
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hospital client s cope with or manage various health problems and their perceptions of illness.
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It does not usually have the robustness of an RCT. Expert opinion is on the bottom of the hie
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rarchical pyramid of evidence. ra ra ra




DIF:Understand (comprehension) ra



OBJ:Summarize the levels of evidence available in the literature. T ra ra ra ra ra ra ra ra ar



OPIC:-Assessment MSC: Management of Care ra ra ra ra




5. The nursing attendant is reviewing a research article on a hospital client care topic. Which
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area should entice the nursing attendant to read the article? a. Literature review
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b. Introduction
c. Methods
d. Results
ACCURATE ANSWER:-B ra



The introduction contains information about its purpose and the importance of the topic to th
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e audience who reads the article. The literature review or background offers a detailed backgr
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ound of the level of science or clinical information about the topic of the article. The methods
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or design section explains how a research study was organized and conducted. The results or
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conclusion section details the results of the study and explains whether a hypothesis is suppor
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ted.

DIF:Understand (comprehension) OBJ:Explain the steps of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar



Communication and Documentation ra ra



MSC: Management of Care ra ra ra




6. The nursing attendant is caring for a hospital client with chronic low back pain. The nursing
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attendant wants to determine the best evidencebased practice regarding clinical guidelines f
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or low back pain. What is the best database for the nursing attendant to access?
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a. MEDLINE
b. EMBASE

, c. PsycINFO
d. Agency for Healthcare Research and Quality (AHRQ) ra ra ra ra ra ra




ACCURATE ANSWER:-D ra



The Agency for Healthcare Research and Quality (AHRQ) includes clinical guidelines and ev
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idence summaries. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry, veter
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inary medicine, and allied health. EMBASE includes biomedical and pharmaceutical studies.
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PsycINFO deals with psychology and related health care disciplines.
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DIF:Understand (comprehension) OBJ:Explain the steps of evidencebased practice. TOPIC:- ra ra ra ra ra ra ar



Implementation MSC: Management of Care ra ra ra




7. A nursing attendant writes the following PICOT question: How do hospital client s wit
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h breast cancer rate their quality of life? How should the nursing attendant evaluate this
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question?
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a. A true PICOT question regardless of the number of elements
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b. A true PICOT question because the intervention comes before the control
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c. Not a true PICOT question because the comparison comes after the intervention
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d. Not a true PICOT question because the time is not designated
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ACCURATE ANSWER:-A ra



A meaningful PICOT question can contain only a P and O: How do hospital client s with bre
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ast cancer (P) rate their quality of life (O)? Note that a welldesigned PICOT question does not ha
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ve to follow the sequence of P, I, C, O, and T. The aim is
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to ask a question that contains as many of the PICOT elements as possible.
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DIF:Analyze (analysis) ra



OBJ:Develop a PICOT question. TOPIC:-Evaluation ra ra ra ar



MSC: Management of Care ra ra ra




8. A nursing attendant is reviewing literature for an evidencebased practice study. Which stud
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y should the nursing attendant use for the most relia
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ble level of evidence that uses statistics to show effectiveness? a. Meta-analysis
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b. Systematic review ra




c. Single random controlled trial ra ra ra




d. Control trial without randomization ra ra ra




ACCURATE ANSWER:-A ra



The main difference is that in a metaanalysis the researcher uses statistics to show the effect of a
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n intervention on an outcome. In
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a systematic review, no statistics are used to draw conclusions about the evidence. A single ra
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ndom controlled trial (RCT) is not as conclusive as a review of several RCTs on the same quest
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ion. Control trials without randomization may involve bias in how the study is conducted.
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DIF:Analyze (analysis) ra



OBJ:Summarize the levels of evidence available in the literature. T ra ra ra ra ra ra ra ra ar



OPIC:-Planning MSC: Management of Care ra ra ra




9. A nursing attendant is reviewing research studies for evidencebased practice. Which article
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should the nursing attendant use for qualitative nursin g research?
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a. An article about the number of falls after use of no side rails
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b. An article about infection rates after use of a new wound dressing
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