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,e 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outdated and ineffective at the long-term care facility where you have recently begun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. WhichmofmthemfollowingmclinicalmquestionsmbestmexemplifiesmthemPICOTmformat?
A) Whatmeffectmdoesmparents'msmokingmhavemonmthemsmokingmhabitsmofmthei
rmchildren,magesm13mtom16?
B) Amongmcancermpatients,mwhatmrolemdoesmmeditation,mrathermthanmbenzodi
azepines,mhavemonmanxietymlevelsmduringmthem7mdaysmfollowingmhospitalmad
mission?
C) Amongmundergraduatemcollegemstudents,mwhatmismthemeffectivenessmofmamsex
ualmhealthmcampaignmundertakenmduringmthemfirstm4mweeksmofmthemfallmseme
stermasmmeasuredmbymincidencemofmnewmgonorrhealmandmchlamydialminfection
smreportedmtomthemcampusmmedicalmcenter?
D) Inmpatientsmagedm8mtom12,mismthemeffectivenessmofmampainmscalemusingmfacesm
superiormtomamnumericmratingmscaleminmthememergencymroommcontext?
8. Aftermformulatingmamclinicalmquestion,mamnursemhasmproceededmtomsearchmformevid
encemformwaysmtomfostermrestfulmsleepminmpatientsmwhomaremreceivingmcareminmth
emintensivemcaremunitm(ICU).mThemnursemhasmidentifiedmamrelevantmmeta-
analysisminmanmelectronicmdatabase.mWhatmwillmthismsourcemofmevidencemconsistmof?
A) Amstatisticalmsummarymofmthemresultsmfrommseveralmdifferentmstudies
B) Anmexaminationmofmthemtheoreticalmandmconceptualmunderpinningsmofmthemissue
C) Anminterdisciplinarymanalysismofmthemclinicalmquestion
D) Amqualitativemstudymofmdifferentminterventionsmrelatedmtomthemclinicalmquestion
, 9. Themnursesmonmampostpartummunitmhavemnotedmthatmmanymprimiparousm(first-
time)mmothersmaremgivingmupmonmbreastfeedingmwithinmthem24mhoursmfollowingmd
elivery,mandmthemnursesmwantmtomcreatemuniformmguidelinesmformpromotingmbreas
tfeedingmonmthemunit.mWhichmofmthemfollowingmsourcesmismmostmlikelymtomprovide
mthembestmevidenceminmtheirmquestmformanmintervention?
A) Evidencemfrommamrandomizedmcontrolmtrialmthatmhadmmoremthanm2500mparticipants
B) Evidencemfrommamstudymthatmismwidelymregardedmasmamclassicmwithinmthem
obstetricalmnursingmcommunity
C) Evidencemfrommamsystematicmreviewmofmbreastfeeding-
promotionmstudiesmthatmonemofmthemnursesmidentifiedminmanmelectronicmdata
base
D) Themconsensusmopinionmofmthemmostmseniormnursesmonmthemunit
10. Themnursemeducatormonmanmacutemmedicinemunitmismadvocatingmformthemusemof
evidence-
basedmclinicalmpracticemguidelinesmonmwoundmcareminmordermtomstandardizemand
moptimizemthempracticemofmthemnursesmonmthemunit.mWhichmofmthemfollowingmsta
tementsmbestmdescribesmclinicalmpracticemguidelines?
A) Themresultmofmreplicationmstudiesmofmexistingmresearchmbymanmimpartialmthirdmparty
B) Amcollectionmofmauthorizedminterventionsmthatmaremrequiredmbymlaw
C) Amnumbermofminterventionsmthatmaremthemresultmofmamlarge,mpublically-fundedmRCT
D) Amgroupmofmpracticemrecommendationsmthatmresultmfrommamrigorousmrevi
ewmofmthemliterature
11. Amnursemismconductingmamliteraturemreviewmonmthemevidencemregardingmthemusemo
fmvacuummdressingsmonmstagemIVmpressuremulcers.mAftermlocatingmamrecentmstudym
thatmappearsmtombemrelevant,mwhichmofmthemfollowingmquestionsmwouldmthemnurse
mconsidermfirstmwhenmcriticallymappraisingmthemstudy?
A) “Aremthemfindingsmofmthismstudymcost-effectiveminmourmclinicalmcontext?”
B) "Howmwouldmthemimplementationmofmthisminterventionmaffectmourmstaffingmneeds?"
C) “Weremthempatientsminmthemstudymsimilarmtomthempatientsmonmmymunit?”
D) “Aremthemfindingsmofmthemstudymsignificantlymdifferentmfrommwhatmwemare
mcurrentlymdoingmonmthemunit?
12. Themprimarymcaremprovidermofmam49-year-
oldmmalempatientmhasmexaminedmandmbrieflymexplainedmthemevidencemthatmsupp
ortsmbeginningmregularmdigital-
rectalmexams.mWhichmofmthemfollowingmfactorsmwouldmjustifymnotmperformingmdig
ital-rectalmexaminationsminmthismpatient'smcare?
A) Thempatientmismvehementlymopposedmtomundergoingmamdigital-rectalmexam.
B) Clinicalmpracticemguidelinesmformprostatemcaremhavemnotmbeenmpublished.
C) ThemclinicianmhasmbeenmunablemtomfindmanymlargemRCTsminmamliteraturemreview.
h
a
p
t
e
r
1
M
a
k
i
n
g
t
h
,e 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. WhichmofmthemfollowingmclinicalmquestionsmbestmexemplifiesmthemPICOTmformat?
A) Whatmeffectmdoesmparents'msmokingmhavemonmthemsmokingmhabitsmofmthei
rmchildren,magesm13mtom16?
B) Amongmcancermpatients,mwhatmrolemdoesmmeditation,mrathermthanmbenzodi
azepines,mhavemonmanxietymlevelsmduringmthem7mdaysmfollowingmhospitalmad
mission?
C) Amongmundergraduatemcollegemstudents,mwhatmismthemeffectivenessmofmamsex
ualmhealthmcampaignmundertakenmduringmthemfirstm4mweeksmofmthemfallmseme
stermasmmeasuredmbymincidencemofmnewmgonorrhealmandmchlamydialminfection
smreportedmtomthemcampusmmedicalmcenter?
D) Inmpatientsmagedm8mtom12,mismthemeffectivenessmofmampainmscalemusingmfacesm
superiormtomamnumericmratingmscaleminmthememergencymroommcontext?
8. Aftermformulatingmamclinicalmquestion,mamnursemhasmproceededmtomsearchmformevid
encemformwaysmtomfostermrestfulmsleepminmpatientsmwhomaremreceivingmcareminmth
emintensivemcaremunitm(ICU).mThemnursemhasmidentifiedmamrelevantmmeta-
analysisminmanmelectronicmdatabase.mWhatmwillmthismsourcemofmevidencemconsistmof?
A) Amstatisticalmsummarymofmthemresultsmfrommseveralmdifferentmstudies
B) Anmexaminationmofmthemtheoreticalmandmconceptualmunderpinningsmofmthemissue
C) Anminterdisciplinarymanalysismofmthemclinicalmquestion
D) Amqualitativemstudymofmdifferentminterventionsmrelatedmtomthemclinicalmquestion
, 9. Themnursesmonmampostpartummunitmhavemnotedmthatmmanymprimiparousm(first-
time)mmothersmaremgivingmupmonmbreastfeedingmwithinmthem24mhoursmfollowingmd
elivery,mandmthemnursesmwantmtomcreatemuniformmguidelinesmformpromotingmbreas
tfeedingmonmthemunit.mWhichmofmthemfollowingmsourcesmismmostmlikelymtomprovide
mthembestmevidenceminmtheirmquestmformanmintervention?
A) Evidencemfrommamrandomizedmcontrolmtrialmthatmhadmmoremthanm2500mparticipants
B) Evidencemfrommamstudymthatmismwidelymregardedmasmamclassicmwithinmthem
obstetricalmnursingmcommunity
C) Evidencemfrommamsystematicmreviewmofmbreastfeeding-
promotionmstudiesmthatmonemofmthemnursesmidentifiedminmanmelectronicmdata
base
D) Themconsensusmopinionmofmthemmostmseniormnursesmonmthemunit
10. Themnursemeducatormonmanmacutemmedicinemunitmismadvocatingmformthemusemof
evidence-
basedmclinicalmpracticemguidelinesmonmwoundmcareminmordermtomstandardizemand
moptimizemthempracticemofmthemnursesmonmthemunit.mWhichmofmthemfollowingmsta
tementsmbestmdescribesmclinicalmpracticemguidelines?
A) Themresultmofmreplicationmstudiesmofmexistingmresearchmbymanmimpartialmthirdmparty
B) Amcollectionmofmauthorizedminterventionsmthatmaremrequiredmbymlaw
C) Amnumbermofminterventionsmthatmaremthemresultmofmamlarge,mpublically-fundedmRCT
D) Amgroupmofmpracticemrecommendationsmthatmresultmfrommamrigorousmrevi
ewmofmthemliterature
11. Amnursemismconductingmamliteraturemreviewmonmthemevidencemregardingmthemusemo
fmvacuummdressingsmonmstagemIVmpressuremulcers.mAftermlocatingmamrecentmstudym
thatmappearsmtombemrelevant,mwhichmofmthemfollowingmquestionsmwouldmthemnurse
mconsidermfirstmwhenmcriticallymappraisingmthemstudy?
A) “Aremthemfindingsmofmthismstudymcost-effectiveminmourmclinicalmcontext?”
B) "Howmwouldmthemimplementationmofmthisminterventionmaffectmourmstaffingmneeds?"
C) “Weremthempatientsminmthemstudymsimilarmtomthempatientsmonmmymunit?”
D) “Aremthemfindingsmofmthemstudymsignificantlymdifferentmfrommwhatmwemare
mcurrentlymdoingmonmthemunit?
12. Themprimarymcaremprovidermofmam49-year-
oldmmalempatientmhasmexaminedmandmbrieflymexplainedmthemevidencemthatmsupp
ortsmbeginningmregularmdigital-
rectalmexams.mWhichmofmthemfollowingmfactorsmwouldmjustifymnotmperformingmdig
ital-rectalmexaminationsminmthismpatient'smcare?
A) Thempatientmismvehementlymopposedmtomundergoingmamdigital-rectalmexam.
B) Clinicalmpracticemguidelinesmformprostatemcaremhavemnotmbeenmpublished.
C) ThemclinicianmhasmbeenmunablemtomfindmanymlargemRCTsminmamliteraturemreview.
