Test Bank For Evidence-Based Practice in Nursing & Healthcare A Guide
B B B B B B B B B B
to Best Practice 5th Edition
B B B B B
by Bernadette Mazurek Melnyk, Ellen Fineout-Overholt
B B B B B
Chapter 1 - 23 Complet
B B B B
,Chapter 1 Making the Case for Evidence-Based Practice and
B B B B B B B B
Cultivating a Spirit of Inquiry B B B B B
In the hospital where Nurse L. provides care, tradition dictates that oral temperatures be
B B B B B B B B B B B B B
included in every set of patient vital signs, regardless of patient diagnosis or acuity. Thisis
B B B B B B B B B B B B B B B B
most likely an example of which of the following phenomena? B B B B B B B B B B
A) The prioritization of internal evidence over external evidence
B B B B B B B
B) Practice that lacks evidence to support its application B B B B B B B
C) The integration of personal expertise into nursing care
B B B B B B B
D) Evidence-based practice B
2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a
B B B B B B B B B B B B
patient chart review after the implementation of a pilot program aimed at promoting
B B B B B B B B B B B B B
early ambulation following surgery. Which of the following components of EBP is the
B B B B B B B B B B B B B
nurse putting into practice?
B B B B
A) Patient preferences B
B) Research utilization B
C) Experience
D) Internal evidence B
3. Nurse R. has observed that reorienting demented patients as frequently as possible tends
B B B B B B B B B B B B
to minimize the patients' level of agitation in the evening. The nurse has shared this
B B B B B B B B B B B B B B B
observation with a colleague, who is skeptical, stating that, “It's best to stick to evidence-
B B B B B B B B B B B B B B B
based practice.” How can Nurse R. best respond?
B B B B B B B
A) “EBP can include clinicians' personal expertise.” B B B B B
B) “Personal experience is often more sound than formal evidence-based practice.” B B B B B B B B B
C) “Traditional practice and EBP are usually shown to be the same.” B B B B B B B B B B
D) “My years of experience can be just as valuable as any literature review or
B B B B B B B B B B B B B
randomized trial.”
B B
4. Which of the following factors provides the most important rationale for the consistent
B B B B B B B B B B B B
implementation of EBP?
B B B
A) EBP provides for the most cost-effective patient care.
B B B B B B B
B) EBP is accessible to all healthcare clinicians.
B B B B B B
C) EBP provides consistency in care across healthcare settings.
B B B B B B B
D) EBP improves patient outcomes. B B B
,5. The Institute of Medicine's Roundtable on Evidence-Based Medicine has been
B B B B B B B B B
established to address EBP. Which of the following issues is the Roundtable
B B B B B B B B B B B B
emphasizing?
B
A) Ensuring that external evidence, rather than internal evidence, is integrated into B B B B B B B B B B
care B
B) Fostering the level of learning that exists in the American healthcare system B B B B B B B B B B B
C) Issuing clinical guidelines to ensure best nursing practice B B B B B B B
D) Comparing the implementation of EBP in the United States with that of other B B B B B B B B B B B B
Western countries
B B
6. You have become frustrated with some aspects of patient care that you believe are
B B B B B B B B B B B B B
outdated and ineffective at the long-term care facility where you have recently begun
B B B B B B B B B B B B B
practicing. Consequently, you have resolved to examine some of these practices in light
B B B B B B B B B B B B B
of evidence. Which of the following should occur first in the steps of EBP?
B B B B B B B B B B B B B B
A) Conducting an electronic search of the literature and ranking individual sources B B B B B B B B B B
B) Creating “buy-in” from the other clinicians who provide care at the facility B B B B B B B B B B B
C) Developing an inquisitive and curious mindset B B B B B
D) Assessing whether the practices in question may, in fact, be evidence-based B B B B B B B B B B
7. Which of the following clinical questions best exemplifies the PICOT format?
B B B B B B B B B B
A) What effect does parents' smoking have on the smoking habits of their children,
B B B B B B B B B B B B
ages 13 to 16?
B B B B
B) Among cancer patients, what role does meditation, rather than benzodiazepines,
B B B B B B B B B
have on anxiety levels during the 7 days following hospital admission?
B B B B B B B B B B B
C) Among undergraduate college students, what is the effectiveness of a sexual health
B B B B B B B B B B B
campaign undertaken during the first 4 weeks of the fall semester as measured by
B B B B B B B B B B B B B B
incidence of new gonorrheal and chlamydial infections reported to the campus
B B B B B B B B B B B
medical center?
B B
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to a
B B B B B B B B B B B B B B B B B
numeric rating scale in the emergency room context?
B B B B B B B B
8. After formulating a clinical question, a nurse has proceeded to search for evidence for
B B B B B B B B B B B B B
ways to foster restful sleep in patients who are receiving care in the intensive care unit
B B B B B B B B B B B B B B B B
(ICU). The nurse has identified a relevant meta-analysis in an electronic database. What
B B B B B B B B B B B B B
will this source of evidence consist of?
B B B B B B B
A) A statistical summary of the results from several different studies
B B B B B B B B B
B) An examination of the theoretical and conceptual underpinnings of the issue
B B B B B B B B B B
C) An interdisciplinary analysis of the clinical question
B B B B B B
D) A qualitative study of different interventions related to the clinical question
B B B B B B B B B B
, 9. The nurses on a postpartum unit have noted that many primiparous (first-time) mothers
B B B B B B B B B B B B
are giving up on breastfeeding within the 24 hours following delivery, and the nurses
B B B B B B B B B B B B B B
want to create uniform guidelines for promoting breastfeeding on the unit. Which of the
B B B B B B B B B B B B B B
following sources is most likely to provide the best evidence in their quest for an
B B B B B B B B B B B B B B B
intervention?
B
A) Evidence from a randomized control trial that had more than 2500 participants B B B B B B B B B B B
B) Evidence from a study that is widely regarded as a classic within the obstetrical B B B B B B B B B B B B B
nursing community
B B
C) Evidence from a systematic review of breastfeeding-promotion studies that one of B B B B B B B B B B
the nurses identified in an electronic database
B B B B B B B
D) The consensus opinion of the most senior nurses on the unit
B B B B B B B B B B
10. The nurse educator on an acute medicine unit is advocating for the use of
B B B B B B B B B B B B B
evidence-based clinical practice guidelines on wound care in order to standardize and B B B B B B B B B B B
optimize the practice of the nurses on the unit. Which of the following statements best
B B B B B B B B B B B B B B B
describes clinical practice guidelines?
B B B B
A) The result of replication studies of existing research by an impartial third party
B B B B B B B B B B B B
B) A collection of authorized interventions that are required by law
B B B B B B B B B
C) A number of interventions that are the result of a large, publically-funded RCT
B B B B B B B B B B B B
D) A group of practice recommendations that result from a rigorous review of the
B B B B B B B B B B B B
literature B
11. A nurse is conducting a literature review on the evidence regarding the use of vacuum
B B B B B B B B B B B B B B
dressings on stage IV pressure ulcers. After locating a recent study that appears to be
B B B B B B B B B B B B B B B
relevant, which of the following questions would the nurse consider first when critically
B B B B B B B B B B B B B
appraising the study?
B B B
A) “Are the findings of this study cost-effective in our clinical context?”
B B B B B B B B B B
B) "How would the implementation of this intervention affect our staffing needs?"
B B B B B B B B B B
C) “Were the patients in the study similar to the patients on my unit?”
B B B B B B B B B B B B
D) “Are the findings of the study significantly different from what we are currently
B B B B B B B B B B B B
doing on the unit?
B B B B
12. The primary care provider of a 49-year-old male patient has examined and briefly
B B B B B B B B B B B B
explained the evidence that supports beginning regular digital-rectal exams. Which of
B B B B B B B B B B B
the following factors would justify not performing digital-rectal examinations in this
B B B B B B B B B B B
patient's care?
B B
A) The patient is vehemently opposed to undergoing a digital-rectal exam.
B B B B B B B B B
B) Clinical practice guidelines for prostate care have not been published.
B B B B B B B B B
C) The clinician has been unable to find any large RCTs in a literature review.
B B B B B B B B B B B B B
D) The clinician has previously waited until patients are 55 to begin regular
B B B B B B B B B B B
digital-rectal exams.
B B
B B B B B B B B B B
to Best Practice 5th Edition
B B B B B
by Bernadette Mazurek Melnyk, Ellen Fineout-Overholt
B B B B B
Chapter 1 - 23 Complet
B B B B
,Chapter 1 Making the Case for Evidence-Based Practice and
B B B B B B B B
Cultivating a Spirit of Inquiry B B B B B
In the hospital where Nurse L. provides care, tradition dictates that oral temperatures be
B B B B B B B B B B B B B
included in every set of patient vital signs, regardless of patient diagnosis or acuity. Thisis
B B B B B B B B B B B B B B B B
most likely an example of which of the following phenomena? B B B B B B B B B B
A) The prioritization of internal evidence over external evidence
B B B B B B B
B) Practice that lacks evidence to support its application B B B B B B B
C) The integration of personal expertise into nursing care
B B B B B B B
D) Evidence-based practice B
2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a
B B B B B B B B B B B B
patient chart review after the implementation of a pilot program aimed at promoting
B B B B B B B B B B B B B
early ambulation following surgery. Which of the following components of EBP is the
B B B B B B B B B B B B B
nurse putting into practice?
B B B B
A) Patient preferences B
B) Research utilization B
C) Experience
D) Internal evidence B
3. Nurse R. has observed that reorienting demented patients as frequently as possible tends
B B B B B B B B B B B B
to minimize the patients' level of agitation in the evening. The nurse has shared this
B B B B B B B B B B B B B B B
observation with a colleague, who is skeptical, stating that, “It's best to stick to evidence-
B B B B B B B B B B B B B B B
based practice.” How can Nurse R. best respond?
B B B B B B B
A) “EBP can include clinicians' personal expertise.” B B B B B
B) “Personal experience is often more sound than formal evidence-based practice.” B B B B B B B B B
C) “Traditional practice and EBP are usually shown to be the same.” B B B B B B B B B B
D) “My years of experience can be just as valuable as any literature review or
B B B B B B B B B B B B B
randomized trial.”
B B
4. Which of the following factors provides the most important rationale for the consistent
B B B B B B B B B B B B
implementation of EBP?
B B B
A) EBP provides for the most cost-effective patient care.
B B B B B B B
B) EBP is accessible to all healthcare clinicians.
B B B B B B
C) EBP provides consistency in care across healthcare settings.
B B B B B B B
D) EBP improves patient outcomes. B B B
,5. The Institute of Medicine's Roundtable on Evidence-Based Medicine has been
B B B B B B B B B
established to address EBP. Which of the following issues is the Roundtable
B B B B B B B B B B B B
emphasizing?
B
A) Ensuring that external evidence, rather than internal evidence, is integrated into B B B B B B B B B B
care B
B) Fostering the level of learning that exists in the American healthcare system B B B B B B B B B B B
C) Issuing clinical guidelines to ensure best nursing practice B B B B B B B
D) Comparing the implementation of EBP in the United States with that of other B B B B B B B B B B B B
Western countries
B B
6. You have become frustrated with some aspects of patient care that you believe are
B B B B B B B B B B B B B
outdated and ineffective at the long-term care facility where you have recently begun
B B B B B B B B B B B B B
practicing. Consequently, you have resolved to examine some of these practices in light
B B B B B B B B B B B B B
of evidence. Which of the following should occur first in the steps of EBP?
B B B B B B B B B B B B B B
A) Conducting an electronic search of the literature and ranking individual sources B B B B B B B B B B
B) Creating “buy-in” from the other clinicians who provide care at the facility B B B B B B B B B B B
C) Developing an inquisitive and curious mindset B B B B B
D) Assessing whether the practices in question may, in fact, be evidence-based B B B B B B B B B B
7. Which of the following clinical questions best exemplifies the PICOT format?
B B B B B B B B B B
A) What effect does parents' smoking have on the smoking habits of their children,
B B B B B B B B B B B B
ages 13 to 16?
B B B B
B) Among cancer patients, what role does meditation, rather than benzodiazepines,
B B B B B B B B B
have on anxiety levels during the 7 days following hospital admission?
B B B B B B B B B B B
C) Among undergraduate college students, what is the effectiveness of a sexual health
B B B B B B B B B B B
campaign undertaken during the first 4 weeks of the fall semester as measured by
B B B B B B B B B B B B B B
incidence of new gonorrheal and chlamydial infections reported to the campus
B B B B B B B B B B B
medical center?
B B
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to a
B B B B B B B B B B B B B B B B B
numeric rating scale in the emergency room context?
B B B B B B B B
8. After formulating a clinical question, a nurse has proceeded to search for evidence for
B B B B B B B B B B B B B
ways to foster restful sleep in patients who are receiving care in the intensive care unit
B B B B B B B B B B B B B B B B
(ICU). The nurse has identified a relevant meta-analysis in an electronic database. What
B B B B B B B B B B B B B
will this source of evidence consist of?
B B B B B B B
A) A statistical summary of the results from several different studies
B B B B B B B B B
B) An examination of the theoretical and conceptual underpinnings of the issue
B B B B B B B B B B
C) An interdisciplinary analysis of the clinical question
B B B B B B
D) A qualitative study of different interventions related to the clinical question
B B B B B B B B B B
, 9. The nurses on a postpartum unit have noted that many primiparous (first-time) mothers
B B B B B B B B B B B B
are giving up on breastfeeding within the 24 hours following delivery, and the nurses
B B B B B B B B B B B B B B
want to create uniform guidelines for promoting breastfeeding on the unit. Which of the
B B B B B B B B B B B B B B
following sources is most likely to provide the best evidence in their quest for an
B B B B B B B B B B B B B B B
intervention?
B
A) Evidence from a randomized control trial that had more than 2500 participants B B B B B B B B B B B
B) Evidence from a study that is widely regarded as a classic within the obstetrical B B B B B B B B B B B B B
nursing community
B B
C) Evidence from a systematic review of breastfeeding-promotion studies that one of B B B B B B B B B B
the nurses identified in an electronic database
B B B B B B B
D) The consensus opinion of the most senior nurses on the unit
B B B B B B B B B B
10. The nurse educator on an acute medicine unit is advocating for the use of
B B B B B B B B B B B B B
evidence-based clinical practice guidelines on wound care in order to standardize and B B B B B B B B B B B
optimize the practice of the nurses on the unit. Which of the following statements best
B B B B B B B B B B B B B B B
describes clinical practice guidelines?
B B B B
A) The result of replication studies of existing research by an impartial third party
B B B B B B B B B B B B
B) A collection of authorized interventions that are required by law
B B B B B B B B B
C) A number of interventions that are the result of a large, publically-funded RCT
B B B B B B B B B B B B
D) A group of practice recommendations that result from a rigorous review of the
B B B B B B B B B B B B
literature B
11. A nurse is conducting a literature review on the evidence regarding the use of vacuum
B B B B B B B B B B B B B B
dressings on stage IV pressure ulcers. After locating a recent study that appears to be
B B B B B B B B B B B B B B B
relevant, which of the following questions would the nurse consider first when critically
B B B B B B B B B B B B B
appraising the study?
B B B
A) “Are the findings of this study cost-effective in our clinical context?”
B B B B B B B B B B
B) "How would the implementation of this intervention affect our staffing needs?"
B B B B B B B B B B
C) “Were the patients in the study similar to the patients on my unit?”
B B B B B B B B B B B B
D) “Are the findings of the study significantly different from what we are currently
B B B B B B B B B B B B
doing on the unit?
B B B B
12. The primary care provider of a 49-year-old male patient has examined and briefly
B B B B B B B B B B B B
explained the evidence that supports beginning regular digital-rectal exams. Which of
B B B B B B B B B B B
the following factors would justify not performing digital-rectal examinations in this
B B B B B B B B B B B
patient's care?
B B
A) The patient is vehemently opposed to undergoing a digital-rectal exam.
B B B B B B B B B
B) Clinical practice guidelines for prostate care have not been published.
B B B B B B B B B
C) The clinician has been unable to find any large RCTs in a literature review.
B B B B B B B B B B B B B
D) The clinician has previously waited until patients are 55 to begin regular
B B B B B B B B B B B
digital-rectal exams.
B B
