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