,Chapter 01: Using Evidence in Nursing Practice
Perry et al.: Nursing Interventions & Clinical Skills, 7th Edition
MULTIPLE CHOICE
1. A nursing educator is explaining how the best clinical practices are determined.
Whichstatement best explains the purpose of evidence-based practice?
a. It ensures that all patients receive holistic care.
b. It provides a definite reason for providing care in a specific manner.
c. It prevents errors when care is being delivered.
d. It guarantees that care delivered is based on research.
ANS: B
Evidence-based practice is the use of the current best evidence in making patient care
decisions. It applies to all types of health care professionals. Currently there is no method
thatcan ensure that all patients receive holistic care, that all errors can be prevented, or that
a guarantee exists that care given is based on research.
DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
2. Which question is a problem-focused trigger for initiating the evidence-based practice
methodin nursing care?
a. What is known about reduction of urinary tract infections in the older adult
withdiabetes?
b. How can chronic pain best be described when the patient is nonverbal?
N
c. How long can an IV catheter remain in place in a patient with obesity?
d. What measures can the nurse take to reduce the rising incidence of urinary
tractinfections on the older adult care unit?
ANS: D
Evidence-based practice (EBP) questions tend to arise from two sources: recurrent
problemsor new knowledge. In the correct option, the increase in urinary tract infections
indicates a trend or recurring problem in a specific group of patients. The other questions
are general information questions, not based on what is happening in a specific area or to
a group of specific patients in an area or relating to an observed trend.
DIF: Cognitive Level: Applying OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
3. What does the “I” indicate in a “PICO” question?
a. Intervention of interest
b. Incorporation of concepts
c. Implementation by nursing
d. Interest of personnel
ANS: A
The “I” stands for intervention of interest, meaning what the nurse hopes to use in practice
and believes is worthwhile or valuable. This could be a treatment for a specific type of
, woundor an approach on how to teach food preparation for a patient with impaired sight.
DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
4. Who will the clinical research nurse contact to search relevant databases in preparation for
anupcoming study?
a. The physician whose patients may be involved in the study
b. The medical librarian
c. The nurse manager of the unit where the study will be conducted
d. The director of nursing of the facility
ANS: B
The medical librarian is most knowledgeable regarding databases relevant to a study.
Theother individuals do not have the knowledge regarding relevant databases.
DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
5. Which database contains summaries of clinical guidelines and their development?
a. MEDLINE
b. CINAHL
c. Cochrane Database of Systematic Reviews
d. The National Guideline Clearinghouse
ANS: D
The National Guideline Clearinghouse is a database supported by the Agency for
Healthcare Research and Quality. It contains summaries of clinical guidelines for practice.
MEDLINE is a database for studies in medicN ine, nursing, dentistry, psychiatry, veterinary
medicine, and
allied health. CINAHL (Cumulative Index of Nursing and Allied Health Literature) includes
studies in nursing, allied health, and biomedicine. The Cochrane Database Full text of
regularly updated systematic reviews prepared by the Cochrane Collaboration
includescompleted reviews and protocols.
DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
6. Which does the nurse researcher identify as the strongest type of research?
a. Randomized controlled trials
b. A qualitative study
c. A descriptive study
d. A case controlled study
ANS: A
Individual randomized controlled trials are close to the top of the research pyramid. Only
systematic reviews and meta-analyses are higher. This type of study tests an
intervention against the usual standard of care. The other types of studies are useful but
do not give thesame type of information as a randomized controlled trial provides.
DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Assessment
, 7. What is the nurse attempting to determine when critiquing the evidence related to a
PICOTquestion?
a. The ethical conduct of the research the nurse read
b. The strength of the evidence found in the literature
c. If there are any experts in the clinical question needing to be researched
d. If the study demonstrates cost-effectiveness if a change in practice occurs
ANS: B
Once a literature search is complete and data are gathered about the question, it is time to
critique the evidence. Critiquing the evidence involves a systematic approach to looking at
thestrength of the work reviewed and its relevance. The other questions are not applicable
to critiquing the evidence.
DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
8. A nurse finds a cohort study comparing one group taking hormone treatment with another
group not taking hormone treatment to determine the incidence of changes in bone
density ofthe lower spine. What can the nurse imply from this study?
a. Low level of strength makes the study limited in value.
b. Moderate level of strength makes the study probably useful.
c. Opinions of the individuals in the cohort are not research.
d. This could be the basis for a Quality Improvement project.
ANS: B
A cohort study is Level 4 evidence as it is a single, non-experimental study. This moderate
level of evidence makes the study probably useful but the nurse should strive to find
stronger
evidence. N
DIF: Cognitive Level: Applying OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Evaluation
9. Which question would be the best example of a knowledge-focused trigger for conducting
anevidence-based practice project?
a. What is the best method for treatment of leg swelling when a patient is
takinggabapentin (Neurontin)?
b. How can we decrease the incidence of skin cancer in adults over the age of 65?
c. What is the current evidence for improving oral intake for cancer patients
withstomatitis?
d. What is the maximal length of time our hospital allows irrigation kits to be used?
ANS: C
Evidence-based practice (EBP) questions tend to arise from two sources: recurrent
problems or new knowledge. In this example, the new knowledge that drives the question
is the one looking at current evidence. The other questions do not look at the newest
knowledge to forma question to research.
DIF: Cognitive Level: Analyzing OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
MULTIPLE RESPONSE
Perry et al.: Nursing Interventions & Clinical Skills, 7th Edition
MULTIPLE CHOICE
1. A nursing educator is explaining how the best clinical practices are determined.
Whichstatement best explains the purpose of evidence-based practice?
a. It ensures that all patients receive holistic care.
b. It provides a definite reason for providing care in a specific manner.
c. It prevents errors when care is being delivered.
d. It guarantees that care delivered is based on research.
ANS: B
Evidence-based practice is the use of the current best evidence in making patient care
decisions. It applies to all types of health care professionals. Currently there is no method
thatcan ensure that all patients receive holistic care, that all errors can be prevented, or that
a guarantee exists that care given is based on research.
DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
2. Which question is a problem-focused trigger for initiating the evidence-based practice
methodin nursing care?
a. What is known about reduction of urinary tract infections in the older adult
withdiabetes?
b. How can chronic pain best be described when the patient is nonverbal?
N
c. How long can an IV catheter remain in place in a patient with obesity?
d. What measures can the nurse take to reduce the rising incidence of urinary
tractinfections on the older adult care unit?
ANS: D
Evidence-based practice (EBP) questions tend to arise from two sources: recurrent
problemsor new knowledge. In the correct option, the increase in urinary tract infections
indicates a trend or recurring problem in a specific group of patients. The other questions
are general information questions, not based on what is happening in a specific area or to
a group of specific patients in an area or relating to an observed trend.
DIF: Cognitive Level: Applying OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
3. What does the “I” indicate in a “PICO” question?
a. Intervention of interest
b. Incorporation of concepts
c. Implementation by nursing
d. Interest of personnel
ANS: A
The “I” stands for intervention of interest, meaning what the nurse hopes to use in practice
and believes is worthwhile or valuable. This could be a treatment for a specific type of
, woundor an approach on how to teach food preparation for a patient with impaired sight.
DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
4. Who will the clinical research nurse contact to search relevant databases in preparation for
anupcoming study?
a. The physician whose patients may be involved in the study
b. The medical librarian
c. The nurse manager of the unit where the study will be conducted
d. The director of nursing of the facility
ANS: B
The medical librarian is most knowledgeable regarding databases relevant to a study.
Theother individuals do not have the knowledge regarding relevant databases.
DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
5. Which database contains summaries of clinical guidelines and their development?
a. MEDLINE
b. CINAHL
c. Cochrane Database of Systematic Reviews
d. The National Guideline Clearinghouse
ANS: D
The National Guideline Clearinghouse is a database supported by the Agency for
Healthcare Research and Quality. It contains summaries of clinical guidelines for practice.
MEDLINE is a database for studies in medicN ine, nursing, dentistry, psychiatry, veterinary
medicine, and
allied health. CINAHL (Cumulative Index of Nursing and Allied Health Literature) includes
studies in nursing, allied health, and biomedicine. The Cochrane Database Full text of
regularly updated systematic reviews prepared by the Cochrane Collaboration
includescompleted reviews and protocols.
DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
6. Which does the nurse researcher identify as the strongest type of research?
a. Randomized controlled trials
b. A qualitative study
c. A descriptive study
d. A case controlled study
ANS: A
Individual randomized controlled trials are close to the top of the research pyramid. Only
systematic reviews and meta-analyses are higher. This type of study tests an
intervention against the usual standard of care. The other types of studies are useful but
do not give thesame type of information as a randomized controlled trial provides.
DIF: Cognitive Level: Remembering OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Assessment
, 7. What is the nurse attempting to determine when critiquing the evidence related to a
PICOTquestion?
a. The ethical conduct of the research the nurse read
b. The strength of the evidence found in the literature
c. If there are any experts in the clinical question needing to be researched
d. If the study demonstrates cost-effectiveness if a change in practice occurs
ANS: B
Once a literature search is complete and data are gathered about the question, it is time to
critique the evidence. Critiquing the evidence involves a systematic approach to looking at
thestrength of the work reviewed and its relevance. The other questions are not applicable
to critiquing the evidence.
DIF: Cognitive Level: Understanding OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
8. A nurse finds a cohort study comparing one group taking hormone treatment with another
group not taking hormone treatment to determine the incidence of changes in bone
density ofthe lower spine. What can the nurse imply from this study?
a. Low level of strength makes the study limited in value.
b. Moderate level of strength makes the study probably useful.
c. Opinions of the individuals in the cohort are not research.
d. This could be the basis for a Quality Improvement project.
ANS: B
A cohort study is Level 4 evidence as it is a single, non-experimental study. This moderate
level of evidence makes the study probably useful but the nurse should strive to find
stronger
evidence. N
DIF: Cognitive Level: Applying OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Evaluation
9. Which question would be the best example of a knowledge-focused trigger for conducting
anevidence-based practice project?
a. What is the best method for treatment of leg swelling when a patient is
takinggabapentin (Neurontin)?
b. How can we decrease the incidence of skin cancer in adults over the age of 65?
c. What is the current evidence for improving oral intake for cancer patients
withstomatitis?
d. What is the maximal length of time our hospital allows irrigation kits to be used?
ANS: C
Evidence-based practice (EBP) questions tend to arise from two sources: recurrent
problems or new knowledge. In this example, the new knowledge that drives the question
is the one looking at current evidence. The other questions do not look at the newest
knowledge to forma question to research.
DIF: Cognitive Level: Analyzing OBJ: NCLEX: Safe and Effective Care Environment
TOP: Nursing Process: Implementation
MULTIPLE RESPONSE
