Page 1 of 95
NR-449 CHAMBERLAIN EVIDENCE-BASED PRACTICE NURSING
MASTER GUIDE COMPREHENSIVE EXAM PREPARATION & NURSING
KNOWLEDGE REVIEW QUESTIONS LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
CHAMBERLAIN EVIDENCE-BASED PRACTICE — NR-449: 250 MULTIPLE CHOICE
QUESTIONS WITH RATIONALES
SECTION A: INTRODUCTION TO EVIDENCE-BASED PRACTICE (QUESTIONS 1-25)
1. A nursing student is learning about the definition of evidence-based practice and
its application to patient care. Which statement best defines evidence-based
practice in nursing?
A) Following established policies and procedures without questioning their
effectiveness
B) Using clinical expertise alone to determine the best course of action for patient care
C) Integrating the best available research evidence with clinical expertise and patient
preferences and values
D) Relying primarily on traditions and customs that have been passed down through
generations of nurses
Answer: C) Integrating the best available research evidence with clinical expertise
and patient preferences and values
Rationale: Evidence-based practice is defined as the integration of the best available
research evidence, clinical expertise, and patient preferences and values. This three-
part definition acknowledges that high-quality patient care requires both scientific
evidence and individualized consideration of patient circumstances.
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2. A nurse is implementing an evidence-based practice change on a medical-
surgical unit and encounters resistance from staff who prefer to continue using
traditional methods. Which statement best describes the most common barrier to
implementing evidence-based practice in clinical settings?
A) Lack of interest in research among nursing staff
B) Time constraints and heavy workloads that limit opportunities to read and implement
research
C) Insufficient patient demand for evidence-based care
D) Lack of available research evidence on common clinical topics
Answer: B) Time constraints and heavy workloads that limit opportunities to read
and implement research
Rationale: Time constraints and heavy workloads are consistently identified as the most
common barriers to EBP implementation. Nurses often report that they lack time to
read research, attend educational sessions, or participate in EBP activities while
managing demanding patient assignments.
3. A nurse educator is explaining the history of evidence-based practice to a group
of nursing students. Which historical event is credited with initiating the modern
evidence-based practice movement?
A) Florence Nightingale's use of statistics to improve sanitation during the Crimean War
B) Archie Cochrane's advocacy for the use of systematic reviews to guide healthcare
decisions
C) The establishment of the Agency for Healthcare Research and Quality (AHRQ)
D) The development of the first nursing research journals in the 1950s
Answer: B) Archie Cochrane's advocacy for the use of systematic reviews to guide
healthcare decisions
Rationale: Archie Cochrane, a British epidemiologist, is considered the father of
evidence-based medicine. He advocated for the use of systematic reviews of
randomized controlled trials to guide healthcare decisions, which laid the foundation
for the evidence-based practice movement. His work led to the establishment of the
Cochrane Collaboration.
4. A nurse is using the Iowa Model of Evidence-Based Practice to guide a practice
change project. According to this model, what is the first step the nurse should
take when implementing a practice change?
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A) Implement the practice change on a pilot unit
B) Identify a clinical problem or triggering issue that warrants investigation
C) Critique and synthesize the available research evidence
D) Develop an evidence-based practice guideline based on the literature
Answer: B) Identify a clinical problem or triggering issue that warrants investigation
Rationale: The Iowa Model of Evidence-Based Practice begins with identifying a clinical
problem or triggering issue. This "trigger" can be a problem-focused trigger (such as a
high infection rate) or a knowledge-focused trigger (such as new research findings).
Once the problem is identified, the team proceeds through the remaining steps of the
model.
5. A nurse is applying the ACE Star Model of Knowledge Transformation to
implement an evidence-based practice change. Which step of this model involves
synthesizing multiple research studies into a single, coherent body of evidence?
A) Discovery
B) Evidence summary
C) Translation
D) Evaluation
Answer: B) Evidence summary
Rationale: The ACE Star Model describes the process of knowledge transformation from
primary research to implementation. The Evidence Summary step involves synthesizing
multiple research studies on a topic into a single, coherent summary that can guide
practice. This step is followed by translation, implementation, and evaluation.
6. A nurse manager is discussing EBP implementation with the unit staff and notes
that many nurses express skepticism about the value of research. Which action by
the manager would be most effective in promoting a culture of evidence-based
practice?
A) Requiring all nurses to read one research article per month
B) Creating a unit-based journal club to discuss research articles
C) Mandating that all nurses implement evidence-based protocols immediately
D) Asking each nurse to develop an individual research project
Answer: B) Creating a unit-based journal club to discuss research articles
Rationale: Journal clubs provide a supportive environment for nurses to read, discuss,
and critique research articles. This collaborative approach helps build EBP knowledge
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and skills, reduces skepticism through education, and fosters a culture of inquiry and
evidence-based practice.
7. A nurse is evaluating a research article for clinical applicability. The nurse notes
that the study was conducted in a different country with different healthcare
resources and patient demographics. Which factor should the nurse consider when
applying these findings to their own clinical setting?
A) The study findings should be implemented regardless of setting differences
B) The study findings should not be used because the setting is different
C) The nurse should consider the generalizability and applicability of the findings to
their patient population
D) The nurse should wait for a local replication study before implementing the findings
Answer: C) The nurse should consider the generalizability and applicability of the
findings to their patient population
Rationale: When applying research findings to practice, nurses must consider whether
the study population and setting are similar enough to their own patient population that
the findings can be generalized. Factors such as patient characteristics, healthcare
resources, and cultural differences affect applicability.
8. A nurse is learning about the levels of evidence hierarchy for making clinical
decisions. Which level of evidence is considered the highest or strongest for
determining the effectiveness of an intervention?
A) A systematic review or meta-analysis of randomized controlled trials
B) A single randomized controlled trial
C) A cohort study
D) Expert opinion
Answer: A) A systematic review or meta-analysis of randomized controlled trials
Rationale: The highest level of evidence in the evidence hierarchy is a systematic review
or meta-analysis of multiple randomized controlled trials. These studies synthesize
findings from multiple well-designed studies, providing the strongest evidence for
clinical decision-making.
9. A nurse is developing a plan to implement evidence-based practice on a busy
surgical unit. Which facilitator of EBP implementation should the nurse prioritize to
improve the likelihood of success?
NR-449 CHAMBERLAIN EVIDENCE-BASED PRACTICE NURSING
MASTER GUIDE COMPREHENSIVE EXAM PREPARATION & NURSING
KNOWLEDGE REVIEW QUESTIONS LATEST VERSION QUESTIONS AND
ANSWERS 2026 EDITION
CHAMBERLAIN EVIDENCE-BASED PRACTICE — NR-449: 250 MULTIPLE CHOICE
QUESTIONS WITH RATIONALES
SECTION A: INTRODUCTION TO EVIDENCE-BASED PRACTICE (QUESTIONS 1-25)
1. A nursing student is learning about the definition of evidence-based practice and
its application to patient care. Which statement best defines evidence-based
practice in nursing?
A) Following established policies and procedures without questioning their
effectiveness
B) Using clinical expertise alone to determine the best course of action for patient care
C) Integrating the best available research evidence with clinical expertise and patient
preferences and values
D) Relying primarily on traditions and customs that have been passed down through
generations of nurses
Answer: C) Integrating the best available research evidence with clinical expertise
and patient preferences and values
Rationale: Evidence-based practice is defined as the integration of the best available
research evidence, clinical expertise, and patient preferences and values. This three-
part definition acknowledges that high-quality patient care requires both scientific
evidence and individualized consideration of patient circumstances.
, Page 2 of 95
2. A nurse is implementing an evidence-based practice change on a medical-
surgical unit and encounters resistance from staff who prefer to continue using
traditional methods. Which statement best describes the most common barrier to
implementing evidence-based practice in clinical settings?
A) Lack of interest in research among nursing staff
B) Time constraints and heavy workloads that limit opportunities to read and implement
research
C) Insufficient patient demand for evidence-based care
D) Lack of available research evidence on common clinical topics
Answer: B) Time constraints and heavy workloads that limit opportunities to read
and implement research
Rationale: Time constraints and heavy workloads are consistently identified as the most
common barriers to EBP implementation. Nurses often report that they lack time to
read research, attend educational sessions, or participate in EBP activities while
managing demanding patient assignments.
3. A nurse educator is explaining the history of evidence-based practice to a group
of nursing students. Which historical event is credited with initiating the modern
evidence-based practice movement?
A) Florence Nightingale's use of statistics to improve sanitation during the Crimean War
B) Archie Cochrane's advocacy for the use of systematic reviews to guide healthcare
decisions
C) The establishment of the Agency for Healthcare Research and Quality (AHRQ)
D) The development of the first nursing research journals in the 1950s
Answer: B) Archie Cochrane's advocacy for the use of systematic reviews to guide
healthcare decisions
Rationale: Archie Cochrane, a British epidemiologist, is considered the father of
evidence-based medicine. He advocated for the use of systematic reviews of
randomized controlled trials to guide healthcare decisions, which laid the foundation
for the evidence-based practice movement. His work led to the establishment of the
Cochrane Collaboration.
4. A nurse is using the Iowa Model of Evidence-Based Practice to guide a practice
change project. According to this model, what is the first step the nurse should
take when implementing a practice change?
, Page 3 of 95
A) Implement the practice change on a pilot unit
B) Identify a clinical problem or triggering issue that warrants investigation
C) Critique and synthesize the available research evidence
D) Develop an evidence-based practice guideline based on the literature
Answer: B) Identify a clinical problem or triggering issue that warrants investigation
Rationale: The Iowa Model of Evidence-Based Practice begins with identifying a clinical
problem or triggering issue. This "trigger" can be a problem-focused trigger (such as a
high infection rate) or a knowledge-focused trigger (such as new research findings).
Once the problem is identified, the team proceeds through the remaining steps of the
model.
5. A nurse is applying the ACE Star Model of Knowledge Transformation to
implement an evidence-based practice change. Which step of this model involves
synthesizing multiple research studies into a single, coherent body of evidence?
A) Discovery
B) Evidence summary
C) Translation
D) Evaluation
Answer: B) Evidence summary
Rationale: The ACE Star Model describes the process of knowledge transformation from
primary research to implementation. The Evidence Summary step involves synthesizing
multiple research studies on a topic into a single, coherent summary that can guide
practice. This step is followed by translation, implementation, and evaluation.
6. A nurse manager is discussing EBP implementation with the unit staff and notes
that many nurses express skepticism about the value of research. Which action by
the manager would be most effective in promoting a culture of evidence-based
practice?
A) Requiring all nurses to read one research article per month
B) Creating a unit-based journal club to discuss research articles
C) Mandating that all nurses implement evidence-based protocols immediately
D) Asking each nurse to develop an individual research project
Answer: B) Creating a unit-based journal club to discuss research articles
Rationale: Journal clubs provide a supportive environment for nurses to read, discuss,
and critique research articles. This collaborative approach helps build EBP knowledge
, Page 4 of 95
and skills, reduces skepticism through education, and fosters a culture of inquiry and
evidence-based practice.
7. A nurse is evaluating a research article for clinical applicability. The nurse notes
that the study was conducted in a different country with different healthcare
resources and patient demographics. Which factor should the nurse consider when
applying these findings to their own clinical setting?
A) The study findings should be implemented regardless of setting differences
B) The study findings should not be used because the setting is different
C) The nurse should consider the generalizability and applicability of the findings to
their patient population
D) The nurse should wait for a local replication study before implementing the findings
Answer: C) The nurse should consider the generalizability and applicability of the
findings to their patient population
Rationale: When applying research findings to practice, nurses must consider whether
the study population and setting are similar enough to their own patient population that
the findings can be generalized. Factors such as patient characteristics, healthcare
resources, and cultural differences affect applicability.
8. A nurse is learning about the levels of evidence hierarchy for making clinical
decisions. Which level of evidence is considered the highest or strongest for
determining the effectiveness of an intervention?
A) A systematic review or meta-analysis of randomized controlled trials
B) A single randomized controlled trial
C) A cohort study
D) Expert opinion
Answer: A) A systematic review or meta-analysis of randomized controlled trials
Rationale: The highest level of evidence in the evidence hierarchy is a systematic review
or meta-analysis of multiple randomized controlled trials. These studies synthesize
findings from multiple well-designed studies, providing the strongest evidence for
clinical decision-making.
9. A nurse is developing a plan to implement evidence-based practice on a busy
surgical unit. Which facilitator of EBP implementation should the nurse prioritize to
improve the likelihood of success?
