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