Evidence-Based Practice BASIC NURSING ESSENTIALS FOR PRACTICE 7TH EDITION BY POTTER

Evidence-Based Practice BASIC NURSING ESSENTIALS FOR PRACTICE 7TH EDITION BY POTTER Evidence-Based Practice BASIC NURSING ESSENTIALS FOR PRACTICE 7TH EDITION BY POTTER Potter: Basic Nursing, 7th Edition Evidence-Based Practice Test Bank MULTIPLE CHOICE 1. Which of the following nurses was the first to use evidence-based practice? A. Mary Brewster B. Clara Barton C. Florence Nightingale D. Lillian Wald ANS: C Evidence-based practice was first used by the founder of nursing, Florence Nightingale. PTS: 1 DIF: Cognitive Level: Knowledge REF: 75 OBJ: Discuss ways to apply evidence in practice TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 2. A registered nurse has been a nurse for 3 years. She questioned the nurses on the neonatal intensive care unit where she works about the practice of kangaroo care for neonates. She had read literature supporting the practice, but the nurses she works with told her that they had never done anything like that at their institution. She continued to ask questions and began a literature review. Which of the following behaviors was she demonstrating? A. Nursing process B. Problem solving methodology C. Peer review D. Evidence-based practice ANS: D More people now question why certain health care approaches are used, which ones work, and which ones do not. Thus evidence-based practice is one response to this shift in thinking, which nurses and other health professionals cannot ignore. Evidence-based practice is a guide for how nurses make accurate, timely, and appropriate clinical decisions. PTS: 1 DIF: Cognitive Level: Analysis REF: 75 OBJ: Discuss ways to apply evidence in practice TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 3. A registered nurse wants to review the latest information regarding prevention of a health care acquired infection. The best place for her to obtain the latest information is which of the following? A. Latest edition of a nursing textbook B. Online information C. Peer-reviewed nursing journal D. Most recent edition of a nursing magazine ANS: C The best scientific evidence comes from well-designed, systematically conducted research studies, usually found in peer-reviewed scientific journals. A good textbook incorporates current evidence into the practice guidelines and procedures it describes. However, a textbook relies on the scientific literature, and sometimes information on a particular topic is outdated by the time a book is published. PTS: 1 DIF: Cognitive Level: Application REF: 75 OBJ: Explain why critiquing of the literature is a necessary step in evidence-based practice TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 4. A 15-year-old male patient was admitted to the hospital with a bowel obstruction. He underwent surgery and was experiencing postoperative pain. The nurse caring for him had recently read a research article in which a study had been done with neonatal patients and the use of therapeutic touch to assist with pain control. Which of the following is most important for the nurse to consider in this case when applying research to clinical practice? A. Patient gender B. Patient preference C. Stage of patient growth and development D. Physician orders ANS: B Using clinical expertise and considering patients’ values and preferences ensures that a nurse will apply the available evidence to practice both safely and appropriately. PTS: 1 DIF: Cognitive Level: Analysis REF: 76 OBJ: Discuss ways to apply evidence in practice TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 5. Evidence-based practice is a systematic approach to determine the most current and relevant information from which to make patient care decisions. Choose the first step in the evidence-based care process. A. Collecting the most relevant and best evidence B. Integrating evidence with one’s clinical expertise C. Critically appraising the evidence gathered D. Asking a clinical question ANS: D EBP is a systematic approach to determine the most current and relevant evidence on which to base patient care decisions. Melnyk and Fineout-Overholt recommend a six-step process for EBP: 1. Ask a clinical question. 2. Collect the most relevant and best evidence. 3. Critically appraise the evidence gathered. 4. Integrate all evidence with one’s clinical expertise and patient preferences and values in making a practice decision or change. 5. Evaluate the practice decision or change. 6. Communicate results of the change. PTS: 1 DIF: Cognitive Level: Knowledge REF: 76 OBJ: Describe the six steps of evidence-based practice TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 6. The nurse manager of a 30-bed medical surgical unit has noticed that the fall rate of postoperative patients has increased in the past 2 months. This is a clinical situation that he believes should be addressed using evidence-based practice. The clinical question that he is formulating has come about because of which of the following? A. Literature-focused trigger B. Problem-focused trigger C. Knowledge-focused trigger D. Expectations-focused trigger ANS: B A problem-focused trigger is one that is experienced in the care for a patient or in an observed trend at a nursing unit. PTS: 1 DIF: Cognitive Level: Analysis REF: 76 OBJ: Develop a PICO or PICOT question TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 7. A registered nurse who works for a surgical intensive care unit (ICU) has recently read several articles in professional nursing journals about the use of quiet time in the ICU to enhance patient outcomes. He would like to apply the research findings to his unit. The clinical question he formulated was generated by which of the following? A. Literature-focused trigger B. Problem-focused trigger C. Knowledge-focused trigger D. Expectations-focused trigger ANS: C A knowledge-focused trigger is a question that arises as a result of new information available on the topic. For example, “What is the current evidence for the best way to educate patients with low health literacy?” Important sources of new scientific information are the standards and practice guidelines available from national agencies such as the Agency for Healthcare Research and Quality (AHRQ), the American Pain Society (APS), or the American Association of Critical-Care Nurses (AACN). Other sources of knowledge-focused triggers include recent research publications and nurse experts within an organization. PTS: 1 DIF: Cognitive Level: Analysis REF: 76 OBJ: Develop a PICO or PICOT question TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 8. A nurse’s manager has suggested that she formulate a PICO question to clarify her topic before doing a literature review. The acronym PICO stands for which of the following? A. Policy, information, comparison, outcome B. Patient, information, collection, outcome C. Patient, intervention, comparison, outcome D. Patient, intervention, communication, outcome ANS: C P: Patient population of interest. Identify patients by age, sex, ethnicity, disease, or health problem. I: Intervention of interest. What is the intervention the nurse wants to use in practice (e.g., a treatment, diagnostic test, educational approach)? C: Comparison of interest. What is the usual standard of care or current intervention used in practice now? O: Outcome. What result is desired to be achieved or observed as a result of an intervention (e.g., change in patient behavior, physical finding, patient perception)? PTS: 1 DIF: Cognitive Level: Knowledge REF: 76 OBJ: Develop a PICO or PICOT question TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 9. A nurse working on a PICO question has found a large amount of literature available on the topic that she is interested in. There have been multiple studies that have been published. Which of the following types of studies should have the best evidence? A. Meta-analysis of randomized control trials B. Opinion of an expert committee C. One well-designed randomized control trial D. Systematic review of descriptive and qualitative studies ANS: A Systematic reviews or meta-analyses are state-of-the-science summaries from an individual researcher or panel of experts. If a nurse is lucky to find a systematic review on the PICO question being asked, it means that a researcher has asked the same PICO question and reviewed the highest level of evidence available. PTS: 1 DIF: Cognitive Level: Knowledge REF: 78 OBJ: Develop a PICO or PICOT question TOP: Nursing Process: Assessment MSC: Client Needs: Safe and Effective Care Environment 10. A registered nurse is concerned about the quality of life that patients experience after a diagnosis of liver cancer. The most appropriate type of research study from which to gather information about this is which of the following? A. Quantitative study B. Randomized trial C. Qualitative study D. Case controlled study