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