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