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