NURSING INTERVENTIONS AND CLINICAL SKILLS 7TH EDITION BY POTTER PERRY TESTBANK
f f f f f f f f f f
(COMPLETE WITH ALL CHAPTERS 1-32) f f f f f
Chapter 01: Using Evidence in Nursing Practice
f f f f f f
Perry et al.: Nursing Interventions & Clinical Skills, 7th Edition
f f f f f f f f f
MULTIPLE CHOICE f
1. A nursing educator is explaining how the best clinical practices are determined. Which
f f f f f f f f f f f f
statement best explains the purpose of evidence-based practice?
f f f f f f f f
a. It ensures that all patients receive holistic care.
f f f f f f f
b. It provides a definite reason for providing care in a specific manner.
f f f f f f f f f f f
c. It prevents errors when care is being delivered.
f f f f f f f
d. It guarantees that care delivered is based on research.
f f f f f f f f
ANS: B f
Evidence-based practice is the use of the current best evidence in making patient care decisions. f f f f f f f f f f f f f f
It applies to all types of health care professionals. Currently there is no method that can ensure that
f f f f f f f f f f f f f f f f f f
all patients receive holistic care, that all errors can be prevented, or that a guarantee exists that
f f f f f f f f f f f f f f f f f
care given is based on research.
f f f f f f
DIF: Cognitive Level: Understanding f f OBJ: NCLEX: Safe and Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
2. Which question is a problem-focused trigger for initiating the evidence-based practice method in
f f f f f f f f f f f f
nursing care?
f f
a. What is known about reduction of urinary tract infections in the older adult with
f f f f f f f f f f f f f
diabetes? f
b. How can chronic pain best be described when the patient is nonverbal?
f f f f f f f f f f f
c. How long can an IV catheter remain in place in a patient with obesity?
f f f f f f f f f f f f f
d. What measures can the nurse take to reduce the rising incidence of urinary tract
f f f f f f f f f f f f f
infections on the older adult care unit?
f f f f f f f
ANS: D f
Evidence-based practice (EBP) questions tend to arise from two sources: recurrent problems or f f f f f f f f f f f f
new knowledge. In the correct option, the increase in urinary tract infections indicates a trend or
f f f f f f f f f f f f f f f f
recurring problem in a specific group of patients. The other questions are general information
f f f f f f f f f f f f f f
questions, not based on what is happening in a specific area or to a group of specific patients in an
f f f f f f f f f f f f f f f f f f f f
area or relating to an observed trend.
f f f f f f f
DIF: Cognitive Level: Applying f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
3. What does the “I” indicate in a “PICO” question?
f f f f f f f f
a. Intervention of interest f f
b. Incorporation of concepts f f
c. Implementation by nursing f f
d. Interest of personnel f f
ANS: A f
The “I” stands for intervention of interest, meaning what the nurse hopes to use in practice and
f f f f f f f f f f f f f f f f
believes is worthwhile or valuable. This could be a treatment for a specific type of wound or an
f f f f f f f f f f f f f f f f f f
approach on how to teach food preparation for a patient with impaired sight.
f f f f f f f f f f f f f
, DIF: Cognitive Level: Remembering f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
4. Who will the clinical research nurse contact to search relevant databases in preparation for an
f f f f f f f f f f f f f f
upcoming study?
f f
a. The physician whose patients may be involved in the study
f f f f f f f f f
b. The medical librarian f f
c. The nurse manager of the unit where the study will be conducted
f f f f f f f f f f f
d. The director of nursing of the facility
f f f f f f
ANS: B f
The medical librarian is most knowledgeable regarding databases relevant to a study. The other
f f f f f f f f f f f f f
individuals do not have the knowledge regarding relevant databases.
f f f f f f f f f
DIF: Cognitive Level: Understanding f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
5. Which database contains summaries of clinical guidelines and their development?
f f f f f f f f f
a. MEDLINE
b. CINAHL
c. Cochrane Database of Systematic Reviews f f f f
d. The National Guideline Clearinghouse
f f f
ANS: D f
The National Guideline Clearinghouse is a database supported by the Agency for Healthcare
f f f f f f f f f f f f
Research and Quality. It contains summaries of clinical guidelines for practice. MEDLINE is
f f f f f f f f f f f f f
a database for studies in medic N
f i ne, nursing, dentistry, psychiatry, veterinary medicine, and
f f f f f f f f f f
allied health. CINAHL (Cumulative Index of Nursing and Allied Health Literature) includes
f f f f f f f f f f f f
studies in nursing, allied health, and biomedicine. The Cochrane Database Full text of
f f f f f f f f f f f f f
regularly updated systematic reviews prepared bythe Cochrane Collaboration includes
f f f f f f f f f
completed reviews and protocols.
f f f f
DIF: Cognitive Level: Remembering f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
6. Which does the nurse researcher identify as the strongest type of research?
f f f f f f f f f f f
a. Randomized controlled trials f f
b. A qualitative study
f f
c. A descriptive study
f f
d. A case controlled study
f f f
ANS: A f
Individual randomized controlled trials are close to the top of the research pyramid. Only
f f f f f f f f f f f f f
systematic reviews and meta-analyses are higher. This type of study tests an intervention against
f f f f f f f f f f f f f f
the usual standard of care. The other types of studies are useful but do not give the same type of
f f f f f f f f f f f f f f f f f f f f
information as a randomized controlled trial provides.
f f f f f f f
DIF: Cognitive Level: Remembering f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Assessment
f f f f
, 7. What is the nurse attempting to determine when critiquing the evidence related to a PICOT
f f f f f f f f f f f f f f
question?
f
a. The ethical conduct of the research the nurse read
f f f f f f f f
b. The strength of the evidence found in the literature
f f f f f f f f
c. Ifthere are any experts in the clinical question needing to be researched
f f f f f f f f f f f f
d. If the study demonstrates cost-effectiveness if a change in practice occurs
f f f f f f f f f f
ANS: B f
Once a literature search is complete and data are gathered about the question, it is time to critique
f f f f f f f f f f f f f f f f f
the evidence. Critiquing the evidence involves a systematic approach to looking at the strength of
f f f f f f f f f f f f f f f
the work reviewed and its relevance. The other questions are not applicable to critiquing the
f f f f f f f f f f f f f f f
evidence.
f
DIF: Cognitive Level: Understanding f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
8. A nurse finds a cohort study comparing one group taking hormone treatment with another group
f f f f f f f f f f f f f f
not taking hormone treatment to determine the incidence of changes in bone density of the lower
f f f f f f f f f f f f f f f f
spine. What can the nurse imply from this study?
f f f f f f f f f
a. Low level of strength makes the study limited in value.
f f f f f f f f f
b. Moderate level of strength makes the study probably useful. f f f f f f f f
c. Opinions of the individuals in the cohort are not research. f f f f f f f f f
d. This could be the basis for a Quality Improvement project.
f f f f f f f f f
ANS: B f
A cohort study is Level 4 evidence as it is a single, non-experimental study. This moderate level
f f f f f f f f f f f f f f f f
of evidence makes the study probably useful but the nurse should strive to find stronger evidence.
f f f f f f f f f f f f f f f f
N
DIF: Cognitive Level: Applying f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Evaluation
f f f f
9. Which question would be the best example of a knowledge-focused trigger for conducting an
f f f f f f f f f f f f f
evidence-based practice project?
f f f
a. What is the best method for treatment of leg swelling when a patient is taking
f f f f f f f f f f f f f f
gabapentin (Neurontin)?
f f
b. How can we decrease the incidence of skin cancer in adults over the age of 65?
f f f f f f f f f f f f f f f
c. What is the current evidence for improving oral intake for cancer patients with
f f f f f f f f f f f f
stomatitis? f
d. What is the maximal length of time our hospital allows irrigation kits to be used?
f f f f f f f f f f f f f f
ANS: C f
Evidence-based practice (EBP) questions tend to arise from two sources: recurrent problems or f f f f f f f f f f f f
new knowledge. In this example, the new knowledge that drives the question is the one looking
f f f f f f f f f f f f f f f f
at current evidence. The other questions do not look at the newest knowledge to form a question to
f f f f f f f f f f f f f f f f f f
research.
f
DIF: Cognitive Level: Analyzing f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
MULTIPLE RESPONSE f
, 1. When planning to implement an evidence-based practice strategy, what factors are most
f f f f f f f f f f f
important for the nurse to consider and include? (Select all that apply.)
f f f f f f f f f f f f
a. Time required to perform the strategy f f f f f
b. Patient preferences and values f f f
c. Clinical expertise f
d. Scientific knowledge f
e. Historical practices f
ANS: B, C, D f f f
When implementing evidence-based practice, the nurse considers and includes clinical expertise
f f f f f f f f f f
and patient preferences and values in addition to the scientific knowledge. Time required to
f f f f f f f f f f f f f f
perform the new strategy and customary practices are not vital to this approach. In fact, EBP seeks
f f f f f f f f f f f f f f f f f
to ensure practices are based on evidence and not just historical practice.
f f f f f f f f f f f f
DIF: Cognitive Level: Remembering f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
2. A new nurse wants to ensure practice is based on the best knowledge available. What actions are
f f f f f f f f f f f f f f f f
best for this nurse to be involved in evidence-based practice? (Select all that apply.)
f f f f f f f f f f f f f f
a. Design and conduct a study based on interest. f f f f f f f
b. Join the hospital’s policy review committee. f f f f f
c. Remain vigilant for recurring problems. f f f f
d. Maintain a spirit of inquiry. f f f f
e. Read current literature appropriate to practice area. f f f f f f
ANS: B, C, D, E f f f f
This novice nurse would best mNaint ain an evidence-based nursing practice by joining policy
f f f f f f f f f f f f
review committees, watching for and taking note of recurring problems in the practice area,
f f f f f f f f f f f f f f
maintaining a spirit of inquiry, and staying current in the literature. The nurse would not need to
f f f f f f f f f f f f f f f f f
design and conduct a study.
f f f f f
DIF: Cognitive Level: Applying f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
3. When explaining the value of evidence-based practice, what benefits does the nurse include?
f f f f f f f f f f f f
(Select all that apply.)
f f f f
a. Improves quality of care. f f f
b. Improves patient outcomes. f f
c. Improves stakeholder satisfaction. f f
d. Incorporates near real-time data in practice. f f f f f
e. Helps nurses remain current in practice. f f f f f
ANS: A, B, D, E f f f f
There are five ways that EBP adds value to the health care system: helps clinicians remain
f f f f f f f f f f f f f f f
current on standardized, evidence-based protocols; uses near real-time scientific data to make
f f f f f f f f f f f f
care decisions; improves transparency, accountability, and value (e.g. safe care); improves
f f f f f f f f f f f
quality of care; and improves outcomes. One would hope all stakeholders would be more
f f f f f f f f f f f f f f
satisfied with this method of determining care but that is not one of the specific benefits.
f f f f f f f f f f f f f f f f
DIF: Cognitive Level: Remembering f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
f f f f f f f f f f
(COMPLETE WITH ALL CHAPTERS 1-32) f f f f f
Chapter 01: Using Evidence in Nursing Practice
f f f f f f
Perry et al.: Nursing Interventions & Clinical Skills, 7th Edition
f f f f f f f f f
MULTIPLE CHOICE f
1. A nursing educator is explaining how the best clinical practices are determined. Which
f f f f f f f f f f f f
statement best explains the purpose of evidence-based practice?
f f f f f f f f
a. It ensures that all patients receive holistic care.
f f f f f f f
b. It provides a definite reason for providing care in a specific manner.
f f f f f f f f f f f
c. It prevents errors when care is being delivered.
f f f f f f f
d. It guarantees that care delivered is based on research.
f f f f f f f f
ANS: B f
Evidence-based practice is the use of the current best evidence in making patient care decisions. f f f f f f f f f f f f f f
It applies to all types of health care professionals. Currently there is no method that can ensure that
f f f f f f f f f f f f f f f f f f
all patients receive holistic care, that all errors can be prevented, or that a guarantee exists that
f f f f f f f f f f f f f f f f f
care given is based on research.
f f f f f f
DIF: Cognitive Level: Understanding f f OBJ: NCLEX: Safe and Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
2. Which question is a problem-focused trigger for initiating the evidence-based practice method in
f f f f f f f f f f f f
nursing care?
f f
a. What is known about reduction of urinary tract infections in the older adult with
f f f f f f f f f f f f f
diabetes? f
b. How can chronic pain best be described when the patient is nonverbal?
f f f f f f f f f f f
c. How long can an IV catheter remain in place in a patient with obesity?
f f f f f f f f f f f f f
d. What measures can the nurse take to reduce the rising incidence of urinary tract
f f f f f f f f f f f f f
infections on the older adult care unit?
f f f f f f f
ANS: D f
Evidence-based practice (EBP) questions tend to arise from two sources: recurrent problems or f f f f f f f f f f f f
new knowledge. In the correct option, the increase in urinary tract infections indicates a trend or
f f f f f f f f f f f f f f f f
recurring problem in a specific group of patients. The other questions are general information
f f f f f f f f f f f f f f
questions, not based on what is happening in a specific area or to a group of specific patients in an
f f f f f f f f f f f f f f f f f f f f
area or relating to an observed trend.
f f f f f f f
DIF: Cognitive Level: Applying f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
3. What does the “I” indicate in a “PICO” question?
f f f f f f f f
a. Intervention of interest f f
b. Incorporation of concepts f f
c. Implementation by nursing f f
d. Interest of personnel f f
ANS: A f
The “I” stands for intervention of interest, meaning what the nurse hopes to use in practice and
f f f f f f f f f f f f f f f f
believes is worthwhile or valuable. This could be a treatment for a specific type of wound or an
f f f f f f f f f f f f f f f f f f
approach on how to teach food preparation for a patient with impaired sight.
f f f f f f f f f f f f f
, DIF: Cognitive Level: Remembering f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
4. Who will the clinical research nurse contact to search relevant databases in preparation for an
f f f f f f f f f f f f f f
upcoming study?
f f
a. The physician whose patients may be involved in the study
f f f f f f f f f
b. The medical librarian f f
c. The nurse manager of the unit where the study will be conducted
f f f f f f f f f f f
d. The director of nursing of the facility
f f f f f f
ANS: B f
The medical librarian is most knowledgeable regarding databases relevant to a study. The other
f f f f f f f f f f f f f
individuals do not have the knowledge regarding relevant databases.
f f f f f f f f f
DIF: Cognitive Level: Understanding f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
5. Which database contains summaries of clinical guidelines and their development?
f f f f f f f f f
a. MEDLINE
b. CINAHL
c. Cochrane Database of Systematic Reviews f f f f
d. The National Guideline Clearinghouse
f f f
ANS: D f
The National Guideline Clearinghouse is a database supported by the Agency for Healthcare
f f f f f f f f f f f f
Research and Quality. It contains summaries of clinical guidelines for practice. MEDLINE is
f f f f f f f f f f f f f
a database for studies in medic N
f i ne, nursing, dentistry, psychiatry, veterinary medicine, and
f f f f f f f f f f
allied health. CINAHL (Cumulative Index of Nursing and Allied Health Literature) includes
f f f f f f f f f f f f
studies in nursing, allied health, and biomedicine. The Cochrane Database Full text of
f f f f f f f f f f f f f
regularly updated systematic reviews prepared bythe Cochrane Collaboration includes
f f f f f f f f f
completed reviews and protocols.
f f f f
DIF: Cognitive Level: Remembering f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
6. Which does the nurse researcher identify as the strongest type of research?
f f f f f f f f f f f
a. Randomized controlled trials f f
b. A qualitative study
f f
c. A descriptive study
f f
d. A case controlled study
f f f
ANS: A f
Individual randomized controlled trials are close to the top of the research pyramid. Only
f f f f f f f f f f f f f
systematic reviews and meta-analyses are higher. This type of study tests an intervention against
f f f f f f f f f f f f f f
the usual standard of care. The other types of studies are useful but do not give the same type of
f f f f f f f f f f f f f f f f f f f f
information as a randomized controlled trial provides.
f f f f f f f
DIF: Cognitive Level: Remembering f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Assessment
f f f f
, 7. What is the nurse attempting to determine when critiquing the evidence related to a PICOT
f f f f f f f f f f f f f f
question?
f
a. The ethical conduct of the research the nurse read
f f f f f f f f
b. The strength of the evidence found in the literature
f f f f f f f f
c. Ifthere are any experts in the clinical question needing to be researched
f f f f f f f f f f f f
d. If the study demonstrates cost-effectiveness if a change in practice occurs
f f f f f f f f f f
ANS: B f
Once a literature search is complete and data are gathered about the question, it is time to critique
f f f f f f f f f f f f f f f f f
the evidence. Critiquing the evidence involves a systematic approach to looking at the strength of
f f f f f f f f f f f f f f f
the work reviewed and its relevance. The other questions are not applicable to critiquing the
f f f f f f f f f f f f f f f
evidence.
f
DIF: Cognitive Level: Understanding f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
8. A nurse finds a cohort study comparing one group taking hormone treatment with another group
f f f f f f f f f f f f f f
not taking hormone treatment to determine the incidence of changes in bone density of the lower
f f f f f f f f f f f f f f f f
spine. What can the nurse imply from this study?
f f f f f f f f f
a. Low level of strength makes the study limited in value.
f f f f f f f f f
b. Moderate level of strength makes the study probably useful. f f f f f f f f
c. Opinions of the individuals in the cohort are not research. f f f f f f f f f
d. This could be the basis for a Quality Improvement project.
f f f f f f f f f
ANS: B f
A cohort study is Level 4 evidence as it is a single, non-experimental study. This moderate level
f f f f f f f f f f f f f f f f
of evidence makes the study probably useful but the nurse should strive to find stronger evidence.
f f f f f f f f f f f f f f f f
N
DIF: Cognitive Level: Applying f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Evaluation
f f f f
9. Which question would be the best example of a knowledge-focused trigger for conducting an
f f f f f f f f f f f f f
evidence-based practice project?
f f f
a. What is the best method for treatment of leg swelling when a patient is taking
f f f f f f f f f f f f f f
gabapentin (Neurontin)?
f f
b. How can we decrease the incidence of skin cancer in adults over the age of 65?
f f f f f f f f f f f f f f f
c. What is the current evidence for improving oral intake for cancer patients with
f f f f f f f f f f f f
stomatitis? f
d. What is the maximal length of time our hospital allows irrigation kits to be used?
f f f f f f f f f f f f f f
ANS: C f
Evidence-based practice (EBP) questions tend to arise from two sources: recurrent problems or f f f f f f f f f f f f
new knowledge. In this example, the new knowledge that drives the question is the one looking
f f f f f f f f f f f f f f f f
at current evidence. The other questions do not look at the newest knowledge to form a question to
f f f f f f f f f f f f f f f f f f
research.
f
DIF: Cognitive Level: Analyzing f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
MULTIPLE RESPONSE f
, 1. When planning to implement an evidence-based practice strategy, what factors are most
f f f f f f f f f f f
important for the nurse to consider and include? (Select all that apply.)
f f f f f f f f f f f f
a. Time required to perform the strategy f f f f f
b. Patient preferences and values f f f
c. Clinical expertise f
d. Scientific knowledge f
e. Historical practices f
ANS: B, C, D f f f
When implementing evidence-based practice, the nurse considers and includes clinical expertise
f f f f f f f f f f
and patient preferences and values in addition to the scientific knowledge. Time required to
f f f f f f f f f f f f f f
perform the new strategy and customary practices are not vital to this approach. In fact, EBP seeks
f f f f f f f f f f f f f f f f f
to ensure practices are based on evidence and not just historical practice.
f f f f f f f f f f f f
DIF: Cognitive Level: Remembering f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
2. A new nurse wants to ensure practice is based on the best knowledge available. What actions are
f f f f f f f f f f f f f f f f
best for this nurse to be involved in evidence-based practice? (Select all that apply.)
f f f f f f f f f f f f f f
a. Design and conduct a study based on interest. f f f f f f f
b. Join the hospital’s policy review committee. f f f f f
c. Remain vigilant for recurring problems. f f f f
d. Maintain a spirit of inquiry. f f f f
e. Read current literature appropriate to practice area. f f f f f f
ANS: B, C, D, E f f f f
This novice nurse would best mNaint ain an evidence-based nursing practice by joining policy
f f f f f f f f f f f f
review committees, watching for and taking note of recurring problems in the practice area,
f f f f f f f f f f f f f f
maintaining a spirit of inquiry, and staying current in the literature. The nurse would not need to
f f f f f f f f f f f f f f f f f
design and conduct a study.
f f f f f
DIF: Cognitive Level: Applying f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
3. When explaining the value of evidence-based practice, what benefits does the nurse include?
f f f f f f f f f f f f
(Select all that apply.)
f f f f
a. Improves quality of care. f f f
b. Improves patient outcomes. f f
c. Improves stakeholder satisfaction. f f
d. Incorporates near real-time data in practice. f f f f f
e. Helps nurses remain current in practice. f f f f f
ANS: A, B, D, E f f f f
There are five ways that EBP adds value to the health care system: helps clinicians remain
f f f f f f f f f f f f f f f
current on standardized, evidence-based protocols; uses near real-time scientific data to make
f f f f f f f f f f f f
care decisions; improves transparency, accountability, and value (e.g. safe care); improves
f f f f f f f f f f f
quality of care; and improves outcomes. One would hope all stakeholders would be more
f f f f f f f f f f f f f f
satisfied with this method of determining care but that is not one of the specific benefits.
f f f f f f f f f f f f f f f f
DIF: Cognitive Level: Remembering f f OBJ: NCLEX: Safeand Effective Care Environment
f f f f f f
TOP: Nursing Process: Implementation
f f f f
