,
,
, 5
whenever possible and has proposed the use of maggot therapy to debride necrotic tissue.
Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this
treatment despite the sizable body of evidence supporting it. How should the nurse
reconcile Mrs. Mayes views with the principles of EBP?
A) The nurse should explain that reliable and valid research evidence overrides the
patients opinion.
B) The nurse should explain the evidence to the patient in greater detail.
C) The nurse should integrate the patients preferences into the plan of care.
D) The nurse should involve the patients family members in the decision-making process.
Ans: C
Feedback:
Patient preferences should be integrated into EBP and considered alongside research evidence
and the nurses clinical expertise; evidence does not trump the patients preferences. The family
should be involved, but this is not an explicit dimension of EBP. Similarly, explaining the evidence
in more detail is not a demonstration of EBP.
8. The administrators of a long-term care facility are considered the use of specialized,
pressure- reducing mattresses in order to reduce the incidence of pressure ulcers among
residents. They have sought input from the nurses on the unit, all of whom are aware of the
need to implement the principles of evidence-based practice (EBP) in this decision. Which
of the following evidence sources should the nurses prioritize?
A) A qualitative study that explores the experience of living with a pressure ulcer
B) A case study that describes the measures that nurses on a geriatric unit took to
reduce pressure ulcers among patients
C) Testimonials from experienced clinicians about the effectiveness of the
D) A randomized controlled trial that compared the pressure-reducing mattress with
standard mattresses
Ans: D
Feedback:
The most reliable evidence is considered RCTs. Qualitative studies, case studies, and expert
opinion are low on the hierarchy of evidence.
9. Hospital administrators are applying the principles of evidence-based practice
(EBP) in their attempt to ascertain the most efficient and effective way to communicate
between nurses who are on different units, a project that will consider many types of
evidence. Which of the following information sources should the administrators
prioritize?
, 6
E) A systematic review about communication in nursing contexts
F) Nurses ideas about communication methods
G) The results of a chart review
H) The hospitals accreditation status
I) Ans: A
Feedback:
Systematic reviews are assigned a high value in EBP. Reviews would be prioritized over
nurses ideas or a chart review, though both are potential considerations. The hospitals
accreditation status is not a relevant consideration.
9. A nurse has resolved to apply the evidence-based practice (EBP) process to the way
that admission assessments are conducted and documented on a unit. How should the
nurse begin the process of establishing EBP?
A) Gather evidence showing the shortcomings of current practices
B) Formulate a clear and concise question to be addressed
C) Elicit support from the nurses who are most often responsible for admissions
D) Search the literature for evidence that is potentially relevant to the practice need
Ans: B
Feedback:
The first step in applying EBP is to ask a clear, focused question. This should precede a search
of the literature or the recruitment of participants. An assessment of the shortcomings of the
current system is not an explicit component of the EBP process.
10. Which of the following questions best exemplifies the PICOT format for
asking evidence-based questions?
A) What affect does parents alcohol use have on the alcohol use of their teenage children?
B) Among postsurgical patients, what role does meditation rather than benzodiazepines
have on anxiety levels during the 48 hours following surgery?
C) Among high school students, what is the effectiveness of a sexual health
campaign undertaken during the first 4 weeks of the fall semester as measured by
incidence of new sexually transmitted infections?
D) In children aged 68, is the effectiveness of a descriptive pain scale superior to a
numeric rating scale in the emergency room context?
Feedback:
The correct answer includes a population (postsurgical patients), intervention
(meditation), comparison (benzodiazepines), outcome (anxiety levels), and a time frame
(48 hours). No other option contains each of the five elements of a PICOT question.
11. A nurse has made plans to implement the University of North Carolina (UNC) model
of 5 As during the process of applying evidence-based practice (EBP) to a practice problem.
What is the final step that the nurse will take in applying this model?