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