g
Chapterg01:gUsinggEvidencegingNursinggPracticegPerrygetgal.:gNursinggInterventionsg&g
ClinicalgSkills,g7thgEditiong g
g
MULTIPLEgCHOICEg
g
1. Agnursinggeducatorgisgexplainingghowgthegbestgclinicalgpracticesgaregdetermined.gWhichgstate
mentgbestgexplainsgthegpurposegofgevidence-
basedgpractice?ga.gItgensuresgthatgallgpatientsgreceivegholisticgcare.g
b. Itgprovidesgagdefinitegreasongforgprovidinggcaregingagspecificgmanner.g
c. Itgpreventsgerrorsgwhengcaregisgbeinggdelivered.g
d. Itgguaranteesgthatgcaregdeliveredgisgbasedgongresearch.g
ANS:gBg
Evidence-
basedgpracticegisgthegusegofgthegcurrentgbestgevidencegingmakinggpatientgcaregdecisions.gItgapp
liesgtogallgtypesgofghealthgcaregprofessionals.gCurrentlygtheregisgnogmethodgthatgcangensuregtha
tgallgpatientsgreceivegholisticgcare,gthatgallgerrorsgcangbegprevented,gorgthatgagguaranteegexistsgt
hatgcareggivengisgbasedgongresearch.g
g
DIF:gCognitivegLevel:gUnderstandingg
OBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentgTOP:gNursinggProcess:gImplementationg
g
2. Whichgquestiongisgagproblem-focusedgtriggergforginitiatinggthegevidence-
basedgpracticegmethodgingnursinggcare?g
a. Whatgisgknowngaboutgreductiongofgurinarygtractginfectionsgingthegoldergadultgwithg
diabetes?g
b. Howgcangchronicgpaingbestgbegdescribedgwhengthegpatientgisgnonverbal?g
c. HowglonggcangangIVgcatheter
Ngremaingingplacegingagpatientgwithgobesity?g
d. Whatgmeasuresgcangthegnursegtakegtogreducegthegrisinggincidencegofgurinarygtractginfection
sgongthegoldergadultgcaregunit?g
ANS:gDg
Evidence-
basedgpracticeg(EBP)gquestionsgtendgtogarisegfromgtwogsources:grecurrentgproblemsgorgnewgkn
owledge.gIngthegcorrectgoption,gthegincreasegingurinarygtractginfectionsgindicatesgagtrendgorgrec
urringgproblemgingagspecificggroupgofgpatients.gThegothergquestionsgareggeneralginformationgq
uestions,gnotgbasedgongwhatgisghappeninggingagspecificgareagorgtogaggroupgofgspecificgpatientsgi
ngangareagorgrelatinggtogangobservedgtrend.g
g
DIF:gCognitivegLevel:gApplyingg
OBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentgTOP:gNursinggProcess:gImplementationg
g
3. Whatgdoesgtheg“I”gindicategingag“PICO”gquestion?g
a. Interventiongofginterestg
b. Incorporationgofgconceptsg
, c. Implementationgbygnursingg
d. Interestgofgpersonnelg
ANS:gAg
Theg“I”gstandsgforginterventiongofginterest,gmeaninggwhatgthegnurseghopesgtogusegingpracticega
ndgbelievesgisgworthwhilegorgvaluable.gThisgcouldgbegagtreatmentgforgagspecificgtypegofgwound
gorgangapproachgonghowgtogteachgfoodgpreparationgforgagpatientgwithgimpairedgsight.g
MedgCg
g
g
DIF:gCognitivegLevel:gRememberinggOBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentgTOP:gNu
rsinggProcess:gImplementationg
g
4. Whogwillgthegclinicalgresearchgnursegcontactgtogsearchgrelevantgdatabasesgingpreparationgforga
ngupcominggstudy?g
a. Thegphysiciangwhosegpatientsgmaygbeginvolvedgingthegstudyg
b. Thegmedicalglibrariang
c. Thegnursegmanagergofgthegunitgwheregthegstudygwillgbegconductedg
d. Thegdirectorgofgnursinggofgthegfacilityg
ANS:gBg
Thegmedicalglibrariangisgmostgknowledgeablegregardinggdatabasesgrelevantgtogagstudy.gThegot
hergindividualsgdognotghavegthegknowledgegregardinggrelevantgdatabases.g
g
DIF:gCognitivegLevel:gUnderstandingg
OBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentgTOP:gNursinggProcess:gImplementationg
g
5. Whichgdatabasegcontainsgsummariesgofgclinicalgguidelinesgandgtheirgdevelopment?g
a. MEDLINEg
b. CINAHLg
c. CochranegDatabasegofgSystematicgReviewsg
d. ThegNationalgGuidelinegClearinghouseg
ANS:gDg
ThegNationalgGuidelinegClearinghousegisgagdatabasegsupportedgbygthegAgencygforgHealthcareg
ResearchgandgQuality.gItgcontainsgsummariesgofgclinicalgguidelinesgforgpractice.gMEDLINEgis
a databasegforgstudiesgingmedicNine,gnursing,gdentistry,gpsychiatry,gveterinarygmedicine,gand
g g
galliedghealth.gCINAHLg(CumulativegIndexgofgNursinggandgAlliedgHealthgLiterature)gincludes
gstudiesgingnursing,galliedghealth,gandgbiomedicine.gThegCochranegDatabasegFullgtextgofgregul
arlygupdatedgsystematicgreviewsgpreparedgbygthegCochranegCollaborationgincludesgcompletedg
reviewsgandgprotocols.g
g
DIF:gCognitivegLevel:gRememberinggOBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentgTOP:gNu
rsinggProcess:gImplementationg
g
6. Whichgdoesgthegnursegresearchergidentifygasgthegstrongestgtypegofgresearch?g
a. Randomizedgcontrolledgtrialsg
b. Agqualitativegstudyg
MedgCg
, c. Agdescriptivegstudyg
d. Agcasegcontrolledgstudyg
ANS:gAg
Individualgrandomizedgcontrolledgtrialsgaregclosegtogthegtopgofgthegresearchgpyramid.gOnlygsys
tematicgreviewsgandgmeta-
analysesgareghigher.gThisgtypegofgstudygtestsganginterventiongagainstgthegusualgstandardgofgcar
e.gThegothergtypesgofgstudiesgaregusefulgbutgdognotggivegthegsamegtypegofginformationgasgagran
domizedgcontrolledgtrialgprovides.g
g
DIF:gCognitivegLevel:gRememberinggOBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentgTOP:gNu
rsinggProcess:gAssessmentg
g
7. WhatgisgthegnursegattemptinggtogdeterminegwhengcritiquinggthegevidencegrelatedgtogagPICOTg
question?g
a. Thegethicalgconductgofgthegresearchgthegnursegreadg
b. Thegstrengthgofgthegevidencegfoundgingthegliteratureg
c. Ifgtheregareganygexpertsgingthegclinicalgquestiongneedinggtogbegresearchedg
d. Ifgthegstudygdemonstratesgcost-effectivenessgifgagchangegingpracticegoccursg
ANS:gBg
Oncegagliteraturegsearchgisgcompletegandgdatagareggatheredgaboutgthegquestion,gitgisgtimegtogcri
tiquegthegevidence.gCritiquinggthegevidenceginvolvesgagsystematicgapproachgtoglookinggatgtheg
strengthgofgthegworkgreviewedgandgitsgrelevance.gThegothergquestionsgaregnotgapplicablegtogcri
tiquinggthegevidence.g
g
DIF:gCognitivegLevel:gUnderstandingg
OBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentgTOP:gNursinggProcess:gImplementationg
g
8. Agnursegfindsgagcohortgstudygcomparinggoneggroupgtakingghormonegtreatmentgwithganotherggr
oupgnotgtakingghormonegtreatmentgtogdeterminegthegincidencegofgchangesgingbonegdensitygofgt
heglowergspine.gWhatgcangthegnursegimplygfromgthisgstudy?ga.gLowglevelgofgstrengthgmakesgth
egstudyglimitedgingvalue.g
b. Moderateglevelgofgstrengthgmakesgthegstudygprobablyguseful.g
c. Opinionsgofgthegindividualsgingthegcohortgaregnotgresearch.g
d. ThisgcouldgbegthegbasisgforgagQualitygImprovementgproject.g
ANS:gBg
AgcohortgstudygisgLevelg4gevidencegasgitgisgagsingle,gnon-
experimentalgstudy.gThisgmoderateglevelgofgevidencegmakesgthegstudygprobablygusefulgbutgthe
gnursegshouldgstrivegtogfindgstrongergevidence.g Ng
g
DIF:gCognitivegLevel:gApplyingg
OBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentgTOP:gNursinggProcess:gEvaluationg
g
9. Whichgquestiongwouldgbegthegbestgexamplegofgagknowledge-
focusedgtriggergforgconductinggangevidence-basedgpracticegproject?g
a. Whatgisgthegbestgmethodgforgtreatmentgofgleggswellinggwhengagpatientgisgtakingggabapentin
g(Neurontin)?g
b. Howgcangwegdecreasegthegincidencegofgskingcancergingadultsgovergthegagegofg65?g
MedgCg
, c. Whatgisgthegcurrentgevidencegforgimprovinggoralgintakegforgcancergpatientsgwithgstomatitis
?g
d. Whatgisgthegmaximalglengthgofgtimegourghospitalgallowsgirrigationgkitsgtogbegused?g
ANS:gCg
Evidence-
basedgpracticeg(EBP)gquestionsgtendgtogarisegfromgtwogsources:grecurrentgproblemsgorgnewgkn
owledge.gIngthisgexample,gthegnewgknowledgegthatgdrivesgthegquestiongisgthegoneglookinggatgc
urrentgevidence.gThegothergquestionsgdognotglookgatgthegnewestgknowledgegtogformgagquestion
gtogresearch.g
g
DIF:gCognitivegLevel:gAnalyzinggOBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentgTOP:gNursin
ggProcess:gImplementationg
g
MULTIPLEgRESPONSEg
g
g
1. Whengplanninggtogimplementgangevidence-
basedgpracticegstrategy,gwhatgfactorsgaregmostgimportantgforgthegnursegtogconsidergandginclu
de?g(Selectgallgthatgapply.)ga.gTimegrequiredgtogperformgthegstrategyg
b. Patientgpreferencesgandgvaluesg
c. Clinicalgexpertiseg
d. Scientificgknowledgeg
e. Historicalgpracticesg
ANS:gB,gC,gDg
Whengimplementinggevidence-
basedgpractice,gthegnursegconsidersgandgincludesgclinicalgexpertisegandgpatientgpreferencesgan
dgvaluesgingadditiongtogthegscientificgknowledge.gTimegrequiredgtogperformgthegnewgstrategyga
ndgcustomarygpracticesgaregnotgvitalgtogthisgapproach.gIngfact,gEBPgseeksgtogensuregpracticesga
regbasedgongevidencegandgnotgjustghistoricalgpractice.g
g
DIF:gCognitivegLevel:gRememberingg OBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentg
TOP:gNursinggProcess:gImplementationg
g
2. Agnewgnursegwantsgtogensuregpracticegisgbasedgongthegbestgknowledgegavailable.gWhatgactio
nsgaregbestgforgthisgnursegtogbeginvolvedgingevidence-
basedgpractice?g(Selectgallgthatgapply.)ga.gDesigngandgconductgagstudygbasedgonginterest.g
b. Joingtheghospital’sgpolicygreviewgcommittee.g
c. Remaingvigilantgforgrecurringgproblems.g
d. Maintaingagspiritgofginquiry.g
e. Readgcurrentgliteraturegappropriategtogpracticegarea.g
ANS:gB,gC,gD,gEg
ThisgnovicegnursegwouldgbestgmNaintaingangevidence-
basedgnursinggpracticegbygjoininggpolicygreviewgcommittees,gwatchinggforgandgtakinggnotegofg
recurringgproblemsgingthegpracticegarea,gmaintaininggagspiritgofginquiry,gandgstayinggcurrentgin
gthegliterature.gThegnursegwouldgnotgneedgtogdesigngandgconductgagstudy.g
g
DIF:gCognitivegLevel:gApplyingg
OBJ:gNCLEX:gSafegandgEffectivegCaregEnvironmentgTOP:gNursinggProcess:gImplementationg
MedgCg