Test Bank for Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice, 5th Edition – Bernadette Mazurek Melnyk & Ellen Fineout-Overholt

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-Based Practice
and Cultivating a Spirit of Inquiry


In the hospital where Nurse L. provides care, tradition dictates that oral temperatures
be included in every set of patient vital signs, regardless of patient diagnosis or acuity.
Thisis most likely an example of which of the following phenomena?
A) The prioritization of internal evidence over external evidence
B) Practice that lacks evidence to support its application
C) The integration of personal expertise into nursing care
D) Evidence-based practice


2. The clinical nurse educator (CNE) on a postsurgical unit has recently completed a
patient chart review after the implementation of a pilot program aimed at promoting
early ambulation following surgery. Which of the following components of EBP is the
nurse putting into practice?
A) Patient preferences
B) Research utilization
C) Experience
D) Internal evidence


3. Nurse R. has observed that reorienting demented patients as frequently as possible
tendsto minimize the patients' level of agitation in the evening. The nurse has shared
this observation with a colleague, who is skeptical, stating that, “It's best to stick to
evidence-based practice.” How can Nurse R. best respond?
A) “EBP can include clinicians' personal expertise.”
B) “Personal experience is often more sound than formal evidence-based practice.”
C) “Traditional practice and EBP are usually shown to be the same.”
D) “My years of experience can be just as valuable as any literature review
orrandomized trial.”


4. Which of the following factors provides the most important rationale for the
consistentimplementation of EBP?
A) EBP provides for the most cost-effective patient care.
B) EBP is accessible to all healthcare clinicians.
C) EBP provides consistency in care across healthcare settings.
D) EBP improves patient outcomes.

,5. The Institute of Medicine's Roundtable on Evidence-Based Medicine has
beenestablished to address EBP. Which of the following issues is the
Roundtable emphasizing?
A) Ensuring that external evidence, rather than internal evidence, is integrated
intocare
B) Fostering the level of learning that exists in the American healthcare system
C) Issuing clinical guidelines to ensure best nursing practice
D) Comparing the implementation of EBP in the United States with that of
otherWestern countries


6. You have become frustrated with some aspects of patient care that you believe are
outdated and ineffective at the long-term care facility where you have recently begun
practicing. Consequently, you have resolved to examine some of these practices in
lightof evidence. Which of the following should occur first in the steps of EBP?
A) Conducting an electronic search of the literature and ranking individual sources
B) Creating “buy-in” from the other clinicians who provide care at the facility
C) Developing an inquisitive and curious mindset
D) Assessing whether the practices in question may, in fact, be evidence-based


7. Which of the following clinical questions best exemplifies the PICOT format?
A) What effect does parents' smoking have on the smoking habits of their
children,ages 13 to 16?
B) Among cancer patients, what role does meditation, rather than
benzodiazepines,have on anxiety levels during the 7 days following hospital
admission?
C) Among undergraduate college students, what is the effectiveness of a sexual
healthcampaign undertaken during the first 4 weeks of the fall semester as
measured by incidence of new gonorrheal and chlamydial infections reported to
the campus medical center?
D) In patients aged 8 to 12, is the effectiveness of a pain scale using faces superior to
anumeric rating scale in the emergency room context?


8. After formulating a clinical question, a nurse has proceeded to search for evidence for
ways to foster restful sleep in patients who are receiving care in the intensive care unit
(ICU). The nurse has identified a relevant meta-analysis in an electronic database.
Whatwill this source of evidence consist of?
A) A statistical summary of the results from several different studies
B) An examination of the theoretical and conceptual underpinnings of the issue
C) An interdisciplinary analysis of the clinical question
D) A qualitative study of different interventions related to the clinical question

, 9. The nurses on a postpartum unit have noted that many primiparous (first-
XV XV XV XV XV XV XV XV XV XV XV



time) mothers are giving up on breastfeeding within the 24 hours following delivery,
XV XV XV XV XV XV XV XV XV XV XV XV XV



and the nurses want to create uniform guidelines for promoting breastfeeding on th
XV XV XV XV XV XV XV XV XV XV XV XV



e unit. Which of thefollowing sources is most likely to provide the best evidence in t
XV XV XV XV V
X XV XV XV XV XV XV XV XV XV XV XV



heir quest for an intervention?
XV XV XV XV



A) Evidence from a randomized control trial that had more than 2500 participants
XV XV XV XV XV XV XV XV XV XV XV



B) Evidence from a study that is widely regarded as a classic within the obstetri
XV XV XV XV XV XV XV XV XV XV XV XV XV



calnursing community V
X XV



C) Evidence from a systematic review of breastfeeding- XV XV XV XV XV XV



promotion studies that one ofthe nurses identified in an electronic database XV XV XV XV V
X XV XV XV XV XV XV



D) The consensus opinion of the most senior nurses on the unit
XV XV XV XV XV XV XV XV XV XV




10. The nurse educator on an acute medicine unit is advocating for the use of
XV XV XV XV XV XV XV XV XV XV XV XV XV



evidence-
based clinical practice guidelines on wound care in order to standardize and optimi
XV XV XV XV XV XV XV XV XV XV XV XV



ze the practice of the nurses on the unit. Which of the following statements bestde
XV XV XV XV XV XV XV XV XV XV XV XV XV XV V
X



scribes clinical practice guidelines?
XV XV XV



A) The result of replication studies of existing research by an impartial third party
XV XV XV XV XV XV XV XV XV XV XV XV



B) A collection of authorized interventions that are required by law
XV XV XV XV XV XV XV XV XV



C) A number of interventions that are the result of a large, publically-funded RCT
XV XV XV XV XV XV XV XV XV XV XV XV



D) A group of practice recommendations that result from a rigorous review of
XV XV XV XV XV XV XV XV XV XV XV XV



theliterature V
X




11. A nurse is conducting a literature review on the evidence regarding the use of vacuu
XV XV XV XV XV XV XV XV XV XV XV XV XV XV



m dressings on stage IV pressure ulcers. After locating a recent study that appears to
XV XV XV XV XV XV XV XV XV XV XV XV XV XV X



be relevant, which of the following questions would the nurse consider first when cri
V XV XV XV XV XV XV XV XV XV XV XV XV XV



ticallyappraising the study?
V
X XV XV



A) “Are the findings of this study cost-effective in our clinical context?”
XV XV XV XV XV XV XV XV XV XV



B) "How would the implementation of this intervention affect our staffing needs?"
XV XV XV XV XV XV XV XV XV XV



C) “Were the patients in the study similar to the patients on my unit?”
XV XV XV XV XV XV XV XV XV XV XV XV



D) “Are the findings of the study significantly different from what we are current
XV XV XV XV XV XV XV XV XV XV XV XV



lydoing on the unit? V
X XV XV XV




12. The primary care provider of a 49-year-
XV XV XV XV XV XV



old male patient has examined and briefly explained the evidence that supports be
XV XV XV XV XV XV XV XV XV XV XV XV



ginning regular digital- XV XV



rectal exams. Which ofthe following factors would justify not performing digital-
XV XV XV V
X XV XV XV XV XV XV XV



rectal examinations in this patient's care?
XV XV XV XV XV



A) The patient is vehemently opposed to undergoing a digital-rectal exam.
XV XV XV XV XV XV XV XV XV



B) Clinical practice guidelines for prostate care have not been published.
XV XV XV XV XV XV XV XV XV



C) The clinician has been unable to find any large RCTs in a literature review.
XV XV XV XV XV XV XV XV XV XV XV XV XV



D) The clinician has previously waited until patients are 55 to begin regul
XV XV XV XV XV XV XV XV XV XV XV