NR-439 – RN Evidence-Based Practice Emphasizes research
utilization, evidence appraisal, clinical decision-making,
practice improvement, and application of scientific findings.
1. Which of the following best defines evidence-based practice (EBP) in
nursing?
A. Using only randomized controlled trials to guide care
B. Integrating the best research evidence with clinical expertise and patient
preferences/values
C. Following tradition and rituals passed down by senior nurses
D. Relying solely on physician orders
Correct Answer: B
Rationale: EBP is the integration of best research evidence, clinical expertise, and
patient preferences/values. It is not limited to RCTs nor tradition.
2. A nurse asks, “In adult patients with pressure injuries, does the use of a
low-air-loss mattress compared to standard foam mattress reduce healing
time?” This question format is known as:
A. Background question
B. PICO(T) question
C. Nondirectional hypothesis
D. Clinical algorithm
Correct Answer: B
Rationale: PICO(T) = Population (adults with pressure injuries), Intervention
(low-air-loss mattress), Comparison (standard foam), Outcome (healing time).
Background questions are broad.
3. The “P” in the PICO(T) framework stands for:
A. Population/Patient/Problem
B. Plan
C. Procedure
D. Prescription
Correct Answer: A
Rationale: P = Population, Patient, or Problem of interest. Other elements: I =
Intervention, C = Comparison, O = Outcome, T = Time (optional).
,4. A nurse wants to find the highest level of evidence for a therapy question.
Which study design provides the strongest evidence for cause-and-effect?
A. Case series
B. Systematic review of randomized controlled trials (RCTs)
C. Expert opinion
D. Qualitative study
Correct Answer: B
Rationale: Systematic reviews of RCTs are at the top of the evidence hierarchy for
intervention questions. Expert opinion is the lowest.
5. A nurse is formulating a foreground question. Which of the following is a
foreground question?
A. “What is the pathophysiology of diabetes?”
B. “In elderly patients with dementia, does a structured exercise program compared
to usual care reduce falls?”
C. “How does the heart work?”
D. “What is the normal range for blood pressure?”
Correct Answer: B
Rationale: Foreground questions are specific, PICO-formatted questions about a
clinical issue. Background questions ask general knowledge.
6. Which of the following is an example of a “non-research” source of
evidence?
A. A randomized controlled trial
B. A systematic review
C. A clinical practice guideline based on expert consensus
D. A meta-analysis
Correct Answer: C
Rationale: Clinical practice guidelines may be evidence-based, but “expert
consensus” alone is considered lower-level evidence than research syntheses.
However, many guidelines are research-based. The term “non-research” includes
opinion, case reports, etc.
7. A nurse is reading a research article. The section that describes the study’s
design, sample, setting, and data collection methods is the:
A. Abstract
B. Introduction
C. Methods section
, D. Discussion
Correct Answer: C
Rationale: The Methods (or Design and Methods) section details how the study
was conducted, allowing appraisal of validity.
8. The Iowa Model of Evidence-Based Practice is used to:
A. Critically appraise an RCT
B. Guide implementation of EBP changes in healthcare organizations
C. Calculate statistical significance
D. Write a literature review
Correct Answer: B
Rationale: The Iowa Model is a well-known framework for identifying practice
problems, forming a team, searching evidence, appraising, and implementing
practice changes.
9. A nurse identifies a clinical problem: high rate of catheter-associated
urinary tract infections (CAUTI). The nurse asks, “What does the current
evidence say about using chlorhexidine bathing to reduce CAUTI?” This step
in the EBP process is:
A. Ask a clinical question
B. Appraise the evidence
C. Assess the patient
D. Apply the evidence
Correct Answer: A
Rationale: The EBP process begins with asking a well-built clinical question.
Appraisal and application come later.
10. A nurse wants to quickly access pre-appraised evidence summaries. Which
database is specifically designed for pre-appraised evidence?
A. CINAHL
B. PubMed
C. The Cochrane Library (Cochrane Systematic Reviews) and ACP Journal Club
D. Google Scholar
Correct Answer: C
Rationale: Cochrane Database of Systematic Reviews provides high-quality, pre-
appraised systematic reviews. CINAHL and PubMed include original research;
Google Scholar is uncurated.
utilization, evidence appraisal, clinical decision-making,
practice improvement, and application of scientific findings.
1. Which of the following best defines evidence-based practice (EBP) in
nursing?
A. Using only randomized controlled trials to guide care
B. Integrating the best research evidence with clinical expertise and patient
preferences/values
C. Following tradition and rituals passed down by senior nurses
D. Relying solely on physician orders
Correct Answer: B
Rationale: EBP is the integration of best research evidence, clinical expertise, and
patient preferences/values. It is not limited to RCTs nor tradition.
2. A nurse asks, “In adult patients with pressure injuries, does the use of a
low-air-loss mattress compared to standard foam mattress reduce healing
time?” This question format is known as:
A. Background question
B. PICO(T) question
C. Nondirectional hypothesis
D. Clinical algorithm
Correct Answer: B
Rationale: PICO(T) = Population (adults with pressure injuries), Intervention
(low-air-loss mattress), Comparison (standard foam), Outcome (healing time).
Background questions are broad.
3. The “P” in the PICO(T) framework stands for:
A. Population/Patient/Problem
B. Plan
C. Procedure
D. Prescription
Correct Answer: A
Rationale: P = Population, Patient, or Problem of interest. Other elements: I =
Intervention, C = Comparison, O = Outcome, T = Time (optional).
,4. A nurse wants to find the highest level of evidence for a therapy question.
Which study design provides the strongest evidence for cause-and-effect?
A. Case series
B. Systematic review of randomized controlled trials (RCTs)
C. Expert opinion
D. Qualitative study
Correct Answer: B
Rationale: Systematic reviews of RCTs are at the top of the evidence hierarchy for
intervention questions. Expert opinion is the lowest.
5. A nurse is formulating a foreground question. Which of the following is a
foreground question?
A. “What is the pathophysiology of diabetes?”
B. “In elderly patients with dementia, does a structured exercise program compared
to usual care reduce falls?”
C. “How does the heart work?”
D. “What is the normal range for blood pressure?”
Correct Answer: B
Rationale: Foreground questions are specific, PICO-formatted questions about a
clinical issue. Background questions ask general knowledge.
6. Which of the following is an example of a “non-research” source of
evidence?
A. A randomized controlled trial
B. A systematic review
C. A clinical practice guideline based on expert consensus
D. A meta-analysis
Correct Answer: C
Rationale: Clinical practice guidelines may be evidence-based, but “expert
consensus” alone is considered lower-level evidence than research syntheses.
However, many guidelines are research-based. The term “non-research” includes
opinion, case reports, etc.
7. A nurse is reading a research article. The section that describes the study’s
design, sample, setting, and data collection methods is the:
A. Abstract
B. Introduction
C. Methods section
, D. Discussion
Correct Answer: C
Rationale: The Methods (or Design and Methods) section details how the study
was conducted, allowing appraisal of validity.
8. The Iowa Model of Evidence-Based Practice is used to:
A. Critically appraise an RCT
B. Guide implementation of EBP changes in healthcare organizations
C. Calculate statistical significance
D. Write a literature review
Correct Answer: B
Rationale: The Iowa Model is a well-known framework for identifying practice
problems, forming a team, searching evidence, appraising, and implementing
practice changes.
9. A nurse identifies a clinical problem: high rate of catheter-associated
urinary tract infections (CAUTI). The nurse asks, “What does the current
evidence say about using chlorhexidine bathing to reduce CAUTI?” This step
in the EBP process is:
A. Ask a clinical question
B. Appraise the evidence
C. Assess the patient
D. Apply the evidence
Correct Answer: A
Rationale: The EBP process begins with asking a well-built clinical question.
Appraisal and application come later.
10. A nurse wants to quickly access pre-appraised evidence summaries. Which
database is specifically designed for pre-appraised evidence?
A. CINAHL
B. PubMed
C. The Cochrane Library (Cochrane Systematic Reviews) and ACP Journal Club
D. Google Scholar
Correct Answer: C
Rationale: Cochrane Database of Systematic Reviews provides high-quality, pre-
appraised systematic reviews. CINAHL and PubMed include original research;
Google Scholar is uncurated.
