NR-449 – Evidence-Based Practice Project
Capstone project integrating research evidence,
quality improvement methods, clinical problem-
solving, and professional nursing competencies.
1. A nurse is explaining evidence-based practice (EBP) to a colleague. Which
statement best defines EBP?
• A) Basing all clinical decisions on tradition and authority
• B) Integrating the best research evidence with clinical expertise and patient
preferences
• C) Relying solely on randomized controlled trials
• D) Using only qualitative research to guide practice
Answer: B
Rationale: EBP is the integration of best research evidence, clinical expertise,
and patient values/preferences. It is not a single source of knowledge but a
synthesis of multiple domains.
2. According to the Iowa Model of Evidence-Based Practice, the first step in
implementing an EBP change is:
• A) Conducting a literature search
• B) Identifying a trigger (problem-focused or knowledge-focused)
• C) Implementing the change on a pilot unit
• D) Evaluating outcomes
Answer: B
Rationale: The Iowa Model begins with identifying a trigger – either a problem-
focused trigger (e.g., high fall rate) or a knowledge-focused trigger (new research).
This prompts the question "Is this a priority?"
,3. A nursing student is learning about the hierarchy of evidence. Which study
design provides the strongest level of evidence for a therapy question?
• A) Case-control study
• B) Systematic review and meta-analysis of randomized controlled trials
(RCTs)
• C) Cohort study
• D) Expert opinion
Answer: B
Rationale: The evidence pyramid places systematic reviews of RCTs at the top
for therapy questions (Level I). RCTs are Level II. Cohort/case-control are lower.
Expert opinion is lowest.
4. A nurse is formulating a PICO question. The "C" in PICO stands for:
• A) Comparison (or control)
• B) Condition
• C) Context
• D) Clinical finding
Answer: A
Rationale: PICO = Population/Problem, Intervention, Comparison (usual care,
placebo, or alternative intervention), Outcome. For some questions, T (Time) or S
(Setting) may be added.
5. A nurse asks: "In hospitalized adults (P), does hourly rounding (I)
compared to no rounding (C) reduce patient falls (O)?" This is a well-built
PICO question. The type of question is:
• A) Etiology question
• B) Therapy/intervention question
• C) Prognosis question
, • D) Diagnostic question
Answer: B
Rationale: This question compares an intervention (hourly rounding) to a control
(no rounding) to determine effect on an outcome (falls). This is
a therapy/intervention PICO.
6. A nurse is appraising a qualitative research study. Which criterion is most
appropriate for evaluating qualitative evidence?
• A) P-value and confidence intervals
• B) Credibility, transferability, dependability, and confirmability
• C) Sample size calculation
• D) Blinding of subjects
Answer: B
Rationale: Qualitative research is evaluated using different
criteria: credibility (truth
value), transferability (applicability), dependability (consistency), confirmabilit
y (neutrality). Quantitative uses validity/reliability.
7. The nurse understands that "clinical expertise" in the EBP triad includes:
• A) Only what is published in textbooks
• B) The nurse's clinical judgment, skills, and previous experience with
similar patients
• C) Patient preferences only
• D) Hospital policies
Answer: B
Rationale: Clinical expertise refers to the clinician's accumulated knowledge,
clinical reasoning, and ability to assess patient circumstances. It is the "art" of
nursing that complements research evidence.
, 8. A nurse is conducting a literature search for high-level evidence on a new
wound care product. Which database is most focused on nursing and allied
health literature?
• A) PubMed/MEDLINE
• B) CINAHL (Cumulative Index to Nursing and Allied Health Literature)
• C) PsycINFO
• D) Cochrane Library
Answer: B
Rationale: CINAHL is the primary nursing database. MEDLINE is biomedical.
Cochrane contains systematic reviews. PsycINFO is psychology. For nursing EBP,
CINAHL is essential.
9. A nurse is reading a systematic review. The reviewer uses GRADE to assess
the quality of evidence. GRADE stands for:
• A) Grading of Recommendations, Assessment, Development, and
Evaluation
• B) General Research Assessment for Data Evaluation
• C) Guideline Review and Agreement for Decision-making
• D) Global Rating of Evidence and Data
Answer: A
Rationale: GRADE is a systematic approach to rating the quality of evidence and
strength of recommendations. It considers study design, risk of bias, inconsistency,
indirectness, imprecision, and publication bias.
10. A nurse implements a new evidence-based protocol for preventing
pressure injuries. After 6 months, the nurse measures the incidence of
pressure injuries. This is an example of:
• A) Process evaluation
• B) Outcome evaluation
Capstone project integrating research evidence,
quality improvement methods, clinical problem-
solving, and professional nursing competencies.
1. A nurse is explaining evidence-based practice (EBP) to a colleague. Which
statement best defines EBP?
• A) Basing all clinical decisions on tradition and authority
• B) Integrating the best research evidence with clinical expertise and patient
preferences
• C) Relying solely on randomized controlled trials
• D) Using only qualitative research to guide practice
Answer: B
Rationale: EBP is the integration of best research evidence, clinical expertise,
and patient values/preferences. It is not a single source of knowledge but a
synthesis of multiple domains.
2. According to the Iowa Model of Evidence-Based Practice, the first step in
implementing an EBP change is:
• A) Conducting a literature search
• B) Identifying a trigger (problem-focused or knowledge-focused)
• C) Implementing the change on a pilot unit
• D) Evaluating outcomes
Answer: B
Rationale: The Iowa Model begins with identifying a trigger – either a problem-
focused trigger (e.g., high fall rate) or a knowledge-focused trigger (new research).
This prompts the question "Is this a priority?"
,3. A nursing student is learning about the hierarchy of evidence. Which study
design provides the strongest level of evidence for a therapy question?
• A) Case-control study
• B) Systematic review and meta-analysis of randomized controlled trials
(RCTs)
• C) Cohort study
• D) Expert opinion
Answer: B
Rationale: The evidence pyramid places systematic reviews of RCTs at the top
for therapy questions (Level I). RCTs are Level II. Cohort/case-control are lower.
Expert opinion is lowest.
4. A nurse is formulating a PICO question. The "C" in PICO stands for:
• A) Comparison (or control)
• B) Condition
• C) Context
• D) Clinical finding
Answer: A
Rationale: PICO = Population/Problem, Intervention, Comparison (usual care,
placebo, or alternative intervention), Outcome. For some questions, T (Time) or S
(Setting) may be added.
5. A nurse asks: "In hospitalized adults (P), does hourly rounding (I)
compared to no rounding (C) reduce patient falls (O)?" This is a well-built
PICO question. The type of question is:
• A) Etiology question
• B) Therapy/intervention question
• C) Prognosis question
, • D) Diagnostic question
Answer: B
Rationale: This question compares an intervention (hourly rounding) to a control
(no rounding) to determine effect on an outcome (falls). This is
a therapy/intervention PICO.
6. A nurse is appraising a qualitative research study. Which criterion is most
appropriate for evaluating qualitative evidence?
• A) P-value and confidence intervals
• B) Credibility, transferability, dependability, and confirmability
• C) Sample size calculation
• D) Blinding of subjects
Answer: B
Rationale: Qualitative research is evaluated using different
criteria: credibility (truth
value), transferability (applicability), dependability (consistency), confirmabilit
y (neutrality). Quantitative uses validity/reliability.
7. The nurse understands that "clinical expertise" in the EBP triad includes:
• A) Only what is published in textbooks
• B) The nurse's clinical judgment, skills, and previous experience with
similar patients
• C) Patient preferences only
• D) Hospital policies
Answer: B
Rationale: Clinical expertise refers to the clinician's accumulated knowledge,
clinical reasoning, and ability to assess patient circumstances. It is the "art" of
nursing that complements research evidence.
, 8. A nurse is conducting a literature search for high-level evidence on a new
wound care product. Which database is most focused on nursing and allied
health literature?
• A) PubMed/MEDLINE
• B) CINAHL (Cumulative Index to Nursing and Allied Health Literature)
• C) PsycINFO
• D) Cochrane Library
Answer: B
Rationale: CINAHL is the primary nursing database. MEDLINE is biomedical.
Cochrane contains systematic reviews. PsycINFO is psychology. For nursing EBP,
CINAHL is essential.
9. A nurse is reading a systematic review. The reviewer uses GRADE to assess
the quality of evidence. GRADE stands for:
• A) Grading of Recommendations, Assessment, Development, and
Evaluation
• B) General Research Assessment for Data Evaluation
• C) Guideline Review and Agreement for Decision-making
• D) Global Rating of Evidence and Data
Answer: A
Rationale: GRADE is a systematic approach to rating the quality of evidence and
strength of recommendations. It considers study design, risk of bias, inconsistency,
indirectness, imprecision, and publication bias.
10. A nurse implements a new evidence-based protocol for preventing
pressure injuries. After 6 months, the nurse measures the incidence of
pressure injuries. This is an example of:
• A) Process evaluation
• B) Outcome evaluation
