MEDICAL SURGICAL NURSING TEST BANK CHAPTER 5

Chapter 5: Evidence-Based Practice in Medical-Surgical Nursing Chapter 5: Evidence-Based Practice in Medical-Surgical Nursing Ignatavicius: Medical-Surgical Nursing, 8th Edition MULTIPLE CHOICE 1. A nurse identifies clinical practice problems on a cardiac unit. Which question is a background question? a. “How should a client experiencing chest pain be prioritized?” b. “What is the experience of a cardiac catheterization like for middle-aged men?” c. “How are a client’s vital signs affected by anxiety?” d. “What is the best treatment for a myocardial infarction?” ANS: C A background question asks for a fact. The response of anxiety on vital signs is a background question. A foreground question asks a question of relationship and may be controversial (best treatment). Questions related to a client’s experience and best treatment are foreground questions. DIF: Understanding/Comprehension REF: 65 KEY: Foreground| background MSC: Integrated Process: Nursing Process: Assessment NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care 2. A nurse researcher is evaluating clinical questions. Which is a quantitative question? a. “What are the effects of hourly rounding on client fall rates?” b. “How do middle-aged men respond to premature balding?” c. “What are the lived experiences of postoperative clients with pain?” d. “What is the experience of having breast cancer like for young women?” ANS: A Quantitative questions ask about the relationship between or among defined, measurable phenomena and include statistical analysis of information that is collected to answer a question. Qualitative questions focus on the meanings and interpretations of human phenomena or experiences of people, and usually analyze the This study source was downloaded by from CourseH on :41:20 GMT -05:00 MEDICAL SURGICAL NURSING TEST BANK CHAPTER 5 content of what a person says during an interview or what a researcher observes. DIF: Understanding/Comprehension REF: 65 KEY: Foreground| background MSC: Integrated Process: Nursing Process: Evaluation NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care 3. A nurse is looking for the best interventions for postoperative pain control. When are the facility’s policies and procedures an appropriate source of evidence? a. When policies are based on high-quality clinical practice guidelines b. When evidence is derived from a valid and reliable quantitative research study c. When procedures originated from opinions of the facility’s chief surgeon d. When evidence is founded on recommendations from experienced nurses ANS: A Facility policies and procedures can be used as evidence of specific nursing practice in the clinical setting if the policies are based on high-quality evidence. Clinical practice guidelines are based on systematic reviews, which provide the highest level of evidence. Policies based on quantitative research, opinions, and experience should not be used because they are not founded on evidence of the highest quality. DIF: Understanding/Comprehension REF: 67 KEY: Policies| clinical practice guidelines MSC: Integrated Process: Nursing Process: Planning NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care 4. A medical-surgical nurse asks the nurse researcher, “What is the difference between qualitative and quantitative questions?” How should the nurse researcher respond? a. “Quantitative questions analyze the content of what a person says or does.” b. “Qualitative questions utilize a strict statistical analysis of information.” c. “Quantitative questions identify relationships between measurable concepts.” d. “Qualitative questions ask about associations among defined phenomena.” ANS: C Quantitative questions ask about the relationship between or among defined, measurable phenomena and include statistical analysis of information that is collected to answer a question. Qualitative questions focus on the meanings and interpretations of human phenomena or experiences of people and usually analyze the content of what a person says during an interview or what a researcher observes. DIF: Understanding/Comprehension REF: 65 KEY: Qualitative research| quantitative research MSC: Integrated Process: Teaching/Learning NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care This study source was downloaded by from CourseH on :41:20 GMT -05:00 5. A nurse is searching for evidence related to a qualitative PICOT question. Which type of evidence should the nurse search first? a. Meta-analyses with credible synthesized findings b. Systematic reviews c. Multi-site randomized clinical trials d. Meta-syntheses ANS: D If searching for answers to qualitative questions, the nurse should first look for meta-syntheses. Top-level evidence for quantitative questions includes meta-analyses, systematic reviews, and multi-site randomized clinical trials. DIF: Remembering/Knowledge REF: 67 KEY: Level of evidence MSC: Integrated Process: Nursing Process: Assessment NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care 6. A nurse assesses this PICOT question: “In the adult hospitalized client, does a COX-2 inhibitor decrease the risk of gastrointestinal bleeding compared with other NSAIDs?” What is the outcome component in this question? a. Adult hospitalized client b. Cyclooxygenase-2 (COX-2) inhibitor c. Decreased risk of gastrointestinal bleeding d. Other nonsteroidal anti-inflammatory drugs (NSAIDs) ANS: C The outcome component of the clinical question specifies the measureable and desired outcomes of the practice innovation. In this question, the decreased risk of gastrointestinal bleeding is the outcome. The population is adult hospitalized clients, the comparison component is NSAIDs, and innovative practice is COX-2 inhibitors. DIF: Remembering/Knowledge REF: 66 KEY: PICOT question MSC: Integrated Process: Nursing Process: Assessment NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care 7. A health care facility is implementing a new evidence-based nursing protocol. Which action is necessary to ensure successful implementation? a. Develop evaluation processes to validate the protocol. b. Ask for recommendations from senior nursing administration. c. Assess cost-effectiveness of the evidence-based protocol. d. Attain support from nurses who are implementing the protocol.