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Chapter 8 Practicing Evidence-Based Decision Making

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Chapter 8 Practicing Evidence-Based Decision Making

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Chapter 08: Practicing Evidence-Based Decision Making
Claywell: LPN to RN Transitions


MULTIPLE CHOICE

1. The American Nurses Credentialing Center (ANCC) developed the Magnet Recognition
Program for hospitals to address quality patient care. What is the significance of achieving
magnet status?
a. Excellence in quality patient care and recruitment and retention of nurses
b. Excellence in research, patient care, and retention of physicians
c. Excellence in recruiting nurses, early discharge, and effective billing
d. Excellence in recruitment and retention of ancillary caregivers
ANS: A
Magnet recognition is one of the many responses to the call for quality of care of the ANCC’s
Magnet Recognition Program. The significance of achieving Magnet status indicates a
hospital that succeeded in creating an atmosphere that nurtures evidence-based practice in
nursing practice. The nurses are free to exercise professional autonomy. The particular
hospital becomes known for its excellence in quality effective and efficient nursing care.
Physician retention, early patient discharge, effective billing, and ancillary caregivers are not
criteria for Magnet status.

DIF: Cognitive Level: Analysis OBJ: Define evidence-based practice.
TOP: Magnet Recognition Program MSC: NCLEX: Safe and Effective Care Environment

2. The chief purpose of evidence-based practice is to
N
a. offer a problem-solving approach to systematically research clinical evidence
directed toward a specific patient problem.
b. prepare the nurse to conduct specific research in patient care practices.
c. prepare the nurse for employment in an evidence-based research center.
d. research clinical evidence that covers the entire aspect of a specific problem.
ANS: A
Evidence-based practice (EBP) is the integration of the best available evidence, combined
with clinical expertise, which enables health practitioners of all varieties to address health care
questions with an evaluative and qualitative approach. EBP preparing the nurse to conduct
specific research in patient care practices reflects too narrow a scope for research. EBP
preparing the nurse for employment in an evidence-based research center has no basis for
requiring evidence-based research. EBP to research clinical evidence that covers the entire
aspect of a specific problem is incorrect.

DIF: Cognitive Level: Analysis OBJ: Define evidence-based practice.
TOP: Evidence-Based Practice
MSC: NCLEX: Safe and Effective Care Environment: Management of Care

3. Which statement reflects an important principle to be applied by the nurse who is developing
a relevant clinical question regarding a specific patient concern, using PICO?
a. The type of question will determine which resources to access.
b. A systematic approach determines which questions will be asked.
c. The clinical question is formulated at the conclusion of the literature search.

, d. Background questions are identified at the conclusion of the literature search.
ANS: A
The type of question helps determine the resources to access to answer the question.
Developing the clinical question is the most important step in the evidence-based process. The
RN must develop a clinical question that encompasses the key components to ensure that the
question addresses an answerable concern that can be converted into relevant application. Use
of the PICO format allows the nurse to develop the question utilizing all needed components.
A systematic approach that determines which questions will be asked is incorrect. All
evidence-based research is a systematic approach. Formulation of the he clinical question at
the conclusion of the literature search and identification of the background questions at the
conclusion of the literature search are stated in the wrong order of the research process.

DIF: Cognitive Level: Evaluation
OBJ: Develop a sound clinical question utilizing the PICO format.
TOP: Developing a Clinical Question
MSC: NCLEX: Safe and Effective Care Environment: Management of Care

4. The nurse is interested in whether antibiotic therapy or observation only is most effective in
the treatment of sinusitis in young adults. Which of the following best describes the type of
question being considered?
a. Background questions
b. Foreground questions
c. General knowledge questions
d. Both A and B.
ANS: B
Foreground questions have fouN r key components: (1) patient- or problem-centered focus on
knowledge about managing patients with a disease, (2) intervention, (3) comparative
intervention (an optional step, used only if relevant), and (4) clinical outcome. Ask for
specific information about managing patients with a disease. Background questions seek
general knowledge about a disease or disease process.

DIF: Cognitive Level: Analysis
OBJ: Develop a sound clinical question utilizing the PICO format.
TOP: Clinical Questions in Evidence-Based Practice
MSC: NCLEX: Safe and Effective Care Environment

5. Can you explain how the nurse’s use of PICO helps to formulate an effective clinical
question?
a. PICO organizes the elements that guide the clinical question.
b. PICO formulates an answer to the clinical question.
c. PICO explains the hierarchy of evidence.
d. PICO identifies the strength of the evidence.
ANS: A
Using the PICO approach allows for a systematic method of identifying important concepts
when formulating the clinical question. Although every component of the PICO model may
not be used in every case, PICO is an acronym used to describe a format of the four elements
required to formulate a good clinical question (P, patient or problem; I, intervention; C,
comparison; O, outcomes). PICO questions do not formulate answers, nor do PICO questions
have anything to do with evidence.

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