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TESTBANK for Davis Advantage for Understanding Medical-Surgical Nursing 7th Edition Linda S. Williams

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TESTBANK for Davis Advantage for Understanding Medical-Surgical Nursing 7th Edition Linda S. Williams

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,TESTBANK for Davis Advantage for Understanding
Medical-Surgical Nursing 7th Edition Linda S.
Williams
Notes
1- The file is chapter after chapter.
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3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
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, W&H 7e TB02-1


Chapter 2. Evidence-Based Practice



Multiple Choice
Identify the choice that best completes the statement or answers the question.



____ 1. The nurse working in a radiation oncology outpatient clinic wants to reduce the incidence of skin
breakdown in patients who receive beam radiation. Which question should the nurse use to guide a
literature search on this topic?
1. How often do patients with beam radiation experience skin breakdown?
2. Why do patients who get radiation beam therapy have skin breakdown?
3. What nursing actions minimize the occurrence of skin breakdown in patients
receiving beam radiation?
4. How does the rate of skin breakdown in our clinic patients receiving beam
radiation compare to other institutions in the city?

ANS: 3
Chapter: Chapter 2. Evidence-Based Practice
Objective: 4. Describe the EBP process.
Page: 11
Heading: Step 1: Ask the Burning Question
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordinated Care
Cognitive Level: Application (Applying)
Concept: Evidence-Based Practice
Difficulty: Difficult

Feedback
1 The frequency of skin breakdown and why patients develop skin breakdown
does not help identify ways to prevent skin breakdown.
2 The frequency of skin breakdown and why patients develop skin breakdown
does not help identify ways to prevent skin breakdown.
3 Asking a burning clinical question is the first step in the evidence-based practice
(EBP) process. It is important to include related factors in the question and to
focus on nursing interventions and care. In this situation, the nurse should focus
on nursing care that may reduce the occurrence of skin breakdown for the
specific patient population of interest.
4 Information on statistics from other organizations will not help the nurse
identify ways to prevent skin breakdown.

, W&H 7e TB02-2


PTS: 1
CON: Evidence-Based Practice



____ 2. A licensed practical nurse (LPN) working in a pediatric clinic is interested in improving patient
outcomes for children with asthma by preventing the need for hospitalization. Which clinical
question would best guide the nurse’s next steps?
1. How many patients with asthma have a pet dog or cat?
2. What is the monthly admission rate of patients with asthma to the hospital?
3. What patient education materials are available that address prevention of asthma
attacks in pediatric patients?
4. How has the occurrence rate of asthma in children under the age of 5 changed
since the clinic instituted a no smoking policy?

ANS: 3
Chapter: Chapter 2. Evidence-Based Practice
Objective: 4. Describe the EBP process.
Page: 11
Heading: Step 1: Ask the Burning Question
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordinated Care
Cognitive Level: Application (Applying)
Concept: Evidence-Based Practice
Difficulty: Moderate

Feedback
1 Information about pets, admission rates of patients with asthma, and asthma
occurrence since the implementation of a no smoking policy will not help
improve patient outcomes for children with asthma.
2 Information about pets, admission rates of patients with asthma, and asthma
occurrence since the implementation of a no smoking policy will not help
improve patient outcomes for children with asthma.
3 Asking a burning clinical question is the first step in the EBP process. It is
important to include related factors in the question and to focus on nursing
interventions and care. For this scenario, the nurse would focus on nursing care
that affects patient outcomes for the specific patient population of interest.
Patient education is a critical component of nursing care.
4 Information about pets, admission rates of patients with asthma, and asthma
occurrence since the implementation of a no smoking policy will not help
improve patient outcomes for children with asthma.

PTS: 1

, W&H 7e TB02-3


CON: Evidence-Based Practice



____ 3. The nurse is working on a committee to update the policy on best practices when delivering oral
care to a patient receiving tube feedings. Which resource will provide the most accurate
information?
1. An internet search engine like Google
2. A nursing literature database like CINAHL
3. Surveying the nurses who perform oral care to determine what they think
4. Surveying patients who are receiving tube feedings to determine what they prefer

ANS: 2
Chapter: Chapter 2. Evidence-Based Practice
Objective: 4. Describe the EBP process.
Page: 11
Heading: Step 2: Search for and Collect the Most Relevant and Best Evidence Available
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordinated Care
Cognitive Level: Application (Applying)
Concept: Evidence-Based Practice
Difficulty: Moderate

Feedback
1 An internet search does not always provide EBPs and it is difficult to filter what
is accurate from what is not.
2 To find the best available evidence, you must search multiple databases for
systematic reviews, research studies, and journal articles. One well-known
database for nursing literature is the Cumulative Index to Nursing and Allied
Health Literature (CINAHL).
3 Surveying fellow nurses will not provide best practices to drive care. Nurses’
opinions are often based on outdated practices.
4 Patients’ preferences are important when providing care, but not when writing
policies.

PTS: 1
CON: Evidence-Based Practice



____ 4. The nurse is reviewing four articles for research and notes the evidence presented in one article is
weaker than the others. Which level of research is the nurse most likely reviewing?
1. Level I

, W&H 7e TB02-4


2. Level II
3. Level III
4. Level IV

ANS: 4
Chapter: Chapter 2. Evidence-Based Practice
Objective: 3. Explain how to identify nursing evidence that should be put into practice.
Page: 10
Heading: Identifying Nursing Evidence
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordination of Care
Cognitive Level: Comprehension (Understanding)
Concept: Evidence-Based Practice
Difficulty: Easy

Feedback
1 The rating scale used to level the quality of evidence ranges from level I
(strongest) to level VII (weakest).
2 The rating scale used to level the quality of evidence ranges from level I
(strongest) to level VII (weakest).
3 The rating scale used to level the quality of evidence ranges from level I
(strongest) to level VII (weakest).
4 The rating scale used to level the quality of evidence ranges from level I
(strongest) to level VII (weakest).

PTS: 1
CON: Evidence-Based Practice



____ 5. The nurse working in an ostomy clinic wants to know if it is best practice to change an ostomy
wafer daily or weekly. What action should the nurse take first?
1. Ask the nurse practitioner what they think is best.
2. Ask the patient what their preference is.
3. Develop a research question to guide a literature search.
4. Continue performing the procedure per clinic policy.

ANS: 3
Chapter: Chapter 2. Evidence-Based Practice
Objective: 4. Describe the EBP process.
Page: 11
Heading: Step 1: Ask the Burning Question
Integrated Process: Clinical Problem-Solving Process (Nursing Process)

, W&H 7e TB02-5


Client Need: SECE: Coordinated Care
Cognitive Level: Application (Applying)
Concept: Evidence-Based Practice
Difficulty: Moderate

Feedback
1 Nurse practitioners do not determine best practice.
2 The patient’s preference may not be reflective of what is best practice.
3 The nurse should formulate a question to guide a literature search to determine
the best practice for cleaning a central line.
4 The nurse should not take no action, as the current practice may not be the best
practice.

PTS: 1
CON: Evidence-Based Practice



____ 6. A group of nurses in a long-term care facility conducted a pilot study about implementing a team
to turn patients every hour to prevent skin breakdown. The results proved the intervention to be a
success and skin breakdown rates decreased. What step should the nurses take next to implement
this process throughout the facility?
1. Educate individuals in the facility about implementing the change agency-wide.
2. Collect evidence to support implementation of a turn team.
3. Plan another pilot study to determine if implementing a turn team will reduce skin
breakdown.
4. Propose the change to a policy and procedure committee.

ANS: 1
Chapter: Chapter 2. Evidence-Based Practice
Objective: 4. Describe the EBP process.
Page: 13
Heading: Step 5: Make it Happen
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordinated Care
Cognitive Level: Application (Applying)
Concept: Evidence-Based Practice
Difficulty: Moderate

Feedback
1 Because turning a patient is an independent nursing intervention, a literature
review has been conducted, and a pilot study has been implemented where
results have been proved to be successful, the next step is to educate other

, W&H 7e TB02-6


nurses in the facility about how to implement the turn team.
2 A literature review has already been done.
3 A pilot study has already been conducted.
4 Because turning patients is an independent nursing intervention, it is not
required to go to a committee for policy and procedure change.

PTS: 1
CON: Evidence-Based Practice



____ 7. A nursing student asks the nurse preceptor why EBP is important. How should the nurse respond to
the student?
1. EBP makes nursing more professional.
2. EBP helps ensure we can demand more pay.
3. EBP helps validate the difference nurses really make.
4. EBP guides nursing decisions to improve patient outcomes.

ANS: 4
Chapter: Chapter 2. Evidence-Based Practice
Objective: 2. Discuss why EBP should be used.
Page: 10
Heading: Reasons for Using EBP
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordinated Care
Cognitive Level: Application (Applying)
Concept: Evidence-Based Practice
Difficulty: Moderate

Feedback
1 EBP is not used to support professionalism in nursing or as a mechanism to
increase nurses’ salaries.
2 EBP is not used to support professionalism in nursing or as a mechanism to
increase nurses’ salaries.
3 EBP is not used to validate the importance of nursing care.
4 EBP is much more than just evaluating research studies to determine what
results to apply to nursing practice. EBP is a systematic process that utilizes
current evidence to make decisions about the care of patients, including
evaluation of quality and applicability of existing research, patient preferences,
costs, clinical expertise, and clinical settings. The use of EBP allows nurses to
give patients the best care possible with improved patient outcomes.

PTS: 1

, W&H 7e TB02-7


CON: Evidence-Based Practice



____ 8. The nurse is reviewing a proposal for changing the type of fall-resistant slippers that are used in a
long-term care facility to reduce the number of patient fall injuries. How should this purposed
change be studied?
1. Plan a pilot study.
2. Integrate the new slippers system-wide and monitor patient falls.
3. Perform a randomized clinical trial and cite it as evidence to support a change
proposal.
4. Compare fall injuries with another long-term care facility in town.

ANS: 1
Chapter: Chapter 2. Evidence-Based Practice
Objective: 4. Describe the EBP process.
Page: 13
Heading: Step 4: Measure Outcomes Before and After Change
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordinated Care
Cognitive Level: Application (Applying)
Concept: Evidence-Based Practice
Difficulty: Difficult

Feedback
1 A small pilot study is typically done before an institute-wide change is made.
2 To implement a change system-wide, a pilot study should be performed first to
save cost if the slippers are ineffective.
3 A study like this is not needed for a minor change.
4 Comparison data of falls is not helpful to evaluate the effectiveness of a single
product change.

PTS: 1
CON: Evidence-Based Practice



____ 9. The nurse is planning a Quality and Safety Education for Nurses (QSEN) project to focus on
informatics. Which would the nurse include in this project?
1. Collecting data on repeat admissions
2. Implementing a medication barcode system
3. Collaborating with a pharmacist about medication reconciliation
4. Including the patient in a care plan meeting

, W&H 7e TB02-8



ANS: 2
Chapter: Chapter 2. Evidence-Based Practice
Objective: 8. Describe how the Quality and Safety Education for Nurses (QSEN) project can
promote safe patient care.
Page: 14
Heading: Quality and Safety Education for Nurses Project
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordination of Care
Cognitive Level: Comprehension (Understanding)
Concept: Evidence-Based Practice
Difficulty: Easy

Feedback
1 Collecting data on repeat admissions is an example of quality improvement.
2 Implementing a medication barcode system is an example of informatics.
3 Collaborating with a pharmacist about medication reconciliation is an example
of teamwork and collaboration.
4 Including a patient in a care plan meeting demonstrates patient-centered care.

PTS: 1
CON: Evidence-Based Practice



____ 10. The nurse is teaching a group of students about implementing EBP to control pain. Which
statement by a student best describes an understanding of evidence-based care?
1. I saw a commercial for pain medication that works well.
2. The patient has chronic pain and will need more medication.
3. We could give this patient morphine every 4 hours. It works for the other patient.
4. There are studies that prove nonpharmacological methods can relieve pain.

ANS: 4
Chapter: Chapter 2. Evidence-Based Practice
Objective: 1. Define evidence-based practice (EBP) and evidence-informed practice.
Page: 10
Heading: Reasons for Using EBP
Integrated Process: Clinical Problem-Solving Process (Nursing Process)
Client Need: SECE: Coordinated Care
Cognitive Level: Application (Applying)
Concept: Evidence-Based Practice
Difficulty: Moderate

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