Complete Test Bank For Clinical Nursing Skills and Techniques 10th Edition by
Anne Griffin Perry, Patricia A. Potter Chapter 1-43 Complete Guide
Chapter 01: Using Evidence in Nursing Practice
MULTIPLE CHOICE
1. Evidence-based practice is a problem-solving approach to making decisions about
patient care that is grounded in:
a. the latest information found in textbooks.
b. systematically conducted research studies.
c. tradition in clinical practice.
d. quality improvement and risk-management data.
ANS: B
The best evidence comes from well-designed, systematically conducted research
studies described in scientific journals. Portions of a textbook often become outdated
by the time it is published. Many health care settings do not have a process to help
staff adopt new evidence in practice, and nurses in practice settings lack easy
access to risk-management data, relying instead on tradition or convenience. Some
sources of evidence do not originate from research. These include quality
improvement and risk-management data; infection control data; retrospective or
concurrent chart reviews; and clinicians‘ expertise. Although
non–research-based evidence is often very valuable, it is important that you learn to
rely more on research-based evidence.
DIF: CognitiveLevel: Comprehension OBJ: Discuss the benefits of evidence-based
practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe and Effective Care Environment (management of care)
2. When evidence-based practice is used, patient care will be:
a. standardized for all.
b. unhampered by patient culture.
c. variable according to the situation.
d. safe from the hazards of critical thinking.
ANS: C
Using your clinical expertise and considering patients‘ cultures, values, and
preferences ensures that you will apply available evidence in practice ethically and
appropriately. Even when you use the best evidence available, application and
outcomes will differ; as a nurse, you will develop critical thinking skills to determine
whether evidence is relevant and appropriate.
DIF: CognitiveLevel: Application OBJ: Discuss the benefits of evidence-based
practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe and Effective Care Environment (management of care)
3. When a PICOT question is developed, the letter that corresponds with the usual
standard of care is:
a. P.
b. I.
c.
c. CHOICE BLANK
d. O.
ANS: C
C = Comparison of interest. What standard of care or current intervention do you
usually use now in practice?
P = Patient population of interest. Identify your patient by age, gender, ethnicity,
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, disease, or health problem.
I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and
prognostic factor) do you think is worthwhile to use in practice?
O = Outcome. What result (e.g., change in patient‘s behavior, physical finding, and change
in patient‘s perception) do you wish to achieve or observe as the result of an intervention?
DIF: CognitiveLevel: Knowledge OBJ: Develop a PICO
question. TOP: PICO KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
4. A well-developed PICOT question helps the nurse:
a. search for evidence.
b. include all five elements of the sequence.
c. find as many articles as possible in a literature search.
d. accept standard clinical routines.
ANS: A
The more focused a question that you ask is, the easier it is to search for evidence in
the scientific literature. A well-designed PICOT question does not have to include all
five elements, nor does it have to follow the PICOT sequence. Do not be satisfied
with clinical routines. Always question and use critical thinking to consider better ways
to provide patient care.
DIF: CognitiveLevel: Analysis OBJ: Describe the six steps of evidence-based
practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
5. The nurse is not sure that the procedure the patient requires is the best possible
for the situation. Utilizing which of the following resources would be the quickest
way to review research on the topic?
a. CINAHL
b. PubMed
c. MEDLINE
d. The Cochrane Database
ANS: D
The Cochrane Community Database of Systematic Reviews is a valuable source of
synthesized evidence (i.e., pre-appraised evidence). The Cochrane Database
includes the full text of regularly updated systematic reviews and protocols for
reviews currently happening. MEDLINE, CINAHL, and PubMed are among the most
comprehensive databases and represent the scientific knowledge base of health
care.
DIF: CognitiveLevel: Synthesis OBJ: Describe the six steps of evidence-based
practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
6. The nurse is getting ready to develop a plan of care for a patient who has a specific
need. The best source for developing this plan of care would probably be:
a. The Cochrane Database.
b. MEDLINE.
c. NGC.
d. CINAHL.
ANS: C
The National Guidelines Clearinghouse (NGC) is a database supported by the
Agency for Healthcare Research and Quality (AHRQ). It contains clinical
guidelines—systematically developed statements about a plan of care for a specific
set of clinical circumstances involving a specific patient population. The NGC is a
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, valuable source when you want to develop a plan of care for a patient. The Cochrane
Community Database of Systematic Reviews, MEDLINE, and CINAHL are all
valuable sources of synthesized evidence (i.e., pre-appraised evidence).
DIF: CognitiveLevel: Synthesis OBJ: Describe the six steps of evidence-based
practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
7. The nurse has done a literature search and found 25 possible articles on the topic
that she is studying. To determine which of those 25 best fit her inquiry, the nurse
first should look at:
a. the abstracts.
b. the literature reviews.
c. the ―Methods‖ sections.
d. the narrative sections.
ANS: A
An abstract is a brief summary of an article that quickly tells you whether the article is
research based or clinically based. An abstract summarizes the purpose of the study
or clinical query, the major themes or findings, and the implications for nursing
practice. The literature review usually gives you a good idea of how past research led
to the researcher‘s question.
The ―Methods‖ or ―Design‖ section explains how a research study is organized and
conducted to answer the research question or to test the hypothesis. The narrative of a
manuscript differs according to the type of evidence-based article—clinical or
research.
DIF: CognitiveLevel: Application
OBJ: Discuss elements to review when critiquing the scientific literature.
TOP: Randomized Controlled Trials KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe and Effective Care Environment
(management of care)
8. The nurse wants to determine the effects of cardiac rehabilitation program
attendance on the level of postmyocardial depression for individuals who have had a
myocardial infarction. The type of study that would best capture this information
would be a:
a. randomized controlled trial.
b. qualitative study.
c. case control study.
d. descriptive study.
ANS: B
Qualitative studies examine individuals‘ experiences with health problems and the
contexts in which these experiences occur. A qualitative study is best in this case of
an individual nurse who wants to examine the effectiveness of a local program.
Randomized controlled trials involve close monitoring of control groups and treatment
groups to test an intervention against the usual standard of care. Case control studies
typically compare one group of subjects with a certain condition against another group
without the condition, to look for associations between the condition and predictor
variables. Descriptive studies focus mainly on describing the concepts under study.
DIF: CognitiveLevel: Synthesis
OBJ: Discuss ways to apply evidence in nursing practice.
TOP: Randomized Controlled Trials KEY: Nursing Process Step:
Implementation MSC: NCLEX: Safe and Effective Care Environment
(management of care)
9. Six months after an early mobility protocol was implemented, the incidence of
deep vein thrombosis in patients was decreased. This is an example of what stage
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, in the EBP process?
a. Asking a clinical question
b. Applying the evidence
c. Evaluating the practice decision
d. Communicating your results
ANS: C
After implementing a practice change, your next step is to evaluate the effect. You
do this by analyzing the outcomes data that you collected during the pilot project.
Outcomes evaluation tells you whether your practice change improved conditions,
created no change, or worsened conditions.
DIF: CognitiveLevel: Application
OBJ: Discuss ways to apply evidence in nursing practice. TOP: Evidence-Based
Practice KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Safe and Effective Care Environment (safety and infection control)
MULTIPLE RESPONSE
1. To use evidence-based practice appropriately, you need to collect the most relevant
and best evidence and to critically appraise the evidence you gather. This process
also includes: (Select all that apply.)
a. asking a clinical question.
b. applying the evidence.
c. evaluating the practice decision.
d. communicating your results.
ANS: A, B, C, D
EBP comprises six steps (Melnyk and Fineout-Overholt, 2010):
1. Ask a clinical question.
2. Search for the most relevant and best evidence that applies to the question.
3. Critically appraise the evidence you gather.
4. Apply or integrate evidence along with one‘s clinical expertise and patient
preferences and values in making a practice decision or change.
5. Evaluate the practice decision or change.
6. Communicate your results.
DIF: CognitiveLevel: Analysis OBJ: Describe the six steps of evidence-based
practice. TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
2. In a clinical environment, evidence-based practice has the ability to improve:
(Select all that apply.)
a. the quality of care provided.
b. patient outcomes.
c. clinician satisfaction.
d. patients‘ perceptions.
ANS: A, B, C, D
EBP has the potential to improve the quality of care that nurses provide, patient
outcomes, and clinicians‘ satisfaction with their practice. Your patients expect nursing
professionals to be informed and to use the safest and most appropriate interventions.
Use of evidence enhances nursing, thereby improving patients‘ perceptions of
excellent nursing care.
DIF: CognitiveLevel: Application OBJ: Discuss the benefits of evidence-based
practice. TOP: Randomized Controlled Trials KEY: Nursing Process Step:
Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
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