Question 1

The nurse is reviewing a proposal for changing the type of needleless systems currently used to administer intravenous (IV)medications in the hospital.Which part of the proposal most effectively supports the proposed change?

Accepted Answer

A small pilot study is typically done before an institute-wide change is made.B.This would not be a statistically significant number to support the need for change.C.More evidence or evidence of a higher level would better support the proposed change.D.It is important to consider the context in which the evidence will be used,and research involving a population similar to that of the nurse's institution is helpful.

Question 2

After completing all of the steps in the research process,the nurse identifies a positive response to a new intervention for foot ulcer care.Which step in EBP should the nurse perform now?

Accepted Answer

The steps of EBP are Ask,Search,Think,Measure,Make It Happen,and Evaluate.Since the nurse completed Ask,Search,Think,and Measure,the next step is Make It Happen.B.A cost-benefit analysis should have been completed already.C.Related research studies should have been validated already.D.A pilot project should have been completed already.

Question 3

While reviewing a patient care assignment with unlicensed assistive personnel (UAP),the nurse explains the reason for turning and repositioning a patient every 2 hours.Why did the nursing include this information?

Accepted Answer

Evidence-based care should be given at all times if possible and in all settings where nursing care is given.A way to ensure that evidence-based care is provided is to explain why the care should be given at the time the care is delegated.B.C.D.Explaining the reason for the care is not done to guarantee that the patient will receive morning care,help the UAP focus on actions,or help with time management.

Question 4

The nurse who works on a medical-surgical unit reads an article about a research study regarding nursing care in the intensive care unit (ICU)and decreased nosocomial infections.Which action should the nurse take in exploring this research topic?'

Accepted Answer

Clinical reality can be very different from research situations.It could be unsafe to apply research findings in an environment that differs from the one in the study,so the next step would be to identify current research related to the current population.A.A pilot study would be premature.B.Discussing the research with the chief of nursing would not help explore the topic.D.Taking the article to the head nurse in the ICU would not help with the issue of nosocomial infections on the medical-surgical unit.

Question 5

The nurse is researching articles prior to determining the best practice for providing an aspect of patient care.On what type of article should the nurse focus when researching best practice?

Accepted Answer

Systematic review,or Level I evidence,is the best evidence; it is an analysis of several well-conducted,randomized,controlled trials.A.Expert opinion is Level IV evidence,which is considered the weakest evidence.C.Traditional practice is not a type of evidence for EBP analysis.D.Quasi-experimental studies are considered Level III evidence,because these studies do not control factors that could falsely change the results and are less predictive of the effectiveness of nursing care.

Question 6

A licensed practical nurse (LPN)working on the pediatric floor is interested in improving patient outcomes for children with asthma.Which clinical question would best guide the nurse's next steps?

Accepted Answer

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.A.B.D.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.

Question 7

The staff development instructor is preparing a presentation on EBP for the nursing staff.Which should the instructor include as being the most important reason for using EBP?

Accepted Answer

The use of EBP allows nurses to give patients the best care possible,which is the goal of all caring nurses.It is considered the gold standard for nursing care.A.C.EBP does not necessarily save money or reduce staff errors.D.EBP does not influence access to health care.

Question 8

The nurse researcher is designing a study using the quasi-experimental approach.What type of data will the nurse obtain from this study design?

Accepted Answer

Quasi-experimental research studies do not control for factors that could falsely change results and as such,are less predictive of the effectiveness of nursing care.B.Outcome tracking over 10 years is a longitudinal study design,however,does not explain the type of data that will be obtained.C.Control of comorbid conditions describes a Level II design study.D.Modifiable and non-modifiable risk factors would not be identified through a quasi-experimental approach,because the variables or factors are not controlled.

Question 9

The nurse working in a radiation oncology department 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 about this topic?

Accepted Answer

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.A.B.The frequency of skin breakdown and why patients develop skin breakdown does not help identify ways to prevent skin breakdown.D.Information on statistics from other organizations will not help the nurse identify ways to prevent skin breakdown.

Question 10

The nurse is preparing to give oral care to a patient receiving tube feedings.Which approach should the nurse use to provide care that is based on EBP?

Accepted Answer

Evidence-based information shows the use of toothbrushes for oral care is much more effective than foam swabs in removing plaque from the teeth.B.Swish-and swallow Nystatin is a medication that treats oral thrush and is not routinely used to provide oral care.C.Oral suctioning is not an approach to provide oral care.D.Toothettes are not an effective mechanism for providing oral care.

Question 11

Prior to administering a prescribed medication to a patient,the nurse talks with the health care provider (HCP)regarding expected effects and then contacts the pharmacist to review the guidelines for administration.Which Quality and Safety Education for Nurses (QSEN)focus is the nurse demonstrating?

Accepted Answer

Discussing expected effects of a prescribed medication with an HCP and reviewing guidelines for administration of the medication with the pharmacist demonstrate teamwork and collaboration.A.Informatics is the management of patient confidential information.B.Patient-centered care is creating an individualized plan of care for a patient.C.Quality improvement is a process to improve patient care.

Question 12

The nurse is planning to review a research article for applicability to EBP.Which acronym should the nurse use to guide this review?

Accepted Answer

An acronym that can be used to recall the steps of the evidence-based process is ASKMME: Ask,Search,Think,Measure,Make It Happen,and Evaluate.A.B.D.RIGHT,MYWAY,and ASKWHY are not acronyms used to recall the steps of the evidence-based process.

Question 13

The nurse is planning to evaluate care provided to a patient.Which step should the nurse take to learn if the best possible care is being provided?

Accepted Answer

Nurses will know from measured outcomes that they are giving the best care possible based on the evidence available at the time.B.Reviewing the literature helps with planning care.C.Constructing a burning question is used to identify the best possible practice for care.D.Determining the validity of clinical research is used to analyze research studies for best practices.

Question 14

The nurse is researching evidence to address a clinical problem.Which evidence should the nurse focus as being the highest level supporting practice?

Accepted Answer

Level I is the best evidence and is an analysis of many well-conducted,randomized,controlled trials.It is a systematic review of studies.D.Level II evidence is obtained from at least one well-designed randomized controlled trial.A.Level III is evidence obtained from quasi-experimental research studies.C.Level IV is evidence from the opinion of authorities and/or reports of expert committees.

Question 15

The nurse working on the burn unit is interested in understanding the rate of renal compromise with a burn.Which step should the nurse take first?

Accepted Answer

Asking a burning clinical question is the first step in the EBP process.A.B.Conducting a literature search and working with a medical librarian to identify key words would be done after the clinical question is formulated.D.Evaluating the impact of care or changes in care is the last step in the EBP process.

Question 16

The nurse is using Level II research when planning best practices for skin care.Which type of evidence is the nurse using?

Accepted Answer

A randomized controlled trial is considered Level II evidence.A.C.The Cochrane Review and Joanna Briggs Best Practices Review are considered Level I evidence.B.A quasi-experimental study is considered Level III evidence.

Question 17

The nurse identifies an intervention that has been proven to enhance patient safety.What should the nurse do before implementing this intervention?

Accepted Answer

It takes critical thinking to use safety interventions at the right times and in the right circumstances.Using them appropriately helps provide safer care with fewer errors.A.The nurse does not need to ask for permission to use a safety intervention.C.The patient will most likely want all safety interventions to be used.D.A pilot study does not need to be conducted before implementing a safety intervention.

Question 18

The nurse wants to find research studies on infection rates as they relate to specific hand washing products.Where should the nurse search for these articles?

Accepted Answer

The only database specific to nursing is CINAHL.CINAHL is available through school libraries and hospital libraries.A.B.Medline and PubMed are the same resource and are used for medical literature.D.Cochrane Reviews focus on reviews of nursing literature.

Question 19

A nursing student asks the registered nurse (RN)preceptor why EBP is important.How should the nurse respond to the student?

Accepted Answer

Evidence-based nursing practice is much more than just evaluating research studies to determine what results to apply to nursing practice.Evidence-based nursing practice 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.A.B.EBP is not used to support professionalism in nursing or as a mechanism to increase nurses' salaries.C.EBP also is not used to validate the importance of nursing care.

Question 20

A nursing committee developed an evidence-based intervention that it would like to initiate institute-wide.Which step should the committee take to implement the intervention?

Accepted Answer

Usually a small pilot study within the institution is done before any institute-wide change in practice is made.B.The charge nurse will not have the evidence needed to propose the change to administration.C.Polling the nursing staff is not going to help with implementing the change.D.Nursing experts might not have the information needed to determine if the change is appropriate within the organization.

Quiz 2: Evidence-Based Practice

The nurse is reviewing a proposal for changing the type of needleless systems currently used to administer intravenous (IV) medications in the hospital.Which part of the proposal most effectively supports the proposed change?