Evidence Based Practice 4th edition in Nursing And Healthcare – Test Bank

Complete Test Bank With Answers

Sample Questions Posted Below

1. A nurse who provides care on a renal unit has posed a number of clinical questions in an effort to implement Which of the following questions could those nurses best answer by consulting a textbook?
   1. “What effect does a diagnosis of renal failure have on type 2 diabetics’ glucose monitoring behavior?”
   2. “What factors influence clinicians’ decisions to recommend peritoneal dialysis over hemodialysis?”
   3. “What are the anatomical characteristics and physiological functions of thekidneys?”
   4. “What is the relationship between dosing of erythropoietin therapy and hemoglobin levels in patients with chronic renal failure?”

2. A nurse has heard from a colleague about a new approach to providing nursing care for confused patients who have been diagnosed with hepatic In which of the following sources is this information most likely to appear first?
   1. A newspaper article
   2. A systematic review
   3. A conference presentation
   4. A journal article

3. After reading an online news article about the surprising role that chewing gum may play in facilitating healing after bowel surgery, a nurse has “googled” the How should the nurse best interpret the results of this search?
   1. The nurse must carefully evaluate the results of this
   2. The results of searching sites such as Google and Yahoo are not clinically
   3. The search is likely to yield inaccurate or biased
   4. The search is a time-efficient substitute for searching online health

4. A nurse is seeking evidence on the most effective ways to promote urinary continence among older adults with Which of the following sources is most likely to provide the nurse with specific interventions and practices to achieve this goal?
   1. Cumulative Index to Nursing and Allied Health Literature (CINAHL)
   2. National Guideline Clearinghouse
   3. PsycINFO
   4. MEDLINE

5. A hospital educator has been commissioned with identifying evidence to inform a revision of the hospital’s policy on the use of physical During the search, what parameters should the nurse establish for the dates of articles and other information sources?
   1. Articles should be ranked according to publication date, with the most recent articles being
   2. The nurse should attempt to identify collaborative evidence for any source that is more than 3 years
   3. The nurse should establish a cutoff for sources more than 5 years
   4. The nurse should prioritize the quality and comprehensiveness of the evidence over its date of

6. While searching an online database for information on the use of drugs to treathypertension, the nurse is unsatisfied with the quantity and quality of results after searching “beta ” How should the nurse proceed?
   1. Identify the appropriate MeSH term
   2. Search for clinical guidelines in the Cochrane Library
   3. Consult the reference lists in articles that appeared during the search
   4. Search the trade names of specific beta-blocking drugs

7. In light of the large number of gall bladder patients recently admitted to the unit, a nurse is searching PubMed for literature relating to cholecystitis, cholecystectomy, cholelithiasis, and Which of the following terms should the nurse enter into the search field?
   1. “chole*”
   2. “cholecystitis or cholecystectomy or cholelithiasis or cholecystography”
   3. “gall bladder”
   4. “chole-”

8. A nurse is aware that patients who are confused often have unmet nutritional needs during their Which of the following searches related to nutrition promotion among patients with dementia or delirium is most likely to yield the greatest number of relevant results?
   1. “nutrition OR (delirium OR dementia)”
   2. “(delirium OR dementia) AND nutrition”
   3. “delirium dementia nutrition”
   4. “delirium AND dementia AND nutrition”

9. In the interest of efficiency, a nurse has limited a search of an electronic database to only those articles containing full What effect is this action likely to have on the results of the search?
   1. Only noncopyrighted resources will be available to the
   2. The nurse will be guaranteed that each result will be from a peer-reviewed
   3. The nurse will be unable to conduct a valid or useful
   4. Articles that are relevant may be excluded from

10. A nurse requires immediate insight into the most effective interventions for maintaining the safety of a patient who is experiencing acute alcohol Which of the following components of the Cochrane Library is most likely to provide the nurse with the most reliable, evidence-based interventions?
    1. Cochrane Database of Systematic Reviews (CDSR)
    2. Cochrane Central Register of Controlled Trials (CENTRAL)
    3. Cochrane Methodology Register
    4. Health Technology Assessment (HTA) Database

11. A nurse has conducted a search of PubMed to answer the question, What factors influence older adults’ decisions to seek care from the emergency department rather than their primary care provider when experiencing fatigue? The nurse is currently reviewing the results of the search in the order that they What factor determines the order of the results in a search of PubMed?
    1. Date of publication
    2. Number of times the article has been cited
    3. Ranking by peer review
    4. Date the article was added to the database

12. A nurse is working on a literature review using a laptop computer while in a café that provides wireless Internet access but will not allow for connection to the hospital library’s server that provides the nurse’s normal access to database Which of the following resources is likely to be unavailable to the nurse through this public Internet connection?
    1. PubMed
    2. Cochrane Library
    3. MEDLINE
    4. EMBASE

13. Management of a county hospital has been resistant to providing time, facilities, and subscriptions to allow nurses to conduct online searches near the point of Which of the following arguments can the nurses present to strengthen their case for these tools?
    1. “Online access at or near the point of care has been mandated by ”
    2. “Providing for literature searches has been shown to save money and shorten patient ”
    3. “It is unethical for nurses to provide care that is not rooted in a recent literature ”
    4. “The increased confidence that nurses gain from accessing knowledge is linked toimproved patient ”

14. Which of the following sources would best provide critical appraisal during a nurse’s search for evidence on which to base practice?
    1. A journal that provides assessments of notable articles recently published in other journals
    2. The expert opinion of qualified and experienced nurse clinicians
    3. A careful examination of the methodology of a study
    4. The insight of a trusted hospital librarian

15. Controversy exists on an intensive care unit regarding the best ways to prevent ventilator-associated pneumonia (VAP). What action should the nurse first take in response to this controversy?
    1. Organize a small-scale clinical trial to test current practices on the
    2. Elicit the views of the most senior nurses and those nurses who exemplify
    3. Formulate a question and conduct a thorough search of the existing
    4. Seek input from physicians with expertise in the area of

Answer Key

1. 1. A nurse is preparing a research proposal in an effort to answer a clinical Which of the following measures is most likely to reduce the potential for bias in the study?
      1. Replicating the research methodology of an existing study that addresses the clinical question
      2. Ensuring the number of participants is sufficiently high
      3. Randomly assigning the participants to groups
      4. Ensuring the clinical question reflects phenomena identified in relevant qualitative research

    

    

   2. A nurse researcher is investigating the effectiveness of a new, school-based smoking prevention Which of the following should the nurse consider as a potential confounding historical factor?
      1. Students’ existing attitudes toward tobacco use
      2. The relationship between tobacco use and alcohol use
      3. Students’ respiratory health status at the commencement of the program
      4. Antismoking messages already present in the media

    

    

   3. While reviewing a study that appears to favorably recommend the use of an innovative mattress for the prevention of pressure ulcers, the nurse notes that the sum of the experimental group and the control group is significantly less than the total How should the nurse best interpret this fact?
      1. This represents a potential threat to the reliability of the
      2. A significant number of participants did not develop pressure
      3. The results of the study have most likely been
      4. A confounding variable was present that the authors did not account

    

    

   4. The historical incidence of deep vein thrombosis in medical patients at a university hospital was 5%. This figure dropped to 2% among an experimental group during the implementation of a new prophylaxis regimen. What is the nurse’s most accurate interpretation of this finding?
      100. The relative risk of DVT among medical patients is 2/100.
      101. The regimen results in a 20% relative risk
      102. The absolute risk of DVT among the control group is 5%.
      103. The results of the intervention are valid and

    

    

   5. The number needed to treat (NNT) for an experimental vaccine is This means
      1. 775 individuals will be prevented from developing the disease in
      2. the relative risk reduction of the disease is -775 among those who were
      3. 775 individuals must be vaccinated to prevent one case of the
      4. vaccinated individuals have a 1-in-775 chance of developing the

    

   6. The findings of a study indicate that the chance of the effect being attributable to chance is 1 in How would this fact be expressed in the study?
      1. RR = 4%
      2. AR = 24 C) p = 04
      3. D) NNT = 25

    

    

   7. While reviewing the findings of a study addressing the nursing management of gestational diabetes, the nurse notes that the study fails to address the findings of the existing literature on the subject in a detailed or specific How should this influence the nurse’s view of the study?
      1. The findings of the study likely represent a notable advance in gestational diabetes
      2. This omission should be addressed in the statistical analysis of the
      3. This is acceptable in a qualitative, but not quantitative,
      4. The authors should have addressed the existing body of knowledge around the

    

    

   8. A nurse has presented a published case study to other nurses on the unit that relates the case of a patient who experienced respiratory arrest and sudden death following the infusion of total parenteral nutrition (TPN). How should the nurses respond to the findings of this case study?
      1. Modify unit practice around TPN administration
      2. Avoid administering TPN until more is known about the subject
      3. Take note of the phenomenon and do further research before implementing practice changes
      4. Disregard the findings of the case study due to the low level of evidence provided by a case study

    

    

   9. A cohort study has investigated the effect of an asthma care support program for asthma patients under 18 years old on participants’ frequency of emergency department Which of the following aspects of the study raises questions about the validity or reliability of the study?
      1. The study included 310 pediatric asthma
      2. The program was initiated over 7 years ago and was evaluated by reviewing medical
      3. The participants received various types of pharmacological treatment and psychosocial support for their
      4. The study was conducted without the presence of a control
   10. Which of the following measures is most likely to ensure baseline equivalency in a randomized controlled trial that will test the efficacy of a new bandaging system for chronic venous leg ulcers?
       1. Ensuring that clinicians are unaware of whether the bandage they are applying is the experimental or control product
       2. Randomly assigning participants to the “new bandage” group and the “oldbandage” group
       3. Rigorously screening potential participants to ensure they have as many characteristics in common as possible
       4. Setting strict criteria around the character and severity of ulcers that will be treated

    

    

   11. A gerontological nurse is reviewing the findings of a study that tested the efficacy of donepezil in the treatment of Alzheimer’s Assignment to groups in the study included the fact that the researchers distributed participants with early Alzheimer’s and advanced Alzheimer’s evenly among the control group and the experimental group. The nurse would recognize that the researchers implemented which of the following?
       1. A quasi-experiment
       2. Cluster randomization
       3. A cohort study
       4. Stratified randomization

    

    

   12. A nurse who provides care in a psychiatric care facility is reviewing the literature on the use of quetiapine for the treatment of When reviewing a randomized control trial (RCT) testing the efficacy of the drug, which of the following measures should the nurse look for to best minimize the potential for bias?
       1. The participants and clinicians did not know if they were receiving or administering a placebo or the
       2. The clinicians were able to select which participants were assigned to the control group or the experimental
       3. The participants did not know if they were receiving quetiapine or a placebo
       4. Participants were selected to the control group or experimental group based on the severity of their
   13. A nurse is reviewing a study comparing a new alcohol screening instrument to an existing instrument in predicting patients’ withdrawal symptoms during hospital The nurse notes that the confidence interval of the study includes a relative risk (RR) of 1. What are the implications of this fact?
       1. The screening instruments are unable to predict patients’ risks for alcohol
       2. Using the new instrument will result in more unanticipated cases of
       3. The new instrument is a modest improvement on the existing
       4. The new instrument may be no better than the existing one in predicting

    

    

   14. In an effort to update the unit protocol for the nursing management of hypoglycemic episodes, a nurse educator has consulted a systematic review that is available on the Which of the following criteria should the nurse prioritize when assessing a systematic review?
       1. Ensuring the inclusion criteria limited the review to studies published within the past 5 years
       2. Checking to see that both studies that were included and those that were excluded are specified
       3. Ensuring that unpublished studies were excluded from the systematic review
       4. Confirming that all of the studies that were included in the review were statistically analyzed as one data set

    

    

   15. When reviewing the studies that were included in a systematic review, a nurse is aware of the potential for publication What is an implication of this phenomenon?
       1. Studies with no demonstrated effect may not appear in the
       2. Studies that challenge accepted practice are often rejected for
       3. The fact that a study has been published constitutes a form of
       4. Biased publications often form the basis of accepted

   Answer Key