2782 Foundational Principles of EBP & Nursing Sciences - Final Exam Review (Qns & Ans) - O, Exams of Nursing

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2 782 Foundational Principles of

EBP & Nursing Science

Final Exam Review

(Questions & Solutions)

1. Multiple Choice Question: Which of the following best defines evidence-based practice (EBP) in nursing?

• A. Relying solely on expert opinions and clinical experience
• B. Integrating the best available research with clinical expertise and patient values
• C. Using randomized controlled trials exclusively to guide interventions
• D. Applying standardized protocols regardless of individual patient preferences Correct ANS : B. Integrating the best available research with clinical expertise and patient values Rationale: EBP involves combining the current best evidence, clinical expertise, and the patient’s unique values and circumstances to guide care decisions. This balanced integration ensures optimal, individualized patient outcomes.

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2. Fill-in-the-Blank Question: The three fundamental components of evidence-based practice are best described as __________, clinical expertise, and patient values. Correct ANS : best research evidence Rationale: These components—best research evidence, clinical expertise, and

Rationale: The EBP process includes formulating a clinical question, searching for and critically appraising evidence, implementing changes based on best evidence, evaluating outcomes, and sharing the results. Skipping outcome evaluation (option C) would undermine the iterative quality improvement process.

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5. Multiple Choice Question: When evaluating research evidence, which level of evidence is generally considered the strongest for informing clinical decisions?

• A. Expert opinion
• B. Randomized controlled trials (RCTs) and systematic reviews
• C. Cohort studies
• D. Case series Correct ANS : B. Randomized controlled trials (RCTs) and systematic reviews Rationale: RCTs and systematic reviews provide high-quality evidence due to their rigorous study designs and ability to minimize bias, making them very influential in guiding clinical decisions.

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6. Fill-in-the-Blank Question: The acronym PICO stands for Patient/Problem, Intervention, Comparison, and __________. Correct ANS : Outcome

Rationale: PICO is a framework that helps formulate clinical questions by specifying the key components required to search for relevant evidence.

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7. True/False Question: True or False: A critical appraisal of literature primarily focuses on the methodological quality and applicability of the study findings to current clinical practice. Correct ANS : True Rationale: Critical appraisal examines the study’s design, reliability, validity, and relevance, ensuring that only the most trustworthy evidence informs practice decisions.

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8. Multiple Response Question: Which strategies can help nurses implement evidence-based practice in a clinical setting? (Select all that apply)

• A. Participating in journal clubs and continuing education
• B. Collaborating with interdisciplinary teams
• C. Relying solely on personal clinical experience
• D. Utilizing clinical practice guidelines
• E. Engaging in quality improvement projects Correct ANS s: A, B, D, E

systematic Rationale: A systematic review is a rigorous summary of current literature that offers healthcare professionals a high level of evidence to guide clinical decision-making and policy formation.

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11. True/False Question: True or False: Patient outcomes are the most important metric in evaluating the success of an evidence-based intervention. Correct ANS : True Rationale: While process measures are important, patient outcomes ultimately indicate the efficacy, safety, and impact of an intervention on patient health, aligning with the ultimate goals of EBP.

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12. Multiple Response Question: When integrating research evidence into practice, which barriers may hinder the implementation of EBP? (Select all that apply)

• A. Lack of time
• B. Limited access to quality research
• C. Organizational culture resistant to change
• D. High levels of interprofessional collaboration
• E. Insufficient EBP training Correct ANS s:

A, B, C, E

Rationale: Barriers to EBP include time constraints, limited access to quality literature, resistance to change within the organization, and inadequate training in EBP processes. High interprofessional collaboration generally facilitates, rather than hinders, EBP.

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13. Multiple Choice Question: In evidence-based practice, which of the following databases is most commonly used by nurses to retrieve research articles?

• A. PubMed/Medline
• B. LexisNexis
• C. JSTOR (for humanities only)
• D. Cochrane Library Correct ANS : A. PubMed/Medline Rationale: PubMed/Medline is a widely used resource for medical and nursing research, offering access to peer-reviewed articles and clinical studies fundamental to EBP.

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14. Fill-in-the-Blank Question: The __________ model emphasizes the importance of formulating a clinical question, acquiring evidence, appraising the evidence, applying it to practice, and evaluating the outcomes.

Correct ANS s: A, B, C, E Rationale: A thorough appraisal examines the study design, sample size, relevance, and risk of bias or confounding. Journal impact factor can be a rough indicator of quality but should not be used in isolation (D).

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17. Multiple Choice Question: A nurse is leading a quality improvement project based on the latest evidence about reducing hospital-acquired infections. Which step of the EBP process does this activity best represent?

• A. Formulating the clinically relevant question
• B. Implementing the intervention
• C. Evaluating outcomes and reflecting on the process
• D. Disseminating evidence to the team Correct ANS : C. Evaluating outcomes and reflecting on the process Rationale: When a quality improvement project is undertaken to reduce infections, nursing staff use evidence to guide practice changes and then evaluate outcomes. Reflecting on the results is a critical step to ensure continuous improvement.

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18. Fill-in-the-Blank Question: The process of translating research findings into clinical practice is often referred to as __________ research.

Correct ANS : translational Rationale: Translational research focuses on bridging the “bench-to-bedside” gap, ensuring that discoveries from basic science and clinical research lead to improvements in patient care and health outcomes.

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19. True/False Question: True or False: Meta-analyses combine data from multiple randomized controlled trials to generate a more precise estimate of treatment effect. Correct ANS : True Rationale: Meta-analyses statistically pool data from several studies, increasing power and providing more robust estimates. This level of evidence is highly valued in EBP for guiding practice.

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20. Multiple Response Question: When reviewing the validity of research evidence, which indicators are most important to assess? (Select all that apply)

• A. Internal validity
• B. External validity
• C. Reliability of measures
• D. Consistency with personal beliefs
• E. Statistical significance

A __________ statement explains the rationale for conducting an EBP project and identifies the problem to be addressed in a clinical setting. Correct ANS : problem Rationale: The problem statement outlines the clinical issue that the project aims to resolve. A clear and concise problem statement is essential for guiding the search for evidence and establishing the study’s focus.

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23. True/False Question: True or False: Integrating EBP into nursing curricula ensures that nurses are prepared to continuously update their practice with new research findings. Correct ANS : True Rationale: Embedding EBP principles in nursing education prepares nurses to be lifelong learners who regularly seek, appraise, and apply new evidence to improve patient care and clinical outcomes.

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24. Multiple Response Question: Which of the following are common barriers to implementing evidence- based practice in clinical settings? (Select all that apply)

• A. Time constraints and heavy workloads
• B. Limited access to research and databases

• C. Organizational culture resistant to change
• D. Absence of patient variability
• E. Lack of EBP training and education Correct ANS s: A, B, C, E Rationale: Common barriers include time limitations, restricted access to current research, resistance to change in clinical environments, and insufficient training. The concept of patient variability (D) is inherent in clinical care and not considered a barrier.

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25. Multiple Choice Question: 

In formulating a clinical question using the PICO framework, which element represents the comparison intervention or alternative?

• A. P (Patient/Problem)
• B. I (Intervention)
• C. C (Comparison)
• D. O (Outcome) Correct ANS : C. C (Comparison) Rationale: Within the PICO framework, the Comparison specifies an alternative to the intervention (which might be a placebo or standard treatment), helping to frame the research question for an effective literature search.

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26. Fill-in-the-Blank 

• B. Participate in interprofessional team discussions
• C. Rely solely on traditional practices learned during training
• D. Audit and evaluate patient outcomes
• E. Advocate for organizational support for EBP initiatives Correct ANS s: A, B, D, E Rationale: Nurses play an active role in EBP by pursuing ongoing education, collaborating with peers, evaluating the impact of interventions, and championing EBP within their organizations. Relying solely on tradition (C) is contrary to the spirit of innovation fostered by EBP.

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29. Multiple Choice Question: 

When determining the quality of evidence, which of the following is considered a key indicator?

• A. The number of authors on the study
• B. The study’s design (e.g., randomized controlled trial)
• C. The geographical location where the research was conducted
• D. The color of the journal cover Correct ANS : B. The study’s design (e.g., randomized controlled trial) Rationale: The design of a study is a crucial indicator of its quality. RCTs and systematic reviews are typically considered high-level evidence due to their ability to minimize bias, which is essential for informing best practices.

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30. Fill-in-the-Blank Question: Before implementing a new clinical guideline, a nurse must __________ evaluate its impact on patient outcomes to ensure that the change has led to improved care. Correct ANS : systematically Rationale: Systematic evaluation—using quantitative and qualitative measures— confirms that the integration of new evidence into practice has a positive effect on patient outcomes. This step is central to the continuous quality improvement process in EBP. A nurse is evaluating a new fall prevention protocol. Which of the following is the most crucial element to consider when assessing the protocol's effectiveness using evidence-based practice? a) The protocol's cost-effectiveness. b) The number of nurses involved in the protocol's implementation. c) The protocol's alignment with current best practices based on research findings. d) The opinions of the nursing staff regarding the protocol. ANS : c Rationale: Evidence-based practice prioritizes using the best available research evidence to guide clinical decisions. Assessing alignment with current research is paramount. Fill-in-the-Blank:

the core PICO components. Multiple Choice: A nurse is appraising a research article. Which section of the article is most critical for determining the study's validity and reliability? a) Introduction b) Results c) Methods d) Discussion ANS : c Rationale: The methods section details how the study was conducted, including data collection and analysis, and is crucial for assessing the study's trustworthiness. Fill-in-the-Blank: The term used to describe the degree to which a study's findings can be applied to other settings or populations is _. ANS : generalizability Rationale: Generalizability refers to the extent to which research findings can be extrapolated to different groups or contexts. True/False: Qualitative research primarily focuses on numerical data and statistical analysis. ANS : False

Rationale: Qualitative research focuses on understanding experiences, perspectives, and meanings, often using non-numerical data like interviews and observations. Multiple Response: Which of the following are potential biases that can affect the validity of a research study? (Select all that apply.) a) Selection bias b) Confirmation bias c) Publication bias d) Randomization bias e) Recall bias ANS : a, b, c, e Rationale: Various biases can compromise a study's results. Selection bias, confirmation bias, publication bias, and recall bias are common threats to validity. Randomization bias is not a recognized form of bias. Multiple Choice: A nurse is conducting a literature search. Which database is most appropriate for finding nursing-specific research? a) PubMed b) CINAHL c) Google Scholar d) The Cochrane Library ANS : b Rationale: CINAHL (Cumulative Index to Nursing and Allied Health Literature) is a database specifically designed for nursing and allied