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Question 1
A nurse manager is preparing to implement EBP on the unit. Which factor can the nurse prioritize as the most important rationale for the consistent implementation of EBP? Correct! Improves client outcomes. Accessible to all healthcare clinicians. Provides for the most cost-effective client care. Provides consistency in care across healthcare settings. The goal of healthcare is to improve the lives of the clients by either helping them maintain good health or helping them heal. Although EBP does contribute to all choices, the most important is to improve client outcome.
Question 2
Several nurses are interested in utilizing EBP to provide better client care. Which PICO question best articulates the EBP process? Among undergraduate college students, what is the effectiveness of a sexual health campaign undertaken during the first 4 weeks of the fall semester as measured by incidence of new gonorrheal and chlamydial infections reported to the campus medical center? In clients aged 8 to 12 years, is the effectiveness of a pain scale using faces superior to a numeric rating scale in the emergency room context? What effect does parents' smoking have on the smoking habits of their children aged 13 to 16 years? Correct! Among clients with cancer, what role does meditation, as compared with the use of benzodiazepines, have on anxiety levels during the 7 days following hospital admission?
Only the answer concerning clients with cancer contains the PICOT elements of patient population, intervention or issue of interest, comparison intervention or group, outcome, and time frame. The answer concerning smoking lacks an intervention, comparison, or time frame, whereas the answer concerning undergraduate college students lacks a comparison. The answer concerning clients aged 8 to 12 years lacks a specific outcome or time frame.
Question 3
A nurse, conducting an EBP search, is evaluating various types of reports. Which type of report will provide the best information for this nurse? Correct! A statistical summary of the results from several different studies A qualitative study of different interventions related to the clinical question An interdisciplinary analysis of the clinical question An examination of the theoretical and conceptual underpinnings of the issue A meta-analysis is the highest level of reports which generates an overall summary statistic that represents the effect of the intervention across multiple studies. It is not a type of qualitative study nor does it primarily address the theory behind a question. It is not necessarily interdisciplinary in nature.
Question 4
A new administrator for a health clinic is concerned that some treatments are not as effective as they could be; however, many of the staff believes the EBP process is not effective. Which step should the administrator prioritize in response? Correct! Present real-case scenarios in which EBP resulted in better care and long- term results.
Seek recommendations for information sources from trusted colleagues. Correct! Narrow the scope of the clinical question. Restrict the information search to publications from the past 24 months. Limit the search to articles that relate the findings of randomized controlled trials (RCTs). A useful response to the problem of information overload is to narrow and hone the clinical question. This strategy is likely to be more effective, and valid, than establishing a narrow date limit, going forward with only the recommendations of colleagues, or limiting a search to RCTs.
Question 7
A nurse is formulating a research question and determines a comparison component would not be necessary with which clinical question? Correct Answer A study on the perceived meaning of hope among palliative clients An examination of the effect of rehydration using lactated Ringer on clients' energy levels An examination of the antipyretic qualities of cool bed bathing You Answered A study on the influence of prenatal care on preventing perineal tearing during delivery Assessing the effectiveness of an intervention, such as prenatal care, cool bathing, or rehydration, would benefit from comparison with an alternative or established intervention. A qualitative study on the subjective meaning of a phenomenon, such as hope, is not amenable to comparison.
Question 8
Which consideration should be prioritized when choosing a client population during the formulation of a clinical question? You Answered Should closely match the demographics of the nurse's geographic region Should be as narrow a range as possible Correct Answer A specific and defensible rationale should exist for the client population choice Should mirror the populations in prominent studies related to the issue Limiting the population to those in a certain age group or other special subgroup can be done if there is a valid reason. It would be erroneous to strive for as narrow a population as possible or to choose a population based on the subject populations found in existing research. The population in a clinical question should reflect the issue at hand, not necessarily the larger demographics of the nurse's geographic region.
Question 9
A client has recently been diagnosed with non-Hodgkin lymphoma and is interested in knowing how other adults in her age group responded to regular chemotherapy versus chemotherapy combined with alternative therapy and whether they saw an improvement in their life span. Which type of resource will best assist the nurse in answering this client's question? Quantitative studies RCT Qualitative studies Correct!
National Guideline Clearinghouse CINAHL The National Guideline Clearinghouse provides clinical practice guidelines and guideline summaries to explicitly guide the nurse's practice. CINAHL, MEDLINE, and PsycINFO are bibliographic databases that are likely to provide the nurse with relevant sources to answer a PICOT question, but they are unlikely to be a source of explicit practice guidelines.
Question 12
A nurse is interested in searching for ways to help clients with dementia or delirium to better meet their nutritional needs. Which search should this nurse prioritize? "nutrition OR (delirium OR dementia)" "delirium dementia nutrition" "delirium AND dementia AND nutrition" Correct! "(delirium OR dementia) AND nutrition" The search "(delirium OR dementia) AND nutrition" will identify articles linking dementia and nutrition. In addition, it will identify articles addressing delirium and nutrition. Linking all three terms with "OR" will result in too many articles because any article containing any of the three terms will be a hit. Listing the three search terms linked by "AND" or with no operators will produce only those articles that have all three terms as keywords, likely resulting in very few hits.
Question 13
A group of nurses are interested in techniques to promote better nutrition among clients who are recovering from septic shock. Which potential resource should they prioritize? Cochrane Central Register of Controlled Trials (CENTRAL) Correct!
Cochrane Database of Systematic Reviews (CDSR) Health Technology Assessment (HTA) Database Cochrane Methodology Register The Cochrane Library's "gold standard" database is the CDSR. It contains Cochrane full-text systematic reviews and should be searched first to answer intervention questions. The CDSR is more likely to be of use than the other five components of the Cochrane Library.
Question 14
A recent viral outbreak has resulted in an epidemic in the community. The nurses are concerned and want to utilize the most effective EBP. Which action would help the nurses gather the most reliable information quickly? Correct! Use pre-appraised literature for answers. Search for randomized controlled trials (RCTs) related to the infection. Assign one nurse to search while others start with traditional treatments. Contact the Centers for Disease Control and Prevention (CDC) for treatment protocol. By using preappraised literature, clinicians can cut down on the amount of time they spend determining whether they have reliable information, which cuts the time between finding suitable evidence and providing appropriate care. If this is a new outbreak, the CDC may not have the information. Searching RCTs may not be appropriate for the type of information needed and can be more time consuming. It is best to start with the correct treatment.
Question 15
Changing practice based on a single study is not normally prudent; a search for further evidence is required. It is likely impractical and unnecessary to perform a replication study.
Question 17
A nurse has called into question the unit protocol around the regular flushing of percutaneous endoscopic gastrostomy (PEG) tubes to prevent occlusion. Which factor should guide the nurse's reconsideration of the evidence around PEG tube flushing? The rigor and reliability of a chosen research study The combination of expertise and internal evidence Correct! Certainty that a new protocol will reliably prevent occlusion Expressions of client preference during a designated period of study In clinical decisions, the key criterion for quality of underlying knowledge is certainty that the clinical action will produce the intended or desired outcome. This consideration would supersede client preferences, expertise, and internal evidence, though these factors may be investigated as individual components of certainty to inform the process. Decisions would not be made on the basis of a single research study.
Question 18
A large university hospital panel is striving to complete a quality improvement initiative to improve client outcomes. One member points out utilizing the NQT-15. Which goal could be achieved utilizing this program? Evidence-based client guidelines that are updated annually by the NQF Correct! Important processes and outcomes that are within the scope of nursing personnel
The nursing practices identified each year as being most in need of improvement Nursing interventions related to the top 15 causes of morbidity and mortality in the United States The NQF-15 is measures that represent processes and outcomes that are affected, provided, and/or influenced by nursing personnel. They are not explicit care guidelines or the areas deemed most in need of improvement. They are not a reflection of the top 15 causes of morbidity and mortality in the United States.
Question 19
During a quality improvement initiative, nursing staff utilized the PDSA cycle. This cycle concludes with which action? Analyzing the results of the change in fall prevention practice Correct! Revising, refining, and repeating the change that was implemented Enacting the change in practice on a small scale Publishing or presenting the results of the quality improvement initiative The PDSA cycle consists of planning, doing, studying, and acting. The final stage (acting) consists of refining the change based on what was learned and repeating the testing. Dissemination is not an explicit component of this small-scale change; analysis takes place during the "study" stage, while enacting the change is part of the "do" stage.
Question 20
A nurse educator has reviewed a study on the coping strategies of freshman nursing students that presents conclusions that differ markedly from other studies that have examined the issue. In which domain may the study in question possibly have a flaw? Believability
