EBP Test #4

The PARIHS framework is being implemented in an effort to identify an evidence base for nurses' pain management practices. Which role will the appointed facilitator primarily prioritize? A) Making the implementation of evidence easier for nurses B) Identifying research that is relevant to the clinical question C) Ensuring that the change process follows ethical guidelines D) Evaluating and disseminating the results of the change in practice

A) Making the implementation of evidence easier for nurses

Quality control audits have revealed a need for EBP in an inner-city hospital. Which factor should the administration prioritize to assist with ensuring success of an EBP initiative? A) Transformational leadership B) Competent, committed, and accessible hospital librarians C) Manageable client loads D) Adequate funding

A) Transformational leadership

A group of nurses is attending the Clinical Scholar program as part of their ongoing professional education. The leader of the program determines the project is successful after the participants correctly choose which goals as essential to achieve? Select all that apply. A) Conducting research B) Being familiar with the language of research C) Monitoring adherence to EBP D) Submitting manuscripts to scholarly publications E) Critique current research

B) Being familiar with the language of research

A group of EBP mentors has been mobilized during a new EBP initiative in a community hospital. What principles should the mentors' prioritize as they engage with members of other healthcare disciplines at the hospital? Select all that apply. A) Elicit leadership from physicians who have experience with EBP. B) Collaborate with other disciplines to foster EBP that is not limited to nurses. C) Keep other disciplines informed of the EBP initiative. D) Limit participation in the initiative to nursing staff. E) Generate internal evidence which can be utilized in the process.

B) Collaborate with other disciplines to foster EBP that is not limited to nurses. E) Generate internal evidence which can be utilized in the process.

The nurses on the unit desire to take recent research findings which demonstrate improved client responses in preventing ventilator-acquired pneumonia and implement these changes to assist their clients. Before they can proceed, the research needs to be translated into a usable form. Which model should the nurses prioritize to meet this goal? A) JHNEBP model B) Stevens Star Model of Knowledge Transformation C) Clinical Scholar model D) Stetler model

B) Stevens Star Model of Knowledge Transformation

In preparation for an EBP initiative that will address the spiritual care that is provided to clients and families, a group of nurses is collecting information on the evidence related to the clinical question, the context in which it will be implemented, and the way in which the process will be facilitated. The nurses are most likely prioritizing which model for EBP implementation? A) Iowa model B) ARCC model C) PARIHS framework D) JHNEBP model

C) PARIHS framework

A hospital is in the process of planning on implementing an EBP educational initiative among the staff. Which factor should the lead nurse educator point out will be a significant determinant in the success or failure of the initiative? A) The prior familiarity with EBP of the bedside caregivers B) The educational level and demographics of the nursing staff C) The availability and quantity of financial resources D) The amount and quality of evidence within the specialties of each hospital unit

C) The availability and quantity of financial resources

A nurse educator has actively included EBP education in all phase of the clinical rotation. The educator determines the students have assimilated the EBP paradigm by correctly portraying which trait? A) Acknowledges the value of evidence in providing sound client care. B) Able to teach others about the process of identifying and appraising evidence. C) Uses the EBP process when making clinical decisions regarding client care. D) Able to synthesize the EBP process in a case study and present it in an academic paper.

C) Uses the EBP process when making clinical decisions regarding client care.

An RN is seeking a program to earn a BSN that incorporates EBP training throughout the curriculum and clinical training. In evaluating the various programs available, which question should the RN prioritize? Select all that apply. A) Does the school have Magnet recognition? B) How many EBP courses are taught? C) What are the capabilities of the computer laboratory? D) What is the institution mission statement? E) Do the educators have EBP skills?

C) What are the capabilities of the computer laboratory? D) What is the institution mission statement? E) Do the educators have EBP skills?

A medical facility has brought in an ANP consultant to help guide their transition to an EBP-based system. Which factors will be the most difficult to determine? Select all that apply. A) The underlying willingness of the staff to change B) Which staff members should take over lead when the consultant leaves C) The underlying assumption about the people who form the culture D) The values of the organization E) The assumed expectations of the organization

C. the underlying assumption about the people who form the culture E) The assumed expectations of the organization

An initiative to improve the quality of care that stroke clients receive is being considered in a county hospital. Which question should the implementation team examine as part of a SCOT analysis? Select all that apply. A) "Who are the stakeholders that would be affected by a change in our practice?" B) "How will we define success during this initiative?" C) "What are the costs that might be incurred if we attempt to change practice?" D) "What are the challenges in our workplace that we need to address?" E) "What potential barriers should we be aware of and possibly prepare for?"

D) "What are the challenges in our workplace that we need to address?" E) "What potential barriers should we be aware of and possibly prepare for?"

Nursing leaders in a large, urban emergency department are aware that many nurses are skeptical of a proposed evidence-based change in the management of clients with mental health problems. How should the nursing leader's best address this skepticism? A) Bring in EBP mentors from an emergency department that has successfully implemented a similar change. B) Distribute copies of a meta-analysis that encompasses the relevant research and elicit feedback. C) Present the evidence that underlies the proposed change at an open forum. D) Create a venue for the nurses to express and discuss their skepticism directly.

D) Create a venue for the nurses to express and discuss their skepticism directly.

The nursing instructor has pointed out various behaviors of a complexity leader in a graduate nurse class. The instructor determines the session is successful after the class correctly chooses which necessary trait? A. Accumulates the facts and then makes a decision B. Identifies performance markers C. Encourages adoption of an EBP D. Develops a high level of emotional competence

D. Develops a high level of emotional competence

An enthusiastic cadre of mentors has been mobilized during a community health center's transition to evidence-based postpartum care in the community. What is the primary role that mentors play within the EBP paradigm? A) Provide a link between the theory of EBP and its actual implementation. B) Ensure collaboration among leaders, educators, and care providers. C) Guide the process of critical appraisal that is foundational to EBP. D) Ensure accountability during periods of transition from traditional practice to EBP.

A) Provide a link between the theory of EBP and its actual implementation.

A focus group is reevaluating the method used to prepare clients who are to undergo bariatric surgery. The group has decided to use the JHNEBP model that utilizes several phases. Which phase of the JHNEBP model will the group prepare to utilize? Select all that apply. A) Translation B) Utilization C) Evidence D) Implementation E) Practice question

A) Translation C) Evidence E) Practice question

A nurse has recently transferred to a new facility where EBP is not incorporated as much as the previous facility. Accepting the challenge to encourage the increased use of EBP, which change should the nurse tackle first? A) Change is easier to implement with larger groups. B) Major changes are better incorporated quickly. C) Before attempting a group change, the individual must change. D) Change is easier by breaking the group into small groups.

C) Before attempting a group change, the individual must change.

There is both a need and a desire to implement EBP at a community hospital that has experienced many client falls in recent months. Which strategy is most likely to identify potential EBP mentors at the outset of this EBP falls prevention initiative? A) Solicit the assistance of the most senior nurses on the unit. B) Attract the participation of nurses who work full time at the hospital. C) Identify nurses who combine expertise with inquisitiveness. D) Ask those who have graduated most recently to share their learning about EBP.

C) Identify nurses who combine expertise with inquisitiveness.

A nurse educator is championing an EBP initiative. Which factor is most likely to support the success of the initiative? A) Effective teaching techniques that implement adult learning theory B) A sufficient quantity of evidence within the nursing literature C) Motivated individuals who can mobilize the transition D) Incentives for abandoning traditional practice and adopting EBP

C) Motivated individuals who can mobilize the transition

A clinical instructor who teaches a group of students has begun using educational prescriptions (EPs) to facilitate students' learning in the hospital setting. When questioned by other instructors about the benefits of utilizing EPs, what is the best response from the instructor? A) Answers clinical questions relevant to the client's care and engaging in reflection B) Identifies the benefits of EBP and the risks of alternative approaches C) Assesses the learning needs of clients and families and performing client education D) Facilitates a change in practice when research exists to justify such a change

A) Answers clinical questions relevant to the client's care and engaging in reflection

A group of nurses are preparing to initiate an EBP change in their unit. Which action should the nurses prioritize to address the need for goals? A) Identify a set of common goals and write them down. B) Allow individual nurses the autonomy to choose their own goals. C) Identify goals from within the literature and disseminate them. D) Allow the project goals to evolve as the initiative progresses.

A) Identify a set of common goals and write them down.

A group of nursing educators has participated in a multiday educational workshop that was aimed at increasing their familiarity with the rationale and execution of mentorship programs. What is the ultimate purpose of this workshop? A) Implementation of EBP in the participants' clinical settings B) Identification of potential mentors in participants' worksites C) Increased effectiveness in participants' own mentorship roles D) Confidence in simultaneously acting as a mentee and mentor

A) Implementation of EBP in the participants' clinical settings

A local health clinic has determined that it needs to incorporate more education for the staff to transition to EBP. The process has been moving forward more slowly than anticipated. Which potential barrier should the leaders prioritize? A) Lack of administration support B) Maintaining workloads of the educators C) Up-to-date training of the educators D) The program is based on what is known versus a recent study

A) Lack of administration support

The hospital administration has been watching a group of EBP mentors to see if one stands out as a good leader to take charge of the program as the current leader is retiring. After monitoring the group's interactions with the rest of the staff, which nurse distinguishes themselves as the best choice? A) Nurse P, who has demonstrated creative ways to help make decisions B) Nurse Q, who recognizes his limits and stays within them C) Nurse R, who does not let his/her inflated ego get in the way D) Nurse S, who is able to keep all the smaller steps in mind while making decisions

A) Nurse P, who has demonstrated creative ways to help make decisions

A medical center is looking at ways to further decrease medication errors. A focus group has utilized the Iowa model of EBP and finished collecting and analyzing recent EBP guidelines. Which step should the group prioritize next? A) Pilot a practice change B) Disseminate the results to the staff C) Form a team to teach the staff D) Inform the stakeholders of the findings

A) Pilot a practice change

A focus team has been instructed to investigate whether there is a better method in decreasing the number of readmissions after ventriculoperitoneal shunt replacement that were occurring within the first week after discharge. The group is interested in using an EBP model that emphasizes research utilization. Which model should the team prioritize? Select all that apply. A) The Stetler model of EBP B) The Model for EBP Change C) The Clinical Scholar D) The JHNEBP Model E) The Stevens Star Model of Knowledge Transformation

A) The Stetler model of EBP B) The Model for EBP Change D) The JHNEBP Model

A local healthcare facility is being congratulated for its success in implementing an ARCC mentor/mentee program. Which factor has most contributed to their successful outcome? A) The chief nursing officer has mentor experience. B) The mentees are able to complete all their tasks with minimal overtime. C) The education department turns all the training over to the mentors. D) The mentees learn quickly how to search for information.

A) The chief nursing officer has mentor experience.

A new nursing supervisor has recently transferred from another organization that was active in following EBP changes. In assessing the new organization's willingness to change, which factors should be present according to the Change Curve model. Select all that apply. A) The leaders are willing to change first. B) The large size of the new organization will make the process easier. C) Emotions must be accounted for in the process. D) There is strong leadership available. E) Starting with a drastic change will make the overall process easier.

A) The leaders are willing to change first. C) Emotions must be accounted for in the process. D) There is strong leadership available.

An EBP team has been working hard to allow innovation and encourage improvement in the process of implementing EBP. The interdisciplinary staff has acknowledged that they appreciate how the changes have improved client care overall. Which factor is an aspect of the Trimodal model that is greatly appreciated? A) There is no fear in recommending a new way to do something. B) Additional research is rewarded. C) All materials are located on the facilities intranet allowing staff to learn as they go without having to attend classes. D) The overall operation works within a fluid structure to enable change with the discovery of new EBP.

A) There is no fear in recommending a new way to do something.

A group of nurses in an intensive care unit is making a case for the implementation of a mentorship program at their worksite. Which argument in favor of such a program is most accurate? A) "We'll likely see the number of incident reports decrease on the unit." B) "This could result in lower staff turnover than we've seen lately." C) "This will probably spur on nurses to conduct and publish research." D) "A mentorship program will allow us to track individual nurses' performance more closely."

B) "This could result in lower staff turnover than we've seen lately."

A clinical nurse is applying for an open position at a local educational institution that is striving to increase EBP training throughout the various nursing programs. Which qualification should this nurse emphasize to the recruiter? Select all that apply. A) Involved with research projects in the past B) Ability to formulate a clinical question C) Ability to critically appraise evidence D) Ability to apply research to a clinical situation E) Ability to support clinical practice with a recognized study

B) Ability to formulate a clinical question C) Ability to critically appraise evidence

The medical center has started the process to acquire Magnet status but recognizes that much work remains to be done to accomplish this. A focus group has pointed out several issues that need to be addressed. Which issues need changing to improve care? Select all that apply. A) Ensure health care providers understand nurses' skills. B) Acknowledge client preferences. C) Encourage staff to take the initiative to examine the client and the current practice. D) Encourage various communication methods to eliminate duplication of diagnostic testing. E) Ensure the staff has adequate education and certification.

B) Acknowledge client preferences. C) Encourage staff to take the initiative to examine the client and the current practice. D) Encourage various communication methods to eliminate duplication of diagnostic testing. E) Ensure the staff has adequate education and certification.

A chart audit suggests the need for EBP in an effort to prevent central line-associated blood infections. In an effort to bring about this change, the leadership team has opted to use the ARCC model. Which activity will the team prioritize to begin the process? A) Consulting experts to guide the change process B) Assessing the readiness of the workplace culture C) Identifying and reviewing the nursing and multidisciplinary literature that addresses line sepsis D) Exploring the problems that have triggered the need for change

B) Assessing the readiness of the workplace culture

Nursing leaders are utilizing Kotter and Cohen's Model of Change to guide a change in pressure ulcer assessment and prevention. What task should the leaders prioritize? A) Assess nurses, willingness to change. B) Cultivate a sense of urgency. C) Mobilize EBP mentors. D) Communicate the proposed vision for change.

B) Cultivate a sense of urgency.

A nursing student who is learning how to provide postsurgical care has asked how to prevent postoperative pneumonia. How should the nursing instructor best enhance this student's learning? A) Provide the student with evidence from the literature that is reliable and valid. B) Encourage the student to access primary resources that they can appraise. C) Encourage the student to systematically test different interventions in the clinical setting. D) Refer the student to relevant clinical practice guidelines.

B) Encourage the student to access primary resources that they can appraise.

A nursing program director is meeting with a local medical center to discuss potential ways to improve the program to better meet the needs of the medical center. Which change should the group prioritize to move from the traditional education format to EBP education? A) Learning to design better studies B) Finding evidence that is applicable to the client situation C) Learning to quickly critique research for its strengths D) Finding the applicable hypotheses of a study that applies to the client situation

B) Finding evidence that is applicable to the client situation

Several nurse educators are frustrated that the school where they teach has been slow to adopt teaching EBP throughout the entire curriculum. Which factor should be addressed to improve the implementation process? A) Continue the mentorship program but increase the ratio of students and mentors B) Lack of belief in the process C) Increase the number of library research staff D) Identify concerns and rewrite the curriculum as appropriate

B) Lack of belief in the process

The clinical nurse educator in a palliative care unit perceives that many of the staff nurses are in the precontemplative and contemplative stages of readiness to adopt a new, evidence-based approach to pain assessment and management. Which strategy should the educator adopt? A) Presenting the findings from the literature that support the change in practice B) Making connections with staff and fostering their readiness to change C) Implementing the initial changes in practice that are necessary D) Identifying and addressing those staff members who are resistant to change

B) Making connections with staff and fostering their readiness to change

An EBP focus team is evaluating their progress to determine if any changes or improvements are needed. The team realizes that in order for their program to meet the guidelines mandated by CMS, which factor should be included? A) It should be based on the main local culture. B) Research and knowledge creation should be exemplified. C) It should include client preferences over the staff. D) Only the recent EBP should be used.

B) Research and knowledge creation should be exemplified.

The advanced nurse practitioner (ANP) has been working with the administration to increase the use of EBP in the facility; however, they can't agree on the best way to increase its use. The administration wants to use billboards to educate the staff, but the ANP feels there is a better way. Which method would be suggested by Schein as the most important? A) Agree with the administration and encourage the use of billboards and buttons. B) Suggest learning more about the critical elements and the impacts of cultural attributes. C) Seek to identify the various symbols used by the organization and use them to educate the staff. D) Verify the various assumptions about the culture of the organization.

B) Suggest learning more about the critical elements and the impacts of cultural attributes.

A group of nurses have been attempting to implement EBP changes in the method of following up on clients with sexually transmitted infections (STIs); however, the desired results have been slower than anticipated and interest is decreasing. Which factor may be occurring? A) The individuals involved have become stagnate and complacent. B) The individuals are beginning to experience fatigue change. C) There was not enough preparation before implementation. D) There has been a change in leadership.

B) The individuals are beginning to experience fatigue change.

An EBP initiative at a large hospital is in the formative stages. Which outcomes should be prioritized during the EBP mentorship program that will be foundational to the initiative? A) Dissemination of the findings of an EBP initiative B) High-quality interactions between mentors and mentees C) Increased familiarity with EBP by mentees D) Implementation of EBP by clinical staff

D) Implementation of EBP by clinical staff

A nursing educator wants to integrate EBP into students' clinical practicum experience on a psychiatry unit. Which strategy is most likely to engage the students and facilitate their implementation of EBP at this early stage? A) Present a complex and intriguing clinical question that involves controversy in psychiatric treatment. B) Pose a PICOT question around psychiatric nursing that can be answered without requiring a search or evidence appraisal. C) Ask students to create original methods for searching and critical appraisal that address a clinical question. D) Introduce a simple psychiatric nursing question that does not require an extensive search.

D) Introduce a simple psychiatric nursing question that does not require an extensive search.

A nursing educator on an acute medicine unit has attempted to assess each student's skill level in EBP and informatics at the beginning of the semester. Which potential goal is the nurse educator prioritizing with this assessment? A) Identify students' areas of clinical interest and expertise B) Create a learning partnership between the students and the educator C) Identify resource needs and possible teaching assistance for the coming semester D) Minimize students' frustration and maximize their growth

D) Minimize students' frustration and maximize their growth

The staff at a small hospital is excited about the improvement in client care that has resulted from the implementation of EBP. They agree that the training and leadership have played an important part. Which action by the leader has best helped in making these improvements? A) The leader distributes a monthly newsletter with up-to-date information. B) The leader maintains a closed group on a social media that allows open communication between the staff. C) The leader hosts a monthly brown-bag discussion lunch. D) The information is clearly communicated and questions are encouraged.

D) The information is clearly communicated and questions are encouraged.

A change in practice is being considered in a hospital unit that is producing an unacceptably high number of incident reports. Which characteristic of the unit best exemplifies the first stage of Duck's Change Curve model? A) A directive to change has been received but ignored. B) The nurses on the unit lack knowledge and experience. C) Relationships between staff and disciplines on the unit are antagonistic. D) The leadership and culture of the unit are stagnant.

D) The leadership and culture of the unit are stagnant.

A medical facility is preparing to sponsor a 5-day EBP Mentorship Program for any nurses in the local community to encourage the increased use of EBP at all locations. Which goals should this program prioritize for the attendees? Select all that apply. A) Learn how to critically appraise information. B) Encourage inquiry among the participants. C) Learn how to search for the best data. D) Develop the best PICOT question. E) Format a proper research report.

A) Learn how to critically appraise information. B) Encourage inquiry among the participants. C) Learn how to search for the best data. D) Develop the best PICOT question. E) Format a proper research report.

A nurse, frustrated with the recent changes being implemented to increase EBPs on the unit, notes there appears to be conflict with what all the healthcare professionals are doing. To ensure the best client outcome, what should this nurse encourage? An interdisciplinary approach with all members planning and coordinating care as a team Instruct the support members as to what they should be doing Create an EBP team to investigate a better approach to provide client care Document and report the inconsistencies to the administration

An interdisciplinary approach with all members planning and coordinating care as a team

A new nurse is excited to be starting orientation in the new job, but the nurse is also a little apprehensive. The older nurse responsible for the orientation said, "Forget everything they told you in school. We do things this way." At the end of the day, the new nurse is beginning to question if becoming a nurse was a mistake. What is happening here? Many long-held assumptions are being challenged with new evidence and proven to not be as effective. The training of the new nurse is more recent and up-to-date. The new nurse is discovering the difference between studying theory and actual work required. The new nurse just needs to survive orientation and can do what she wants after she is on her own.

Many long-held assumptions are being challenged with new evidence and proven to not be as effective.

The nursing leadership of a university hospital wishes to implement EBP around the prevention of Clostridium difficile infection among inpatients. As the team prepares to follow the Model for EBP Change, which activity would be considered inappropriate? A) Dissemination of the success or failure of the practice change B) Engaging stakeholders in the early stages of the practice change C) Conducting a literature review D) Implementing a pilot study

A) Dissemination of the success or failure of the practice change

The nurse educators at a local hospital are preparing to begin an EBP training program with the staff. Which learning outcome should be prioritized in the early stages of a hospital's EBP educational initiative? A) Formulation of PICOT questions relevant to their clinical context. B) Generation of CPGs that are evidence based. C) Performance of critical appraisal of evidence sources. D) Correlation of evidence with the policies and protocols of the unit.

A) Formulation of PICOT questions relevant to their clinical context.

A nursing program desires to increase the success of EBP education among the students. Which option is proven to meet this goal? A) Hire proven mentors. B) Require more EBP classes. C) Encourage focus group teams among the students. D) Encourage students to maintain a portfolio detailing their EBP findings to use as reference after they graduate.

A) Hire proven mentors.

Owing to low levels of familiarity with EBP among the hospital's staff nurses, a group of nurse educators has identified a need for an EBP educational initiative. How should the educators begin preparing for this educational initiative? A) Identifying resources that are available for the program B) Assessing the strengths and shortcomings of past EBP educational programs C) Performing a critical appraisal of the literature D) Forming a cadre of EBP practice mentors for each unit at the hospital

A) Identifying resources that are available for the program

A group of mentors were sharing about the various mentees they have worked with over time. The mentors also noted that working with some mentees was more enjoyable than others. Which characteristics did the mentors point out were typical of the best mentees? Select all that apply. A) Leadership B) Patience C) Political awareness D) Integrity E) Creative thinking

A) Leadership C) Political awareness D) Integrity E) Creative thinking

Pediatric nurses are using the JHNEBP model to integrate more evidence into their child abuse screening protocol. Which information sources would the nurses consider as an external factor of influence? A) Legislation that addresses child abuse B) The staffing levels that is typical on the unit C) Supplies and equipment that child abuse screening may require D) Research that addresses the clinical question

A) Legislation that addresses child abuse

A medical center has been trying to develop an EBP environment, but it has proved challenging, and the council members are frustrated with the slow adoption. Which staff member should the council ensure is helping with the process? Select all that apply. A) Managers B) UAP C) Advanced practice nurses D) Ancillary departments (laboratory, radiology, etc.) E) Physicians

A) Managers C) Advanced practice nurses

An EBP team has been working steadily in identifying and implementing various EBPs over the past several years. To ensure continued success of the program which major category should the leadership prioritize? A) There is a continual introduction and evaluation of new ideas. B) Each idea is given an educational session. C) There is a defined nursing staff structure. D) Two planning sessions each month will allow for adequate planning and implementation.

A) There is a continual introduction and evaluation of new ideas.

A nurse has begun a mentorship role during an EBP initiative aimed at improving triage in a busy emergency department. What role would be best for the mentor to delegate to another staff member? A) Teaching mentees how to search and appraise literature B) Evaluating mentees' work performance C) Identifying practice goals in collaboration with mentees D) Advising mentees on possible improvements to their nursing practice

B) Evaluating mentees' work performance

A cohort of knowledgeable and experienced faculty members has volunteered to act as EBP mentors in the department of nursing at their college. What function should the mentors prioritize in this role? A) Assisting faculty and nursing students with the evaluation and appraisal of evidence B) Helping staff and students understand and implement EBP in teaching and practice C) Promoting examination of the negative consequences of neglecting EBP D) Teaching the nursing educators how to conduct research that is valid, reliable, and relevant

B) Helping staff and students understand and implement EBP in teaching and practice

Assessment of the characteristics and practices of the nurses at a large university hospital reveals that numerous barriers to the implementation of EBP exist. Which barrier should nurse educators focus their efforts in an attempt to integrate evidence with client care at the hospital? A) The majority of nurses graduated from nursing school more than 10 years ago. B) Most nurses cannot demonstrate the ability to search a bibliographic database. C) The average age of nurses at the hospital is 49 years. D) Nurses must care for an increasing number of clients per shift.

B) Most nurses cannot demonstrate the ability to search a bibliographic database.

Implementation of a new EBP guideline aimed at reducing urinary incontinence among hospitalized elders has proven difficult because of increased demands on nursing staff. Nurses on the unit state that the guideline requires them to spend more time and effort assessing for precursors to incontinence and toileting clients. Which factor challenged the implementation of the practice guideline? A) Client preferences and actions B) Clients' clinical states C) Clinical expertise D) Healthcare resources

D) Healthcare resources

A group of RNs is vehemently opposed to a role for unlicensed care providers in the OR despite the existence of valid and reliable evidence to support such a change. How should the nursing leadership best address this resistance? A) Clearly presenting the benefits of the proposed change B) Allowing unlicensed care providers to present their perceived attributes to the RNs C) Implementing the change and allowing the benefits to become apparent D) Listening to the concerns of the RNs and creating a dialogue

D) Listening to the concerns of the RNs and creating a dialogue

The nursing leadership of a hospital system is mobilizing EBP mentors in the early stages of an evidence-based initiative to amend infection-control practices. Which format should the leaders prioritize to achieve their goal? A) The Model for Evidence-Based Practice Change B) The Iowa model C) The Stetler model D) The Advancing Research and Clinical practice through close Collaboration (ARCC) model

D) The Advancing Research and Clinical practice through close Collaboration (ARCC) model

A nurse has accepted a position with an organization that provides health care in the South Pacific on various islands. The nurse has observed that the staff utilizes some EBP but also allows for local traditional methods. What can be accomplished by this clinic by utilizing both modern and traditional cultural methods? A) Collect evidence and information concerning the cause and effect and effectiveness of the traditional methods. B) The staff will earn the trust of the local community. C) The community will get the best of both worlds in their health care. D) Implementing traditional with more current care will increase reimbursement.

A) Collect evidence and information concerning the cause and effect and effectiveness of the traditional methods.

A hospital has been working hard over the past few years to change from a traditional format to one that incorporates more innovation and care. The board determines that all their hard work and efforts have been successful when they can point out which activities are now occurring? Select all that apply. A) The staff is willing to act on evidence. B) The staff is more flexible in accepting good change. C) Asking questions is encouraged to continually challenge the status quo. D) Each department has found EBP which works best for them. E) The staff has access to and is aware of the ever-changing information and research, and can quickly determine how best to apply it in their organization.

A) The staff is willing to act on evidence. B) The staff is more flexible in accepting good change. C) Asking questions is encouraged to continually challenge the status quo. E) The staff has access to and is aware of the ever-changing information and research, and can quickly determine how best to apply it in their organization.

In light of the high incidence of nosocomial methicillin-resistant Staphylococcus aureus (MRSA), there is an apparent need for improvements in infection-control practice at a county hospital. Which goal should be established for a proposed evidence-based change in practice? A) "The incidence of nosocomial MRSA will decrease significantly within the next 60 days." B) "New cases of MRSA colonization will go down by 15% between now and 90 days from now." C) "Within the next 3 months, nosocomial MRSA colonization will be eliminated in our hospital." D) "MRSA will decrease by a minimum of 10%."

B) "New cases of MRSA colonization will go down by 15% between now and 90 days from now."

A nurse educator has organized a journal club on campus in which nursing students will engage in a "hunting" approach to identifying and appraising evidence. Which activity will form a component of the club's activities? A) Each student will be responsible for scanning a given number of journals for relevant articles. B) The group will collectively review relevant articles from a secondary publication that surveys the literature. C) Each member will look for answers to a predetermined PICOT question and then bring the research to the group. D) The group will decide which publications are most relevant to their areas of clinical interest.

C) Each member will look for answers to a predetermined PICOT question and then bring the research to the group.

A nurse has noted how some clients respond differently to the basic treatment of an exacerbation of their chronic obstructive pulmonary disease (COPD) compared with others. The administration insists that the standard treatments be given to everyone initially and then change as needed. How should the nurse respond? A) Follow the administration's directions. B) Find a new facility to work at that is willing to try new ways. C) Find evidence to back the questions and present them to the administration. D) Research a better client care approach and use it and report the outcome to the administration.

C) Find evidence to back the questions and present them to the administration.

An EBP initiative in home care nursing has been announced with the goal of improving home-based wound care. Which characteristic of a nurse interested in mentoring should raise questions of qualification for a mentorship role? A) Lacks a graduate degree in nursing. B) Is 23 years old. C) Has an advanced beginner level of knowledge. D) Began working at the home care office 9 months ago.

C) Has an advanced beginner level of knowledge.

A nurse has praised the recent efforts on a medical unit to utilize research in an effort to improve the quality of nursing care of clients with dyspnea. The nurse educator on the unit, however, has characterized the initiative as an example of EBP rather than research utilization. Which action has this unit incorporated in this process? A) The change was based on expert opinion rather than journal articles and textbooks. B) The effects of the practice change will be evaluated formally, and the change will be revisited if outcomes are unsatisfactory. C) Internal evidence was considered during the practice change. D) There was multidisciplinary input during the planning and implementation of the change.

C) Internal evidence was considered during the practice change.

The director of a rural public health department is concerned by the low percentage of residents who do not get pre-cancer screenings, such as mammograms and prostate screenings. After researching the situation, the department has decided to use which measure to increase the use of prescreenings? A) Utilize public service announcements on the local radio and TV to encourage residents to make and keep appointments. B) Increase the hours of the main clinics to evenings and weekends to accommodate clients' schedules. C) Start a campaign in the schools to encourage the children to talk to their parents. D) Acquire mobile units that will offer mammograms and prostate screenings in various remote locations on a rotating basis throughout the district.

D) Acquire mobile units that will offer mammograms and prostate screenings in various remote locations on a rotating basis throughout the district.

Nurses are applying the PARIHS framework in order to guide their implementation of evidence-based diabetes education in the hospital. Which consideration will the team examine under the dimension of "context"? A) The similarities between sites where research was conducted and the site where it will be implemented B) The significance that a new diagnosis of diabetes has for clients and families C) The existing EBP that is used in other medical facilities in the neighborhood D) The character and quality of leadership that exists in the hospital

D) The character and quality of leadership that exists in the hospital

A nurse has accepted the leadership role at the facility to introduce and implement EBP among the staff. Which activity should the nurse prioritize to help the staff embrace and implement EBP? A. Maintain an open-door policy so staff can ask questions and confirm data if necessary. B. Conduct weekly discussion groups for staff to discuss information and voice concerns. C. Encourage staff to always be thinking of better ways to do procedures. D. Consistently ensure all clinicians are using the same evidentiary set of guidelines.

D. Consistently ensure all clinicians are using the same evidentiary set of guidelines.

The dean of a nursing program is evaluating the qualifications of new instructor candidates for the nursing program. As the program emphasizes EBP education, which candidate should the dean prioritize? A) Helped conduct five research projects B) Worked in a clinic which utilizes EBPs C) Attended EBP training D) Developed EBP education

D) Developed EBP education

The nursing leadership of a large urban emergency department recognizes a need to foster EBP in their care setting, an effort that will require an educational initiative to familiarize staff with the principles of the EBP paradigm. The leaders should attempt to form a partnership with which group? A) Local universities B) Third-party payers C) Regulatory and accrediting agencies D) Client advocacy groups

A) Local universities

An organization has decided to implement EBP changes in an attempt to reduce Foley catheter-related urinary tract infections (UTIs). To ensure success, change will begin to take hold after which result occurs? A) 15% to 20% of innovators, early adopters, and early majority make the change. B) 20% to 25% of the early majority make the change. C) 15% of the traditional individuals make the change. D) 10% to 15% of the innovators and early adopters make the change.

A) 15% to 20% of innovators, early adopters, and early majority make the change.

The hospital administrator is looking for a nurse mentor to take on the role of the EBP mentor. Which personality type should the administrator choose?? A) D B) I C) S D) C

A) D

A nurse manager is noted to initiate evidence-based change successfully within the organization. This nurse is displaying which type of individuality according to Rogers' theory? A) Innovators B) Mentors C) Catalysts D) Leaders

A) Innovators

A nursing supervisor has noted that a nurse who is working with the focus group appears to be taking too much time to start a new project after delaying another project in the past. After investigating, the supervisor suspects this nurse is which personality type? A) D B) I C) S D) C

D) C

A nurse discovers a client is angry and frustrated over the lack of knowing what is wrong and why no one can agree. The nurse learns the client sees the primary care physician, a cardiologist for atrial fibrillation, and an urologist for BPH. The client states, "I just want answers and consistent care." Which action should this nurse prioritize to best assist this client? Provide the client with a copy of his/her medical records to share with the other physicians and request permission to get records from the others. Apologize for the misunderstanding and document the client's concerns for the physician. Offer to contact the other physicians and try to coordinate care. Allow the client and the client's spouse to verbalize their frustration and explain that unfortunately there is nothing that can be done.

Offer to contact the other physicians and try to coordinate care.

A major healthcare provider operates multiple clinics and facilities around a large metropolitan area. The leadership is desiring to earn Magnet status and exploring options for increased EBP throughout the organization. Which potential options should the administration prioritize to increase EBP training and utilization? Select all that apply. A) Journal club B) Fellowship program C) EBP committees D) Online training E) Weekly inservices

A) Journal club B) Fellowship program C) EBP committees

A new nurse manger is approached by a nurse who has been working at the clinic for a long time and is requesting to be a part of the new EBP council. The nurse has faithfully attended yearly conferences and was introduced to EBP and finds it interesting and challenging. Which could be a barrier for this nurse to participate in the EBP council? A) Lack of computer literacy B) Inability to fulfill normal nursing functions C) Anticipating forced retirement D) Educational background not sufficient enough

A) Lack of computer literacy

On a busy postsurgical care unit, many clients have undergone bowel surgery and are faced with the prospect of caring for a new permanent or temporary ostomy. Traditionally, preoperative and predischarge teaching has been minimal and sporadic, with high levels of client anxiety evident. An initiative for implementing EBP around client education ideally should originate with which people or groups? A) The nurses who provide care on the postsurgical unit B) The medical team who perform colectomies and bowel resections C) The leadership who oversee the care and organization of the hospital's surgical program D) Client and family groups who have experienced bowel surgery in the past

A) The nurses who provide care on the postsurgical unit

An EBP council has been established within a group of long-term care facilities. Which activity should the council's mandate prioritize? A) Critically appraising evidence sources relevant to the practice setting B) Guiding the application of evidence in practice settings C) Assessing client outcomes resulting from the application of traditional practice D) Assisting nurses to upgrade their education to a baccalaureate level

B) Guiding the application of evidence in practice settings

Scheduling challenges on the part of nurses forms a significant challenge to the EBP education initiative that is being planned at a hospital. How should the leadership team best address this challenge? A) Require each nurse to attend on one of his or her normal days off. B) Provide self-directed learning modules. C) Create a group of nurses that will learn about EBP and a group that will not. D) Remind nurses to implement EBP as much as possible in their practice.

B) Provide self-directed learning modules.

A nurse is evaluating an EBP project for implementation at the facility. After evaluating the project for compliance to the Centers for Medicare and Medicaid Services (CMS), the nurse discovers which section is not in compliance? A. It addresses the various cultures of the community. B. It excludes the client's family if the client requests it. C. It includes information about practice expertise. D. It has guidelines to improve client outcomes.

B. It excludes the client's family if the client requests it.

A hospital has refreshed the knowledge of its leaders and nurse educators and has mobilized them in preparation for an institution-wide EBP educational initiative. How should the leaders and educators now proceed with the initiative? A) Identify available resources. B) Introduce evidence-based clinical practice guidelines (CPGs) to each unit. C) Begin to educate the bedside caregivers. D) Begin to measure the outcomes of the initiative in preparation for dissemination.

C) Begin to educate the bedside caregivers.

A nurse educator who works in a postpartum obstetrical unit wishes to introduce an evidence-based algorithm for the nursing management of breastfeeding challenges. How can the educator best create a desire among nurses for a change in practice? A) Create incentives for nurses for complying with a change in practice. B) Evenly distribute the workload required for implementing the change among the nursing staff. C) Demonstrate how a similar change has improved outcomes in other hospitals. D) Link the change to the mandates released by regulatory agencies.

C) Demonstrate how a similar change has improved outcomes in other hospitals.

A medical facility has made the decision to implement the use of EBP among all the staff but is facing challenges they did not expect. Which trend is this medical facility discovering that is a barrier? A) Apathy has become an increasingly common trait among nurses. B) Nursing demographics involve a decreasing average age and, consequently, less maturity. C) Even recent nursing graduates are frequently unfamiliar with EBP concepts. D) Access to valid and reliable research has become more difficult in recent years.

C) Even recent nursing graduates are frequently unfamiliar with EBP concepts.

A rural hospital has been struggling with increased causes of urinary tract infections after surgery. To help improve the care provided, a few nurses approached the hospital administration with an offer to help. Which would be the best approach to improve this situation? A) Require certification of all UAP involved in catheterization B) Offer to conduct an investigation into the cause C) Offer to serve on an EBP council to research best approaches to decrease the incidents D) Offer to hold workshops on safe catheterization techniques

C) Offer to serve on an EBP council to research best approaches to decrease the incidents

A new nurse educator has noted a significant resistance to implementing EBP at a county hospital by the staff nurses. What disadvantage to maintaining the traditional practice should the new nurse emphasize when pointing out the pros and cons of utilizing EBP? A) It denies the individuality of clients. B) It is a less efficient use of time and resources than EBP. C) It promotes intellectual stagnation on the part of nurses. D) It does not guarantee predictable outcomes

D) It does not guarantee predictable outcomes

An EBP council is preparing an educational seminar to train the staff in a different approach in preventing foot drop following a stroke. Which factor is important context to include in the program? Select all that apply A) The opportunity to determine whether the change should be made by the staff B) A date all training is to be completed C) Incentives to encourage staff to participate D) An outline detailing each step of the process E) A project to complete

D) An outline detailing each step of the process E) A project to complete

There is an apparent lack of familiarity and application of EBP on a geriatric, subacute medicine unit. Which principle should guide the nurse educator's efforts to change this situation? A) The outcomes of traditional practice should be quantified in order to determine whether EBP is necessary. B) Efforts to teach the EBP paradigm should be focused on the younger nurses and recent graduates. C) Funding sources must be secured prior to beginning a change initiative. D) It is important to plan a strategy for creating buy-in among the nursing staff.

D) It is important to plan a strategy for creating buy-in among the nursing staff.

High-incidence rates of nosocomial infections, pressure ulcers, and other nonreimbursable health problems suggest that an EBP educational initiative is necessary at a county hospital. Which group should first receive teaching on EBP? A) The leadership and management of the hospital's nursing units B) The mentorship team that has been established C) The nurses who provide direct client care D) The hospital's nursing educators

D) The hospital's nursing educators

Refugees from El Salvador are reporting to the clinic nurse that they have been using herbs unsuccessfully for an upper respiratory infection. Which response should this nurse prioritize in this situation? Recognize there could be some help from this and research if there is evidence of a particular substance in the herb that has been found to be helpful. Scold the clients for believing in old wives' tales and remind them where they are. Explain why this method does not work and probably never did. Ignore that the client even reported using the herbs.

Recognize there could be some help from this and research if there is evidence of a particular substance in the herb that has been found to be helpful.

A group of nurses have introduced EBP rounds to their community health clinic. What goal should the nurses prioritize with these meetings? A) Identify the nurses' practices that are evidence based B) Generate and answer practice questions C) Generate evidence to guide practice D) Assess the nurses' readiness to change

B) Generate and answer practice questions

A hospital committee has noted greater success with mentors to transform practice more effectively than teaching alone. Which factor can the committee point out has greatly improved with the use of mentors? A) Bedside application of the principles of EBP B) More effective and accurate critical appraisal of evidence C) Better literature searching skills than other nurses D) Clearer clinical decision-making

A) Bedside application of the principles of EBP

A nursing supervisor is requesting volunteers among the staff to be mentors for a new group of nursing students and is noting few want to participate. Which statement from a staff nurse should the supervisor prioritize? A) "The librarian was very helpful, although not always available." B) "It was very difficult to get my work done, without being interrupted all the time." C) "It was difficult to complete and submit all those required daily reports." D) "The mentee always asked too many questions."

B) "It was very difficult to get my work done, without being interrupted all the time."

The time frame that is necessary to fully implement an evidence-based change in the staffing mix on a postpartum care unit is very long. What strategy should the EBP mentors implement in order to prevent nurses from becoming fatigued and disenchanted with the change process? A) Issue reminders of the benefits that will result from the change. B) Release regular updates on the progress of the change. C) Celebrate the accomplishment of smaller goals within the larger project. D) Conduct a research study parallel to the change that documents the process.

C) Celebrate the accomplishment of smaller goals within the larger project.

A nurse educator is meeting with a group of nurses who are interested in being mentors to the new graduates. After the meeting, the educator determines the session is successful when one states which statement? A) "It will be nice to have someone who can do some of the work." B) "I'm glad they already know what to do. I'm not good at explaining things." C) "So, every 6 months, we will get a new mentee to work with." D) "It will be great to watch these graduates blossom into nurses."

D) "It will be great to watch these graduates blossom into nurses."

A nurse manager is evaluating several nurses who have expressed interest in EBP. Which practitioner best meets the recommended requirements to lead and implement EBP as per the Stetler model? A) An outside consultant and, thus, possesses objectivity B) One with direct leadership experience C) Experience among a large variety of client populations D) A graduate-level nursing education

D) A graduate-level nursing education

A large medical center has implemented the necessary steps to develop a comprehensive mentorship program throughout the entire staff. Which goal has this organization prioritize in this process? A) American Nurses Association (ANA) membership B) Hospital approval by the Joint Commission C) Hospital Magnet status D) American Nurses Credentialing Center (ANCC) nurse certification

C) Hospital Magnet status

A nursing educator is attempting to integrate EBP into the maternity rotation. Which action is most likely to ensure that the process has meaning for the students? A) Choosing scenarios that closely mimic those that the students encounter in their clinical practicum B) Ensuring that evidence presented is peer reviewed, reliable, and valid C) Bringing in guests who are recognized experts in the field of obstetrical nursing D) Including evidence about birthing choices from popular books, magazines, and newspaper articles

A) Choosing scenarios that closely mimic those that the students encounter in their clinical practicum

The nursing supervisor has requested volunteers to be part of a focus group to explore possible ways to decrease the incidence of postpartum infections status post episiotomies. The supervisor is prepared for which actions to occur during the storming stage of developing this team? Select all that apply. A) Competitiveness B) Feedback is shared with others C) Anxiety D) Tension E) Resistance to different approaches

A) Competitiveness D) Tension E) Resistance to different approaches

A committee has been established at a school of nursing to integrate EBP into the curriculum in a greater way. Which skill should the committee ensure each educator is most proficient at? A) Computer resources and computer literacy B) A large and recent base of clinical experience C) Experience in conducting research D) Adequate clinical placements for students at sites where EBP is practiced

A) Computer resources and computer literacy

A nurse is in the process of implementing EBP on the unit. Which process should the nurse prioritize if utilizing the Stetler model? A) Critical thinking B) Evaluation of individual research studies C) Dissemination of findings D) Interpreting clinical experiences

A) Critical thinking

The ARCC model is being implemented as a hospital system seeks to improve the care of clients' skeletal pin sites. Which individuals will play the primary role in guiding the process? A) EBP mentors B) Academic experts in nursing and change theory C) Staff nurses D) Nursing leadership and administration

A) EBP mentors

Some nurses are frustrated that their facility has been slowly implementing EBP standards in daily activities. They are concerned that the appointed leaders were chosen based on seniority within the organization and not because they were the best ones for the position. Which issue is most likely contributing to the failure of the model of care this organization is using? A) Each department is using evidence that pertains just to them. B) The teams are too large to be effective. C) The team is having difficulty finding relevant information. D) The leaders feel overwhelmed by their responsibilities.

A) Each department is using evidence that pertains just to them.

Nurses at a county hospital are using the ARCC model to foster EBP in their screening for delirium, depression, and dementia among older adult clients. Which data sources should be prioritized and combined with research evidence in order to guide practice? A) Input from an interdisciplinary panel B) The experiences of other institutions that have undertaken similar initiatives C) The results of a cost analysis around implementing a change in practice D) Preferences of clients and families

D) Preferences of clients and families

A nursing educator is preparing a proposal requesting funding for the purchase of new client simulators. Which benefit of client simulation should the nurse cite in the proposal? A) Simulation has been shown to represent cost-savings because fewer instructors are required. B) EBP is dependent on the extensive use of client simulators in nursing education. C) Simulation is an effective strategy for contexts where EBP is not possible. D) Simulation provides a safe and supportive environment where students can implement EBP.

D) Simulation provides a safe and supportive environment where students can implement EBP.

A nurse is concerned that the current practice of the obstetrical unit is resulting in women choosing not to breastfeed after discharge. Which factor is most important in determining success or failure of an EBP initiative to encourage continued breastfeeding? A) The positive effects of breastfeeding in neonatal health and development B) The strength and specificity of the nurse's vision for change C) The depth and breadth of the nurse's experience base D) The credibility that the nurse holds on the unit

B) The strength and specificity of the nurse's vision for change

The administration of a rural hospital has struggled in recent years to attract and retain nurses. As the committee questions instituting an EBP mentorship program, which effect should they be prepared to produce? A) Elimination of the need for unlicensed care providers B) Increased recruitment of new staff C) Decreased attrition of nurses D) Increased efficiency and consequent decreased staffing needs

C) Decreased attrition of nurses

A clinical practicum instructor who is teaching within an EBP integration curriculum has created a learning task that requires the application of the specific principles of EBP. What time constraints should the educator place on the activity? A) Allow students the autonomy to determine the pace and end date of the assignment. B) Have the students complete the task in a series of real-time stages within clinical time. C) Establish a firm deadline that is sufficient to maintain students' attention but not too distant. D) Establish a deadline that is no more than 48 hours past the introduction of the task.

C) Establish a firm deadline that is sufficient to maintain students' attention but not too distant.

Kotter and Cohen's Model of Change has been implemented successfully, resulting in an evidence-based change in pressure ulcer assessment and prevention on a unit. What is the final step in this change process? A) Disseminating the results of the change in practice B) Sending out mentors to stimulate similar change on other units and in other hospitals C) Nourishing the change to ensure the new practice is sustained D) Monitoring nurses' compliance with the new practice

C) Nourishing the change to ensure the new practice is sustained

The nurse educator on a gerontological unit has recognized the need to implement EBP around the prevention of wandering. When questioned by the administration regarding the need for this process, which response should the nurse prioritize? A) The emergence of new and innovative research around the prevention and management of wandering B) The release of new standards by the administration of the hospital C) The fact that wandering clients have recently fallen or gone missing from the unit D) Increases in client acuity of the past several months with no commensurate increase in staffing levels

C) The fact that wandering clients have recently fallen or gone missing from the unit

The nurses who provide care on an obstetrical unit of a busy, urban hospital have resolved to amend their practice around the facilitation of breastfeeding for preterm infants. Which phase of the Stetler model will the nurses prioritize for the review of relevant studies? A) Translation B) Preparation C) Validation D) Comparative evaluation

C) Validation

A nurse educator has been promoting the use of mobile devices by faculty and students. Which factor should the nurse educator point out is the best argument in favor of the mobile devices? A) Allow students to make mistakes in a safe and supportive environment. B) Students and instructors can access more evidence than they can using a computer. C) Enables closer communication between clients and care providers. D) Allows for access to information at the actual point of care.

D) Allows for access to information at the actual point of care.

A pediatric unit will be announcing an evidence-based practice initiative shortly, and nursing educators on the unit are actively recruiting mentors. Which nurse most clearly exemplifies the attributes of an effective mentor? A) 18 years of practice experience in varied settings and a nurse practitioner designation B) Nearing completion of a PhD degree C) Provides bedside care and teaches in a school of nursing D) Considered an expert with an inquisitive nature

D) Considered an expert with an inquisitive nature

The school administrator has determined that the best approach to increasing the EBP education within the school is to add educators with EBP skills. Which should the administration conclude is the most qualified? Select all that apply. A) Author of several studies B) Has taught for at least 20 years C) Attended EBP training D) Demonstrates excellent clinical judgment E) Proof of excellent clinical skills

D) Demonstrates excellent clinical judgment E) Proof of excellent clinical skills

A group of mentors is currently engaged in an EBP initiative at their public health agency that began several months ago and has met expectations to this point. What task should the mentors prioritize to finish this process? A) Evaluate the results of the EBP initiative B) Celebrate the successes to this point C) Debrief with the nurses and other stakeholders D) Disseminate the results of the initiative

D) Disseminate the results of the initiative

A nurse desires to find a facility which is actively utilizing innovation and EBP to care for the clients. When asked if there are questions during the interview, which question should this nurse prioritize? A) How often does the organization update its EBP protocol? B) How large is the EBP team? C) Are the nurses able to use standard tried-and-true methods instead of innovated methods? D) Do practices change as reliable evidence is discovered?

D) Do practices change as reliable evidence is discovered?