Ch.5 Evidence-Based Practice in Medical Surgical Nursing

4. A medical-surgical nurse asks the nurse researcher, "What is the difference between qualitative and quantitative questions?" How should the nurse researcher respond? a. "Quantitative questions analyze the content of what a person says or does." b. "Qualitative questions utilize a strict statistical analysis of information." c. "Quantitative questions identify relationships between measurable concepts." d. "Qualitative questions ask about associations among defined phenomena."

c. "Quantitative questions identify relationships between measurable concepts."

7. A health care facility is implementing a new evidence-based nursing protocol. Which action is necessary to ensure successful implementation? a. Develop evaluation processes to validate the protocol. b. Ask for recommendations from senior nursing administration. c. Assess cost-effectiveness of the evidence-based protocol. d. Attain support from nurses who are implementing the protocol.

d. Attain support from nurses who are implementing the protocol.

5. A nurse is searching for evidence related to a qualitative PICOT question. Which type of evidence should the nurse search first? a. Meta-analyses with credible synthesized findings b. Systematic reviews c. Multi-site randomized clinical trials d. Meta-syntheses

d. Meta-syntheses

2. A nurse researcher is evaluating clinical questions. Which is a quantitative question? a. "What are the effects of hourly rounding on client fall rates?" b. "How do middle-aged men respond to premature balding?" c. "What are the lived experiences of postoperative clients with pain?" d. "What is the experience of having breast cancer like for young women?"

a. "What are the effects of hourly rounding on client fall rates?"

2. A nurse plans evidence-based care for a client on a medical-surgical unit. Which elements should the nurse assess when developing this plan of care? (Select all that apply.) a. Client values b. Nurse's experiences c. Organizational budget d. Staffing ratios e. Best available evidence

a. Client values b. Nurse's experiences e. Best available evidence

9. A nurse who wants to incorporate evidence-based practices into client care on a medical unit is meeting resistance. Which barrier does the nurse identify as preventing nurses from engaging in evidence-based practices? a. Difficulty accessing research materials b. Lack of value for client preferences c. Trouble understanding client needs d. Inadequate nurse-client ratios

a. Difficulty accessing research materials

3. A nurse is looking for the best interventions for postoperative pain control. When are the facility's policies and procedures an appropriate source of evidence? a. When policies are based on high-quality clinical practice guidelines b. When evidence is derived from a valid and reliable quantitative research study c. When procedures originated from opinions of the facility's chief surgeon d. When evidence is founded on recommendations from experienced nurses

a. When policies are based on high-quality clinical practice guidelines

8. A research nurse meets with the nurse manager to discuss plans for the development of evidence-based practice (EBP) guidelines using the Reavy and Tavernier model. Which statement should the nurse include in the discussion? a. "Our efforts should focus on forming a team to develop an EBP initiative." b. "I will assist staff nurses with literature reviews and the synthesis of evidence." c. "You should identify barriers to evidence-based implementation." d. "I will develop a PICOT question and share it with the staff nurses."

b. "I will assist staff nurses with literature reviews and the synthesis of evidence."

1. A nurse is developing a clinical question in a PICOT format. What components are included in the question? (Select all that apply.) a. Patient b. Comparison c. Outcome d. Implementation e. Time

b. Comparison c. Outcome e. Time

10. A nurse wants to explore why clients who receive patient-controlled analgesia (PCA) after abdominal surgery ambulate sooner than clients who receive nurse-administered pain medications. Which action should the nurse take first? a. Contact the medical center's clinical pharmacist. b. Search the medical library for the best evidence. c. Recommend PCA for all clients. d. Appraise data obtained through client chart audits.

b. Search the medical library for the best evidence.

11. A nurse manager educates staff nurses in the use of clinical practice guidelines. Which statement should the nurse include in this teaching? a. "Clinical practice guidelines are implemented by The Joint Commission." b. "Practice guidelines are based on hospital management staff's expertise." c. "Clinical practice guidelines are official recommendations based on evidence." d. "Practice guidelines allow for greater reimbursement from insurance companies."

c. "Clinical practice guidelines are official recommendations based on evidence."

1. A nurse identifies clinical practice problems on a cardiac unit. Which question is a background question? a. "How should a client experiencing chest pain be prioritized?" b. "What is the experience of a cardiac catheterization like for middle-aged men?" c. "How are a client's vital signs affected by anxiety?" d. "What is the best treatment for a myocardial infarction?"

c. "How are a client's vital signs affected by anxiety?"

12. A cardiac nurse wants to know about the best practices to prevent pneumonia after open-heart surgery. In what order do the steps of the evidence-based practice (EBP) process take place? 1. 2. 3. 4. 5. 6. a. b. c. d. 1. Asking "burning" clinical questions 2. Making recommendations for practice improvement 3. Implementing accepted recommendations 4. Finding the very best evidence to try to answer those questions 5. Evaluating outcomes 6. Critically appraising and synthesizing the relevant evidence a. 5, 1, 4, 6, 3, 2 b. 1, 5, 4, 3, 2, 6 c. 1, 4, 6, 2, 3, 5 d. 5, 2, 1, 4, 6, 3

c. 1, 4, 6, 2, 3, 5

6. A nurse assesses this PICOT question: "In the adult hospitalized client, does a COX-2 inhibitor decrease the risk of gastrointestinal bleeding compared with other NSAIDs?" What is the outcome component in this question? a. Adult hospitalized client b. Cyclooxygenase-2 (COX-2) inhibitor c. Decreased risk of gastrointestinal bleeding d. Other nonsteroidal anti-inflammatory drugs (NSAID

c. Decreased risk of gastrointestinal bleeding