Nursing Research/Evidence Based Practice Exam 1 (ch.1-3)

In light of the large number of gall bladder patients recently admitted to the unit, a nurse is searching PubMed for literature relating to cholecystitis, cholecystectomy, cholelithiasis, and cholecystography. which of the following terms should the nurse enter into the search field? A. "Chole* B. "cholecystitis or cholecystectomy or cholelithiasis or cholecystography" C. "gall bladder" D. "chole-"

A. "Chole*

Nurse R. has observed that reorienting demented patients as frequently as possible tends to minimize the patients level of agitation in the evening. The nurse has shared this observation with a colleague, who is skeptical, stating that, "its best to stick to EBP." How can nurse R. best respond? A. "EBP can include clinicians personal expertise" B. "personal experience is often more sound than formal EBP" C. "traditional practice and EBP are usually shown to be the same" D. "my years of experience can be just as valuable as any literature review or randomized trial"

A. "EBP can include clinicians personal expertise"

which of the following clinical questions can be best addressed by a meta-synthesis of qualitative studies A. "what is the meaning of spiritual support in hospice patients who are younger than 50?" B. "what is the effectiveness of physical activity compared with beta-blockers in reducing the blood pressure of adult, African-American men?" C. "Is the use of a stroke team in the emergency department, rather than the standard assessment and treatment, associated with improved outcomes among patients diagnosed with stroke?" D. "Are single occupancy hospital rooms, rather than shared rooms, associated with increased patient satisfaction reports?"

A. "what is the meaning of spiritual support in hospice patients who are younger than 50?"

Which of the following is a facilitator to EBP? A. Adequate resources B. Confusion about EBP C. Understaffing D. Excessive evidence

A. Adequate resources

A nurse requires immediate insight into the most effective interventions for maintaining the safety of a patient who is experiencing acute alcohol withdrawal. Which of the following components of the Cochrane Library is most likely to provide the nurse with the most reliable, evidence-based interventions? A. Cochrane Database of Systematic Reviews (CDSR) B. Cochrane Central Register of controlled trials (CENTRAL) C. cochrane methodology register D. health technology assessment (HTA) database

A. Cochrane Database of Systematic Reviews (CDSR)

choose the highest level of evidence A. RCT B. literature review C. grounded theory study D. cohort study

A. RCT

After formulating a clinical question, a nurse has proceeded to search for evidence for ways to foster restful sleep in patients who are receiving care in the ICU. The nurse has identified a relevant meta-analysis in an electronic database. What will this source of evidence consist of? A. a statistical summary of the results from several different studies B. an examination of the theoretical and conceptual underpinnings of the issue C. an interdisciplinary analysis of the clinical question D. a qualitative study of different interventions related to the clinical question.

A. a statistical summary of the results form several different studies

while searching an online database for information on the use of drugs to treat hypertension, the nurse is unsatisfied with the quantity and quality of results after "beta-blockers". how should the nurse proceed? A. identify the appropriate MeSH term B. search for clinical guidelines in the Cochrane Library C. Consult the reference lists in articles that appeared during the search D. Search the trade names for specific beta-blocking drugs

A. identify the appropriate MeSH term

a nurse has attempted to begin the process of implementing EBP in the area of falls prevention but has become disillusioned by the possibility of having to read a vast number of publications. Which of the following strategies should the nurse implement in response to this problem? A. narrow a scope of clinical question B. restrict the information search to publications from the past 24 months C. seek recommendations for information sources from trusted colleagues D. limit the search to articles that relate the findings of randomized control trials (RCT's)

A. narrow a scope of clinical quesiton

after reading an online news article about the surprising role that chewing gum may play in facilitating healing after bowel surgery, a nurse has "googled" the subject. How should the nurse best interpret the results of this search? A. the nurse must carefully evaluate the results of this search B. the results of searching sites such as google and yahoo are not clinically useful C. the search is likely to yield inaccurate or biased results D. the search is a time-efficient substitute for searching online health databases

A. the nurse must carefully evaluate the results of this search

which of the following statements is true of foreground questions? A. they focus on issues that can be addressed by applying scientific evidence B. they have a broad, rather than narrow, scope C. they can be answered by examining electronic information sources instead of print sources D. they are rooted in the current practices of a nurse's clinical setting

A. they focus on issues that can be addressed by applying scientific evidence

Identify the I in this PICOT: is spironolactone more effective than clonidine in reducing BP in teenagers? A. use of spironolactone B. blood pressure C. teenagers D. use of clonidine

A. use of spironolactone

Management of a county hospital has been resistant to providing time, facilities, and subscriptions to allow nurses to conduct online searches near the point of care. which of the following arguments can the nurses present to strengthen their case for these tools? A. "online access at or near the point of care has been mandated by law" B. "providing for literature searches has been shown to save money and shorten patient stays" C. "it is unethical for nurses to provide care that is not rooted in a recent literature search" D. "the increased confidence that nurses gain from accessing knowledge is linked to improved patient outcomes"

B. "providing for literature searches has been shown to save money and shorten patient stays"

a nurse is aware that patients who are confused often have unmet nutritional needs during their care. which of the following searches related to nutrition promotion among patients with dementia or delirium is most likely to yield the greatest number of relevant results? A. nutrition OR (delirium OR dementia) B. (delirium OR dementia) AND nutrition C. delirium dementia nutrition D. delirium AND dementia AND nutrition

B. (delirium OR dementia) AND nutrition

Which of the following clinical questions best exemplifies the PICOT format? A. what effect does parents smoking have on the smoking habits of their children ages 13 to 16 B. among cancer patients, what role does meditation, rather than benzodiazepines, have on anxiety levels during the 7 days following hospital admission? C. among undergraduate college students, what is the effectiveness of a sexual health campaign undertaken during the first 4 weeks of a fall semester as measured by incidence of new gonorrheal and chlamydial infections reported to the campus medical center? D. in patients aged 8-12, is the effectiveness of a pain scale using faces superior to a numeric rating scare in the ER context?

B. Among cancer patients, what role does meditation rather than benzodiazepines, have on anxiety levels during the 7 days following hospital admission?

Which statement is true regarding research and EBP? A. research is systematic B. EBP uses research to support practice change C. Research is better than EBP D. EBP is putting what we already know into practice

B. EBP uses research to support practice change

Which of the following is the strongest level of evidence? A. Systematic review B. Meta-analysis C. Randomized Controlled Trial D. Cross-sectional study

B. Meta-analysis

A nurse is seeking evidence on the most effective ways to promote urinary continence among older adults with dementia. Which of the following sources is most likely to provide the nurse with specific interventions and practices to achieve this goal? A. Cumulative Index to Nursing and Allied Health Insurance (CINAHL) B. National Guideline Clearninghouse C. PsycINFO D. MEDLINE

B. National Guideline Clearinghouse

Which of the following scenarios represents the most common obstacle that nurses encounter when attempting to gain the knowledge necessary for EBP? A. a nurse identifies several articles relevant to a clinical questions, but the methodology of each is significantly flawed B. a nurse is overwhelmed by the number of hits during a CINAHL search C. current research that relates to the nurse's clinical question does not exist D. the research that the nurse locates is rooted in a medical, not nursing, perspective

B. a nurse is overwhelmed by the number of hits during a CINAHL search.

In the process of advocating for EBP in the unit guidelines around the management of increased intracranial pressure, a nurse has met with skepticism from other members of the nursing staff, with several stating, "evidence based practice is good in theory, but its almost impossible to actually search hundreds of journals and find the evidence". What could the nurse recommend? A. self-reflection on the nurses current practices B. accessing the Cochrane Library C. Contacting the clinical nurse educator on the unit D. beginning with lay publications before progressing to peer-reviewed journals

B. accessing the Cochrane Library

what type of evidence is used to answer clinical questions for PICOTs A. external evidence B. best evidence C. internal evidence D. internal and external evidence

B. best evidence

which of the following groups would most likely be considered a self-selected cohort? A. obese, hispanic females B. cigarrette smokers C. patients with hypertension who take diuretics D. teenage females

B. cigarrette smokers

Clinical or research question? Are mobile devices more effective managing workflow among ER nurses? A. research B. clinical

B. clinical

choose the weakest level of evidence A. meta-analysis B. correlational study C. RCT with randomization D. RCT without randomization

B. correlational study

what is the purpose of the PICOT A. narrow the search of literature B. guide the search of literature C. broaden the search of the literature D. increase the number of studies found in the literature

B. guide the search of literature

What is the P in this PICOT: Does hand washing by healthcare providers reduce hospital acquired infections? A. reducing infection B. Healthcare providers C. hand washing D. while in the hospital

B. healthcare workers

The implementation of a new, evidence based infection control regimen in a community hospital has resulted in a significant reduction in the incidence of nosocomial (hospital acquired) infections. What should constitute the final step in the nurses' evidence-based practice? A. calculating the cost-savings that will be realized by using the new regimen B. sharing their experience with other health care professionals C. implementing enforcement measures to ensure compliance with the new regimen D. conducting a meta-analysis of other infection-control measures

B. sharing their experience with other health care professionals

Background or foreground? what are the symptoms of bacteremia?

Background

an oncology nurse is engaged in increasing the quality of EBP that is provided on the cancer unit of the local hospital. Which of the following questions would the nurse consider to be an adequate and useful foreground question? A. "are benzodiazepines and analgesics provided before patients have bone marrow biopsy?" B. "what is the clinical rationale for using bone marrow biopsy to gauge and predict the course of a patient's cancer?" C. "does guided imagery reduce the anxiety of patients who undergo bone marrow biopsy?" D. "How often is bone marrow biopsy performed on the unit?"

C. "does guided imagery reduce the anxiety of patients who undergo bone marrow biopsy?"

When given a choice of external evidence, which of the following would provide the weakest support for practice change? A. Systematic Review B. RCT without randomization C. Expert opinion editorial D. Qualitative Study

C. Expert opinion editorial

which of the following considerations should be prioritized when choosing a patient population during the formulation of a clinical question? A. the patient population should be as narrow a range as possible B. the population in the clinical question should closely match the demographics of the nurse's geographic region C. A specific and defensible rationale should exist for the choice of patient population D. The patient population in the clinical question should mirror the populations in prominent studies related to the issue

C. a specific and defensible rationale should exist for the choice of patient population

Choose the highest level of evidence based on the title of the article. A. breakfast skipping associated with cyberbullying: a cross-sectional study B. Cyberbullying and LGBTQ youth: a systematic literature review C. Bullying in the digital age: a critical review and meta-analysis D. Social media uses and deliberate self-harm: a systematic narrative review

C. bullying in the digital age: a critical review and meta-analysis

The nurses on a postpartum unit have noted that many primiparous (first-time) mothers are giving up on breastfeeding within the 24 hours following delivery, and the nurses want to create uniform guidelines for promoting breastfeeding on the unit. Which of the following sources is most likely to provide the best evidence in their quest for an intervention? A. evidence from a randomized control trial that had more than 2500 participants B. Evidence from a study that is widely regarded as a classic within the obstetrical nursing community C. evidence from a systematic review of breastfeeding-promotion studies that one of the nurses identified in an electronic database D. the consensus opinion of the most senior nurses on the unit

C. evidence from a systematic review of breastfeeding-promotion studies that one of the nurses identified in an electronic database

choose the highest level of evidence A. case control study B. RCT without randomization C. systematic review of RCTs D. RCT without randomization

C. systematic review of RCTs

Based on the titles of the studies, which is most likely the strongest level evidence? A. "Bacterial Pneumonia in Children: A Prospective Cohort Study" B. "A Case Study: Pneumonia" C. "A Literature Review of Childhood Pneumonia Etiology Studies" D. "Systematic Review of Respiratory Viral Co-Infections in Children"

D. "Systematic Review of Respiratory Viral Co-Infections in Children's"

Which of the following factors provides the most important rationale for the consistent implementation of EBP? A. EBP provides for the most cost-effective patient care B. EBP is accessible to all healthcare clinicians C. EBP provides consistency in care across healthcare systems D. EBP improves patient outcomes

D. EBP improves patient outcomes

Identify the O: is a chest x ray more effective than CT scan in identifying pneumonia in patients with emphysema? A. patient with emphysema B. chest x ray C. CT scan D. Identifying pneumonia

D. Identifying pneumonia

which one of the following is NOT included in the steps of EBP? A. Cultivate a spirit of inquiry B. Evaluate outcomes of the practice change C. conduct rapid critical appraisal of evidence D. Inquire about the preferences of nurses

D. Inquire about the preferences of nurses

a pediatric nurse provides care for many children who present to the emergency department (ED) with signs and symptoms of asthma. Which of the following questions is a background question that the nurse can utilize in the process of providing EBP? A. what evidence exists to recommend the use of nebulizers over metered-dose inhalers (MDIs) B. what patient populations respond best to nebulized bronchodilators? C. how effective are nebulizers compared to metered-dose inhalers at reducing bronchospasm? D. are nebulizers provided to patients in the ED more often that metered-dose inhalers?

D. are nebulizers provided to patients in the ED more often that metered-dose inhalers?

in the interest of efficiency, a nurse has limited a search of an electronic database to only those articles containing full text. what effect is this action likely to have on the results of the search? A. only noncopyrighted resources will be available to the nurse B. the nurse will be guaranteed that each result will be from a peer-reviewed source C. the nurse will be unable to conduct a valid or useful search D. articles that are relevant may be excluded from consideration

D. articles that are relevant may be excluded from consideration

a nurse has conducted a search of PubMed to answer the question, what factors influence older adults decisions to seek care from the emergency department rather than their primary care provider when experiencing fatigue? the nurse is currently reviewing the results of the search in the order that they appear. what factor determines the order of the results in a search of PubMed? A. date of publication B. number of times the article has been cited C. ranking by peer review D. date the article was added to the database

D. date the article was added to the database

The nurse has gotten staff on board and created a team for the EBP project. What is the next step? A. conduct a thorough review of the literature B. make a recommendation for practice C. disseminate findings D. develop the PICO(T)

D. develop the PICO(T)

Choose the lowest/weakest level of evidence: A. cohort study B. qualitative descriptive C. ground theory D. expert opinion

D. expert opinion

which of the following principles can help a nurse rank levels of evidence when answering clinical questions of all types and scopes? A. quantitative research supersedes qualitative research B. randomized control trials must be included when answering clinical questions C. sources of evidence must be peer reviewed D. syntheses are the highest level of evidence

D. syntheses are the highest level of evidence

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

D. the nurse should prioritize the quality and comprehensiveness of the evidence over its date of publication

internal or external evidence? systematic analysis?

External

internal or external evidence? published study on masks reducing the spread of infection

external

background or foreground? does iphone use, as compared to android use, increase the risk of trigger finger among teens?

foreground

background or foreground? does the use of iodine instead of neosporin decrease the risk of post-animal bite infection?

foreground

internal or external evidence? patient satisfaction scores

internal