Evidence-Based Practice in Nursing and Healthcare, Exams of Nursing

Download Evidence-Based Practice in Nursing and Healthcare and more Exams Nursing in PDF only on Docsity!

4th Edition Melnyk Test Bank.

Evidence Based Practice For Nurses 4th Edition

By Schmidt Brown – Test Bank

Test bank for Schmidt & Brown 4th Edition Evidence-Based Practice for Nurses: Appraisal and Application of Research CHAPTER 1 WHAT IS EVIDENCE BASED PRACTICE? Multiple Choice

1. Which of the following is the best definition of research?
2. Critically thinking about problems that occur in health care to determine possible solutions.

4th Edition Melnyk Test Bank.

1. Information that is based on personal experience or tradition.
2. Planned and systematic activity that leads to new knowledge and/or the discovery of solutions to problems or questions.
3. Trying a variety of approaches to a clinical problem and settling on the approach that is effective more often than not. Definition of research utilization (p. 4)
4. Which of the following is the best definition of research utilization?
5. Applying research findings from individual studies to practice.
6. Analyzing multiple research studies to synthesize findings.
7. Appreciating the importance of clinical decision making.
8. Using previous personal experience to build confidence. Definition of EBP (pp. 4-5)
9. Which of the following is the best definition of evidence- based practice (EBP)?
10. Application of research findings based on scientific theories in a clinical setting.
11. Research studies that correspond to nationally established priorities for healthcare, conducted by experts in their fields.
12. Use of theory-derived, research-based information in making decisions about health care delivery, with consideration of individual needs and preferences and the clinical expertise of the provider.
13. Using the individual health care provider’s perception of truth without conscious attention or reasoning. Difference between research utilization and EBP (pp. 4-5)

4th Edition Melnyk Test Bank.

4. Which of the following best describes the difference between research utilization and EBP?
5. Research utilization is a process of evaluating multiple studies for the most generalizable findings; EBP is use of the most recent study on a topic.
6. Research utilization involves changing practice based on findings of a single research study; EBP is the syntheses of findings from multiple studies to incorporate with practitioner skills and client preference to determine best care.
7. Research utilization is the application of research findings to health care practice; EBP is considered in selecting medication options.
8. Research utilization is review of research publications; EBP is using the healthcare provider’s perception of what care would be best in individual situations. Evidence from other disciplines (p. 6)
9. In what way can evidence from disciplines other than nursing be helpful?
10. Theory based non-nursing evidence can provide a basis on which to build new evidence.
11. Non-nursing evidence supports the use of nursing knowledge obtained by trial and error.

4th Edition Melnyk Test Bank.

1. Clinical decision making can be based on findings from single non- nursing research studies.
2. All evidence is equally important to the practice of nursing. Identification of sources of evidence (p. 6)
3. You are a new nurse working at XYZ hospital. Your preceptor tells you to dangle Ms. Jones’ legs on the side of the bed before you attempt to assist her to a chair. You ask your preceptor why this is done and she answers, “This is what we have always done, so go do it.” This is an example of which type of evidence?
4. Trial and error
5. Intuition
6. Borrowed evidence
7. Tradition Identification of sources of evidence (p. 6)
8. You are a new nurse working at XYZ hospital. Your preceptor tells you to dangle Ms. Jones’ legs on the side of the bed before you attempt to assist her to a chair. You ask your preceptor why this is done and she answers, “Because I said so.” This is an example of which type of evidence?
9. Intuition
10. Tradition
11. Authority
12. Borrowed evidence Identification of sources of evidence (p. 6)

4th Edition Melnyk Test Bank.

8. Trial and error is not a preferred approach for delivering nursing care because
9. it is not based on systematic scientific approaches.
10. it is not a sanctioned method by the American Nurses Association.
11. it is based only on intuition and therefore not scientifically based.
12. patient outcomes are always based only on level 1 evidence. Identification of sources of evidence (p. 8)
13. Many nurses in clinical settings base nursing interventions on information obtained from
14. level 1 evidence.
15. individual research studies.
16. colleagues.
17. the American Nurses Association. Barriers to adopting EBP (p. 8)
18. Studies have shown that the reasons that nurses do not draw on research are related to
19. communication problems.
20. individual and organizational factors.
21. personal disinterest.
22. rapid organizational changes. Environment for EBP to flourish (p. 11)
23. Which of the following promotes consistent EBP practice changes in an institution?
24. Clinical experts such as Advanced Practice Nurses (APNs) should be the authority for any change in practices.
25. Change champions are needed on each work shift to facilitate practice changes.
26. Nurse managers must mandate research within healthcare institutions.
27. Opinion leaders should enforce adherence to their opinions.

4th Edition Melnyk Test Bank.

Environment for EBP to flourish (p. 10)

4th Edition Melnyk Test Bank.

12. One method for overcoming a lack of resources to access evidence is to
13. devote 15 minutes a day to reading evidence related to a clinical problem.
14. attend conferences where clinical research is presented..
15. bookmark important Web sites that are sources of clinical guidelines.
16. collaborate with a nursing program for access to resources. Barriers to adopting EBP (p. 9)
17. What steps can be taken to overcome the time barrier to adopting an EBP?
18. Devote 15 minutes a day to reading evidence related to a clinical problem.
19. Subscribe to e-mail summaries of research studies in your area of interest.
20. Take advantage of available technologies to provide quick and convenient access to relevant data and clinical guidelines.
21. All of the above Parts of a research article (p. 18)
22. Which section of a research article provides an overview of the study?
23. Abstract
24. Introduction
25. Review of literature
26. Theoretical framework Parts of a research article (pp. 18)
27. Which section of a research article identifies the problem being studied and includes a purpose statement and background information on the topic?
28. Discussion section
29. Introduction

4th Edition Melnyk Test Bank.

3. Methods section
4. Results section Parts of a research article (p. 19)
5. A major portion of a research article is the methods section, which includes a discussion of the study design, the sample, and the collected.
6. solutions
7. statistics
8. data
9. theories Parts of a research article (p. 19)
10. The section of a research article outlines the methods used to analyze the data and notes the findings.
11. results
12. summary
13. introduction
14. abstract Parts of a research article (p. 20)
15. Which section of a research article provides an interpretation of the study’s results?
16. Abstract
17. Introduction
18. Methods
19. Discussion Ethical issues (p. 24)
20. The first regulations to protect human subjects in medical research studies were proposed by the in 1973.

4th Edition Melnyk Test Bank.

1. American Medical Association
2. U.S. Department of Health, Education, and Welfare
3. U.S. Food and Drug Administration
4. Association of American Universities Ethical issues (p. 31)
5. Which of the following forms the basis for ethical conduct in medical research internationally?
6. Jewish Chronic Disease Hospital study
7. Nuremberg Code
8. Tuskegee studies
9. Willowbrook studies Short Answer/Fill-in Identifying types of research
10. The category of research that addresses why or how phenomena are related is .
11. research aims to forecast when certain phenomena will occur.
12. The type of research that analyzes words to focus on the meanings individuals give to their experiences is.
13. Quantitative research focuses on collecting evidence, which is evidence gathered through observation using one or more of the five senses.
14. research is concerned with providing accurate observations of phenomena in natural settings CHAPTER TWO

4th Edition Melnyk Test Bank.

USING EVIDENCE THROUGH COLLABORATION TO PROMOTE

EXCELLENCE IN NURSING PRACTICE

Multiple choice EBP levels of collaboration (p. 40)

1. What are the five EBP levels of collaboration?
2. Organizational, societal, fraternal, national, and international
3. Individual, organizational, regional, national, and international
4. Professional, educational, organizational, regional, and national
5. Individual, organizational, societal, regional, and international EBP levels of collaboration ( p. 40)
6. Of the situations listed, which is the best example of collaboration between the levels described in the model of EBP collaboration?
7. A health care organization funds a group of nurses to attend a research conference related to practice areas that have had less than desirable outcomes in the past year.
8. An individual nurse searches databases for the best evidence to support practice with a population of clients on a particular unit.
9. A participant at a national nursing organization conference listens attentively to presenters related to the most relevant topics for the population served.
10. A staff nurse uses findings from the Joanna Briggs Institute to support an EBP project, evaluates outcomes, and reports the findings at an international

4th Edition Melnyk Test Bank.

conference. Individual nurse level (pp. 40-41)

3. What is one step a staff nurse can take to advance EBP at the point of care?
4. Establish the culture for EBP in institutional settings.
5. Identify clinical questions related to current nursing practice.
6. Promote consistent practice changes among different shifts.
7. Reward nurses involved in EBP and help those who lack involvement. Individual nurse level (p. 41)
8. As a staff nurse, what steps can you take to advance EBP as part of your team or unit?
9. Participate in implementing practice changes based on evidence.
10. Participate as a member of an EBP project team.
11. Participate in QI initiatives
12. All of the above. Individual nurse level (p. 41)
13. As a staff nurse, how can you further educate yourself about EBP?
14. Read evidence related to your area of practice on a regular basis.
15. Watch what other nurses do.
16. Follow the example of your supervisor.
17. Act as a role model for younger staff. Nurse manager level (p. 41)
18. How can a nurse manager advance EBP as part of evaluating his or her staff?
19. Set a good example with own behavior.
20. Clearly outline goals for the team.
21. Use performance criteria related to EBP.
22. Participate in QI initiatives. Advanced practice nurse level (p. 41)
23. The advanced practice nurse can work to implement EBP by
24. Serving as a coach and mentor in EBP.

4th Edition Melnyk Test Bank.

9. Locates relevant evidence and synthesizes evidence for practice.
10. Uses evidence to writes and modify practice standards.

4th Edition Melnyk Test Bank.

11. All of the above. Organizational level (p. 43)
12. Creating an EBP culture is an example of contribution at the
13. organizational level.
14. individual nurse level.
15. regional level.
16. international level. International level (p. 48)
17. The Cochrane Collaboration and the Joanna Briggs Institute are examples of which EBP collaboration level?
18. Individual
19. International
20. Organizational
21. Regional National level (p. 46)
22. What national organizations can nurses use to locate EBP resources and EBP-based clinical guidelines?
23. Agency for Healthcare Research and Quality, National Institute of Nursing Research, National Nursing Practice Network, and specialty nursing organizations.
24. National Institutes of Health and regional resource centers.
25. American Nurses Credentialing Center and the American Nurses Association.
26. Department of Health and Human Services, Sigma Theta Tau International, and the Joanna Briggs Institute.

4th Edition Melnyk Test Bank.

Ethical guidelines (pp. 50-51)

11. Which international code for ethical conduct by physicians conducting biomedical research followed the Nuremberg Code and provides more specific guidelines?
12. ANA Code of Ethics
13. Belmont Report
14. Code of Federal Regulations
15. Declaration of Helsinki Ethical guidelines (p. 52)
16. Federal regulations mandate the establishment of institutional review boards whose purpose is to
17. develop guidelines for conducting research.
18. identify basic ethical principles in conducting research.
19. review and approve research studies.
20. provide a code of ethics for conducting research. Institutional review board ( p. 56)
21. Which type of IRB review is required for research involving vulnerable populations or when there are substantial risks to participants?
22. Special review
23. Full review
24. Expanded review
25. Expedited review Institutional review board ( p. 56)
26. A nurse researcher wants to interview parents and their autistic children regarding the children’s sleep patterns. This study would require which type of IRB review?

4th Edition Melnyk Test Bank.

1. Expedited review
2. Full review
3. Special review
4. Exempt from review Institutional review board (pp. 57-58)
5. A nurse educator is planning a research study related to experiential learning activities regarding caring for older adults with cognitive changes. Which type of IRB review is needed?
6. Exempt from review
7. Expedited review
8. Expanded review
9. Full review Institutional review board (p. 56)
10. Research proposals may be eligible for an expedited review by the IRB if they involve minimal risk to participants. This means that
11. there is a very low risk of harm or discomfort to study participants, no more than that involved in daily life or routine physical or psychological exams.
12. the study will be based on the analysis of existing specimens or data only.
13. there is some chance of harm to study participants due to invasive procedures.
14. the study will only involve subject 18 years or older who have given consent. Ethical issues (p. 52)
15. The Belmont Report, issued in 1979, identified the following three ethical principles:

4th Edition Melnyk Test Bank.

18. confidentiality, consent, and justice.
19. autonomy, social justice, and respect for persons.
20. beneficence, respect for persons, and justice.
21. altruism, confidentiality, and consent. Institutional review board (p. 49)
22. In regard to IRB criteria, which of the following are included in the category of vulnerable populations?
23. Fetuses, infants, children, pregnant women
24. Prisoners, students, females, African Americans
25. Residents of long-term care facilities, students under the age of 18, infants
26. Hospitalized adults, illegal aliens, premature infants, children Nurses as patient advocates (p. 59)
27. A nurse has agreed to assist in collecting data from patients in a primary care setting as part of a research study on grieving and coping skills. What would be the most appropriate action by the nurse when a patient becomes visibly upset after relating that his son was recently killed in an automobile accident and that he does not want to talk further about it?
28. Sympathize and explain how his answers will help many others.
29. Weigh the potential greater good for a greater number of people and continue.
30. Support the patient receiving care by ceasing further questioning.
31. Consider the primary duty to advance nursing knowledge and continue questioning after a brief break. Ethical issues (pp. 51, 54)

4th Edition Melnyk Test Bank.

20. A nurse has agreed to assist in collecting data from clients in a long-term-care setting. The nurse becomes concerned upon realizing that many of the clients participating in the study have documented cognitive impairments. Which ethical responsibility is being violated?
21. Beneficence
22. Confidentiality
23. Voluntary participation
24. Informed consent CHAPTER THREE IDENTIFYING RESEARCH QUESTIONS Multiple choice Research question (p. 68)
25. An area of concern due to a gap in knowledge that requires a solution that can be described, explained, or predicted to improve practice is a
26. research problem.
27. purpose statement.
28. null hypothesis.
29. research hypothesis. Research question (p. 68)
30. Which one of the following could form the basis for a potential research study?
31. The majority of patients are admitted between the hours of midnight and 4: a.m.

4th Edition Melnyk Test Bank.

1. The majority of nurses do not want to work the night shift.
2. The majority of patient falls occur on the evening shift.
3. The nurses who work the evening shift are not attentive to their patients. Research process (pp. 72-73)
4. An example of a is: “The use of alcohol by freshman at XYZ State University contributes to alcohol-related injuries and increasing numbers of visits to the local emergency room.”
5. purpose statement.
6. hypothesis.
7. problem statement.
8. research problem. Research process (pp. 72-73)
9. An example of a is: “To determine if brief screening for alcohol use and nursing intervention during orientation reduces self-reported alcohol use, alcohol-related injuries, and visits to the emergency room by college students during their freshman year.”
10. problem statement
11. purpose statement
12. research question
13. research hypothesis Research process (p. 74)
14. The following statement: “There will be a change in nursing practice of nurses after completion of an EBP mentorship program as compared to before the mentorship program,”

4th Edition Melnyk Test Bank.

is an example of a

4th Edition Melnyk Test Bank.

1. problem statement.
2. purpose statement.
3. research hypothesis.
4. correlation. Research process (p. 71)
5. Once an idea is generated for a research problem, what is the next step?
6. Identify variables to be studied.
7. Perform a review of the literature.
8. Conduct a survey to ascertain if the problem really exists.
9. Formulate a hypothesis. Hypothesis (p. 76)
10. A simple hypothesis
11. describes the associative or causal relationship between three or more variables.
12. predicts how strong the relationship is between the variables.
13. predicts an inverse relationship between the variables.
14. describes the associative or causal relationship between two variables. Hypothesis (p. 77)
15. The following statement: “There will be no difference in practice of nurses after completion of an EBP mentorship program as compared to before the mentorship program,” is an example of a
16. problem statement.
17. purpose statement.
18. directional hypothesis.
19. null hypothesis. Hypothesis (pp. 74-75)
20. What is the purpose of formulating a hypothesis or hypotheses?
21. To validate the research problem

4th Edition Melnyk Test Bank.

11. To provide direction for the research study by identifying possible outcomes
12. To identify the independent variable
13. To identify the dependent variable Variables (p. 80)
14. “There will be a change in nursing practice after completion of an EBP mentorship program as compared to before the mentorship program.” In the preceding statement, “completion of an EBP mentorship program” represents the
15. confounding variable.
16. dependent variable.
17. extraneous variable.
18. independent variable. Variables (p. 80)
19. Variables that confuse the effect of the independent variable on the dependent variable, so that the research results do not really reflect a true relationship between the independent and dependent variables are
20. extraneous variables.
21. random variables.
22. within-group variables.
23. control variables. Hypotheses (p. 75)
24. A relationship between variables so that when one variable changes, the other variable changes is a(n)

4th Edition Melnyk Test Bank.

1. associative relationship.
2. causal relationship.
3. indirect relationship.
4. predictive relationship. Formulating EBP questions (p. 81)
5. A widely used EBP model consisting of four components for identifying clinical questions for specific patient problems is known as the model.
6. AHRQ
7. PICO
8. intervention
9. comparison Formulating EBP questions (p. 82)
10. There is a study being conducted of adults over the age of 65 to investigate the effect of caregiver education on calming communication techniques in comparison to sedative medications on the agitation level of clients experiencing stage 2 dementia. In this study, the clients’ level of agitation would be the measured
11. intervention.
12. association.
13. variable.
14. outcome. Short Answer/Fill-in Dependent and independent variables (p. 80)
15. In a study investigating the effect of eating a bowl of oatmeal every day for 30 days and serum cholesterol levels, is the independent variable.

4th Edition Melnyk Test Bank.

2. In a study investigating the effect of eating a bowl of oatmeal every day for 30 days and serum cholesterol levels, is the dependent variable.
3. In a study designed to determine if exposure to x-rays during pregnancy increases the likelihood of birth defects, x-ray exposure is the variable.
4. In a study designed to determine if exposure to x-rays during pregnancy increases the likelihood of birth defects, birth defects are the variable.
5. “The purpose of this study was to determine the extent to which sex, age, height, and weight predict selected physiologic outcomes: namely, forced expiratory volume in one second (FEV), hemoglobin concentration, food intake, serum glucose concentration, total serum cholesterol concentration, and cancer-related weight change (Brown et al., 1997).” In this study, the variable is the physiologic outcomes.
6. “The purpose of this study was to determine the extent to which sex, age, height, and weight predict selected physiologic outcomes: namely, forced expiratory volume in one second (FEV), hemoglobin concentration, food intake, serum glucose concentration, total serum cholesterol concentration, and cancer-related weight change (Brown et al., 1997).” In this study, the variables are: sex, age, height, and weight. CHAPTER FOUR

4th Edition Melnyk Test Bank.

FINDING SOURCES OF EVIDENCE

Multiple choice Purpose of finding evidence (p. 89)

1. As an undergraduate student, which of the following should be the focus of your literature review?
2. gathering information
3. helping to identify a research question
4. identifying gaps in current research
5. identifying a source for publication of new findings Purpose of finding evidence (p. 89)
6. Researchers perform a literature review for the purpose of
7. helping to sharpen and focus a research question.
8. highlighting areas of needed change.
9. identifying gaps in current research.
10. all of the above. Purpose of finding evidence (p. 91)
11. To begin a literature review, what initial sources would you use to locate information on your topic of interest?
12. Online search engines, journal archives in the local library, and recommendations from your supervisor or professor
13. Journal articles by nationally recognized researchers, health sciences publication indexes, and online search engines

4th Edition Melnyk Test Bank.

1. Health sciences publication indexes, government and university literature databases, academic and hospital library resources
2. Textbooks, government and university literature databases, and online medical sites Types of evidence (pp. 93-94)
3. Which of the following is an example of primary sources?
4. Biographies
5. Journal articles
6. Systematic reviews
7. Textbooks Types of evidence (pp. 93-94)
8. Which of the following best describes a primary source?
9. Historical reviews
10. Interpretations of other sources
11. Original information
12. Written summaries Types of evidence (p. 94)
13. Which of the following is an example of secondary sources?
14. Summaries of primary sources
15. Commentaries or interpretations
16. Reviews
17. All of the above Peer reviewed and refereed sources (p. 94)
18. What is the purpose of the peer-review process?
19. To ensure confidence in the quality of published works
20. To confirm that the work is from a primary source
21. To evaluate publications included in the literature review
22. To make a decision about best practice Types of reviews (p. 96)