Chapter 07: Evidence-Based Practice

Chapter 07: Evidence-Based Practice

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which organization is preparing future nurses to have the knowledge, skills, and attitudes (KSAs) of evidence-based practices necessary to continuously improve the quality and safety of the health care systems within which they work?

ANS:   B

Evidence-based practice is also one of the Quality and Safety Education for Nurses’ (QSEN) competencies, with the overall goal for the QSEN project being to meet the challenge of preparing future nurses to have the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the health care systems within which they work (QSEN, 2012). The Joint Commission provides Patient Safety Goals. All magnet-designated hospitals maintain the National Database of Nursing Quality Improvement (NDNQI). The database has information on falls, pressure ulcer incidence, and nurse satisfaction. The AHRQ is a national agency that provides important sources of new scientific information that include standards and practice guidelines.

PTS:    1                      DIF:    Cognitive Level: Remembering (Knowledge)

REF:    91                    OBJ:    Discuss the QSEN competencies for evidence-based practice.

TOP:    Nursing Process: Evaluation              MSC:   NCLEX: Management of Care

2. A registered nurse questioned the nurses on the neonatal intensive care unit about the practice of kangaroo care for neonates. The nurse had read literature supporting the practice, but the nurses that work on the neonatal unit stated that they had never done anything like that at their institution. The nurse continued to ask questions and began a literature review. Which behavior was the nurse demonstrating?

ANS:   C

Evidence-based practices (EBP) guide nurses and other health care providers in making effective, timely, and appropriate clinical decisions. Nurses and other health care providers can no longer accept and practice the status quo. Greater attention must be given to why certain health care approaches are used, which ones work, and which ones do not. Hypotheses are predictions made about the relationship among study variables (e.g., characteristics or traits that vary among subjects). An example of a research question is: Does the use of chlorhexidine 2% compared with povidone-iodine reduce CLABSI in patients with CVCs? Within that question the author is studying the variables (independent) of chlorhexidine and povidone-iodine solutions as they affect the outcome (dependent variable) of CLABSI in patients. Peer review is the practice of nurses evaluating nurses. A peer-reviewed article is one submitted for publication and reviewed by a panel of experts familiar with the topic or subject matter of the article. When you implement a practice change, you sometimes want to monitor whether or not the process or protocol was implemented. This requires a process measurement. The nurse has not implemented kangaroo care (only reviewed literature), so there is no need for a process measurement.

PTS:    1                      DIF:    Cognitive Level: Applying (Application)

REF:    89-90               OBJ:    Discuss ways to apply evidence in nursing practice.

TOP:    Nursing Process: Assessment            MSC:   NCLEX: Management of Care

3. A registered nurse wants to review the latest information regarding prevention of a health care acquired infection. Where is the best place for the nurse to obtain this information?

ANS:   C

The best scientific evidence comes from well-designed, systematically conducted research studies, usually found in peer-reviewed scientific journals. A good textbook incorporates current evidence into the practice guidelines and procedures it describes. However, a textbook relies on the scientific literature, and sometimes information on a particular topic is outdated by the time a book is published. Peer-reviewed material is better than online information or recent popular magazines.

PTS:    1                      DIF:    Cognitive Level: Applying (Application)

REF:    91                    OBJ:    Discuss the levels of evidence in the literature.

TOP:    Nursing Process: Evaluation              MSC:   NCLEX: Management of Care

4. A 15-year-old patient was admitted to the hospital with a bowel obstruction. The patient underwent surgery and was experiencing postoperative pain. The nurse caring for the patient had recently read a research article in which a study had been done with neonatal (infant) patients and the use of therapeutic touch to assist with pain control. Which factor is most important for the nurse to consider in this case when applying research to clinical practice?

ANS:   B

Using clinical expertise and considering patients’ values and preferences ensures that a nurse will apply the available evidence to practice both safely and appropriately. Even when you use the best evidence available, application and outcomes differ based on your patients’ values, state of health, preferences, concerns, and/or expectations. Patient’s allergies, gender, and roommate are not important in this scenario as it does not affect therapeutic touch.

PTS:    1                      DIF:    Cognitive Level: Analyzing (Analysis)

REF:    91

OBJ:    Explain how critiquing the scientific literature leads to best evidence for practice changes.            TOP:            Nursing Process: Assessment

MSC:   NCLEX: Management of Care