A nurse is providing care for a 73-year-old female patient whose balance is compromised by a vestibular disorder. The nurse has advocated for the installation of balance bars and handholds throughout the patient’s home, but the patient is reluctant, saying, “Those are for old ; Which of the following is the best guide for making the decision?

A)

The patient’s preference and history of using such devices

B)

Research that addresses the effectiveness of this intervention

C)

Existing evidence: the nurse’s experience with the intervention and the patient’s opinion

D)

The cost of installation, the opinion of the patient and her peers, and evidence-based articles regarding the intervention

2.

What is the relationship between research utilization (RU) and evidence-based practice (EBP)?

A)

RU is based on an individual clinician’s personal research, while EBP is based on published research.

B)

RU considers the personal expertise of nurses, while EBP is based solely on published evidence.

C)

RU provides a general guide to practice, while EBP provides patient-specific insights.

D)

RU is often based on a single study, while EBP considers the larger body of knowledge.

3.

A nurse has approached the unit educator with a recently-published article that calls into question the unit’s practices around routine changing of peripheral intravenous sites. How should the findings of this article be best translated into practice?

A)

Unit practices should be amended to reflect the findings of the study.

B)

The nurses on the unit should combine the study results with their own expertise to create a new guide for practice.

C)

The nurses should search for further evidence before changing unit practices.

D)

The nurses should conduct a trial similar to that in the published study.

4.

In light of the continually-changing clinical context in which she provides care, a nurse is aware of the need to ensure that her practice is current. Which of the following actions is most likely to help the nurse achieve this goal?

A)

Continually eliciting input from more senior nurses

B)

Staying current with published evidence that has been critically appraised

C)

Regularly attending continuing education opportunities

D)

Reviewing the practice guidelines and evidence that are presented in textbooks available on the unit and at the hospital library

5.

A nurse has called into question the unit protocol around the regular flushing of percutaneous endoscopic gastrostomy (PEG) tubes to prevent occlusion. Which of the following should guide the nurse’s reconsideration of the evidence around PEG tube flushing?

A)

Certainty that a new protocol will reliably prevent occlusion

B)

Expressions of patient preference during a designated period of study

C)

The rigor and reliability of a chosen research study

D)

The combination of expertise and internal evidence

6.

A nurse has reviewed a study on the use of signs, symptoms, and blood tests to diagnose acute sinus infections and has concluded that the study was of high quality. Which of the following criteria best describe the quality of a research study?

A)

The degree to which the findings are corroborated by other similar studies

B)

The degree to which the study has the ability to improve patient outcomes

C)

The degree to which the study was designed to minimize biases

D)

The degree to which the study cohort reflects the demographics of the nurse’s patient population

7.

A nurse is reluctant to recommend a change in practice around teaching deep breathing and coughing to postsurgical patients, citing a lack of randomized controlled trials (RCTs) that directly address the subject. Which of the following statements best captures the role of RCTs in evidence-based practice?

A)

Only systematic reviews are considered more valuable than RCTs in establishing EBP.

B)

RCTs provide very high levels of quantitative analysis but are prone to lapses in consistency.

C)

A qualitative study with a sound and rigorous methodology is considered equal to a well-designed RCT.

D)

RCTs are the highest level of evidence that can be used to guide practice.

8.

On an acute medicine unit, the results of a pilot program that implemented a new screening tool for drug and alcohol abuse has been shown to be effective at identifying patients who may require intervention. In light of these results, the unit has included the screening tool in the nursing assessment of every patient who is admitted to the unit. The nurses on this unit have made this change in practice based on

A)

evidence-based practice.

B)

internal evidence.

C)

clinician experience.

D)

randomized controlled trial (RCT).

9.

The manager of a subacute geriatric unit has referenced the Agency for Healthcare Research and Quality National Healthcare Quality Report during the annual review of the unit’s operations. The report will provide the manager with

A)

incidence and prevalence statistics for major infectious diseases.

B)

measurements of national trends in the effectiveness of patient care.

C)

evidence-based practice guidelines.

D)

systematic reviews of the 15 most common areas of nursing intervention.

10.

A quality improvement initiative at a large university hospital has referred to the National Quality Forum’s list of 15 nursing standards for inpatient care (NQF-15). The NQF-15 are

A)

important processes and outcomes that are within the scope of nursing personnel.

B)

nursing interventions related to the top 15 causes of morbidity and mortality in the United States.

C)

the nursing practices identified each year as being most in need of improvement.

D)

evidence-based patient guidelines that are updated annually by the NQF.

11.

During a quality improvement initiative aimed at improving patient outcomes in falls prevention, the nursing staff of a long-term care facility utilized the PDSA cycle. This cycle would conclude with which of the following actions?

A)

Publishing or presenting the results of the quality improvement initiative

B)

Revising, refining, and repeating the change that was implemented

C)

Analyzing the results of the change in falls-prevention practice

D)

Enacting the change in practice on a small scale

12.

Which of the following changes in practice would be most amenable to the PDSA cycle?

A)

A change to care guidelines for patients presenting to emergency departments with chest pain

B)

A change to the parameters of prescriptive authority held by a state’s nurse practitioners

C)

A change to the national guidelines for childhood immunizations

D)

A change in a medical unit’s schedule of turning immobilized patients

13.

The nursing leadership of a large, urban hospital are dissatisfied with the results of the hospital’s most recent nursing quality audit when the results were examined through the lens of the National Database of Nursing Quality Indicators® (NDNQI®). Which of the following results of the hospital’s review would fall with the scope of the NDNQI’s structure indicators?

A)

The incidence of pressure ulcers among inpatients was unacceptably high during the past year.

B)

Eleven percent fewer nurses expressed satisfaction with the way their work schedules are organized than the previous year.

C)

The number of nurses who possessed baccalaureate degrees increased by over the previous year.

D)

The average length of stay on the hospital’s post-surgical units decreased from days to days.

14.

The effectiveness of change that is implemented according to the PDSA cycle can be best improved by which of the following measures?

A)

The inclusion of external evidence

B)

Recognition of the importance of clinician experience

C)

An increase in the size of the sample

D)

Consultation with outside stakeholders

15.

A nurse educator has reviewed a study on the coping strategies of freshman nursing students that presents conclusions that differ markedly from other studies that have examined the issue. The study in question may possibly have a flaw in which of the following domains?

A)

Consistency

B)

Believability

C)

Veracity

D)

Utility

1.

C

2.

D

3.

C

4.

B

5.

A

6.

C

7.

A

8.

B

9.

B

10.

A

11.

B

12.

D

13.

C

14.

A

15.

A