Question: The nursing leadership of a university hospital wishes to implement EBP around the prevention of Clostridium difficile infection among inpatients. The team will be following the Model for Evidence-Based Practice Change. Which of the activities below is included in the steps of the model?
Answer Options:
Dissemination of the success or failure of the practice change
All activities listed
Include stakeholders in the early steps of the practice change
Implementing a pilot study
Answer: All activities listed
Question: Which of the following statements most accurately conveys the relationship between systematic reviews and CPGs?
Answer Options:
CPGs are a more reliable and valid source of guidance than systematic reviews
CPGs and systematic reviews are largely synonymous
In the absence of a relevant and current systematic review, clinicians should base their practice on available CPGs
CPGs normally integrate the results of systematic reviews into their recommendations
Answer: CPGs normally integrate the results of systematic reviews into their recommendations
Question: Outcomes of quality improvement projects are measured using which of the following criteria?
Answer Options:
SMART
PDSA
QI
EBP
Answer: SMART
Question: The nurses on a postpartum unit want to create uniform guidelines for promoting breastfeeding on the unit. Which of the following sources is most likely to provide the best evidence?
Answer Options:
Evidence from a systematic review of breastfeeding promotion studies that one of the nurses identified in an electronic database
Evidence from a randomized controlled trial (RCT) that had more than 2,500 participants
Evidence from a study that is widely regarded as a classic within the obstetrical nursing community
The consensus opinion of the most senior nurses on the unit
Answer: Evidence from a systematic review of breastfeeding promotion studies that one of the nurses identified in an electronic database
Question: Your Quality Improvement Team is searching for relevant EBP for a male client who has breast cancer. The search reveals copious articles dealing with breast cancer. Which of the following should be done to assist with this search?
Answer Options:
Set more specific inclusion criteria
Limit the database sources
Look at the most recent studies
Look at full articles
Answer: Set more specific inclusion criteria
Question: The nurses on the unit desire to take recent research findings which demonstrate improved patient responses in preventing ventilator-acquired pneumonia and implement these changes to assist their patients. Before they can proceed, the research needs to be translated into a usable form. Which of the following models will best assist with this translation?
Answer Options:
ACE Star Model of Knowledge Transformation
JHNEBP model
Clinical Scholar model
Answer: ACE Star Model of Knowledge Transformation
Question: An APRN has referred to a clinical practice guideline (CPG) that addresses prenatal screening. The APRN would recognize that which of the following phenomena provides the best rationale for consulting CPGs when planning and providing care?
Answer Options:
Significant variations in care exist between different regions and institutions
CPGs are a form of evidence that is superior to systematic reviews
Clinicians frequently lack access to databases and publications
The complexity and volume of research means that clinicians do not have the specialized skills needed to implement research findings
Answer: Significant variations in care exist between different regions and institutions
Question: An APRN has referred to a clinical practice guideline (CPG) that addresses prenatal screening. The APRN would recognize that which of the following phenomena contributes to the best rationale for consulting CPGs when planning and providing care?
Answer Options:
A. Significant variations in care exist between different regions and institutions.
B. CPGs are a form of directive set to supersede clinical expertise.
C. Clinicians frequently lack access to databases and publications.
D. The complexity and volume of research means that clinicians do not have the specialized skills needed to implement research findings.
Answer: A. Significant variations in care exist between different regions and institutions.
Question: A nurse has observed that reorienting demented clients as frequently as possible tends to minimize the clients’ level of agitation in the evening. The nurse has shared this observation with a colleague, who is skeptical, stating that, “It’s best to stick to evidence-based practice.” Which of the following is the best response to this colleague?
Answer Options:
“EBP can include clinicians’ personal expertise”
“Personal experience is often more sound than formal EBP”
“Traditional practice and EBP are usually shown to be the same”
“My years of experience can be just as valuable as any literature review or randomized trial”
Answer: “EBP can include clinicians’ personal expertise”
Question: A nurse is interested in working for a hospital which facilitates EBP and looks for one which is a magnet-designated hospital. The nurse is aware that this hospital will have which of the following components? Select all that apply.
Answer Options:
Empirical quality results
Transformational leadership
Exemplary professional practice
Enforcement of effective methods
Yearly in-services
Answer: Empirical quality results
Transformational leadership
Exemplary professional practice
Question: A hospital has appointed a group of clinicians to evaluate the current technique being used for preventing pressure sores. After an extensive review, the group has issued a recommendation for change. Which of the following types of evidence are used in EBP? Select all that apply.
Answer Options:
Evidence from a meta-analysis of relevant RCTs
Evidence-based clinical guidelines
Systematic Internet searches
Traditional practices
Answer: Evidence from a meta-analysis of relevant RCTs
Evidence-based clinical guidelines
Question: The nurse educator on a gerontological unit has recognized the need to implement EBP around the prevention of wandering. The nurse will be implementing the Iowa model of EBP. According to the model, which of the following is a “problem-focused trigger” that most likely prompted the nurse’s desire for changes in practice?
Answer Options:
A. The fact that wandering patients have recently fallen or gone missing from the unit.
B. The emergence of new and innovative research around the prevention and management of wandering.
C. The release of new standards by the administration of the hospital.
D. Widespread discontent among staff concerning existing procedures.
Answer: A. The fact that wandering patients have recently fallen or gone missing from the unit.
Question: Nurses are applying the PARIHS framework in order to guide their implementation of evidence-based diabetes education in the hospital. Which of the following considerations will the team examine under the dimension of ‘context’?
Answer Options:
The character and quality of leadership that exists in the hospital
The similarities between sites where research was conducted and the site where it will be implemented
The significance that a new diagnosis of diabetes has for patients and families
The existing EBP in use in other medical facilities in the neighborhood
Answer: The character and quality of leadership that exists in the hospital
Question: A hospital has appointed a group of clinicians to evaluate the current technique being used for preventing pressure sores. After an extensive review, the group has issued a recommendation for change. Which of the following types of evidence are used in EBP? Select all that apply.
Answer Options:
Evidence from a meta-analysis of relevant RCTs
Evidence-based clinical guidelines
Systematic Internet searches
Traditional practices
Answer: Evidence from a meta-analysis of relevant RCTs
Evidence-based clinical guidelines
Question: During a quality improvement initiative, nursing staff utilized the PDSA cycle. This cycle concludes with which of the following actions?
Answer Options:
Relying, refining, and repeating the change that was implemented
Publishing or presenting the results of the quality improvement initiative
Analyzing the results of the change in a test prevention practice
Enacting the change in practice on a small scale
Answer: Relying, refining, and repeating the change that was implemented
Question: A public health nurse has noted that the U.S. Preventive Services Task Force (USPSTF) recommends screening for chlamydial infection for all sexually active nonpregnant young women aged 24 and younger and for older nonpregnant women who are at increased risk. This recommendation is classified as a grade A recommendation. This primarily means which of the following?
Answer Options:
The recommendation is based solely on randomized controlled trials (RCTs)
The evidence underpinning the recommendation has been classified as “authoritative”
There is good evidence that doing so improves clients’ health outcomes
The recommendation is based on the fact that implementing the recommendation will not harm clients
Answer: There is good evidence that doing so improves clients’ health outcomes
Question: A nurse is interested in working for a hospital which facilitates EBP and looks for one which is a magnet-designated hospital. The nurse is aware that this hospital will have which of the following components? Select all that apply.
Answer Options:
Empirical quality results
Transformational leadership
Exemplary professional practice
Enforcement of effective methods
Yearly in-services
Answer: Empirical quality results
Transformational leadership
Exemplary professional practice
Question: The certified nurse educator on a postsurgical unit has recently completed a client chart review after the implementation of a pilot program aimed at promoting early ambulation following surgery. Which of the following components of EBP is the nurse putting into practice?
Answer Options:
Internal evidence
Patient preferences
Research utilization
Experience
Answer: Research utilization
Question: The effectiveness of change that is implemented according to the PDSA cycle can be best improved by which of the following measures?
Answer Options:
The inclusion of external evidence
Recognition of the importance of clinician experience
An increase in the size of the sample
Consultation with outside stakeholders
Answer: The inclusion of external evidence