Chapter 09: Evidence-Based Practice
Stanhope: Foundations for Population Health in Community/Public Health Nursing,
MULTIPLE CHOICE
1. A nurse executive is implementing evidence-based practice at a community nursing center that serves
immigrant population. Which of the following actions would be the most helpful for the nurse?
a. Review clinical policies with cultural competency experts from the local
university.
b. Conduct weekly staff meetings to discuss which methods work best when helping
immigrants.
c. Invite Cuban immigrants from the community to serve on the center’s advisory
board.
d. Send personnel to conferences and seminars that focus on treating Hispanic
immigrants.
ANS: C
To determine whether practice is serving the needs of the population, the nurse will need to consult the
means that evidence should be applied with input from the community. For example, decisions related
in a nurse-managed clinic should be made with input from the clinic’s advisory board, which should in
and consumers of the clinic’s services. Information about the population needs to come from the popul
competency experts within the community or from the staff members. Cuban immigrant needs may no
Hispanic immigrants from other places such as Mexico or Spain.
2. A community health nurse is determining the best way to address an outbreak of a new infectious dise
practice (EBP). Which of the following actions would the nurse most likely take?
a. Review policies and procedures.
b. Review outcomes of clinical trials.
c. Review several nursing textbooks.
d. Review reputable sites on the Internet.
ANS: B
Research findings, knowledge from basic science, clinical knowledge, and expert opinion shoul
evidence for EBP. The use of policies and procedures is only helpful if they have been written using E
they were written, there may be evidence that supports the use of a different practice. The problem w
many are
not grounded in evidence-based practice, because the concept is relatively new to the United States. Sc
ideas is helpful only if evidence-based practice sites are accessed, and most internet sites are not EBP s
3. A nursing administrator wants to develop a work environment conducive to the implementation of evid
Which of the following actions would best achieve this goal?
a. Conducting market research to determine customer satisfaction with EBP
b. Eliciting opinions from nurses on how EBP will affect workload
c. Purchasing computers and Internet access for use by employees
d. Sending staff to conferences related to incorporation of EBP into practice
ANS: C
A lack of computers and Internet access can create a barrier to implementation of EBP in community-b
these are provided, nurses can quickly access current evidence-based findings and recommendations. C
will not change the work environment to make it more conductive to implementing EBP. Learning abo
how it will affect workload would not impact the work environment and make it more conducive to im
administrator would need to discuss the benefits of the use of EBP with the staff. Sending staff to a con
change staff attitudes, would not necessarily change the work environment.
4. A busy school health nurse concerned over the rising incidence of obesity wants to implement evidenc
faces barriers because of time constraints. Which of the following actions should the nurse take first?
a. Identify students who are obese so that they may be closely monitored for weight
control success or failure.
b. Evaluate best practices to determine those that have the highest success rates for
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5. The nurse has been reading extensively on a particular clinical problem, using both the closest medical
Which of the following would be the most helpful source?
a. A journal with a whole issue devoted to research on that clinical problem
b. A randomized controlled clinical trial related to that clinical problem
c. A researcher who has built a career on studying that clinical
problem d. A systematic review related to the clinical problem
ANS: D
A systematic review is an approach to identifying, appraising, and synthesizing research evidence to e
available research that is relevant to a particular research question. Systematic reviews can be accessed
Systematic reviews require more rigor and contain less opinion of the author than typical reviews of th
journal devoted to research on a clinical problem may be helpful, but it is unknown what type of resear
journal. A well-designed systematic review can provide stronger evidence than a single randomized co
alone
does not provide the best evidence, rather one would need to look at the information that has been pub
peer-reviewed journals.
6. A school health nurse plans to use evidence-based practice (EBP) to guide the development of health e
likely to increase retention of learning in elementary schoolchildren. Which of the following would be
this situation?
a. Ask other school health nurses what they included in their own education
programs.
b. Compare and contrast randomized controlled trials related to learning in
elementary schoolchildren.
c. Develop a series of games to accompany the programs developed to promote
health.
d. Seek out and examine health education programs for elementary schoolchildren
on the Internet.
ANS: B
Randomized controlled trials are generally ranked as the highest level of evidence. EBP is not collecte
the nurse must look in the literature to obtain the best information. There is no evidence that a series of
retention of learning based on what is stated in this question. This may be an appropriate activity, but t
gathered from the literature. Searching the Internet for ideas is helpful only if evidence-based practice
most Internet sites are not EBP sites.
7. After finding several studies related to the clinical problem, a nurse knows the studies must be evaluate
characteristics should be present in the literature?
a. Federally supported multiagency clinical studies
b. Multiple high-quality studies with large sample sizes and consistent findings
c. Research studies done by multidisciplinary teams in multiple settings
d. Controlled clinical trials
ANS: B
The Agency for Healthcare Research and Quality (AHRQ) reviewed 40 systems used to evaluate the q
strength of evidence. The report identified three domains for evaluating systems that grade the strength
quantity, and consistency. The quality of a study refers to the extent to which bias is minimized. Quan
studies, the magnitude of the effect, and the sample size. Consistency refers to studies that have simila
different study designs. Federally supported multiagency clinical studies, research studies completed b
multiple settings, and controlled clinical trials do not necessarily meet the three domains for evaluating
strength of the evidence: quality, quantity, and consistency. These are the criteria that should be used t
additional information is needed about these studies in order to evaluate them.
8. A nurse is familiar with evidence-based practice (EBP) and wants to implement it into the care of clien
would present the biggest challenge?
a. Assessing one’s current practice and accessing evidence-based resources
b. Convincing administration that EBP is beneficial
c. Distinguishing EBP from practice based on old standards
d. Showing clients that EBP will improve their health outcomes
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