,Chapter 01: Using Evidence in Nursing Practice
Perry et al.: Clinical Nursing Skills & Techniques, 11th Edition
MULTIPLE CHOICE
1. Evidence-based practice is a problem-solving approach to making decisions about client care
that is grounded in:
a. the latest information found in textbooks.
b. systematically conducted research studies.
c. tradition in clinical practice.
d. quality improvement and risk-management data.
CORRECT ANSWER:-B
EXPLANATION :->>>The best evidence comes from well-designed, systematically conducted
research studies described in scientific journals. Portions of a textbook often become outdated
by the time it is published.
Many primary care settings do not have a process to help staff adopt new evidence in practice, and
nurse practitioners in practice settings lack easy access to risk-management data, relying instead on
tradition or convenience. Some sources of evidence do not originate from research. These include
quality improvement and risk-management data; infection control data; retrospective or concurrent
chart reviews; and clinicians‘ expertise. Although
non–research-based evidence is often very valuable, it is important that you learn to rely more on
research-based evidence.
DIF: CognitiveLevel: Comprehension OBJ: Discuss the benefits of evidence-based practice.
TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe and Effective Care Environment (management of care)
2. When evidence-based practice is used, client care will be:
a. standardized for all.
b. unhampered by client culture.
c. variable according to the situation.
d. safe from the hazards of critical thinking.
CORRECT ANSWER:-C
EXPLANATION :->>>Using your clinical expertise and considering clients‘ cultures,
values, and preferences ensures that you will apply available evidence in practice ethically and
appropriately. Even when you use the best evidence available, application and outcomes will
differ; as a nurse practitioner, you will develop critical thinking skills to determine whether
evidence is relevant and appropriate.
DIF: CognitiveLevel: Application OBJ: Discuss the benefits of evidence-based practice.
TOP: Evidence-Based Practice KEY: Nursing Process Step: Assessment
MSC: NCLEX: Safe and Effective Care Environment (management of care)
3. When a PICOT question is developed, the letter that corresponds with the usual standard of
care is:
a. P.
b. I.
, c. CHOICE BLANK
d. O.
CORRECT ANSWER:-C
EXPLANATION :->>>C = Comparison of interest. What standard of care or current
intervention do you usually use now in practice?
P = Client population of interest. Identify your client by age, gender, ethnicity, disease, or
health problem.
I = Intervention of interest. What intervention (e.g., treatment, diagnostic test, and prognostic
factor) do you think is worthwhile to use in practice?
O = Outcome. What result (e.g., change in client‘s behavior, physical finding, and change in
client‘s perception) do you wish to achieve or observe as the result of an intervention?
DIF: CognitiveLevel: Knowledge OBJ: Develop a PICO question.
TOP: PICO KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
4. A well-developed PICOT question helps the nurse practitioner:
a. search for evidence.
b. include all five elements of the sequence.
c. find as many articles as possible in a literature search.
d. accept standard clinical routines.
CORRECT ANSWER:-A
EXPLANATION :->>>The more focused a question that you ask is, the easier it is to search
for evidence in the scientific literature. A well-designed PICOT question does not have to
include all five elements, nor does it have to follow the PICOT sequence. Do not be satisfied
with clinical routines.
Always question and use critical thinking to consider better ways to provide client care.
DIF: CognitiveLevel: Analysis OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
5. The nurse practitioner is not sure that the procedure the client requires is the best
possible for the situation. Utilizing which of the following resources would be the
quickest way to review research on the topic?
a. CINAHL
b. PubMed
c. MEDLINE
d. The Cochrane Database
CORRECT ANSWER:-D
EXPLANATION :->>>The Cochrane Community Database of Systematic Reviews is a valuable
source of synthesized evidence (i.e., pre-appraised evidence). The Cochrane Database includes the
full text of regularly updated systematic reviews and protocols for reviews currently happening.
MEDLINE, CINAHL, and PubMed are among the most comprehensive databases and
represent the scientific knowledge base of primary care.
DIF: CognitiveLevel: Synthesis OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
, 6. The nurse practitioner is getting ready to develop a plan of care for a client who has a specific
need. The best source for developing this plan of care would probably be:
a. The Cochrane Database.
b. MEDLINE.
c. NGC.
d. CINAHL.
CORRECT ANSWER:-C
EXPLANATION :->>>The National Guidelines Clearinghouse (NGC) is a database supported
by the Agency for Healthcare Research and Quality (AHRQ). It contains clinical guidelines—
systematically developed statements about a plan of care for a specific set of clinical circumstances
involving a specific client population. The NGC is a valuable source when you want to develop
a plan of care for a client. The Cochrane Community Database of Systematic Reviews,
MEDLINE, and CINAHL are all valuable sources of synthesized evidence (i.e., pre-appraised
evidence).
DIF: CognitiveLevel: Synthesis OBJ: Describe the six steps of evidence-based practice.
TOP: Evidence-Based Practice KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
7. The nurse practitioner has done a literature search and found 25 possible articles on the
topic that she is studying. To determine which of those 25 best fit her inquiry, the nurse
practitioner first should look at:
a. the abstracts.
b. the literature reviews.
c. the ―Methods‖ sections.
d. the narrative sections.
CORRECT ANSWER:-A
An abstract is a brief summary of an article that quickly tells you whether the article is research
EXPLANATION :->>>based or clinically based. An abstract summarizes the purpose of the study
or clinical query, the major themes or findings, and the implications for nursing practice. The
literature review usually gives you a good idea of how past research led to the researcher‘s
question.
The ―Methods‖ or ―Design‖ section explains how a research study is organized and conducted to
answer the research question or to test the hypothesis. The narrative of a manuscript differs
according to the type of evidence-based article—clinical or research.
DIF: CognitiveLevel: Application
OBJ: Discuss elements to review when critiquing the scientific literature.
TOP: Randomized Controlled Trials KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment (management of care)
8. The nurse practitioner wants to determine the effects of cardiac rehabilitation program
attendance on the level of postmyocardial depression for individuals who have had a
myocardial infarction. The type of study that would best capture this information would be
a:
a. randomized controlled trial.
b. qualitative study.
c. case control study.
d. descriptive study.
CORRECT ANSWER:-B
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