Concept 45: Evidence My Nursing Test Banks

Concept 45: Evidence

Test Bank

MULTIPLE CHOICE

1. One of the first nurse researchers to document evidence-based practice for nursing was Florence Nightingale. What did Nightingale incorporate into her practice that made her practice different from her colleagues?

a.

Nightingale gathered scientific data.

b.

Nightingale calculated statistics to report her findings.

c.

Nightingale communicated her findings to powerful others.

d.

Nightingale based her nursing practice on her findings.

ANS: D

Florence Nightingale had tried to develop the role of researcher by using evidence from her practice and implementing these findings. Evidence-based practice (EBP) includes conducting quality studies, synthesizing the study findings into the best research evidence available, and using that research evidence effectively in practice. Although gathering scientific data, calculating statistics to report findings, and communicating findings to powerful others are all important components of conducting research, Nightingales action that most appropriately reflects the current nursing research priority is that she based her nursing practice on her findings.

REF: 454

OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

2. Critical Thinking: The nurse administrator is doing a study that entails gathering data about new employees over a 10-year period. Which research method would be the best one to use for this type of study?

a.

Quantitative longitude cohort

b.

Qualitative longitudinal

c.

Qualitative interview

d.

Qualitative case study

ANS: A

Quantitative research has been defined as being focused on the testing of a hypothesis through objective observation and validation. The types of studies that make up this category include randomized controlled studies, cohort studies, longitudinal studies, case-controlled studies, and case reports. The other options are examples of quantitative, not qualitative, studies.

REF: 454|461

OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

3. Critical Thinking: The nurse in the outpatient setting would like to conduct a research study that compares patients who take tramadol (Ultracet) to patients who take oxycodone hydrochloride and acetaminophen (Percocet) for managing back pain. Which quantitative research method should yield the best results?

a.

Longitude study

b.

Controlled study

c.

Systematic reviews/meta-analysis

d.

Survey study

ANS: B

A controlled study is a type of quantitative research that seeks to control and examine the variables to determine effectiveness. In this case, the variables would be those that were administered tramadol (Ultracet) and those that were administered hydrochloride and acetaminophen (Percocet) for managing back pain. Correlational research methods help determine association between or among variables. A longitudinal study examines variables over a designated course of time. A systematic reviews/meta-analysis is a type of literature review and not a research method. A survey study is a type of qualitative research method.

REF: 454-455

OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

4. The nurse in the psychiatric unit is involved in a research study for a depression medication. In the study, patients are randomly assigned to one depression medication and the other group is receiving no medication to treat the depression. What method of research are the patients involved with?

a.

Descriptive

b.

Correlational

c.

Quasi-experimental

d.

Experimental

ANS: D

Experimental tests an intervention and includes both a control group and random assignment. This research study tests an intervention and includes both a control group and random assignment. Descriptive defines the magnitude of a concept and its characteristics. Correlational determines association between or among variables. Quasi-experimental tests an intervention and lacks either a control group or random assignment.

REF: 454

OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

MULTIPLE RESPONSE

1. How does the Iowa model transcend mere nursing care? (Select all that apply.)

a.

It includes formalized internal feedback loops.

b.

Its triggers can have their origins practically anywhere.

c.

It generates change in practice solely through research.

d.

It implies a layer of policy development.

e.

It addresses multiple disciplines impacts on quality.

ANS: A, B, D, E

The triggers addressed within the Iowa model process can be problem focused and evolve from risk management data, process improvement data, benchmarking data, financial data, and clinical problems. The triggers can also be knowledge focused, such as new research findings, change in a national agencys or an organizations standards and guidelines, expanded philosophy of care, or questions from the institutional standards committee. Because the Iowa model is often implemented at a fairly high level of nursing or hospital administration, it scrutinizes the input of nursing and other disciplines in its process. Its output is applied as widely as possible throughout the organization, and it can affect policy within a multihospital system and even across systems. The success of EBP is determined by all involved, including health care agencies, administrators, nurses, physicians, and other health care professionals.

REF: 457

OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

2. Which statements are true about the Iowa model of EBP? (Select all that apply.)

a.

It addresses utilization of research findings at an individual level.

b.

It prioritizes pressing items of interest related to quality of care.

c.

Individual nurses enact an Iowa decision tree when they examine risk management data.

d.

It identifies triggers capable of posing hazard or benefit.

e.

It reiterates that innovators embrace change far earlier than laggards.

ANS: B, D

The Iowa model of EBP provides direction for the development of EBP in a clinical agency. This EBP model was initially developed in 1994 and revised in 2001. In a health care agency, there are triggers that initiate the need for change, and the focus should always be to make changes based on best evidence. These triggers can be problem focused and evolve from risk management data, process improvement data, benchmarking data, financial data, and clinical problems. The triggers can also be knowledge focused, such as new research findings, change in a national agencys or an organizations standards and guidelines, expanded philosophy of care, or questions from an institutional standards committee.

REF: 457

OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

3. The nurse is conducting a review of the literature for pain management techniques. Which of the following would the nurse consider when conducting research that yields solid EBP? (Select all that apply.)

a.

Search the literature to uncover evidence to answer the question.

b.

Evaluate the outcome.

c.

Use the nursing process to evaluate evidence.

d.

Evaluate the evidence found.

e.

Develop an answerable question.

f.

Develop a question that has not been answered.

g.

Apply the evidence to the practice situation.

ANS: A, B, D, E, G

To facilitate the use of evidence, steps have been developed to systematically approach a question of patient care. The steps are outlined as follows:

Develop an answerable question

Search the literature to uncover evidence to answer the question

Evaluate the evidence found

Apply the evidence to the practice situation

Evaluate the outcome

The nursing process is a method of problem solving and can be used to develop a plan of care. Formulating a question that has not been answered in the research would be considered primary research. Therefore, there is no evidence in which to draw from.

REF: 457-458

OBJ: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

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