University of San Francisco - NURS 320

Chapter 10: Evidence-Based Practice

Stanhope: Foundations for Population Health in Community/Public Health Nursing, 5th Edition

MULTIPLE CHOICE

1)A nurse executive is implementing evidence-based practice at a community nursing center that serves a large Cuban immigrant population. Which of the following actions would be the most helpful for the nurse?

1. 1. Review clinical policies with cultural competency experts from the local university.
   2. Conduct weekly staff meetings to discuss which methods work best when helping immigrants.
   3. Invite Cuban immigrants from the community to serve on the center’s advisory board.
   4. Send personnel to conferences and seminars that focus on treating Hispanic immigrants.

2. A community health nurse is determining the best way to address an outbreak of a new infectious disease using evidence-based practice. Which of the following actions would the nurse most likely take?
   1. Review policies and procedures.
   2. Review outcomes of clinical trials.
   3. Review several nursing textbooks.
   4. Review reputable sites on the Internet

3. A nursing administrator wants to develop a work environment conducive to the implementation of evidence-based practice (EBP). Which of the following actions would best achieve this goal?
   1. Conducting market research to determine customer satisfaction with EBP

1. 2. Eliciting opinions from nurses on how EBP will affect workload
   3. Purchasing computers and Internet access for use by employees
   4. Sending staff to conferences related to incorporation of EBP into practice

4. A busy school health nurse concerned over the rising incidence of obesity wants to implement evidence-based practice (EBP) but faces barriers because of time constraints. Which of the following actions should the nurse take first?
   1. Identify students who are obese so that they may be closely monitored for weight control success or failure.
   2. Evaluate best practices to determine those that have the highest success rates for weight control in children.
   3. Schedule physician appointments for obese children.
   4. Develop an obesity management program for children whose body mass index exceeds normal.

5. The nurse has been reading everything she can find on a particular clinical problem, using both the closest medical library and the Internet. Which of the following would be the most helpful source?
   1. A journal with a whole issue devoted to research on that clinical problem
   2. A randomized controlled clinical trial related to that clinical problem
   3. A researcher who has built a career on studying that clinical problem
   4. A systematic review related to the clinical problem

6. A school health nurse plans to use evidence-based practice (EBP) to guide the development of health education programs most likely to increase retention of learning in elementary schoolchildren. Which of the following would be the best way to use EBP in this situation?
   1. Ask other school health nurses what they included in their own education programs.
   2. Compare and contrast randomized controlled trials related to learning in elementary schoolchildren.
   3. Develop a series of games to accompany the programs developed to promote health.
   4. Seek out and examine health education programs for elementary school children on the Internet.

7. After finding several studies related to the clinical problem, a nurse knows the studies must be evaluated. Which of the following characteristics should be present in the literature?
   1. Federally supported multiagency clinical studies
   2. Multiple high-quality studies with large sample sizes and consistent findings
   3. Research studies done by multidisciplinary teams in multiple settings
   4. Controlled clinical trials

8. A nurse is familiar with evidence-based practice (EBP) and wants to implement it into the care of clients. Which of the following would present the biggest challenge?
   1. Assessing one’s current practice and accessing evidence-based resources
   2. Convincing administration that EBP is beneficial
   3. Distinguishing EBP from practice based on old standards
   4. Showing clients that EBP will improve their health outcomes

9. Which of the following groups is pressuring clinicians the most to use evidence-based practice (EBP)?
   1. Administrators
   2. Insurance companies
   3. Nurses
   4. Physicians
10. A nurse implements an education program that incorporates computer games to reinforce learning for a group of older adults. Although the research demonstrates evidence of improved retention of this information, the nurse experiences exactly the opposite with this group. Which of the following is the most likely cause of such poor outcomes?
    1. Failure to consider client and setting differences
    2. Inadequate incorporation of evidence into practice
    3. Inferior quality of the available research evidence
    4. Lack of skills when evaluating the evidence

11. A health care provider is concerned about the high number of clients with type 2 diabetes mellitus who have poor glucose control. What would be the best reference for the provider to implement evidence-based practice (EBP) in the management of this problem?
    1. Published protocols
    2. Current research findings
    3. Opinions of colleagues
    4. Nursing journals

12. Staff members have agreed to implement evidence-based practice; they have chosen a specific problem and searched the literature. The group has selected the interventions that seem the easiest to implement. Which of the following actions would the staff take next?
    1. Assess the quality of the evidence in the literature.
    2. Decide how best to orient the staff and community to the proposed changes.
    3. Eliminate all nursing interventions that are not evidence based.
    4. Choose another specific problem for the next literature search.

13. A school nurse is developing a primary prevention strategy for school-aged children. Which of the following interventions would the nurse most likely implement?
    1. Developing individualized exercise programs for overweight children
    2. Drafting policy for increases in noncompetitive physical activity programs
    3. Monitoring body mass index (BMI) in children to identify elevations before they become difficult to manage
    4. Notifying parents and/or guardians of their child’s height–weight scale in comparison with national norms

14. Which of the following is the best way to increase the number of persons who come to their screening test appointments?
    1. Reminding clients via telephone, e-mail, or mail
    2. Emphasizing long life and happy family when conditions are caught early and treated successfully
    3. Pointing out how inexpensive and convenient screening tests are
    4. Stressing the dangerousness of the condition if not caught early

15. A nurse manager wants to facilitate incorporation of evidence-based practice (EBP) in the clinical setting. Which of the following would be the best strategy to accomplish this goal?
    1. Encourage group reflection on the ideals and expectations of nursing care.
    2. Refer agency nurses to Internet sources of research findings.
    3. Support nurses using practice-oriented research findings in decision making.

MULTIPLE RESPONSE

1. A nurse has decided to increase the evidence base of current nursing practice in an agency. Which of the following describes a barrier that could be encountered by the nurse? (Select all that apply.)
   1. Colleagues who do not know how to search the literature or critique research
   2. Dedication to the history and tradition of the agency
   3. Little or no research published in the clinical area of concern