MULTIPLE RESPONSE
1. A nurse is using a nursing metaparadigm to define nursing.
Which concepts will the nurse include? (Select all that apply.)
a. Person
b. Disease
c. Health
d. Nursing
e. Environment
ANS: A, C, D, E
Nursing’s metaparadigm includes four concepts: person,
health, environment/situation, and
nursing. Disease is not part of nursing’s metaparadigm.
DIF:Understand (comprehension)
OBJ:Propose examples of the four concepts included in the nursing metaparadigm.
TOP: Planning
MSC: Management of Care
2. A nurse wants to incorporate psychosocial theories into nursing practice. Which elements will
the nurse include? (Select all that apply.)
a. Physiological needs of the patient
b. Psychological needs of the patient
c. Sociocultural needs of the patient
d. Cognitive needs of the patient
e. Spiritual needs of the patient
ANS: A, B, C, E
When nursing incorporates psychosocial theories into nursing practice, the nurse strives to
meet the physiological, psychological, sociocultural, developmental, and spiritual needs of
patients. Cognitive needs of the patient are included in educational theories.
DIF:Understand (comprehension)
OBJ:Review selected shared theories from other disciplines.
MSC: Psychosocial Integrity
TOP: Caring
Chapter 05: Evidence-Based Practice
Potter: Fundamentals of Nursing, 11th Edition
MULTIPLE CHOICE
1. A nurse uses evidence-based practice (EBP) to provide nursing care. What is the best rationale
for the nurse’s behavior?
a. EBP is a guide for nurses in making clinical decisions.
b. EBP is based on the latest textbook information.
c. EBP is easily attained at the bedside.
d. EBP is always right for all situations.
ANS: A
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Evidence-based practice (EBP) is a guide for nurses to structure how to make appropriate,
timely, and effective clinical decisions. A textbook relies on the scientific literature, which
may be outdated by the time the book is published. Unfortunately, much of the best evidence
never reaches the bedside. EBP is not to be blindly applied without using good judgment and
critical thinking skills.
DIF:Understand (comprehension)
OBJ:Discuss the benefits of evidence-based practice.
TOP: Evaluation
MSC: Management of Care
2. In caring for patients, what must the nurse remember about evidence-based practice (EBP)?
a. EBP is the only valid source of knowledge that should be used.
b. EBP is secondary to traditional or convenient care knowledge.
c. EBP is dependent on patient values and expectations.
d. EBP is not shown to provide better patient outcomes.
ANS: C
Even when the best evidence available is used, application and outcomes will differ based on
patient values, preferences, concerns, and/or expectations. Nurses often care for patients on
the basis of tradition or convenience. Although these sources have value, it is important to
learn to rely more on research evidence than on non-research evidence. Evidence-based care
improves quality, safety, patient outcomes, and nurse satisfaction while reducing costs.
DIF:Understand (comprehension)
TOP: Implementation
OBJ:Discuss the benefits of evidence-based practice.
MSC: Management of Care
3. A nurse wants to change a patient procedure. Which action will the nurse take to easily find
research evidence to support this change?
a. Read all the articles found on the Internet.
b. Make a general search of the Internet.
c. Use a PICOT format for the search.
d. Start with a broad question.
ANS: C
The more focused the question is, the easier it becomes to search for evidence in the scientific
literature. The PICO format allows the nurse to ask focused questions that are intervention
based. Inappropriately formed questions (general search or broad question) will likely lead to
irrelevant sources of information. It is not beneficial to read hundreds of articles. It is more
beneficial to read the best four to six articles that specifically address the question.
DIF:Apply (application)
TOP: Implementation
OBJ:Explain the steps of evidence-based practice.
MSC: Management of Care
4. A nurse has collected several research findings for evidence-based practice. Which article will
be the best for the nurse to use?
a. An article that uses randomized controlled trials (RCT).
b. An article that is an opinion of expert committees.
c. An article that uses qualitative research.
d. An article that is peer-reviewed.
ANS: A
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Individual RCTs are the highest level of evidence or ―gold standardǁ for research. A
peer-reviewed article means that a panel of experts has reviewed the article; this is not a
research method. Qualitative research is valuable in identifying information about how
patients cope with or manage various health problems and their perceptions of illness. It does
not usually have the robustness of an RCT. Expert opinion is on the bottom of the hierarchical
pyramid of evidence.
DIF:Understand (comprehension)
OBJ:Summarize the levels of evidence available in the literature.
TOP: Assessment MSC: Management of Care
5. The nurse is reviewing a research article on a patient care topic. Which area should entice the
nurse to read the article?
a. Literature review
b. Introduction
c. Methods
d. Results
ANS: B
The introduction contains information about its purpose and the importance of the topic to the
audience who reads the article. The literature review or background offers a detailed
background of the level of science or clinical information about the topic of the article. The
methods or design section explains how a research study was organized and conducted. The
results or conclusion section details the results of the study and explains whether a hypothesis
is supported.
DIF:Understand (comprehension)
OBJ:Explain the steps of evidence-based practice.
TOP: Communication and Documentation
MSC: Management of Care
6. The nurse is caring for a patient with chronic low back pain. The nurse wants to determine the
best evidence-based practice regarding clinical guidelines for low back pain. What is the best
database for the nurse to access?
a. MEDLINE
b. EMBASE
c. PsycINFO
d. Agency for Healthcare Research and Quality (AHRQ)
ANS: D
The Agency for Healthcare Research and Quality (AHRQ) includes clinical guidelines and
evidence summaries. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry,
veterinary medicine, and allied health. EMBASE includes biomedical and pharmaceutical
studies. PsycINFO deals with psychology and related health care disciplines.
DIF:Understand (comprehension)
TOP: Implementation
OBJ:Explain the steps of evidence-based practice.
MSC: Management of Care
7. A nurse writes the following PICOT question: How do patients with breast cancer rate their
quality of life? How should the nurse evaluate this question?
a. A true PICOT question regardless of the number of elements
b. A true PICOT question because the intervention comes before the control
c. Not a true PICOT question because the comparison comes after the intervention
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d. Not a true PICOT question because the time is not designated
ANS: A
A meaningful PICOT question can contain only a P and O: How do patients with breast
cancer (P) rate their quality of life (O)? Note that a well-designed PICOT question does not
have to follow the sequence of P, I, C, O, and T. The aim is to ask a question that contains as
many of the PICOT elements as possible.
DIF:Analyze (analysis)
OBJ:Develop a PICOT question.
TOP: Evaluation
MSC: Management of Care
8. A nurse is reviewing literature for an evidence-based practice study. Which study should the
nurse use for the most reliable level of evidence that uses statistics to show effectiveness?
a. Meta-analysis
b. Systematic review
c. Single random controlled trial
d. Control trial without randomization
ANS: A
The main difference is that in a meta-analysis the researcher uses statistics to show the effect
of an intervention on an outcome. In a systematic review, no statistics are used to draw
conclusions about the evidence. A single random controlled trial (RCT) is not as conclusive as
a review of several RCTs on the same question. Control trials without randomization may
involve bias in how the study is conducted.
DIF:Analyze (analysis)
OBJ:Summarize the levels of evidence available in the literature.
TOP: Planning
MSC: Management of Care
9. A nurse is reviewing research studies for evidence-based practice. Which article should the
nurse use for qualitative nursing research?
a. An article about the number of falls after use of no side rails
b. An article about infection rates after use of a new wound dressing
c. An article about the percentage of new admissions on a new floor
d. An article about emotional needs of dying patients and their families
ANS: D
Studying emotional needs is a qualitative study. Qualitative nursing research is the study of
phenomena that are difficult to quantify or categorize, such as patients’ perceptions of illness.
The number of falls, infection rates, and percentages of new admissions are all examples of
quantitative research.
DIF:Analyze (analysis)
OBJ:Elaborate on how nursing research improves nursing practice.
TOP: Assessment MSC: Management of Care
10. A nurse develops the following PICOT question: Do patients who listen to music achieve
better control of their anxiety and pain after surgery when compared with patients who receive
standard nursing care following surgery? Which information will the nurse use as the ―Cǁ?
a. After surgery.
b. Who listen to music?
c. Who receive standard nursing care?
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d. Achieve better control of their anxiety and pain.
ANS: C
Do patients (P) who listen to music (I) achieve better control of their anxiety and pain (O)
after surgery (T) when compared with patients who receive standard nursing care following
surgery (C)?
DIF:Understand (comprehension)
TOP: Implementation
OBJ:Develop a PICOT question.
MSC: Management of Care
11. The nurse uses a PICOT question to develop an evidence-based change in protocol for a
certain nursing procedure. However, to make these changes throughout the entire institution
would require more evidence than is available at this time. What is the nurse’s best option?
a. Conduct a pilot study to investigate findings.
b. Drop the idea of making the change at this time.
c. Insist that management hire the needed staff to facilitate the change.
d. Seek employment in another institution that may have the staff needed.
ANS: A
When evidence is not strong enough to apply in practice, the next option is to conduct a pilot
study to investigate the PICOT question. Dropping the idea would be counterproductive;
insisting that management hire staff could be seen as a mandate and could produce negative
results. Seeking employment at another institution most likely would not be the answer
because most institutions operate under similar established guidelines.
DIF:Apply (application)
TOP: Implementation
OBJ:Discuss how nurses apply evidence in practice.
MSC: Management of Care
12. The nurse is trying to identify common general themes relative to the effectiveness of cardiac
rehabilitation from patients who have had heart attacks and have gone through cardiac
rehabilitation programs. The nurse conducts interviews and focus groups. Which type of
research is the nurse conducting?
a. Nonexperimental research
b. Experimental research
c. Qualitative research
d. Evaluation research
ANS: C
Qualitative research involves using inductive reasoning to develop generalizations or theories
from specific observations or interviews. Evaluation and experimental research are forms of
quantitative research. Nonexperimental descriptive studies describe, explain, or predict
phenomena such as factors that lead to an adolescent’s decision to smoke cigarettes.
DIF:Analyze (analysis)
OBJ:Elaborate on how nursing research improves nursing practice.
TOP: Implementation
MSC: Management of Care
13. In conducting a research study, the nurse researcher guarantees the subject no information will
be reported in any manner that will identify the subject and only the research team will have
access to the information. Which concept is the nurse researcher fulfilling?
a. Bias
b. Confidentiality
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c. Informed consent
d. The research process
ANS: B
Confidentiality guarantees that any information the subject provides will not be reported in
any manner that identifies the subject and will not be accessible to people outside the research
team. Biases are opinions that may influence the results of research. Informed consent means
that research subjects: (1) are given full and complete information about the purpose of the
study, procedures, data collection, potential harm and benefits, and alternative methods of
treatment; (2) are capable of fully understanding the research; (3) have the power to
voluntarily consent or decline participation; and (4) understand how confidentiality or
anonymity is maintained. The research process is a broader concept that provides an orderly
series of steps that allow the researcher to move from asking a question to finding the answer.
DIF:Understand (comprehension)
TOP: Implementation
OBJ:Discuss the steps of the research process.
MSC: Management of Care
14. The nurse researcher is preparing to publish the findings and is preparing to add the
limitations to the manuscript. Which area of the manuscript will the nurse researcher add this
information?
a. Abstract
b. Conclusion
c. Study design
d. Clinical implications
ANS: B
During results or conclusions, the researcher interprets the findings of the study, including
limitations. An abstract summarizes the purpose of the article with major findings. Study
design involves selection of research methods and type of study conducted. The researcher
explains how to apply findings in a practice setting for the type of subjects studied in the
clinical implications section.
DIF:Understand (comprehension)
TOP: Implementation
OBJ:Discuss the steps of the research process.
MSC: Management of Care
15. A nurse is trying to decrease the rate of falls on the unit. After reviewing the literature, a
strategy is implemented on the unit. After 3 months, the nurse finds that the falls have
decreased. Which process did the nurse institute?
a. Performance improvement
b. Peer-reviewed project
c. Generalizability study
d. Qualitative research
ANS: A
Performance improvement focuses on performance issues like falls or pressure injury
incidence. A peer-reviewed article is reviewed for accuracy, validity, and rigor and approved
for publication by experts before it is published. Generalizability is not a study/research; it is
if the results of a study can be compared to other patients with similar experiences. This is a
quantitative study, not a qualitative study.
DIF:Understand (comprehension)
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OBJ:Compare the similarities and differences between evidence-based practice, research, and
performance improvement.
TOP: Implementation
MSC: Management of Care
16. A nurse identifies a clinical problem with pressure injuries. Which step should the nurse take
next in the research process?
a. Analyze results.
b. Conduct the study.
c. Determine method.
d. Develop a hypothesis.
ANS: D
After identifying an area of interest or clinical problem, the steps of the research process are
as follows: develop research question(s)/hypotheses, determine how the study will be
conducted, conduct the study, and analyze results of the study.
DIF:Apply (application)
TOP: Implementation
OBJ:Discuss the steps of the research process.
MSC: Management of Care
17. After reviewing the literature, the evidence-based practice committee institutes a practice
change that bedrails should be left in the down position and hourly nursing rounds should be
conducted. The results indicate over a 40% reduction in falls. What is the committee’s next
step?
a. Evaluate the changes in 1 month.
b. Implement the changes as a pilot study.
c. Wait a month before implementing the changes.
d. Communicate to staff the results of this project.
ANS: D
The last step of evidence-based practice (EBP) is to share the outcomes of EBP changes with
others. Changes must be evaluated before the outcomes are shared. Once communicated,
changes should be put in place as the committee deems reasonable (i.e., either hospital wide
or as a pilot study). Waiting should not be an option unless the results are not to the
committee’s liking.
DIF:Apply (application)
TOP: Implementation
OBJ:Discuss how nurses apply evidence in practice.
MSC: Management of Care
18. A nurse is developing a care delivery outcomes research project. Which population will the
nurse study?
a. Nurses
b. Patients
c. Administrators
d. Health care providers
ANS: B
Similar to the expected outcomes you develop in a plan of care, a care delivery outcome
focuses on the recipients of service (e.g., patient, family, or community) and not the providers
(e.g., nurse or physician/health care provider). Administrators are not recipients of service.
DIF:Understand (comprehension)
OBJ:Elaborate on how nursing research improves nursing practice.
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TOP: Implementation
MSC: Management of Care
19. A nurse is implementing an evidence-based practice project regarding infection rates. After
reviewing research literature, which other evidence should the nurse review?
a. Quality improvement data
b. Inductive reasoning data
c. Informed consent data
d. Biased data
ANS: A
When implementing an evidence-based practice project, it is important to first review
evidence from appropriate research and quality improvement data. Inductive reasoning is used
to develop generalizations or theories from specific observations; this study needs specifics.
Informed consent is not data but a process and form that subjects must sign before
participating in research projects/studies. Biased data is based on opinions; facts are needed
for this study.
DIF:Understand (comprehension)
OBJ:Compare the similarities and differences between evidence-based practice, research, and
performance improvement.
TOP: Implementation
MSC: Management of Care
20. A nurse is using the research process. Place in order the sequence that the nurse will follow.
1. Analyze results.
2. Conduct the study.
3. Identify clinical problem.
4. Develop research question.
5. Determine how study will be conducted.
a. 3, 4, 5, 2, 1
b. 4, 3, 5, 2, 1
c. 3, 5, 4, 2, 1
d. 4, 5, 3, 2, 1
ANS: A
The steps of the research process are as follows: (1) identify area of interest or clinical
problem, (2) develop research question(s)/hypotheses, (3) determine how study will be
conducted, (4) conduct the study, and (5) analyze results of the study.
DIF:Understand (comprehension)
TOP: Implementation
OBJ:Discuss the steps of the research process.
MSC: Management of Care
MULTIPLE RESPONSE
1. The nurse is preparing to conduct research that will allow precise measurement of a
phenomenon. Which methods will provide the nurse with the right kind of data? (Select all
that apply.)
a. Surveys
b. Phenomenology
c. Grounded theory
d. Evaluation research
e. Nonexperimental research
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ANS: A, D, E
Experimental research, nonexperimental research, surveys, and evaluation research are all
forms of quantitative research that allow for precise measurement. Phenomenology and
grounded theory are forms of qualitative research.
DIF:Understand (comprehension)
OBJ:Elaborate on how nursing research improves nursing practice.
TOP: Assessment MSC: Management of Care
2. Before conducting any study with human subjects, the nurse researcher must obtain informed
consent. What must the nurse researcher ensure to obtain informed consent? (Select all that
apply.)
a. Gives complete information about the purpose.
b. Allows free choice to participate or withdraw.
c. Understands how confidentiality is maintained.
d. Identifies risks and benefits of participation.
e. Ensures that subjects complete the study.
ANS: A, B, C, D
Informed consent means that research subjects: (1) are given full and complete information
about the purpose of a study, procedures, data collection, potential harm and benefits, and
alternative methods of treatment; (2) are capable of fully understanding the research and the
implications of participation; (3) have the power of free choice to voluntarily consent or
decline participation in the research; and (4) understand how the researcher maintains
confidentiality or anonymity.
Completion of the study is not needed for informed consent.
DIF:Understand (comprehension)
TOP: Implementation
OBJ:Discuss the steps of the research process.
MSC: Management of Care
3. The nurse is reviewing nursing research literature related to a potential practice problem on
the nursing unit. What is the rationale for the nurse’s action? (Select all that apply.)
a. Nursing research ensures the nurse’s promotion.
b. Nursing research identifies new knowledge.
c. Nursing research improves professional practice.
d. Nursing research enhances effective use of resources.
e. Nursing research leads to decreases in budget expenditures.
ANS: B, C, D
Nursing research is a way to identify new knowledge, improve professional education and
practice, and use resources effectively. Nursing research itself does not lead to a decrease in
budget expenditures; however, it does lead to using health care resources effectively. A
promotion is not a direct result of nursing research.
DIF:Understand (comprehension)
OBJ:Explain the relationship between evidence-based practice and clinical judgment.
TOP: Implementation
MSC: Management of Care
Chapter 06: Health and Wellness
Potter: Fundamentals of Nursing, 11th Edition
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MULTIPLE CHOICE
1. A nurse is following the goals of Healthy People 2030 to provide care. Which action should
the nurse take?
a. Allowing people to continue current behaviors to reduce the stress of change.
b. Focusing only on health changes that will lead to better local communities.
c. Promoting a society in which all people live long, healthy lives.
d. Focusing on illness treatment to provide fast recuperation.
ANS: C
Healthy People sets objectives to help the United States increase its focus on health promotion
and disease prevention (instead of illness care) and encourages cooperation among
individuals, communities, and other public, private, and nonprofit organizations to improve
health. The current publication, Healthy People 2030, promotes a society in which all people
live long, healthy lives. The goals do not include continuing current behaviors to reduce
stress, focusing only on health changes for communities, or focusing on fast recuperation.
DIF:Apply (application)
OBJ:Explain how Healthy People guides public health goals for Americans.
TOP: Implementation
MSC: Health Promotion and Maintenance
2. A nurse is using the World Health Organization definition of health to provide care. Which
area will the nurse focus on while providing care?
a. Focusing on helping patients be disease free
b. Providing care that involves the whole person
c. Assuring that care is strictly personal in nature
d. Directing focus only on the pathological state
ANS: B
The World Health Organization (WHO) defines health as a ―state of complete physical,
mental, and social well-being, not merely the absence of disease or infirmity.ǁ Therefore,
nurses’ attitudes toward health and illness should consider the total person, as well as the
environment in which the person lives. All people free of disease are not necessarily healthy.
Strictly personal and a focus only on pathological states do not correlate to WHO’s definition.
DIF:Understand (comprehension)
TOP: Implementation
OBJ:Discuss how individuals define health.
MSC: Management of Care
3. The nurse is preparing a smoking cessation class for family members of patients with lung
cancer. The nurse believes that the class will convert many smokers to nonsmokers once they
realize the benefits of not smoking. Which health care model is the nurse following?
a. Health belief model
b. Holistic health model
c. Health promotion model
d. Maslow’s hierarchy of needs
ANS: A
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