Chapter 5. Evidence-Based Care
Multiple Choice
Identify the choice that best completes the statement or answers the
question.
1. Which of the following are parts of evidence-based practice?
a. Clinician
b. Patient
c. Evidence
d. All of the above
2. Which is the most important question to ask in nursing
research?
a. What findings constitute evidence?
b. How will the findings be used?
c. Is this a randomized controlled trial?
d. What theory is being utilized?
3. Nursing research should be utilized by:
a. Nurses at the bedside
b. Advanced practice nurses
c. Nurse researchers
d. Nurses at all levels of practice
4. Applying evidence at the point of care requires:
a. Readily available evidence-based resources
b. Ability to review research literature
c. Single articles in journals
d. Current textbooks
5. Practice guidelines are designed to:
a. Be inflexible
b. Be utilized in every circumstance
c. Provide a reference point for decision making
d. Be created by a professional organization to guide the practice of a profession
6. Which of the following is a crucial element of developing a guideline?
a. Creating a physician expert panel
b. Reviewing the literature with ratings of available evidence
c. Conducting an external review of a guideline
d. Developing evidence-based tables
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7. Which of the following would be considered the research design for Level I evidence?
a. Single, well-designed randomized clinical trial
b. Systematic review of randomized clinical trial studies
c. Well-designed controlled trials without randomization
d. Systematic reviews of descriptive or qualitative studies
8. Which of the following would be considered the research design for Level II evidence?
a. Single descriptive or qualitative study
b. Well-designed case control or cohort studies
c. Single, well-designed, randomized clinical trial
d. Systematic review of randomized clinical trial studies
9. Which of the following would be considered the research design for Level III evidence?
a. Well-designed controlled trials without randomization
b. Systematic reviews of descriptive or qualitative studies
c. Systematic review of randomized clinical trial studies
d. Opinion of authorities and expert committees
10. Which of the following would be considered the research design for Level IV evidence?
a. Single descriptive or qualitative study
b. Opinion of authorities and expert committees
c. Systematic review of randomized clinical trial studies
d. Well-designed controlled trials without randomization
11. Which of the following would be considered the research design for Level V evidence?
a. Systematic review of randomized clinical trial studies
b. Well-designed controlled trials without randomization
c. Systematic reviews of descriptive or qualitative studies
d. Single descriptive or qualitative study
12. Which of the following would be considered the research design for Level VI evidence?
a. Systematic reviews of descriptive or qualitative studies
b. Opinion of authorities and expert committees
c. Well-designed case control or cohort studies
d. Single descriptive or qualitative study
13. Which of the following would be considered the research design for Level VII evidence?
a. Well-designed controlled trials without randomization
b. Opinion of authorities and expert committees
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c. Well-designed case control or cohort studies
d. Single descriptive or qualitative study
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Chapter 5. Evidence-Based Care
Answer Section
MULTIPLE CHOICE
1. ANS: D
PTS: 1
2. ANS: B
PTS: 1
3. ANS: D
PTS: 1
4. ANS: A
PTS: 1
5. ANS: C
PTS: 1
6. ANS: B
PTS: 1
7. ANS: B
PTS: 1
8. ANS: C
PTS: 1
9. ANS: A
PTS: 1
10. ANS: D
PTS: 1
11. ANS: C
PTS: 1
12. ANS: C
PTS: 1
13. ANS: B
PTS: 1
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Chapter 6. Common Neurological Complaints
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. Which statement about confusion is true?
a. Confusion is a disease process.
b. Confusion is always temporary.
c. Age is a reliable predictor of confusion.
d. Polypharmacy is a major contributor to confusion in older adults.
2. Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following
medications will help to decrease edema in the labyrinth of the ear?
a. Meclizine
b. Diphenhydramine
c. Diamox
d. Promethazine
3. The hallmark of an absence seizure is:
a. No activity at all
b. A blank stare
c. Urine is usually voided involuntarily
d. The attack usually lasts several minutes
4. How often should drug levels be monitored when a seizure medication has controlled the seizures,
and the drug level is adequate?
a. Every 3 months
b. Every 6 months
c. Annually
d. Whenever there is a problem
5. Which of the following persons fits the classic description of a patient with multiple sclerosis (MS)?
a. A teenage male
b. A 65-year-old male
c. A 25-year-old female
d. A 60-year-old female
6. Which of the following is a specific test to MS?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
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c. A lumbar puncture
d. There is no specific test.
7. Which drug for Alzheimer’s disease should be administered beginning at the time of diagnosis?
a. Cholinesterase inhibitors
b. Anxiolytics
c. Antidepressants
d. Atypical antipsychotics
8. Which hematoma occurs along the temporal cranial wall and results from tears in the middle
meningeal artery?
a. Epidural hematoma
b. Subdural hematoma
c. Subarachnoid hematoma
d. Intraparenchymal hemorrhage
9. Which cranial nerve is affected in a patient with a cerebrovascular accident who has difficulty
chewing?
a. CN V
b. CN VII
c. CN IX
d. CN X
10. Which statement best describes a carotid bruit?
a. It is felt with the middle three fingers over the carotid artery.
b. A bruit becomes audible when the lumen is narrowed to 1 mm or less.
c. A low-pitched bruit is a medical emergency.
d. The higher the pitch of the bruit, the higher the degree of stenosis.
11. Which patient is more likely to have a cluster headache?
a. A female in her reproductive years
b. A 40-year-old African American male
c. A 55-year-old female who drinks 10 cups of coffee daily
d. A 45-year-old male awakened at night
12. Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?
a. Dementia
b. Alzheimer’s disease
c. Parkinson’s disease
d. Delirium
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13. Which type of meningitis is more benign, self-limiting, and caused primarily by a virus?
a. Purulent meningitis
b. Chronic meningitis
c. Aseptic meningitis
d. Herpes meningitis
14. Which is the most sensitive neuroimaging test to evaluate patients with encephalitis?
a. MRI
b. CT
c. Electroencephalogram (EEG)
d. An initial lumbar puncture
15. What is usually the first sign or symptom that a patient would present with that would make you
suspect herpes zoster?
a. A stabbing pain on one small area of the body
b. A vesicular skin lesion on one side of the body
c. A pain that is worse upon awakening
d. A lesion on the exterior ear canal
16. Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is
concerned about permanent paralysis and pain. What do you tell her?
a. “Most patients have complete recovery in 3 to 6 months.”
b. “Unfortunately, you’ll probably have a small amount of residual damage.”
c. “Don’t worry, I’ll take care of everything.”
d. “You may have a few more episodes over the course of your lifetime but no
permanent damage.”
17. Sam, aged 65, is started on L-dopa for his Parkinson’s disease (PD). He asks why this is necessary.
You tell him:
a. “L-dopa is neuroprotective.”
b. “The primary goal of therapy is to replace depleted stores of dopamine.”
c. “This is the only drug that can provide symptomatic benefit.”
d. “This is the initial monotherapy drug.”
18. Which of the following signs is seen in a patient with more advanced PD?
a. Resting tremor
b. Bradykinesia
c. Rigidity
d. Postural instability
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19. Which of the following is the most commonly experienced symptom of migraine?
a. Light sensitivity
b. Pulsatile pain
c. Sound sensitivity
d. Experiencing an aura
20. Which of the following characteristics differentiates peripheral vertigo from central vertigo?
a. The duration of central vertigo is shorter than that of peripheral vertigo.
b. There is an auditory-associated symptom with peripheral vertigo and a visualassociated symptom with central vertigo.
c. Central vertigo is positional, and peripheral vertigo is not.
d. The onset of central vertigo is more sudden than that of peripheral vertigo.
21. Carotid endarterectomy should be considered only for symptomatic patients with greater than what
percentage of stenosis?
a. Greater than 25%
b. Greater than 50%
c. Greater than 75%
d. Only for 100% occlusion
22. What antiplatelet agent is most widely used for secondary prevention of stroke?
a. Aspirin
b. Ticlopidine
c. Clopidogrel
d. Aspirin and clopidogrel
23. Which adjunctive diagnostic test should be used in the work-up of a patient with suspected
Creutzfeldt-Jakob disease or transient epileptic amnesia?
a. MRI
b. CT
c. Cerebrospinal fluid analysis
d. EEG
24. Which herbal preparation may cause delirium and should be avoided in an elderly patient?
a. Sam-e
b. Saint John’s Wort
c. Melatonin
d. Saw Palmetto
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25. Which of the following activities is part of the functional activities questionnaire?
a. Asking the patient to unravel a Rubik’s cube
b. Determining if the patient can drive on the highway
c. Asking the patient about a news event from the current week
d. Seeing if the patient can keep his or her home clean
26. About 90% of all headaches are?
a. Tension
b. Migraine
c. Cluster
d. Without pathological cause
27. Which statement is true regarding driving and patients with a seizure disorder?
a. Once diagnosed with a seizure disorder, patients must never drive again.
b. After being seizure free for 6 months, patients may drive.
c. Each state has different laws governing driving for individuals with a seizure
disorder.
d. These persons may drive but never alone.
28. Julie has relapsing-remitting muscular sclerosis. She has not had a good response to interferon.
Which medication might help given intravenously once a month?
a. Glatiramer acetate
b. Natalizumab
c. Fingolimod
d. Glucocorticoids
29. The ‘freezing phenomenon’ is a cardinal feature of?
a. Parkinson’s disease
b. Alzheimer’s disease
c. A CVA
d. Bell’s palsy
30. A ratchet-like rhythmic contraction, especially in the hand, during passive stretching is known as?
a. Spinothalamic dysfunction
b. Ratcheting
c. Cogwheeling
d. Hand tremors
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31. Clinical features of insidious onset, slow progression, and a lack of other findings to explain the
symptoms are fairly diagnostic of which condition?
a. Guillain-Barré syndrome
b. Parkinson’s disease
c. Alzheimer’s disease
d. Huntington’s disease
32. Which condition is characterized by the impaired ability to learn new information along with either a
cognitive disturbance in language, function, or perception?
a. Guillain-Barré syndrome
b. Parkinson’s disease
c. Alzheimer’s disease
d. Delirium
33. A score of 20 to 25 on this test indicates early-stage Alzheimer’s disease:
a. SLUMS
b. MoCA
c. FAST
d. MMSE
34. Intravenous thrombolytic therapy following an ischemic CVA should be given within how many
hours of symptom onset?
a. 1 hour
b. 3 hours
c. 6 hours
d. 12 hours
35. When administered at the beginning of an attack, oxygen therapy may help this kind of headache?
a. Tension
b. Migraine
c. Cluster
d. Stress
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