CHAPTER 1
1. Which of the following groups would be best served by the development of a scientific
base for nursing practice?
A) Nursing
... [Show More] administrators
B) Practicing nurses
C) Nurses' clients
D) Health care policymakers
Ans: C
Feedback:
Nursing research is systematic inquiry designed to develop trustworthy evidence about
issues of importance to nurses and their clients. Nurse leaders recognize the need to base
specific nursing decisions on evidence indicating that the decisions are clinically
appropriate, cost-effective, and result in positive client outcomes. Although all of the
people listed would benefit from the development of a scientific base for nursing
practice, ultimately it is the clients themselves who would most benefit, as they would
then receive the most appropriate and most effective care.
2. An especially important goal for the nursing profession is to do which of the following?
A) Conduct research to better understand the context of nursing practice
B) Establish a solid base of evidence for practice through disciplined research
C) Document the role nursing serves in society
D) Establish research priorities
Ans: B
Feedback:
Nurses are increasingly expected to understand and undertake research and to base their
practice on evidence from research. Evidence-based practice is the use of the best
evidence in making patient care decisions and typically comes from research conducted
by nurses and other health-care professionals. All of the other answers are possible goals
for the nursing profession, but none is as important as establishing evidence for practice.
3. Which of the following is a fundamental belief of those who hold to the constructivist
paradigm?
A) A fixed reality exists in nature for humans to understand
B) The nature of reality has changed over time
C) Reality is multiply constructed and multiply interpreted by humans
D) Reality cannot be studied empirically
Ans: C
Feedback:
In the constructivist paradigm, it is assumed that reality is not a fixed entity but is rather
a construction of human minds, and thus “truth” is a composite of multiple constructions
of reality. However, constructivists do believe that reality can be studied empirically.
Belief in a fixed reality that exists in nature for humans to understand would be an
example of a positivist belief, not a constructivist one. The constructivist belief does not
hold so much that the nature of reality has changed over time as that it has always been
constructed by human minds.
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4. Which of the following is a fundamental belief of those who hold to the positivist
paradigm?
A) The researcher is objective and independent of those being studied
B) The researcher cannot interact with those being studied
C) The researcher instructs those being studied to be objective in providing
information
D) The distance between the researcher and those being researched is minimized to
enhance the interactive process
Ans: A
Feedback:
In the positivist paradigm, it is assumed that there is an objective reality and that natural
phenomena are regular and orderly. In the constructivist paradigm, it is assumed that
reality is not a fixed entity but is rather a construction of human minds, and thus “truth”
is a composite of multiple constructions of reality.
5. Which of the following attributes is least characteristic of the traditional scientific
method?
A) Control over external factors
B) Systematic measurement and observation of natural phenomena
C) Testing of hunches deduced from theory or prior research
D) Emphasis on a holistic view of a phenomenon, studied in a rich context
Ans: D
Feedback:
Quantitative research (associated with positivism) involves the collection and analysis
of numeric information. Quantitative research is typically conducted within the
traditional scientific method, which is systematic and controlled. Quantitative
researchers base their findings on empirical evidence (evidence collected by way of the
human senses) and strive for generalizability beyond a single setting or situation.
Constructivist researchers emphasize understanding human experience as it is lived
through the collection and analysis of subjective, narrative materials using flexible
procedures; this paradigm is associated with qualitative research.
6. Empiricism refers to which of the following?
A) Making generalizations from specific observations
B) Articulating a study purpose in terms of an appropriate classification system
C) Gathering evidence about real-world phenomena through the senses
D) Verifying the assumptions on which the study was based
Ans: C
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Feedback:
Empiricism is gathering and analyzing evidence through their senses. Quantitative
research involves the collection and analysis of numeric information. Quantitative
research is typically conducted within the traditional scientific method, which is
systematic and controlled. Quantitative researchers base their findings on empirical
evidence and strive for generalizability beyond a single setting or situation.
Constructivist researchers emphasize understanding human experience as it is lived
through the collection and analysis of subjective, narrative materials using flexible
procedures; this paradigm is associated with qualitative research.
7. Which of the following is a hallmark of the scientific method?
A) Rigorous
B) Holistic
C) Systematic
D) Flexible
Ans: C
Feedback:
Quantitative research is typically conducted within the traditional scientific method,
which is systematic and controlled. Quantitative researchers base their findings on
empirical evidence and strive for generalizability beyond a single setting or situation.
Constructivist researchers emphasize understanding human experience as it is lived
through the collection and analysis of subjective, narrative materials using flexible
procedures; this paradigm is associated with qualitative research.
8. Which of the following limits the capacity of the scientific method to answer questions
about humans?
A) The necessity of departing from traditional beliefs
B) The difficulty of accurately measuring complex human traits
C) The lack of funding for research
D) The shortage of theories about human behavior
Ans: B
Feedback:
Nursing research focuses on human beings, who are inherently complicated and diverse.
The traditional scientific method typically focuses on a relatively small aspect of human
experiences in a single study. Complexities tend to be controlled and, if possible,
eliminated rather than studied directly, and this narrowness of focus can sometimes
obscure insights.
9. The classic scientific method has its intellectual roots in which of the following?
A) Positivism
B) Determinism
C) Constructivism
D) Empiricism
Ans: A
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Feedback:
In the positivist paradigm, it is assumed that there is an objective reality and that natural
phenomena are regular and orderly. The related assumption of determinism refers to the
belief that phenomena result from prior causes and are not haphazard. In the
constructivist paradigm, it is assumed that reality is not a fixed entity but is rather a
construction of human minds, and thus “truth” is a composite of multiple constructions
of reality. Although the word empiricism has come to be allied with the classic scientific
method, researchers in both traditions gather and analyze evidence empirically, that is,
through their senses.
10. Constructivist qualitative research typically does which of the following?
A) Involves deductive processes
B) Attempts to control the research context to better understand the phenomenon
being studied
C) Involves gathering narrative, subjective materials
D) Focuses on numeric information
Ans: C
Feedback:
In the constructivist paradigm, it is assumed that reality is not a fixed entity but is rather
a construction of human minds, and thus “truth” is a composite of multiple constructions
of reality. In the positivist paradigm, it is assumed that there is an objective reality and
that natural phenomena are regular and orderly. Constructivist researchers emphasize
understanding human experience as it is lived through the collection and analysis of
subjective, narrative materials using flexible procedures; this paradigm is associated
with qualitative research. The other answers are truer of positivist, quantitative research.
11. Quantitative and qualitative research share which of the following features? Select all
that apply.
A) A desire to understand the true state of human affairs
B) An emphasis on formal measurement
C) A reliance on external evidence collected through the senses
D) Utility to the nursing profession
Ans: A, C, D
Feedback:
Both quantitative and qualitative research share a desire to understand the true state of
human affairs, a reliance on external evidence collected through the senses, and utility to
the nursing profession. However, quantitative, not qualitative, research emphasizes
formal measurement.
12. Which of the following is a descriptive question that a qualitative researcher most likely
would ask?
A) What is the nature of this phenomenon?
B) What is the average intensity of this phenomenon?
C) How frequently does this phenomenon occur?
D) What is the average duration of this phenomenon?
Ans: A
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Feedback:
Description of phenomena is an important purpose of research. In descriptive studies,
researchers count, delineate, and classify. Nurse researchers have described a wide
variety of phenomena, such as patients' stress, health beliefs, and so on. Quantitative
description focuses on the prevalence, size, and measurable aspects of phenomena.
Qualitative researchers describe the nature, dimensions, and salience of phenomena
13. A researcher wants to investigate the effect of patients' body position on blood pressure.
The study would most likely be of which type?
A) Qualitative
B) Quantitative
C) Either quantitative or qualitative (researcher preference)
D) Insufficient information to determine
Ans: B
Feedback:
Because this study would involve a measurable, numeric outcome, blood pressure, it
should most likely be a quantitative study.
14. A researcher wants to explore the process by which men make decisions about treatment
for prostate cancer. The researcher's paradigm is most likely which of the following?
A) Positivism
B) Determinism
C) Empiricism
D) Constructivism
Ans: D
Feedback:
As this study involves gathering subjective, non-measurable data, the researcher's
paradigm is most likely constructivism. Positivism is not likely, as there is no emphasis
on an objective, orderly reality. Determinism, which refers to the belief that phenomena
result from prior causes and are not haphazard, is not pertinent here. Although the
research will involve empiricism, or gathering information using the senses, this is not
the primary paradigm.
15. Which of the following would be most strongly associated with cause-probing research?
A) Identification
B) Description
C) Exploration
D) Explanation
Ans: D
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Feedback:
A fundamental distinction that is especially relevant in quantitative research is between
studies whose primary intent is to describe phenomena and those that are cause-probing.
Specific purposes on the description/explanation continuum include identification,
description, exploration, prediction/control and explanation. Many nursing studies can
also be classified in terms of a key EBP aim: therapy/treatment/intervention; diagnosis
and assessment; prognosis; etiology and harm; and meaning and process.
16. Nursing has experienced constant change over the past decades as a result of increased
research. When determining best practices, nursing decisions should do which of the
following? Select all that apply.
A) Be based on tradition
B) Include holistic approaches
C) Be clinically appropriate
D) Be cost effective
Ans: C, D
Feedback:
Nurse leaders recognize the need to base specific nursing decisions on evidence
indicating that the decisions are clinically appropriate, cost-effective, and result in
positive client outcomes. Holistic treatments may be appropriate in some, but not all,
circumstances. Tradition alone is an inadequate basis for practice.
17. Evidenced-based nursing primarily uses which of the following to answer clinical
questions?
A) Consulting an authority
B) Using intuition
C) Obtaining the newest research
D) Relying on experience
Ans: C
Feedback:
Nurses are increasingly expected to understand and undertake research, and to base their
practice on evidence from research, that is, to adopt an evidence-based practice (EBP).
EBP, broadly defined, is the use of the best evidence in making patient care decisions.
Experience, intuition, and authority are not wholly ignored in the EBP process, but
research is a priority.
18. The major difference between quantitative and qualitative research is that qualitative
research seeks to find answers based on which of the following?
A) Solid factual data
B) Experiences or descriptions
C) Etiology
D) Systematic process
Ans: B
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Feedback:
Human experiences, and people's descriptions and interpretations of these experiences,
are the main focus of qualitative research. Systematic process, etiology, and factual data
are more closely aligned with the quantitative tradition.
19. Which of the following research focuses is qualitative?
A) Weekend and night outcomes of patients admitted to a specific hospital system's
trauma departments
B) Trends in hospitalizations of patients with antibiotic-resistant tuberculosis
C) Predicting risks for serious complications with abdominal surgery
D) Needs of nursing students living with chronic illness
Ans: D
Feedback:
Constructivist studies are heavily focused on understanding the human experience as it
is lived, through the careful collection and analysis of qualitative materials that are
narrative and subjective. Human needs, and individuals' perceptions of those needs, are
a common focus of qualitative research. Outcomes, risk factors, and treatment
modalities are often addressed with quantitative research.
20. When little is known about a phenomenon or the phenomenon is not clearly identified,
the best type of research suited to uncover this is which of the following?
A) Exploration
B) Description
C) Identification
D) Prediction
Ans: C
Feedback:
Qualitative researchers sometimes study phenomena about which little is known. In
some cases, so little is known that the phenomenon has yet to be clearly identified or
named or has been inadequately defined. Identification is thus necessary. Exploration
(which addresses causation), predication, and description would likely be subsequent
efforts.
21. Consumers of research do which of the following?
A) Design studies
B) Undertake studies
C) Produce research
D) Read research
Ans: D
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Feedback:
In the current EBP environment, every nurse is likely to engage in one or more activity
along a continuum of research participation. At one end of the continuum are users
(consumers) of nursing research, nurses who read research reports to keep up-to-date on
findings that may affect their practice. EBP depends on well-informed nursing research
consumers. At the other end of the continuum are the producers of nursing research:
nurses who actively design and undertake studies.
22. When nurses rely primarily on tradition, they are most likely to do which of the
following?
A) Produce a precise range of answers
B) Increase new knowledge
C) Maintain an unbiased perspective
D) Undermine effective problem solving
Ans: D
Feedback:
Tradition may undermine effective problem solving. There is growing concern that
many nursing actions are based on tradition, custom, and “unit culture” rather than on
sound evidence. This prevents the acceptance of new knowledge and increases bias and
is unlikely to produce a precise range of answers.
23. A research nurse understands that evidenced-based practice in nursing does which of the
following?
A) Relies on tradition
B) Consults recognized authorities
C) Depends primarily on textbooks
D) Is based on the latest research
Ans: D
Feedback:
EBP prioritizes research findings, which are found primarily in primary sources, such as
journals, rather than in secondary sources, such as textbooks. It is not dependent on
tradition or authority.
24. Non-research-based evidence includes which of the following? Select all that apply.
A) Unit culture
B) Nurse's experience
C) Qualitative studies
D) Trial and error
Ans: C
Feedback:
Clinical reports, experience and beliefs are non-research based sources of evidence,
which are considered to be comparatively weak. Qualitative studies are research-based.
CHAPTER 2
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1. Research utilization is a process that begins with which of the following?
A) A clinical problem that needs to be solved
B) A problem-focused trigger
C) A knowledge-focused trigger or research finding
D) A well-worded clinical question
Ans: C
Feedback:
Research utilization (RU) is the use of findings from disciplined research in a practical
application that is unrelated to the original research. Evidence-based practice is broader
than RU because it integrates research findings with other factors. Several models of
EBP, such as the Iowa Model, have distinguished two types of stimulus (“triggers”) for
an EBP endeavor, (1) problem-focused triggers, the identification of a clinical practice
problem in need of solution, or (2) knowledge-focused triggers, readings in the research
literature. A second catalyst for an EBP project is the research literature, knowledgefocused triggers, which is the origin akin to research utilization.
2. Which of the following is an example of a systematic review?
A) An RCT study published in the journal Nursing Research
B) A meta-analysis from the Cochrane database
C) A synopsis published in Evidence-Based Nursing
D) A clinical practice guideline from the National Guideline Clearinghouse
Ans: B
Feedback:
A meta-analysis is a type of systematic review and a technique for integrating
quantitative research findings statistically. In essence, meta-analysis treats the findings
from a study as one piece of information. The findings from multiple studies on the
same topic are combined and then all of the information is analyzed statistically in a
manner similar to that in a usual study. Unlike systematic reviews, clinical practice
guidelines (which often are based on systematic reviews) give specific
recommendations for evidence-based decision-making. Guideline development typically
involves the consensus of a group of researchers, experts, and clinicians. A randomized
controlled trial (RCT) is an individual study that focuses on the effectiveness of
therapies rather than on broader health-care interventions. Synopses, or summaries, of
systematic reviews and of single studies are available in evidence-based abstract
journals such as Evidence-Based Nursing.
3. Most evidence hierarchies put which of the following at the pinnacle?
A) Randomized clinical trials (RCTs)
B) Systematic reviews of multiple studies
C) Quality improvement projects
D) It depends on the research question
Ans: B
Feedback:
In all evidence hierarchies that include randomized clinical trials, quality improvement
projects and research questions, systematic reviews are at the pinnacle.
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4. Which of the following can be used to critically appraise clinical practice guidelines?
A) A systematic review from the Cochrane Collaboration
B) The Iowa model
C) The AGREE instrument
D) An evidence hierarchy
Ans: C
Feedback:
Evidence-based clinical practice guidelines distill a body of evidence into a usable form.
Unlike systematic reviews, clinical practice guidelines, which often are based on
systematic reviews, give specific recommendations for evidence-based decisionmaking. Several appraisal instruments are available to evaluate clinical practice
guidelines, but one with broad support is the Appraisal of Guidelines Research and
Evaluation (AGREE) Instrument. The Iowa model is used in selecting a problem for an
institutional evidence-based project. An evidence hierarchy is a tool for ranking
evidence sources according to the strength of the evidence they provide.
5. Which of the following models was explicitly developed with the idea that individual
nurses could engage in RU-type activities?
A) Iowa Model
B) Johns Hopkins Model
C) Cochrane Model
D) Stetler Model
Ans: D
Feedback:
Some models focus on the use of research from the perspective of individual clinicians
such as the Stetler Model, one of the oldest models that originated as an RU model, but
most focus on institutional EBP efforts such as the John Hopkins Nursing EBP Model
and the Iowa Model. There is no Cochrane Model; the Cochrane Collaboration is an
organization that prepares, maintains, and promotes the accessibility of systematic
reviews.
6. In the following clinical question, what is the Outcome (O component): What is the
effect of relaxation therapy versus biofeedback on the functional ability of patients with
rheumatoid arthritis?
A) Functional ability
B) Rheumatoid arthritis
C) Biofeedback
D) Relaxation therapy
Ans: A
Feedback:
In the PIO acronym, P stands for the population or patients (rheumatoid arthritis); I
stands for the intervention, influence, or exposure (biofeedback or relaxation therapy);
and O stands for the outcomes (functional ability).
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7. In the following clinical question, what is the Intervention/influence/exposure (I
component): Does taking antidepressants affect the risk of suicide in cognitively
impaired adolescents?
A) Adolescence
B) Suicide
C) Antidepressant use
D) Cognitive impairment
Ans: C
Feedback:
In the PIO acronym, P stands for the population or patients (cognitively impaired
individuals); I stands for the intervention, influence, or exposure (antidepressants); and
O stands for the outcomes (risk of suicide).
8. In the following clinical question, what is the Population (P component): Do stress and
depression affect dyspnea in patients with chronic obstructive pulmonary disease
(COPD)?
A) Patients who are stressed
B) Patients who are depressed
C) Patients who experience dyspnea
D) Patients with COPD
Ans: D
Feedback:
In the PIO acronym, P stands for the population or patients (patients with chronic
obstructive pulmonary disease); I stands for the intervention, influence, or exposure
(stress and depression); and O stands for the outcomes (dyspnea).
9. In the following clinical question, what is the Comparison (C component): Does
chronic stress affect inflammatory responses in older men with atherosclerotic disease?
A) Chronic stress
B) Inflammatory response
C) Atherosclerotic disease
D) There is no “C” component
Ans: D
Feedback:
In the PICO acronym, P stands for the population or patients (older men with
atherosclerotic disease); I stands for the intervention, influence, or exposure (chronic
stress); C stands for the component that is needed (there is no intervention or influence
of interest contrasted with a specific alternative); and O stands for the outcomes
(inflammatory response).
10. In which of the following clinical questions is fatigue the “I” component?
A) Does fatigue affect agitation in cognitively impaired elders?
B) Does a physical activity intervention affect fatigue in patients undergoing cardiac
rehabilitation?
C) What is the meaning of fatigue among patients with sleep apnea?
D) Does the level of depression of patients suffering from chronic fatigue improve by
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participating in an exercise intervention?
Ans: A
Feedback:
Fatigue is the “I” component (intervention, influence, or exposure) in the question,
“Does fatigue affect agitation in cognitively impaired elders?” In the other answers,
fatigue is one of the other components.
11. Which of the following is a question that would be asked as part of the process of
appraising research evidence?
A) What are the P, I, and O components?
B) How rigorous and reliable is the evidence?
C) What type of trigger should I use?
D) Is a relevant systematic review available?
Ans: B
Feedback:
Individual nurses have opportunities to put research into practice. The five basic steps
for individual EBP are: (1) asking an answerable clinical question as evidenced by,
“What are the P, I, and O components?” (2) searching for relevant research-based
evidence as evidenced by, “Is a relevant systematic review available?” (3) appraising
and synthesizing the evidence as evidenced by, “How rigorous and reliable is the
evidence?” Triggers for an organizational project include both pressing clinical
problems (problem-focused) and existing knowledge (knowledge-focused) such as asked
by the question, “What type of trigger would I use?”
12. Which of the following activities is part of an organizational -but not an individual- EBP
endeavor?
A) Asking a good question/identifying a problem
B) Searching for evidence
C) Assessing implementation potential
D) Synthesizing and appraising evidence
Ans: C
Feedback:
EBP in an organizational context involves many of the same steps as individual EBP
efforts, but is more formalized and must take organizational factors into account.
Triggers for an organizational project include both pressing clinical problems (problemfocused) and existing knowledge (knowledge-focused), such as assessing
implementation potential. Individual nurses have opportunities to put research into
practice. The five basic steps for individual EBP are: (1) asking an answerable clinical
question; (2) searching for relevant research-based evidence; (3) appraising and
synthesizing the evidence; (4) Integrating the evidence with your own clinical expertise,
patient preferences, and local context; (5) Assessing the effectiveness of the decision,
intervention, or advice.
13. Asking a clinical question is the first step in evidence-based practice. What are the four
components of a PICO clinical question?
A) Population, implication, comparison, outcome
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B) Population, intervention, clinical, outcome
C) Population, intervention, comparison, outcome
D) Population, implication, clinical, outcome
Ans: C
Feedback:
A crucial first step in evidence-based practice (EBP) involves asking relevant clinical
questions that reflect uncertainties in clinical practice. Most guidelines for EBP use the
acronyms PIO or PICO to help practitioners develop well-worded questions that
facilitate a search for evidence. In the acronym PIO, the P stands for population or
patients; the I stands for intervention; and the O stands for outcome. The acronym PICO
includes these same three components plus a fourth, C, which stands for comparison.
14. Which following level of evidence includes systematic reviews of multiple studies?
A) Level IV
B) Level III
C) Level II
D) Level I
Ans: D
Feedback:
Systematic reviews are at the pinnacle of the hierarchy (Level I), because the strongest
evidence comes from careful syntheses of multiple studies. The next highest level
(Level II) includes individual randomized controlled trials (RCTs). Going down the
“rungs” of the evidence hierarchy for Therapy questions results in less reliable evidence,
for example, Level III evidence comes from a type of study called quasi-experiment. Indepth qualitative studies are near the bottom, in terms of evidence regarding
intervention effectiveness.
15. A nurse in the United States is scheduled to care for a child with an ostomy. Which of
the following resource would best assist the nurse with specific guidelines for evidencebased decision making for this patient?
A) MEDLINE
B) TRIP
C) www.guidelines.gov
D) www.rnao.org/bestpractices
Ans: C
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Feedback:
Finding clinical practice guidelines can be challenging, because there is no single
guideline repository. A standard search in bibliographic databases such as MEDLINE
will yield many references, but could yield a mixture of citations to not only the actual
guidelines, but also to commentaries, implementation studies, and so on.
A recommended approach is to search in guideline databases, or through specialty
organizations that have sponsored guideline development. In the United States, nursing
and health-care guidelines are maintained by the National Guideline Clearinghouse
(www.guideline.gov). In Canada, the Registered Nurses Association of Ontario (RNAO)
(www.rnao.org/bestpractices) maintains information about clinical practice guidelines.
Two sources in the United Kingdom are the Translating Research into Practice (TRIP)
database and the National Institute for Clinical Excellence (NICE).
16. Which of following study types is a systematic review used for integration of statistical
quantitative research findings?
A) Meta-synthesis
B) Meta-analysis
C) Randomized controlled trial
D) Quasi-experiment
Ans: B
Feedback:
Systematic reviews can take various forms. One form is a narrative (qualitative)
integration that merges and synthesizes findings, much like a rigorous literature review.
For integrating evidence from quantitative studies, narrative reviews increasingly are
being replaced by a type of systematic review known as a meta-analysis. Meta-analysis
is a technique for integrating quantitative research findings statistically. For qualitative
studies, integration may take the form of a meta-synthesis. A meta-synthesis, however,
is distinct from a quantitative meta-analysis: a meta-synthesis is less about reducing
information and more about interpreting it. Randomized controlled trials and quasiexperiments are not types of systematic reviews.
17. The best-known early research utilization (RU) project sought to bridge the gap between
research and practice. Which following is the name of that well-known project?
A) Cochrane Collaboration
B) Stetler Model of Research Utilization
C) Conduct and Utilization of Research in Nursing (CURN) Project
D) Promoting Action on Research Implementation in Health Services
Ans: C
Feedback:
Recognition of the gap between research and practice led to formal attempts to bridge
the gap. The best-known of several early RU projects is the Conduct and Utilization of
Research in Nursing (CURN) Project, which was awarded to the Michigan Nurses'
Association by the Division of Nursing in the 1970s. The Stetler Model of Research
Utilization and Promoting Action on Research Implementation in Health Services are
evidence-based practice models, not projects. One keystone of the EBP movement is the
Cochrane Collaboration, which was founded in the United Kingdom based on work by
British epidemiologist Archie Cochrane. It is not a research utilization project.
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18. The Iowa Model identifies problem-focused triggers for implementing an EBP project.
Which of the following is a problem-focused trigger in the Iowa Model?
A) A finding published recently in a nursing journal
B) A new clinical guideline issued by a federal agency
C) An increase in latex allergy among emergency room nurses
D) Questions from hospital committee
Ans: C
Feedback:
Several models of EBP, such as the Iowa Model, have distinguished two types of
stimulus (“triggers”) for an EBP endeavor, (1) problem-focused triggers, the
identification of a clinical practice problem in need of solution, or (2) knowledgefocused triggers, readings in the research literature. A second catalyst for an EBP project
is the research literature, knowledge-focused triggers, which is the origin akin to
research utilization. The catalyst might be a new clinical guideline or a research article
discussed in a journal club.
19. As a nurse, you must understand the difference between research utilization and
evidence-based nursing practice. Which of the following best defines evidence-based
practice?
A) Begins with research itself, clinical expertise, and patient preference
B) Uses new evidence and translates research findings into real-world applications
C) Uses findings from disciplined research in practical application unrelated to
original research
D) Integrates best research evidence, with clinical expertise, patient preference, and a
particular clinical situation
Ans: D
Feedback:
Advocates of EBP do not minimize the importance of clinical expertise. Rather, they
argue that evidence-based decision-making should integrate best research evidence with
clinical expertise, patient preferences, and local circumstances. Research utilization
(RU) is the use of findings from disciplined research in a practical application that is
unrelated to the original research. In research utilization, the emphasis is on translating
research findings into real-world applications. The starting point in RU is new evidence
or a research-based innovation. EBP is broader than RU because it integrates research
findings with other factors. Whereas RU begins with the research itself (how can I put
this innovation to good use in my clinical setting?), EBP starts with a clinical question
(what does the evidence say is the best approach to solving this problem?).
20. Some EBP models recommend a formal assessment of organizational “fit”, known as
implementation potential, when an organization is considering undertaking an EBP
project. Which following issue is of particular importance to address to determine the
implementation potential of the EBP project for the organization?
A) Effectiveness of the innovation
B) Nurses' attitude toward the innovation
C) Patient benefit of the innovation
D) Transferability of the innovation
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Ans: D
Feedback:
Some EBP models recommend a formal assessment of organizational “fit,” often called
implementation potential (or, environmental readiness). In determining the
implementation potential of an innovation in a particular setting, several issues should
be considered, particularly the transferability of the innovation (i.e., the extent to which
the innovation might be appropriate in new settings), the feasibility of implementing it,
and its cost-benefit ratio.
21. A nurse is observing how the time of feeding impacts an inpatient's gastric reflux. In
which of the following steps of the EBP process would the nurse determine whether a
specific feeding time alleviated the patient's gastric reflux symptoms?
A) Searching for and collecting evidence that addresses the question
B) Appraising and synthesizing the evidence
C) Integrating the evidence with own clinical expertise, patient preferences, and local
context
D) Assessing the effectiveness of the decision, intervention, or advice
Ans: D
Feedback:
It would be during step 5 of the EBP process, assessing the effectiveness of the decision,
intervention, or advice, that the nurse would determine whether a specific feeding time
(an intervention) is effective in alleviating the patient's gastric reflux symptoms.
22. After an institutional project has been developed, the next step is to conduct a pilot
study (a trial study). Based on the Iowa Model, which step would identify the success or
failure of a pilot study?
A) Developing an evaluation plan
B) Measuring client outcomes prior to implementation
C) Training relevant staff in the use of the new guideline
D) Evaluating the project in terms of both the process and the outcomes [Show Less]