Chapter 2--Clinical Decision Making and Evidence-Based Practice

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Chapter 2--Clinical Decision Making and Evidence-Based Practice MULTIPLE CHOICE 1. The nurse is implementing evidence-based practice. Which of the following is not a component of this process? ... 1. Patient preference 2. Clinical expertise 3. Research evidence 4. Leader practice PTS: 1 DIF: Analyze REF: The Process of EBP 2. The nurse is planning the care for a client using an unstructured approach. Which of the following approaches did the nurse most likely use? 1. Research 2. Trial and error 3. Nursing theory 4. Validated order PTS: 1 DIF: Analyze REF: Knowledge Bases for Clinical Decisions 3. The nurse is participating in an activity that is the first step of the ACE Star Model of Knowledge Transformation. Which of the following is the nurse doing? 1. Creating evidence summaries 2. Evaluating outcomes 3. Integrating findings into practice 4. Participating in research . PTS: 1 DIF: Analyze REF: EBP in Nursing 4. A committee has been developed to implement knowledge transformation when providing client care. The members realize that the purpose of knowledge transformation is to: 1. reduce length of stay. 2. convert research findings to impact health outcomes. 3. reduce the cost of care. 4. increase the number of patients with health insurance. PTS: 1 DIF: Analyze REF: Definition of Knowledge Transformation 5. An advance practice nurse is being consulted to participate during the translation phase of the ACE Star Model of Knowledge Transformation. During this phase, which of the following will the nurse create? 1. Standardized care plans 2. Critical pathways 3. Clinical practice guidelines 4. Checklists to streamline documentation PTS: 1 DIF: Apply REF: Star Point 3: Translation 6. The nurse leaders of a health care organization are creating plans to change clinical and organizational practices to support evidence-based practice. Which phase of the ACE Star Model of Knowledge Transformation are the leaders implementing? 1. Integration 2. Evaluation 3. Translation 4. Evidence summaries PTS: 1 DIF: Apply REF: Star Point 4: Integration 7. The advance practice nurse is writing clinical practice guidelines. Prior to writing these guidelines which of the following will the nurse need? 1. Current client census 2. Evidence summaries 3. Nursing department budget 4. Staffing ratios PTS: 1 DIF: Apply REF: Evidence Summaries 8. The nurse is writing a systematic review. After the nurse formulates questions and locates relevant studies, the nurse thing the nurse will do is: 1. update the reviews. 2. interpret the findings. 3. summarize and synthesize results. 4. select and appraise the studies. PTS: 1 DIF: Apply REF: Method for Producing Systematic Reviews 9. The nurse is using the scale for rating the strength of research evidence for one research article for potential inclusion in a clinical practice guideline. Which of the following is considered the strongest evidence? 1. Individual cohort study 2. Meta-analysis of randomized clinical trials 3. Expert opinion 4. Case studies PTS: 1 DIF: Analyze REF: Table 2-1 Scale for Rating the Strength of Research Evidence 10. The nurse is considering a research study for inclusion in a clinical practice guideline that has been identified as being sufficient to determine effects on health outcomes. This research study would be considered as being: 1. fair. 2. passable. 3. poor. 4. good. PTS: 1 DIF: Analyze REF: Table 2-2 Scale for Rating the Quality of Research Evidence 11. The nurse is reviewing evidence-based clinical practice guidelines to use when planning care for a client. One guideline has been graded by the U.S. Preventive Services Task Force as being an A. According to this grade, the nurse should do which of the following? 1. Do not use this guideline because the harm outweighs the benefits. 2. Do not use this guideline because the benefits and harms cannot be determined. 3. Use this guideline because the benefit is substantial. 4. Use this guideline but understand that the net benefit to the client is small. PTS: 1 DIF: Apply REF: Box 2-6 Strength of Recommendations from the U.S. Preventive Services Task Force 12. The nurse identifies errors and hazards in a care environment and implements basic safety to reduce the likelihood of an adverse event. Which of the following core competencies is this nurse implementing? 1. Provide patient-centered care 2. Apply quality improvement 3. Employ evidence-based practice 4. Utilize informatics PTS: 1 DIF: Apply REF: Box 2-1 Core Competencies for Health Professions 13. The nurse is participating on a committee to select evidence-based practice guidelines.Which of the following statements by the nurse indicate a clear understanding of the purpose of these guidelines? 1. “They provide the best evidence to make decisions about the care of individual clients.” 2. “They promote changes in client care according to a research study. 3. “They ensure cost-effective care to the client.” 4. “They identify safe staffing ratios for client care.” PTS: 1 DIF: Analyze REF: The Process of EBP MULTIPLE RESPONSE 1. The nurse is determining the best way to ensure adherence to the core competencies for health professions. Which of the following competencies will the nurse implement when providing client care? (Select all that apply.) 1. Work in interdisciplinary teams 2. Utilize informatics 3. Implement basic safety principles 4. Employ evidence-based practice 5. Apply quality improvement 6. Provide patient-centered care PTS: 1 DIF: Apply REF: Box 2-1 Core Competencies for Health Professions. 2. There are impediments that make the practice of evidence-based practice difficult. Which of the following are impediments to evidence-based practice? (Select all that apply.) 1. Complexity of science and technology 2. Difficulty of nowledge transformation 3. Variety of knowledge forms 4. Number of patient diagnoses 5. Evidence summary 6. Application of quality improvement PTS: 1 DIF: Apply REF: Applying Evidence-Based Concept 3. The nurse identifyies evidence summaries for evidence-based practice. Which of the following are references to types of evidence summaries? (Select all that apply.) 1. Review of literature 2. Evidence synthesis 3. Authentication review 4. Systematic reviews 5. Integrative reviews 6. Substantiation evidence PTS: 1 DIF: Apply REF: Star Point 2: Evidence Summary 4. A health care organization is determining which clinical practice guidelines to adopt when providing client care. The organization is using the AGREE Instrument for Assessing Guidelines because this checklist helps the organization determine which of the following? (Select all that apply.) 1. Scope and purpose 2. Stakeholder involvement 3. Rigor of development 4. Clarity and presentation 5. Author credentials 6. Application PTS: 1 DIF: Analyze REF: Clinical Practice Guidelines 5. The nurse is participating in a committee to address the Institute of Medicine’s priority areas for quality improvement. Which of the following are considered priority areas? (Select all that apply.) 1. Diabetes 2. End-of-life organ failures 3. Motor vehicle accidents 4. Scoliosis 5. Tobacco dependence 6. Major depression PTS: 1 DIF: Analyze REF: Box 2-7 IOM-Priority Areas for National Action [Show More]

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