Nursing Leadership and Management 2nd Edition Kelly Test Bank

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Chapter 3-EVIDENCE-BASED PRACTICE

MULTIPLE CHOICE

1. At which university’s school of medicine was the term evidence-based medicine first coined?
a. Johns Hopkins University
b. University of Toronto
c. McMaster University
d. Oxford University
ANS: C
RAT: The term evidenced-based medicine was first used in the 1970s to refer to a clinical learning
model used by the McMaster University School of Medicine. In the 1980s the term was used to refer
to movement in medical practice. David Sackett along with educators and researchers at Oxford
University encouraged the concept of evidence-based medicine as a way to integrate clinical
experience with the best available research evidence using a systematic approach to guide clinical
decision making.

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2. Which other two terms does the term evidence-based practice encompass?
a. evidence-based medicine and the clinical setting
b. evidence-based medicine and evidenced-based care
c. guidelines and care plans
d. research utilization and practice
ANS: B
RAT: Evidence-based practice is a more inclusive and neutral term that incorporates evidence-based
medicine with evidenced-based care. Research utilization is just one factor in evidence-based practice.
The clinical setting and client circumstances are two factors considered in evidenced-based practice.
Guidelines and care plans are based on the best research evidence and developed with consideration
for local values and resources.

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3. Which term refers to research on the safety and effectiveness of nursing interventions?
a. clinical expertise evidence
b. best research evidence
c. evidence-based research
d. clinical interventions data
ANS: B
RAT: Best research evidence refers to research that is methodologically sound on a range of clinically
relevant elements such as safety and effectiveness of nursing interventions; accuracy and precision of
nursing assessment measures; the power of prognostic markers; the strength of causal relationships;
cost-effectiveness of nursing interventions; and the meaning of illness and client experiences. Clinical
expertise refers to our ability to use clinical skills and experiences to assess clients, teach clients and
families, implement interventions, and ensure a supportive and comforting environment
Evidence-based clinical interventions are important as a way of predicting clinical outcomes and as a
basis of care within institutions.

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4. Which observation about the actual implementation of evidenced-based practice is often true in
practice?
a. A large portion of clinical practice in medicine is not supported by research.
b. Most clinical practice is evidence based.
c. Research evidence has replaced traditional practices in health care.
d. A large portion of nursing practice is not supported by research.
ANS: A
RAT: In spite of an increasing focus on evidence based practice much of clinical practice is still not
supported by research, and there is concern about the length of time it takes new knowledge created by
research to find its way into daily clinical practice. Many within nursing believe that nursing is likely
in the same position.

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5. Which of the following is an example of a government-funded project to examine nursing-sensitive

client outcomes?
a. the Evidenced-Based Nursing Study
b. the Ontario Nursing Task Force
c. the Nursing and Health Outcomes Project
d. the Best Nursing Practice Project
ANS: C
RAT: In 1998 the Ontario government created the Ontario Nursing Task Force to examine the impact
of health reform on nursing. One outcome was the creation of the Nursing and Health Outcomes
Project whose mandate was examine nurse-sensitive client outcomes, determine outcome measures,
and specify the databases on which outcomes could be housed. The scope of this project was later
expanded and the project renamed Health Outcomes for Better Information and Care.

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6. Which of the following is an evidenced-based nursing program or initiative in Canada?

a. Joanna Briggs Evidence Based Nursing and Midwifery
b. Sara Cole Hirsch Institute for Best Nursing Practice Based on Evidence
c. Nursing Health Services Research Unit
d. The University of York Centre for Evidenced Based Nursing
ANS: C
RAT: Canada the Universities of Toronto and McMaster University received provincial funding for
the forerunner of the Nursing Health Services Research Unit. The Joanna Briggs Evidence Based
Nursing and Midwifery was established in Australia and in the United States the Sara Cole Hirsch
Institute for Best Nursing Practice Based on Evidence was established in 1998. In Britain, The
University of York has established a centre for evidenced-based nursing

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7. Despite the importance of evidence-based medicine, many physicians have been concerned that it may
most devalue which of the following factors?
a. individual preference
b. clinical expertise
c. continuing education
d. the art of clinical medicine
ANS: D
RAT: Tracy (2003) observed that it has taken physicians almost 20 years to accept that evidence-based
practice does not devalue the “art” of clinical medicine. Evidence-based practice also acknowledges
the importance of balancing current evidence with clinical expertise, individual preference, and local
availability.

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8. Which of these factors does evidence-based medicine and practice integrate with the best external
evidence and individual clinical expertise?
a. RTCs
b. current practice
c. client choice
d. physician preferences
ANS: C
RAT: Evidence-based practice requires a bottom up approach that integrates client choice with clinical
expertise and research evidence so as to not result in a cookbook approach to client care. Clinical
expertise is critical for determining whether the external evidence applies to the individual client and
how it should be applied.

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9. Some concerns about evidence-based practice expressed by nurses and other health professionals
include which of the following statements?
a. It requires additional education.
b. It requires additional time and resources.
c. It is difficult to implement.
d. It ignores client preferences and values.
ANS: D
RAT: Nurses and other health professionals have some concerns that evidence-based practice may not
always take into account client preferences and values, that it is outside of a theoretical base, and that it
overemphasizes quantitative research and randomized control trials.

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10. What does the term EPC stand for in relation to health care research?
a. evidence-based care
b. evidence-based practice and collaboration
c. evidence-based practice centres
d. evidence-based consultations
ANS: C
RAT: Evidence-based practice centres (EPCs) were first established in 1997 in the United States by
the U.S. Agency for Healthcare Research and Quality. There are now 13 EPCs: 10 are located
throughout the U.S. and 3 are located in Canada in Edmonton, Ottawa, and Hamilton.

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11. Which type of evidence is used by nursing administrators to inform their decision-making?
a. quasi-experimental studies
b. organization evidence
c. political evidence
d. qualitative research evidence
ANS: B
RAT: Nursing administrators use organization evidence to help them make administrative decisions.
Organizational evidence comes from outside the scientific realm and includes information such as
financial reports and program evaluations. Political evidence refers to systematically collected
information about how various stakeholders will respond to policy decisions.

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12. What is the purpose of the nursing research chairs established across Canada?
a. to promote evidence-based practice
b. to promote the nursing profession
c. to examine nursing practice and resources, and develop knowledge transfer strategies
d. to fund nursing research
ANS: C
RAT: A number of nursing research chairs have been established across Canada funded jointly by the
Canadian Institute for Health Research and the Canadian Health Services Research Foundation. The
purpose of the chairs is to set up research programs to examine nursing practice, nursing resources,
and strategies for transferring into policy and practice.

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13. Which of these information sources provides nurses with up-to-the-moment clinical information that
warrants immediate attention?
a. Evidenced-Based Nursing
b. Clinical Nursing Research
c. Canadian Journal of Nursing Leadership
d. Worldwide Nursing
ANS: A
RAT: Evidence-Based Nursing aims to assist busy practitioners by scanning articles from the research
literature and selecting those that warrant immediate attention by practicing nurses. The selections
include an appraisal of the research, a summary of the published article, and comments from clinical
experts.

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14. What is the term for the systematic review of international medical research literature that was started
by a British epidemiologist?
a. the McMaster Library
b. the Cochrane Database
c. Online Journal of Knowledge Synthesis
d. the Cochrane Library
ANS: D
RAT: The Cochrane Library, formally known as the Cochrane Collaboration, is an international
organization that prepares, maintains, and promotes accessibility of systematic reviews of the evidence
related to health care interventions. The Canadian Cochrane Centre at McMaster University was
established in 1993. The Cochrane Library contains over 400 nursing-related reviews.

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15. In researching a focused clinical question, what type of source would provide an appraisal of
comprehensive current evidence?
a. synthesis
b. a systematic review
c. a database
d. narrative review
ANS: B
RAT: A systematic review will provide study selection; appraisal; data extraction and analysis.
Systematic reviews start with an identification of a focused question and proceed through the
comprehensive literature search, selection of studies based on predetermined inclusion criteria,
assessment of the research methodology, extraction and synthesis of the data, and presentation of
conclusions. A traditional narrative review is similar but usually deals with a broader question, utilizes
a less comprehensive literature review, and it may extend results and recommendations beyond the
specific data.

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Nursing Leadership and Management 2nd Edition Kelly Test Bank
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16. Which of the following defines the term meta-analysis?

a. a statistical technique to compare results of different studies
b. an evaluation of a large number of similar studies
c. an overview of related research studies
d. a statistical technique for pooling results of multiple studies measuring the same outcome
ANS: D
RAT: Meta-analysis is a statistical technique for quantitatively gathering the results of multiple studies
that measure the same outcomes. The results are then summarized or combined into a single pooled
estimate.

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17. Which of the following is referred to by the acronym KTE?

a. Knowledge Transfer and Exchange
b. Knowledge Terms and Education
c. Knowledge Technology and Education
d. Knowledge Transfer and Effect
ANS: A
RAT: KTE stands for an approach to knowledge dissemination known as Knowledge Transfer and
Exchange. KTE is based on the assumption that decision-makers are more likely to use research results
if they are included in the process and have input into the identifying research questions.

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18. What is the purpose of the Canadian Health Services Research Foundation (CHSRF)?
a. to promote the development of evidence-based care
b. to bridge the gap between research and health care management and policy
c. to conduct primary research
d. to provide funding for research
ANS: B
RAT: The Canadian Health Services Research Foundation was established in 1997 to “support the
evidence-informed management of Canada’s healthcare system by facilitating knowledge transfer and
exchange—bridging the gap between research and healthcare management and policy.”

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