NCLEX - W4 - Evidenced-Based Practice

Question 1

A nurse is caring for a patient who is experiencing pain. The nurse wants to find the best evidence for pain management. Which of the following is the most appropriate first step?
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a. Ask the doctor for a pain medication order.
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b. Formulate a searchable question using the PICOT format.
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c. Search the internet for pain management techniques.
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d. Ask the patient what has worked for them in the past.

Answer 1

b. Formulate a searchable question using the PICOT format.

Rationale: Formulating a searchable question using the PICOT format helps to narrow the search and find the most relevant evidence.
The PICOT format stands for:

• P: Patient or Problem
• I: Intervention
• C: Comparison intervention
• O: Outcome
• T: Time

Question 2

A nurse is reading a research article and is evaluating the quality of the study. The nurse notes that the researcher’s qualifications are not related to the study topic. This raises concerns about which aspect of the study?
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a. Validity
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b. Reliability
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c. Authority
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d. Feasibility

Answer 2

c. Authority

Rationale:
When evaluating a research article, it is important to consider the authority of the researcher.
If the researcher is not an expert on the study topic, it raises concerns about the quality of the research.

Question 3

A nurse is trying to implement an evidence-based practice change on the unit. Which of the following is an example of a barrier to change?
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a. Support from the nurse manager.
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b. Adequate funding for the project.
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c. Resistance from staff nurses.
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d. A clear and concise plan for implementation.

Answer 3

c. Resistance from staff nurses.

Rationale:
Resistance to change is a common barrier to implementing evidence-based practice. Nurses may be resistant to change for a variety of reasons, including lack of time, fear of the unknown, or lack of belief in the evidence.

Question 4

Which of the following research designs is most appropriate for studying the lived experiences of patients with chronic illness?
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a. Experimental
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b. Correlational
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c. Qualitative
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d. Quantitative

Answer 4

c. Qualitative

Rationale:
Qualitative research is best suited for exploring subjective experiences and gaining in-depth understanding of complex phenomena, making it appropriate for studying the lived experiences of patients with chronic illness.

Question 5

Which of the following is a characteristic of a strong research article?
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a. Published in a popular magazine.
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b. Based on the opinions of experts.
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c. More than 10 years old.
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d. Peer-reviewed.

Answer 5

d. Peer-reviewed.

Rationale: A strong research article is typically published in a peer-reviewed journal. This means that the article has been reviewed by other experts in the field to ensure that it is of high quality.

Question 6

What is the purpose of the PICOT format in evidence-based practice?
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a. To summarize the findings of a research study.
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b. To develop a searchable question.
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c. To evaluate the quality of evidence.
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d. To implement a practice change.

Answer 6

b. To develop a searchable question.

Rationale:
PICOT is a framework for formulating a clinical question that is searchable and answerable through research, guiding the search for relevant evidence.

Question 7

A nurse is conducting a literature review on the effectiveness of a new wound dressing. The nurse wants to find the highest level of evidence. Which of the following sources should the nurse prioritize?
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a. Textbooks.
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b. Case reports.
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c. Systematic reviews of randomized controlled trials (RCTs).
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d. Opinion articles.

Answer 7

c. Systematic reviews of randomized controlled trials (RCTs).

Rationale: Systematic reviews of RCTs are considered the highest level of evidence in medical research, as they synthesize findings from multiple well-designed studies, minimizing bias and providing robust conclusions.

Question 8

Which of the following is an example of a quantitative research question?
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a. What are the experiences of nurses who work in intensive care units?
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b. What is the relationship between pain medication dosage and patient satisfaction?
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c. How do patients perceive the quality of nursing care?
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d. What are the cultural beliefs about pain management?

Answer 8

b. What is the relationship between pain medication dosage and patient satisfaction?

Rationale: A quantitative research question seeks to measure and analyze relationships between variables using numerical data, like the relationship between pain medication dosage and patient satisfaction.

Question 9

A nurse researcher is studying the effects of a new medication on patient anxiety levels. The researcher randomly assigns patients to either the control group or the experimental group. What is the purpose of random assignment in this study?
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a. To ensure that the groups are as similar as possible.
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b. To ensure that all patients receive the medication.
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c. To eliminate bias from the researcher.
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d. To make the study more generalizable.

Answer 9

a. To ensure that the groups are as similar as possible.

Rationale:
Random assignment aims to distribute potential confounding factors evenly between the control and experimental groups, minimizing the risk of these factors influencing the study results and increasing confidence that observed differences are due to the intervention.

Question 10

A nurse is caring for a patient who has just been diagnosed with cancer. The patient is feeling overwhelmed and anxious. Which of the following nursing interventions is most consistent with Watson’s theory of human caring?

a. Provide the patient with a pamphlet on cancer treatment options.
b. Administer the patient’s pain medication as ordered.
c. Sit with the patient and listen to their fears and concerns.
d. Delegate the task of emotional support to the chaplain.

Answer 10

c. Sit with the patient and listen to their fears and concerns.

Rationale:
Watson’s theory of caring emphasizes the importance of establishing a caring relationship with the patient and providing holistic care that addresses their physical, emotional, and spiritual needs.
Sitting with the patient and actively listening demonstrates presence and empathy, key components of Watson’s theory.

Question 11

A nurse is providing discharge teaching to a patient who is going home after surgery. The nurse is using the teach-back method to evaluate the patient’s understanding of the instructions. Which level of nursing knowledge is the nurse primarily using in this situation?
* a. Theoretical knowledge
* b. Practical knowledge
* c. Ethical knowledge
* d. Self-knowledge

Answer 11

• b. Practical knowledge

Rationale:
Practical knowledge encompasses the skills and procedures necessary for effective nursing care, which includes using teaching strategies like the teach-back method to ensure patient understanding.

Question 12

A nurse is caring for a patient who has a central venous catheter (CVC). The nurse is aware that central line-associated bloodstream infections (CLABSIs) are a significant risk for patients with CVCs. Which of the following is the most appropriate way for the nurse to prevent CLABSIs?

• a. Ask the doctor to order prophylactic antibiotics.
• b. Follow evidence-based guidelines for CVC care.
• c. Change the CVC dressing every day.
• d. Flush the CVC with heparin every shift.

Answer 12

• b. Follow evidence-based guidelines for CVC care.

Rationale:
Evidence-based guidelines provide specific recommendations for CVC care based on research findings, offering the most reliable approach to minimizing infection risk.

Question 13

A nurse manager wants to improve patient satisfaction on the unit. The manager decides to implement a new rounding procedure based on evidence from a recent nursing research study. What phase of the research process is the manager currently in?

• a. Selecting and defining the problem.
• b. Selecting a research design.
• c. Collecting data.
• d. Using the research findings.

Answer 13

• d. Using the research findings.

Rationale: The nurse manager is putting the research findings into practice, demonstrating the application of research to real-world healthcare settings.

Question 14

What is the primary role of an Institutional Review Board (IRB)?

• a. To conduct research studies.
• b. To publish research findings.
• c. To protect the rights of human subjects in research.
• d. To provide funding for research studies.

Answer 14

• c. To protect the rights of human subjects in research.

Rationale:
The IRB reviews research proposals involving human subjects to ensure ethical treatment, informed consent, and that potential risks to participants are minimized.

Question 15

Which of the following is an example of a nursing theory that can guide nursing practice?

• a. Theory of relativity.
• b. Orem’s Self-Care Deficit Theory.
• c. Maslow’s Hierarchy of Needs.
• d. Piaget’s Theory of Cognitive Development.

Answer 15

• b. Orem’s Self-Care Deficit Theory.

Rationale:
While the other options are valuable theories, only Orem’s theory is a nursing theory.
It focuses on identifying and addressing self-care deficits in patients, providing a framework for planning nursing interventions to enhance patient autonomy and well-being.

Question 16

A nurse is caring for a patient who is experiencing anxiety related to an upcoming surgical procedure. Using Maslow’s Hierarchy of Needs, which of the following nursing actions should be prioritized?

• a. Teaching the patient about the surgical procedure.
• b. Administering pain medication for the patient’s headache.
• c. Assisting the patient with ambulation to the bathroom.
• d. Encouraging the patient to express their feelings.

Answer 16

• b. Administering pain medication for the patient’s headache.

Rationale: Based on Maslow’s Hierarchy, physiological needs like pain relief are fundamental and need to be addressed before higher-level needs such as education or emotional expression can be effectively met.

Question 17

A nurse is interested in understanding how patients perceive the quality of care they receive on the unit. Which type of research method is most appropriate for this research question?

• a. Correlational research
• b. Experimental research
• c. Qualitative research
• d. Quantitative research

Answer 17

• c. Qualitative research

Rationale: Qualitative research aims to understand subjective experiences and perceptions, making it suitable for exploring patient perspectives on care quality through interviews or focus groups.

Question 18

A nurse is evaluating a research article and notices that the sample size is very small. What is a potential limitation of a small sample size?

• a. The study is more likely to be reliable. * b. The study’s findings may not be generalizable.
• c. The study is more likely to be valid.
• d. The study is easier to conduct.

Answer 18

• b. The study’s findings may not be generalizable.

Rationale: A small sample size may not adequately represent the population of interest, limiting the ability to confidently generalize the study results to a larger group.

Question 19

A nurse is participating in a research study on the effectiveness of a new intervention for preventing pressure injuries. The nurse is responsible for collecting data from patients in the experimental group. What is an important ethical consideration for the nurse in this role?

• a. Sharing the patient’s data with other nurses on the unit.
• b. Altering the patient’s data to support the study’s hypothesis.
• c. Maintaining the confidentiality of the patient’s data.
• d. Providing the patient with a copy of the research article.

Answer 19

• c. Maintaining the confidentiality of the patient’s data.

Rationale:
Protecting patient privacy and confidentiality is a core ethical principle in research. The nurse must ensure the data is stored securely and not shared inappropriately.

Question 20

Which of the following nursing actions is an example of implementing evidence-based practice?

• a. Using a traditional method of wound care because “that’s how it’s always been done.”
• b. Using a new type of wound dressing that has been shown to reduce healing time.
• c. Using a pain management technique that the nurse learned from a colleague.
• d. Using a medication that is not supported by current evidence.

Answer 20

• b. Using a new type of wound dressing that has been shown to reduce healing time.

Rationale: Evidence-based practice involves integrating the best available research evidence into clinical decision-making, such as choosing a wound dressing supported by research to improve patient outcomes.

Question 21

A nurse is developing a PICOT question to guide a literature search on the prevention of catheter-associated urinary tract infections (CAUTIs). Which of the following is an appropriate PICOT question?

• a. In hospitalized patients with indwelling urinary catheters, does the use of a silver-alloy catheter reduce the risk of CAUTI compared with a standard latex catheter? * b. What are the patient’s perceptions of CAUTIs?
• c. Why do CAUTIs occur?
• d. How can nurses prevent CAUTIs?

Rationale: This question specifies the patient population (hospitalized patients with catheters), intervention (silver-alloy catheter), comparison (standard latex catheter), outcome (CAUTI risk reduction), making it a focused, searchable PICOT question.

Answer 21

Rationale: This question specifies the

patient population (hospitalized patients with catheters),

intervention (silver-alloy catheter),

comparison (standard latex catheter),

outcome (CAUTI risk reduction),

making it a focused, searchable PICOT question.

Question 22

A nurse is reading a research article and comes across the term “validity.” What does validity refer to in research?

• a. Whether the study is reliable.
• b. Whether the study is generalizable.
• c. Whether the study measures what it intends to measure.
• d. Whether the study is ethical.

Answer 22

• c. Whether the study measures what it intends to measure.

Rationale: Validity assesses whether the research instruments or methods accurately capture the concept being studied, ensuring the study’s findings are meaningful and relevant.

Question 23

A nurse is conducting a literature review using CINAHL. What type of resource is CINAHL?

• a. A textbook publisher.
• b. A professional nursing organization.
• c. A journal publisher.
• d. A nursing research database.

Answer 23

• d. A nursing research database.

Rationale: CINAHL is an electronic database that indexes a vast collection of nursing and allied health literature, including journal articles, research studies, and other relevant publications, making it a valuable tool for nurses seeking evidence.

Question 24

A nurse is caring for a patient who is experiencing pain. The nurse wants to use a non-pharmacological intervention to help manage the patient’s pain. Which of the following is an example of a non-pharmacological pain management intervention?

• a. Administering pain medication as ordered.
• b. Providing a back massage.
• c. Applying a heating pad.
• d. Using guided imagery.

Answer 24

• b. Providing a back massage.

Rationale:
While options c and d are also non-pharmacological, a back massage is the most direct example of a hands-on, non-pharmacological intervention for pain relief.

Question 25

A nurse is working on a research project and is collecting data from patients. The nurse is careful to explain the study to the patients and obtain their informed consent. Which ethical principle is the nurse upholding by obtaining informed consent?

• a. Autonomy
• b. Beneficence
• c. Justice
• d. Nonmaleficence

Answer 25

• a. Autonomy

Rationale: Informed consent demonstrates respect for the patient’s autonomy by ensuring they understand the study, potential risks and benefits, and have the freedom to choose to participate or decline without coercion.

Question 26

A nurse wants to share the findings of a recent research study with colleagues. What is the most appropriate way for the nurse to disseminate the research findings?

• a. Post the research article on social media.
• b. Discuss the findings with the patient.
• c. Email the findings to a personal contact.
• d. Present the findings at a nursing conference or publish them in a peer-reviewed journal.

Answer 26

• d. Present the findings at a nursing conference or publish them in a peer-reviewed journal.

Rationale: Nursing conferences and peer-reviewed journals provide formal venues for sharing research findings, ensuring the information reaches a wider audience of healthcare professionals and undergoes scrutiny for quality and accuracy.

Question 27

A nurse is caring for a patient who is from a different culture. The nurse wants to provide culturally competent care. Which nursing theory is most relevant to this situation?

• a. Watson’s Theory of Human Caring.
• b. Orem’s Self-Care Deficit Theory.
• c. Leininger’s Transcultural Nursing Theory.
• d. Benner’s Novice to Expert Theory.

Answer 27

• c. Leininger’s Transcultural Nursing Theory.

Rationale:
Leininger’s theory focuses specifically on cultural considerations in nursing care, emphasizing the importance of understanding and integrating the patient’s cultural beliefs and practices into the care plan to provide meaningful and respectful interventions.

Question 28

A nurse is collecting data for a research study. The nurse is using a standardized tool to measure patient pain levels. What is the benefit of using a standardized tool for data collection?

• a. It is easier to collect data.
• b. It increases the reliability of the data.
• c. It is less time-consuming.
• d. It eliminates bias from the researcher.

Answer 28

• b. It increases the reliability of the data.

Rationale: Standardized tools have established validity and reliability, minimizing variability in measurement and enhancing the consistency and accuracy of the data collected across different researchers or settings.

Question 29

A nurse is conducting a research study on the effects of a new intervention. The nurse has obtained informed consent from the participants and is following the study protocol carefully. Which ethical principle is the nurse demonstrating?

• a. Autonomy
• b. Beneficence
• c. Justice
• d. Fidelity

Answer 29

• d. Fidelity

Rationale: Fidelity emphasizes adherence to one’s commitments and responsibilities, including following research protocols and ethical guidelines to ensure the integrity of the study and the well-being of the participants.

Question 30

A nurse is evaluating the feasibility of implementing a new evidence-based practice on the unit. Which of the following factors should the nurse consider?

• a. Cost of implementation.
• b. Patient preferences.
• c. Staff availability.
• d. All of the above.

Answer 30

• d. All of the above.

Rationale: Evaluating the feasibility of a new practice involves considering multiple factors, including resource availability, costs, workflow implications, and staff acceptance to ensure successful and sustainable implementation.