Evidence-Based Research

Every question here, with the answer

1. A client's blood pressure drops suddenly. A new graduate nurse asks why the unit no longer places hypotensive clients in the Trendelenburg position. What is the best response?

   1. It is avoided only because clients dislike having their head lowered.
   2. Research found it statistically not beneficial for most clients, and it carries risks such as increased pressure on the brain.
   3. It is still best practice, but only a provider may position the client.
   4. It works for every client, but it is uncomfortable.

   Answer: Research found it statistically not beneficial for most clients, and it carries risks such as increased pressure on the brain.

   Studies showed the Trendelenburg position is statistically not beneficial for the general population and has risks, including increased pressure on the brain and decreased respiratory ability, so current EBP discourages it. The other answers misstate the evidence or the reason for the change.

2. A nurse is interviewing a client who uses unfamiliar terms to describe a health problem. Which question best follows the approach that helped the experienced nurse in the section?

   1. "Please tell me why you do not like doctors."
   2. "Can you explain what you mean by that?"
   3. "Do you mean you eat too much candy?"
   4. "Do you have hypertension or asthma, yes or no?"

   Answer: "Can you explain what you mean by that?"

   The experienced nurse used open-ended questions and did not make assumptions, which revealed that the client had diabetes. Guessing the meaning makes an assumption, a yes-or-no question limits the answer, and asking why the client dislikes doctors is a leading question.

3. A nurse evaluating sources for a unit policy change finds a narrative article summarizing other studies, a single original study, a systematic review, and an expert opinion editorial. Which source generally offers the highest quality of evidence?

   1. The narrative literature review
   2. The expert opinion editorial
   3. The single original study
   4. The systematic review

   Answer: The systematic review

   Researchers generally agree that expert opinion is the lowest quality of evidence and that systematic and metareviews offer the highest. A narrative literature review does not use statistics, and a single study sits below systematic reviews in the hierarchy.

4. A nurse finds evidence supporting a new comfort intervention for one client. Under which conditions can the individual nurse introduce this change into their own practice?

   1. When it does not violate hospital policy, the nurse believes in its value, and the client accepts it.
   2. Only after a unit-wide committee approves a new policy.
   3. Whenever the evidence comes from a manufacturer-funded study.
   4. Only after the nurse publishes the results.

   Answer: When it does not violate hospital policy, the nurse believes in its value, and the client accepts it.

   An individual nurse can introduce an evidence-based change for a single client if it does not violate policy, the nurse believes in its value, and the client accepts it. Committee approval is needed for larger changes, manufacturer-funded research can be biased, and publishing is not required.

5. A nurse is asked to take part in a research study on the unit. According to the ANA, which responsibilities does the nurse have toward participants? Select all that apply.

   1. Continue the study even if it is clearly harmful, so the data are complete.
   2. Continually weigh the risks of the research against its potential benefits.
   3. Explain the purpose, risks, and benefits in the informed consent.
   4. Prevent harm to research participants.
   5. Ensure clients give uncoerced agreement to participate.

   Answer: Continually weigh the risks of the research against its potential benefits., Explain the purpose, risks, and benefits in the informed consent., Prevent harm to research participants., Ensure clients give uncoerced agreement to participate.

   Nurses in research ensure uncoerced consent that explains purpose, risks, and benefits, continually evaluate risks versus benefits, and prevent harm. Research that is clearly harmful must be stopped, not continued.

6. A nurse is searching for evidence to answer a client's question. Which sources are considered high-quality? Select all that apply.

   1. Consumer blogs
   2. Online encyclopedias such as Wikipedia
   3. Governmental bodies such as the CDC
   4. Practice guidelines from national-level bodies such as the ANA
   5. Peer-reviewed journals

   Answer: Governmental bodies such as the CDC, Practice guidelines from national-level bodies such as the ANA, Peer-reviewed journals

   High-quality information comes from peer-reviewed journals, national practice guidelines, condition-related organizations, and governmental bodies such as the CDC. Consumer websites and blogs are lower quality, and online encyclopedias are not necessarily peer reviewed and are not authoritative.