NURS6011 EVIDENCE BASED PRACTICE FOR PATIENT CENTERED CARE & POPULATION HEALTH EXAM Q & A, Exams of Nursing

Download NURS6011 EVIDENCE BASED PRACTICE FOR PATIENT CENTERED CARE & POPULATION HEALTH EXAM Q & A and more Exams Nursing in PDF only on Docsity! NURS6011 Evidence Based Practice for Patient Centered Care & Population Health Q & A w/ Rationales 2024 A: 1. The nurse reviews the patient's medical history and notes that he has been prescribed several medications for his COPD, including a long-acting beta-agonist (LABA), an inhaled corticosteroid (ICS), and a short-acting bronchodilator (SABA). The nurse wants to evaluate the effectiveness of these medications for the patient. Which of the following sources of evidence would provide the most reliable and valid information for this purpose? a) A systematic review of randomized controlled trials (RCTs) that compare different combinations of COPD medications b) A narrative review of observational studies that describe the outcomes of COPD patients using different medications c) A case report of a single patient who had a positive response to a specific combination of COPD medications d) A clinical practice guideline that summarizes the recommendations for COPD management based on expert opinion Answer: A. A systematic review of RCTs is the highest level of evidence for evaluating the effectiveness of interventions, as it synthesizes the results of multiple studies that have minimized bias and confounding factors. A narrative review, a case report, and a clinical practice guideline are lower levels of evidence, as they may not be based on rigorous methods, may not be generalizable to other patients, or may not reflect the current state of 3. The nurse finds a systematic review of RCTs that compares different combinations of COPD medications. He or she reads the abstract and notes that it reports a meta- analysis of 12 RCTs with a total of 8,456 participants. The meta-analysis shows that there is no significant difference in exacerbation rates between patients who use LABA/ICS versus patients who use LABA alone. However, there is a significant difference in pneumonia rates between these two groups, with LABA/ICS users having a higher risk of pneumonia. The nurse wants to interpret these results and apply them to his or her patient. Which of the following measures would help the nurse to assess the validity and applicability of these results? a) The p-value and the confidence interval b) The effect size and the heterogeneity c) The risk ratio and the number needed to treat d) All of the above Answer: D. All of the above measures would help the nurse to assess the validity and applicability of these results. The p-value and the confidence interval would indicate the statistical significance and precision of the results, respectively. For example, a p-value < 0.05 and a confidence interval that does not include 1 would suggest that there is a significant difference between the two groups. The effect size and the heterogeneity would indicate the magnitude and consistency of the results, respectively. For example, a large effect size and a low heterogeneity would suggest that there is a strong and reliable difference between the two groups. The risk ratio and the number needed to treat would indicate the clinical significance and relevance of the results, respectively. For example, a risk ratio > 1 and a low number needed to treat would suggest that there is a meaningful and important difference between the two groups that could affect patient outcomes. Rationale: The nurse should use various measures to interpret and apply the results of a meta-analysis, which is a statistical method that combines the results of multiple studies that address a similar question. The measures should include both statistical and clinical indicators that reflect the validity and applicability of the results. The statistical indicators should include the p-value and the confidence interval, which measure the probability and range of error in the results, respectively. The clinical indicators should include the effect size and the heterogeneity, which measure the size and variation of the effect across different studies, respectively. The clinical indicators should also include the risk ratio and the number needed to treat, which measure the relative and absolute difference in outcomes between two groups, respectively. B; 1. Which statement best describes the nature of evidence in clinical decision-making? a) Evidence refers to the facts and information gathered from patient assessments. b) Evidence consists of research studies and scientific literature. c) Evidence is based on healthcare professionals' personal experiences and opinions. d) Evidence includes subjective beliefs and biases. Answer: b) Evidence consists of research studies and scientific literature. Rationale: In clinical decision-making, evidence refers to the information derived from research studies and scientific literature. It is based on rigorous scientific methods, ensuring objectivity and minimizing bias. 2. What is the relative value of evidence obtained through systematic reviews and meta-analyses compared to single research studies? a) Systematic reviews and meta-analyses provide stronger evidence than single research studies. b) Single research studies yield stronger evidence than systematic reviews and meta-analyses. c) Both systematic reviews/meta-analyses and single research studies possess equal evidential value. d) The value of evidence depends on the type of outcome being studied. Answer: a) Systematic reviews and meta-analyses provide stronger evidence than single research studies. causal inferences. 6. How does the quality of evidence impact its relative value? a) Higher quality evidence holds more relative value. b) Lower quality evidence holds more relative value. c) Quality of evidence does not affect its relative value. d) Relative value depends on individual interpretations. Answer: a) Higher quality evidence holds more relative value. Rationale: The quality of evidence refers to the rigor of the research methods employed, such as study design, sample size, statistical analyses, and minimizing bias. Higher quality evidence is considered more reliable, providing greater relative value in making clinical decisions. 7. In terms of population outcomes, why is evidence from systematic reviews and meta-analyses valuable? a) It provides a comprehensive picture of the population demographics. b) It synthesizes evidence from multiple studies to provide robust conclusions. c) It highlights individual patient experiences to guide population-level decisions. d) It allows for subjective interpretation based on personal biases. Answer: b) It synthesizes evidence from multiple studies to provide robust conclusions. Rationale: Systematic reviews and meta-analyses analyze data from multiple studies, allowing for a comprehensive synthesis of evidence. By pooling data and conducting statistical analyses, these approaches provide robust conclusions that inform clinical decisions and population outcomes. 8. Which factor is important to consider while evaluating the generalizability of evidence? a) The country in which the study was conducted b) The level of media attention the study received c) The potential bias of the researchers involved d) The characteristics of the study population Answer: d) The characteristics of the study population Rationale: Evaluating the generalizability of evidence involves considering the characteristics of the study population. The applicability of research findings to other populations depends on factors such as age, gender, socioeconomic status, and underlying health conditions. 9. Which type of evidence is most useful for making recommendations about healthcare policies? a) Single research studies b) Clinical guidelines c) Expert opinions d) Patient testimonials Answer: b) Clinical guidelines Rationale: Clinical guidelines, developed by expert panels using a systematic and evidence-based approach, provide recommendations for healthcare policies. These guidelines synthesize the available evidence to inform decision- making regarding patient care, healthcare policies, and resource allocation. 10. How does conflicting evidence impact clinical decision-making? a) Conflicting evidence makes decision-making challenging and uncertain. b) Conflicting evidence holds greater weight in decision- making. c) Conflicting evidence should be ignored to maintain consistency. d) Evidence conflict rarely occurs in healthcare research. Answer: a) Conflicting evidence makes decision-making challenging and uncertain. Rationale: When different studies provide conflicting evidence, decision-making can become challenging and 14. Which aspect of evidence is crucial when addressing health disparities in the population? a) Cultural appropriateness of the evidence b) Number of studies conducted in the population of interest c) Media coverage and public opinion about the evidence d) Alignment with healthcare professional's personal beliefs Answer: a) Cultural appropriateness of the evidence Rationale: Addressing health disparities requires considering the cultural appropriateness of the evidence. The evidence should be relevant to the population of interest, account for diverse cultural backgrounds, and promote equitable healthcare delivery. 15. How does evidence contribute to patient and population outcomes? a) Evidence eliminates the need for clinical decision- making. b) Evidence guides healthcare professionals' professional development. c) Evidence supports informed clinical decisions for improved outcomes. d) Evidence predicts future healthcare trends accurately. Answer: c) Evidence supports informed clinical decisions for improved outcomes. Rationale: Evidence supports informed clinical decisions by providing healthcare professionals with valid and reliable information. By considering the best available evidence, healthcare professionals can make decisions that optimize patient and population outcomes. C: Question: Which of the following is considered the highest level of evidence in healthcare research? A. Expert opinion B. Randomized controlled trial C. Case report D. Cohort study Answer: B. Randomized controlled trial Rationale: Randomized controlled trials are widely regarded as the gold standard in healthcare research due to their rigorous methodology, control of variables, and ability to establish causality. Question: When evaluating the quality of evidence, which of the following factors should be considered? A. Sample size B. Statistical significance C. Bias D. All of the above Answer: D. All of the above Rationale: All the listed factors are essential in evaluating the quality of evidence as they contribute to the validity and reliability of research findings. Question: Which type of evidence is based on the opinions of experts in the field? A. Systematic review B. Meta-analysis C. Expert opinion D. Case-control study Answer: C. Expert opinion Rationale: Expert opinion is based on the experiences and insights of professionals in the field and is considered a valuable but less rigorous form of evidence. Question: What is the role of evidence-based practice in nursing? A. To rely solely on personal experience B. To integrate best available evidence with clinical expertise C. To disregard research findings D. To follow outdated protocols Answer: B. To integrate best available evidence with clinical expertise Rationale: Evidence-based practice in nursing involves integrating the best available evidence with clinical expertise, patient preferences, and the context of care. Question: Which type of study design is best suited to establish cause-and-effect relationships between variables? A. Cohort study B. Case-control study C. Cross-sectional study D. Qualitative study Answer: A. Cohort study Rationale: Cohort studies are ideal for establishing cause-and-effect relationships due to their prospective nature and ability to assess exposures and outcomes over time. Question: In evidence-based practice, what role does clinical expertise play in decision-making? A. Clinical expertise is irrelevant in evidence-based practice B. Clinical expertise is the sole determinant of treatment plans C. Clinical expertise complements the best available evidence D. Clinical expertise overrides research findings Answer: C. Clinical expertise complements the best available evidence Rationale: In evidence-based practice, clinical expertise complements the best available evidence and guides its application in specific patient care contexts. Question: Which of the following sources of evidence is most susceptible to bias? A. Randomized controlled trial B. Systematic review C. Expert opinion D. Case report Answer: C. Expert opinion Rationale: Expert opinion is more susceptible to bias compared to rigorous study designs like randomized controlled trials and systematic reviews. Question: What is the significance of patient preferences in evidence-based practice? A. Patient preferences are irrelevant in clinical decision- making B. Patient preferences should override research findings C. Patient preferences should be integrated with the best available evidence D. Patient preferences are only considered in non-serious conditions Answer: C. Patient preferences should be integrated with the best available evidence Rationale: In evidence-based practice, patient preferences should be integrated with the best available evidence and clinical expertise to make patient-centered decisions. Question: Which of the following best describes the concept of translational research in evidence-based practice? A. Translating research findings into clinical guidelines and practice B. Translating patient preferences into research questions C. Translating clinical expertise into evidence D. Translating outdated protocols into modern healthcare Answer: A. Translating research findings into clinical guidelines and practice Rationale: Translational research in evidence-based practice involves translating research findings into clinical guidelines and practice to improve patient outcomes. Question: What role does continuous learning and critical appraisal play in evidence-based practice? A. Continuous learning is unnecessary in evidence-based practice B. Critical appraisal is only relevant for senior clinicians C. Continuous learning and critical appraisal are essential for maintaining evidence-based practice D. Critical appraisal hinders the implementation of evidence-based practice Answer: C. Continuous learning and critical appraisal are essential for maintaining evidence-based practice Rationale: Continuous learning and critical appraisal are essential for nursing professionals to stay updated with the latest evidence and maintain the practice of evidence-based care.