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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 ofÂ
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