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,Chapter1. Primary Care in the Twenty-First Century: A Circle of Caring
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1. A nurse has conducted a literature review in an effort to identifythe effect ofhandwashing on the
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incidence of nosocomial (hospital-acquired) infections in acute care settings. An article presented
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findings at a level of significance of <0.01. This indicates that
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A) the control group and the experimental group were more than 99% similar.
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B) the findings ofthe studyhave less than 1% chance ofbeing attributable to chance.
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C) the effects ofthe intervention were nearlyzero.
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D) the clinical significance ofthe findings was less than 1:100.
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Ans: B r
Feedback: The level ofsignificance is the levelat whichthe researcher believes that the studyresults most
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likely represent a no chance event. A level of significance of <0.01 indicates that there is less than 1%
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probability that the result is due to chance.
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2. A nurse has read a qualitative research studyinorder to understand the lived experience ofparents who
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have a neonatal loss. Which of the following questions should the nurse prioritize when appraising the
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results of this study?
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A) Howwell did the authors capture the personal experiences ofthese parents?
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B) Howwelldid the authors control for confounding variables that mayhave affected the findings?
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C) Did the authors usestatistical measures that were appropriate tothe phenomenon inquestion?
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D) Werethe instruments that the researchers used statisticallyvalid and reliable?
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Ans: A r
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the subjective
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experiences of individuals. Statistical measures and variables are not dimensions ofa qualitative
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methodology.
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3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming that
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nursing research has little relevance to practice. How can the nurses colleague best defend the importance
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of nursing research?
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test bank for primary care art and science of advanced practice
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nursing – an interprofessional approach 5th edition dunphy
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,A) The existence of nursing research means that nurses are now able to access federal grant money,
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something that didnt use to be the case.
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B) Nursing research has allowed the development ofmasters and doctoralprograms and has greatly
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increased the credibility of the profession.
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C) The growth of nursing research has caused nursing to be viewed as a true profession, rather than simply
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as a trade or a skill.
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D) The applicationof nursing researchhas the potentialto improve nursing practice and patient
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outcomes.
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Ans: D r
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimately,
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to improvepatient outcomes. This supersedes the contributions ofnursing researchto education programs,
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grant funding, or the public view of the profession.
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4. Tracyis a nurse with a baccalaureate degree who works in the labor and deliveryunit ofa busy urban
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hospital. She has noticed that many new mothers abandon breast-feeding their babies when they
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experience early challenges and wonders what could be done to encourage more women to continue
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breast-feeding. What role is Tracy most likely to play in a research project that tests an intervention
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aimed at promoting breast-feeding?
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A) Applying for grant funding forthe research project r r r r r r r
B) Posing the clinicalproblemto oneor more nursing researchers r r r r r r r r r
C) Planning the methodologyof the research project r r r r r r
D) Carrying out the interventionand submitting the results for publication r r r r r r r r r
r Ans: B r
Feedback: A major role for staff nurses is to identify questions or problems for research. Grant
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applications, methodological planning, and publication submission are normally carried out by
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nurses who have advanced degrees in nursing.
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5. A patient signed the informed consent form for a drug trial that was explained to patient by a
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research assistant. Later, the patient admitted to his nurse that he did not understand the research
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assistants explanationor his ownrole inthe study. How should this patients nurse respond to this
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revelation?
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A) Explainthe researchprocess to the patient ingreater detail. r r r r r r r r r
B) Describethe details of a randomized controlled trial for the patient. r r r r r r r r r r
, C) Informthe research assistant that the patients consent is likely invalid.
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D) Explainto the patient that his written consent is now legally binding. r r r r r r r r r r r
Ans: C r
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsible
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for research consent. If patients who have agreed to participate exhibit ambivalence or uncertainty about
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participating, do not try to convince them to participate. Ask the person from the research teamwho is
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managing consentsto speak withconcerned patients about the study, even after a patient has signed the
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consent forms.
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MultipleSelection r
6. A nurse leader is attempting to increase the awareness of evidence-based practice (EBP) among the
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nurses on a unit. Anurse who is implementing EBP integrates which ofthe following? (Select all that
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apply.)
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A) Interdisciplinary consensus r
B) Nursing tradition r
C) Research studies r
D) Patient preferences and values r r r
E) Clinicalexpertise r
r Ans: C, D, E r r r
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-solving
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approach to the deliveryofhealthcare that integrates the best evidence from studies and patient care data
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with clinician expertise and patient preferences and values.
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MultipleChoice r
7. Mrs. Mayes is a 73-year-old woman who has a diabetic foot ulcer that has been extremely slow to heal
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and which now poses a threat of osteomyelitis. The wound care nurse who has been working with Mrs.
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Mayes applies evidence-based practice (EBP) whenever possible and has proposed the use of maggot
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therapy to debride necrotic tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly
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opposes this treatment despite the sizable bodyofevidence supporting it. Howshould the nurse reconcile
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Mrs. Mayes views with the principles of EBP?
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A) Thenurse should explain that reliable and valid research evidence overrides the patientsopinion.
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B) Thenurse should explain the evidence to the patient ingreater detail.
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