,Primary Care The Art and Science of Advanced Practice Nursing an Interprofessional Approach 6th Edition Dun
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phy Test Bank
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Table of Contents rr rr
Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring rr rr rr rr rr rr rr rr rr rr rr
1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on the inci
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
dence of nosocomial (hospital-rr rr rr
acquired) infections in acute care settings. An article presented findings at a level of significance of <0
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
.01. This indicates that
rr rr rr
A) the control group and the experimental group were more than 99% similar
rr rr rr rr rr rr rr rr rr rr rr
B) the findings of the study have less than 1% chance of being attributable to chance.
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
C) the effects of the intervention were nearly
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D) the clinical significance of the findings was less than 1:100.
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Ans: B rr
Feedback: The level of significance is the level at which the researcher believes that the study results mos
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
t likely represent a nonchance event. A level of significance of <0.01 indicates that there is less than 1%
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
probability that the result is due to chance. rr rr rr rr rr rr rr
2. A nurse has read a qualitative research study in order to understand the lived experience of parents wh
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
o have a neonatal loss. Which of the following questions should the nurse prioritize when appraising th
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
e results of this study?
rr rr rr rr
A) How well did the authors capture the personal experiences of these parHow well did the authors con
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
trol for confounding variables that may have affected the findings?
rr rr rr rr rr rr rr rr rr
B) Did the atuhors use statistical measures that were appropriate to the phenomenon in question?
rr rr rr rr rr rr rr rr rr rr rr rr rr
C) Were the instruments that the researchers used statistically valid and reliable?
rr rr rr rr rr rr rr rr rr rr
Ans: A rr
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the subjectiv
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
e experiences of individuals. Statistical measures and variables are not dimensions of a qualitative metho
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
dology.
3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming that nur
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
sing research has little relevance to practice. How can the nurses colleague best defend the importance
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
of nursing research?
rr rr
,A) The existence of nursing research means that nurses are now able to access federal grant money, so
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
mething that didnt use to be the case. rr rr rr rr rr rr rr
B) Nursing research has allowed the development of masters and doctoral programs and has greatly inc
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
reased the credibility of the profession.
rr rr rr rr rr
C) The growth of nursing research has caused nursing to be viewed as a true profession, rather than sim
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
ply as a trade or a skill.
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D) The application of nursing research has the potential to improve nursing practice and patient out
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
comes.
Ans: D rr
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimatel
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
y, to improve patient outcomes. This supersedes the contributions of nursing research to education progr
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
ams, grant funding, or the public view of the profession.
rr rr rr rr rr rr rr rr rr
4. Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of a busy urba
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
n hospital. She has noticed that many new mothers abandon breast-
rr rr rr rr rr rr rr rr rr rr
feeding their babies when they experience early challenges and wonders what could be done to enco
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
urage more women to continue breast-
rr rr rr rr rr
feeding. What role is Tracy most likely to play in a research project that tests an intervention aimed a
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
t promoting breast-feeding?
rr rr
A) Applying for grant funding for the research project rr rr rr rr rr rr rr
B) Posing the clinical problem to one or more nursing researchers
rr rr rr rr rr rr rr rr rr
C) Planning the methodology of the research project rr rr rr rr rr rr
D) Carrying out the intervention and submitting the results for publication A rr rr rr rr rr rr rr rr rr rr
ns: B rr
Feedback: A major role for staff nurses is to identify questions or problems for research. Grant app
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
lications, methodological planning, and publication submission are normally carried out by nurse
rr rr rr rr rr rr rr rr rr rr rr
s who have advanced degrees in nursing.
rr rr rr rr rr rr
5. A patient signed the informed consent form for a drug trial that was explained to patient by a rese
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
arch assistant. Later, the patient admitted to his nurse that he did not understand the research assista
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
nts explanation or his own role in the study. How should this patients nurse respond to this revelation
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
?
A) Explain the research process to the patient in greater detail. rr rr rr rr rr rr rr rr rr
B) Describe the details of a randomized controlled trial for the patient. rr rr rr rr rr rr rr rr rr rr
, C) Inform the research assistant that the patients consent is likely invalid.
rr rr rr rr rr rr rr rr rr rr
D) Explain to the patient that his written consent is now legally binding.
rr rr rr rr rr rr rr rr rr rr rr
Ans: C rr
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsible
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
for research consent. If patients who have agreed to participate exhibit ambivalence or uncertainty abou
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
t participating, do not try to convince them to participate. Ask the person from the research team who is
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
managing consents to speak with concerned patients about the study, even after a patient has signed the c
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
onsent forms. rr
Multiple Selection rr
6. A nurse leader is attempting to increase the awareness of evidence-
rr rr rr rr rr rr rr rr rr rr
based practice (EBP) among the nurses on a unit. A nurse who is implementing EBP integrates which of t
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
he following? (Select all that apply.)
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A) Interdisciplinary consensus rr
B) Nursing tradition rr
C) Research studies rr
D) Patient preferences and values rr rr rr
E) Clinical expertise r rr
Ans: C, D, E rr rr rr
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-
rr rr rr rr rr rr rr rr rr rr
solving approach to the delivery of healthcare that integrates the best evidence from studies and patient c
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are data with clinician expertise and patient preferences and values.
rr rr rr rr rr rr rr rr rr
Multiple Choice rr
7. Mrs. Mayes is a 73-year- rr rr rr rr
old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now poses a thr
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
eat of osteomyelitis. The wound care nurse who has been working with Mrs. Mayes applies evidence-
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
based practice (EBP) whenever possible and has proposed the use of maggot therapy to debride necrotic
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this treatment desp
rr rr rr rr rr rr rr rr rr rr rr rr rr
ite the sizable body of evidence supporting it. How should the nurse reconcile Mrs. Mayes views with th
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
e principles of EBP?
rr rr rr
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
rr rr rr rr rr rr rr rr rr rr rr rr rr
B) The nurse should explain the evidence to the patient in greater detail.
rr rr rr rr rr rr rr rr rr rr rr
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
phy Test Bank
rr rr
Table of Contents rr rr
Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring rr rr rr rr rr rr rr rr rr rr rr
1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on the inci
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
dence of nosocomial (hospital-rr rr rr
acquired) infections in acute care settings. An article presented findings at a level of significance of <0
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
.01. This indicates that
rr rr rr
A) the control group and the experimental group were more than 99% similar
rr rr rr rr rr rr rr rr rr rr rr
B) the findings of the study have less than 1% chance of being attributable to chance.
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
C) the effects of the intervention were nearly
rr rr rr rr rr rr
D) the clinical significance of the findings was less than 1:100.
rr rr rr rr rr rr rr rr rr
Ans: B rr
Feedback: The level of significance is the level at which the researcher believes that the study results mos
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
t likely represent a nonchance event. A level of significance of <0.01 indicates that there is less than 1%
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
probability that the result is due to chance. rr rr rr rr rr rr rr
2. A nurse has read a qualitative research study in order to understand the lived experience of parents wh
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
o have a neonatal loss. Which of the following questions should the nurse prioritize when appraising th
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
e results of this study?
rr rr rr rr
A) How well did the authors capture the personal experiences of these parHow well did the authors con
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
trol for confounding variables that may have affected the findings?
rr rr rr rr rr rr rr rr rr
B) Did the atuhors use statistical measures that were appropriate to the phenomenon in question?
rr rr rr rr rr rr rr rr rr rr rr rr rr
C) Were the instruments that the researchers used statistically valid and reliable?
rr rr rr rr rr rr rr rr rr rr
Ans: A rr
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the subjectiv
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
e experiences of individuals. Statistical measures and variables are not dimensions of a qualitative metho
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
dology.
3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming that nur
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
sing research has little relevance to practice. How can the nurses colleague best defend the importance
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
of nursing research?
rr rr
,A) The existence of nursing research means that nurses are now able to access federal grant money, so
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
mething that didnt use to be the case. rr rr rr rr rr rr rr
B) Nursing research has allowed the development of masters and doctoral programs and has greatly inc
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
reased the credibility of the profession.
rr rr rr rr rr
C) The growth of nursing research has caused nursing to be viewed as a true profession, rather than sim
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
ply as a trade or a skill.
rr rr rr rr rr rr
D) The application of nursing research has the potential to improve nursing practice and patient out
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
comes.
Ans: D rr
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimatel
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
y, to improve patient outcomes. This supersedes the contributions of nursing research to education progr
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
ams, grant funding, or the public view of the profession.
rr rr rr rr rr rr rr rr rr
4. Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of a busy urba
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
n hospital. She has noticed that many new mothers abandon breast-
rr rr rr rr rr rr rr rr rr rr
feeding their babies when they experience early challenges and wonders what could be done to enco
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
urage more women to continue breast-
rr rr rr rr rr
feeding. What role is Tracy most likely to play in a research project that tests an intervention aimed a
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
t promoting breast-feeding?
rr rr
A) Applying for grant funding for the research project rr rr rr rr rr rr rr
B) Posing the clinical problem to one or more nursing researchers
rr rr rr rr rr rr rr rr rr
C) Planning the methodology of the research project rr rr rr rr rr rr
D) Carrying out the intervention and submitting the results for publication A rr rr rr rr rr rr rr rr rr rr
ns: B rr
Feedback: A major role for staff nurses is to identify questions or problems for research. Grant app
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
lications, methodological planning, and publication submission are normally carried out by nurse
rr rr rr rr rr rr rr rr rr rr rr
s who have advanced degrees in nursing.
rr rr rr rr rr rr
5. A patient signed the informed consent form for a drug trial that was explained to patient by a rese
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
arch assistant. Later, the patient admitted to his nurse that he did not understand the research assista
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
nts explanation or his own role in the study. How should this patients nurse respond to this revelation
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
?
A) Explain the research process to the patient in greater detail. rr rr rr rr rr rr rr rr rr
B) Describe the details of a randomized controlled trial for the patient. rr rr rr rr rr rr rr rr rr rr
, C) Inform the research assistant that the patients consent is likely invalid.
rr rr rr rr rr rr rr rr rr rr
D) Explain to the patient that his written consent is now legally binding.
rr rr rr rr rr rr rr rr rr rr rr
Ans: C rr
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsible
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
for research consent. If patients who have agreed to participate exhibit ambivalence or uncertainty abou
rr rr rr rr rr rr rr rr rr rr rr rr rr rr
t participating, do not try to convince them to participate. Ask the person from the research team who is
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
managing consents to speak with concerned patients about the study, even after a patient has signed the c
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
onsent forms. rr
Multiple Selection rr
6. A nurse leader is attempting to increase the awareness of evidence-
rr rr rr rr rr rr rr rr rr rr
based practice (EBP) among the nurses on a unit. A nurse who is implementing EBP integrates which of t
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
he following? (Select all that apply.)
rr rr rr rr rr
A) Interdisciplinary consensus rr
B) Nursing tradition rr
C) Research studies rr
D) Patient preferences and values rr rr rr
E) Clinical expertise r rr
Ans: C, D, E rr rr rr
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-
rr rr rr rr rr rr rr rr rr rr
solving approach to the delivery of healthcare that integrates the best evidence from studies and patient c
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
are data with clinician expertise and patient preferences and values.
rr rr rr rr rr rr rr rr rr
Multiple Choice rr
7. Mrs. Mayes is a 73-year- rr rr rr rr
old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now poses a thr
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
eat of osteomyelitis. The wound care nurse who has been working with Mrs. Mayes applies evidence-
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
based practice (EBP) whenever possible and has proposed the use of maggot therapy to debride necrotic
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this treatment desp
rr rr rr rr rr rr rr rr rr rr rr rr rr
ite the sizable body of evidence supporting it. How should the nurse reconcile Mrs. Mayes views with th
rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr rr
e principles of EBP?
rr rr rr
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
rr rr rr rr rr rr rr rr rr rr rr rr rr
B) The nurse should explain the evidence to the patient in greater detail.
rr rr rr rr rr rr rr rr rr rr rr
