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