TEST BANK
Primary Care: The Art and Science of Advanced Practice
Nursing-An Interprofessional Approach
Lynne M. Dunphy, Jill E. Winland-Brown, Brian O. Porter, Debera J. Thomas
5th Edition
,Table of Contents
Unit 01, Chapter 03. Health Promotion 1
Unit 01, Chapter 05. Evidence-Based Care 3
Unit 02, Section 01. Neurological Problems 6
Unit 02, Section 02. Skin Problems 13
Unit 02, Section 03. Eye Problems 22
Unit 02, Section 04. Ear, Nose, and Throat Problems 27
Unit 02, Section 05. Respiratory Problems 34
Unit 02, Section 06. Cardiovascular Problems 43
Unit 02, Section 07. Abdominal Problems 52
Unit 02, Section 08. Renal Problems 60
Unit 02, Section 09. Gender-Related Health Problems 68
Unit 02, Section 10. Musculoskeletal Problems 81
Unit 02, Section 11. Endocrine and Metabolic Problems 90
Unit 02, Section 12. Hematological and Immunological Problems 99
Unit 02, Section 13. Psychosocial Problems 108
Unit 02, Section 14. Urgent Care Problems 117
Unit 03, Chapter 76. Sports Physicals 126
Unit 03, Chapter 77. Primary Care of Older Adults 130
Unit 03, Chapter 78. Palliative Care and Pain Management 133
Unit 03, Chapter 79. Ethical and Legal Issues of a Caring-Based Practice 137
Unit 03, Chapter 80. The Business of Advanced Practice Nursing 141
Unit 03, Chapter 81. The 15-Minute Hour-Practical Approaches to Behavioral Health for
Primary Care 144
Unit 03, Chapter 82. Putting Caring Into Practice-Caring for Self 147
,______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
Unit 01, Chapter 3. Health Promotion
MULTIPLE CHOICE
1. Which of the following is a primary prevention measure for a 76-year-old man newly
diagnosed with a testosterone deficiency?
a. Calcium supplementation
b. Testicular self-examination
c. Bone density test
d. Digital rectal examination
ANS: A PTS: 1
2. Which of the following is an example of secondary prevention in a 50-year-old woman?
a. Yearly mammogram
b. Low animal-fat diet
c. Use of seat belt
d. Daily application of sunscreen
ANS: A PTS: 1
3. Which of the following is an example of tertiary prevention in a patient with chronic renal
failure?
a. Fluid restriction
b. Hemodialysis 4 days a week
c. High-protein diet
d. Maintenance of blood pressure at 120/80
ANS: B PTS: 1
4. Immunizations are an example of which type of prevention?
a. Primary
b. Secondary
c. Tertiary
d. Quaternary
ANS: A PTS: 1
5. The nurse is speaking to a patient regarding endemic diseases. Which of these choices
describes an endemic statistic?
a. The typical incidence of influenza in a country
b. The surprise outbreak of malaria in new regions
c. Higher levels of Ebola in a country when compared to the previous year
d. Abnormal outbreak of measles in pockets of a country
ANS: A PTS: 1
6. The nurse is reviewing old and current trends in disease history. Which of these would be
considered an example of a sporadic outbreak?
a. The number of people diagnosed with rabies virus in 2017
______________________________________________________________________________________________
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Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
b. The number of people diagnosed with chlamydia in Texas over a 1-month period
c. The number influenza cases diagnosed from 1918 to 1919
d. The number of common cold cases diagnosed in Washington between October
2016 and March 2017
ANS: A PTS: 1
7. Which accurately defines incidence rate?
a. The number of old cases of a disease at a point in time
b. The number of cases of a disease at a point in time divided by the percentage of the
population at a point in time
c. The number of total cases of a disease total diagnosed at a point in time
d. The number of new cases of a disease diagnosed at a point in time
ANS: D PTS: 1
8. What describes a pandemic?
a. An event more than epidemic magnitude affecting a single community or country
over a long period of time
b. An event of epidemic magnitude affecting a single community or country in a
short period of time
c. An event of epidemic magnitude affecting multiple communities and countries in a
short period of time
d. An event less than epidemic magnitude affecting multiple communities and
countries over a long period of time
ANS: C PTS: 1
9. Which test of health literacy can be completed quickly and provide results comparable to
more time-consuming tests?
a. Test of Functional Health Literacy in Adults (TOFHLA)
b. Patient Health Questionnaire (PHQ-9)
c. Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF)
d. Newest Vital Sign (NVS)
ANS: D PTS: 1
10. The nurse is working with a 65-year-old patient who was recently diagnosed with
hypertension. The patient is concerned about their optimal health with their new diagnosis.
Which nursing action is necessary for health promotion with the patient?
a. Discussing appropriate stress management techniques
b. Sharing with the patient how to increase sodium consumption
c. Discussing with the patient exercises that increase heart rate
d. Emphasizing the importance of avoiding flu vaccinations
ANS: A PTS: 1
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,______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
Unit 01, Chapter 5. Evidence-Based Care
MULTIPLE CHOICE
1. What is the goal of nursing research?
a. Make decisions regarding nursing education based on published literature
b. Determine topics that could develop nursing knowledge
c. Gather information from published literature to make decisions about application
to clinical practice
d. Conduct studies to develop a body of nursing knowledge
ANS: D PTS: 1
2. Which is the most important question to ask in evidence-based practice?
a. What findings constitute evidence?
b. How will the findings be used?
c. Is this a randomized controlled trial?
d. What theory is being utilized?
ANS: B PTS: 1
3. Nursing research should be utilized by:
a. Nurses at the bedside
b. Advanced practice nurses
c. Nurse researchers
d. Nurses at all levels of practice
ANS: D PTS: 1
4. A clinical guideline may be found useful if the guideline was:
a. Published 2 years ago
b. Created using one group
c. Authored by a relatively unknown source
d. Funded by an anonymous source
ANS: A PTS: 1
5. Practice guidelines are designed to:
a. Be inflexible
b. Be utilized in every circumstance
c. Provide a reference point for decision making
d. Be created by a professional organization to guide the practice of a profession
ANS: C PTS: 1
6. Which of the following is an example of determining whether a crucial element of a
guideline is applicable to your patients?
a. There are no intended specific patients in the guideline.
b. You are a primary-care provider and the guidelines were written for primary-care
providers.
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Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
c. Your patients have a much lower prevalence of a condition than the patients in the
guideline.
d. You are a pediatric oncologist and the guidelines were written for geriatric
specialists.
ANS: B PTS: 1
7. Which of the following would be considered the research design for Level I evidence?
a. Single, well-designed, randomized clinical trial
b. Systematic review of randomized clinical trial studies
c. Well-designed controlled trials without randomization
d. Systematic reviews of descriptive or qualitative studies
ANS: B PTS: 1
8. Which of the following would be considered the research design for Level II evidence?
a. Single descriptive or qualitative study
b. Well-designed case control or cohort studies
c. Single, well-designed, randomized clinical trial
d. Systematic review of randomized clinical trial studies
ANS: C PTS: 1
9. Which of the following would be considered the research design for Level III evidence?
a. Well-designed controlled trials without randomization
b. Systematic reviews of descriptive or qualitative studies
c. Systematic review of randomized clinical trial studies
d. Opinion of authorities and expert committees
ANS: A PTS: 1
10. Which of the following would be considered the research design for Level IV evidence?
a. Single descriptive or qualitative study
b. Opinion of authorities and expert committees
c. Systematic review of randomized clinical trial studies
d. Well-designed controlled trials without randomization
ANS: D PTS: 1
11. Which of the following would be considered the research design for Level V evidence?
a. Systematic review of randomized clinical trial studies
b. Well-designed controlled trials without randomization
c. Systematic reviews of descriptive or qualitative studies
d. Single descriptive or qualitative study
ANS: C PTS: 1
12. Which of the following would be considered the research design for Level VI evidence?
a. Systematic reviews of descriptive or qualitative studies
b. Opinion of authorities and expert committees
c. Well-designed case control or cohort studies
d. Single descriptive or qualitative study
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,______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
ANS: C PTS: 1
13. Which of the following would be considered the research design for Level VII evidence?
a. Well-designed controlled trials without randomization
b. Opinion of authorities and expert committees
c. Well-designed case control or cohort studies
d. Single descriptive or qualitative study
ANS: B PTS: 1
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Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
Unit 02, Section 1. Neurological Problems
MULTIPLE CHOICE
1. Which statement about confusion is true?
a. Confusion is a disease process.
b. Confusion is always temporary.
c. Age is a reliable predictor of confusion.
d. Polypharmacy is a major contributor to confusion in older adults.
ANS: D PTS: 1
2. Which of the following indicates a diagnosis of dementia?
a. Onset after an infection
b. Abrupt onset over a week
c. Difficulty with long-term memory
d. Hard time finding words
ANS: D PTS: 1
3. Which of the following aspects of the patient history is a hallmark of delirium?
a. Patient has chronic kidney disease.
b. Patient has had aphasia for a year.
c. Patient has diabetes mellitus.
d. Patient has been getting lost driving home.
ANS: A PTS: 1
4. Which of the following may trigger migraines?
a. Taking an ibuprofen for muscle pain
b. A cup of coffee with regular sweetener
c. A glass of merlot wine
d. Drinking a cup of green tea
ANS: C PTS: 1
5. Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following
medications will help to decrease edema in the labyrinth of the ear?
a. Meclizine
b. Diphenhydramine
c. Diamox
d. Promethazine
ANS: C PTS: 1
6. The hallmark of an absence seizure is:
a. No activity at all
b. A blank stare
c. Urine is usually voided involuntarily
d. The attack usually lasts several minutes
______________________________________________________________________________________________
6|Page
, ______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
ANS: B PTS: 1
7. Which of the following persons fits the classic description of a patient with multiple
sclerosis (MS)?
a. A teenage male
b. A 65-year-old male
c. A 25-year-old female
d. A 60-year-old female
ANS: C PTS: 1
8. Which of the following is a specific test to MS?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test
ANS: D PTS: 1
9. Over the course of 3 years, a patient has had two MS flares. The patient’s primary
complaints during the episodes are bilateral tingling and pain in their legs, depression, and
numbness in their right hand with complete recovery in between occurrences. Which MS
classification fits their disease process?
a. Clinically isolated syndrome
b. Relapsing-remitting
c. Primary progressive
d. Secondary progressive
ANS: B PTS: 1
10. A patient with MS is complaining of new-onset “electric tingling” in both their arms. Which
medication specifically treats these acute exacerbations?
a. Lemtrada
b. Aubagio
c. Zanaflex
d. Depo-Medrol
ANS: D PTS: 1
11. Which of the following is a risk factor for developing Alzheimer’s disease?
a. Having a master’s or doctoral degree
b. Patient is a physician
c. Patient has Down’s syndrome
d. History of neurological disease
ANS: C PTS: 1
12. Which drug for Alzheimer’s disease should be administered beginning at the time of
diagnosis?
a. Cholinesterase inhibitors
b. Anxiolytics
______________________________________________________________________________________________
7|Page
Primary Care: The Art and Science of Advanced Practice
Nursing-An Interprofessional Approach
Lynne M. Dunphy, Jill E. Winland-Brown, Brian O. Porter, Debera J. Thomas
5th Edition
,Table of Contents
Unit 01, Chapter 03. Health Promotion 1
Unit 01, Chapter 05. Evidence-Based Care 3
Unit 02, Section 01. Neurological Problems 6
Unit 02, Section 02. Skin Problems 13
Unit 02, Section 03. Eye Problems 22
Unit 02, Section 04. Ear, Nose, and Throat Problems 27
Unit 02, Section 05. Respiratory Problems 34
Unit 02, Section 06. Cardiovascular Problems 43
Unit 02, Section 07. Abdominal Problems 52
Unit 02, Section 08. Renal Problems 60
Unit 02, Section 09. Gender-Related Health Problems 68
Unit 02, Section 10. Musculoskeletal Problems 81
Unit 02, Section 11. Endocrine and Metabolic Problems 90
Unit 02, Section 12. Hematological and Immunological Problems 99
Unit 02, Section 13. Psychosocial Problems 108
Unit 02, Section 14. Urgent Care Problems 117
Unit 03, Chapter 76. Sports Physicals 126
Unit 03, Chapter 77. Primary Care of Older Adults 130
Unit 03, Chapter 78. Palliative Care and Pain Management 133
Unit 03, Chapter 79. Ethical and Legal Issues of a Caring-Based Practice 137
Unit 03, Chapter 80. The Business of Advanced Practice Nursing 141
Unit 03, Chapter 81. The 15-Minute Hour-Practical Approaches to Behavioral Health for
Primary Care 144
Unit 03, Chapter 82. Putting Caring Into Practice-Caring for Self 147
,______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
Unit 01, Chapter 3. Health Promotion
MULTIPLE CHOICE
1. Which of the following is a primary prevention measure for a 76-year-old man newly
diagnosed with a testosterone deficiency?
a. Calcium supplementation
b. Testicular self-examination
c. Bone density test
d. Digital rectal examination
ANS: A PTS: 1
2. Which of the following is an example of secondary prevention in a 50-year-old woman?
a. Yearly mammogram
b. Low animal-fat diet
c. Use of seat belt
d. Daily application of sunscreen
ANS: A PTS: 1
3. Which of the following is an example of tertiary prevention in a patient with chronic renal
failure?
a. Fluid restriction
b. Hemodialysis 4 days a week
c. High-protein diet
d. Maintenance of blood pressure at 120/80
ANS: B PTS: 1
4. Immunizations are an example of which type of prevention?
a. Primary
b. Secondary
c. Tertiary
d. Quaternary
ANS: A PTS: 1
5. The nurse is speaking to a patient regarding endemic diseases. Which of these choices
describes an endemic statistic?
a. The typical incidence of influenza in a country
b. The surprise outbreak of malaria in new regions
c. Higher levels of Ebola in a country when compared to the previous year
d. Abnormal outbreak of measles in pockets of a country
ANS: A PTS: 1
6. The nurse is reviewing old and current trends in disease history. Which of these would be
considered an example of a sporadic outbreak?
a. The number of people diagnosed with rabies virus in 2017
______________________________________________________________________________________________
1|Page
,______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
b. The number of people diagnosed with chlamydia in Texas over a 1-month period
c. The number influenza cases diagnosed from 1918 to 1919
d. The number of common cold cases diagnosed in Washington between October
2016 and March 2017
ANS: A PTS: 1
7. Which accurately defines incidence rate?
a. The number of old cases of a disease at a point in time
b. The number of cases of a disease at a point in time divided by the percentage of the
population at a point in time
c. The number of total cases of a disease total diagnosed at a point in time
d. The number of new cases of a disease diagnosed at a point in time
ANS: D PTS: 1
8. What describes a pandemic?
a. An event more than epidemic magnitude affecting a single community or country
over a long period of time
b. An event of epidemic magnitude affecting a single community or country in a
short period of time
c. An event of epidemic magnitude affecting multiple communities and countries in a
short period of time
d. An event less than epidemic magnitude affecting multiple communities and
countries over a long period of time
ANS: C PTS: 1
9. Which test of health literacy can be completed quickly and provide results comparable to
more time-consuming tests?
a. Test of Functional Health Literacy in Adults (TOFHLA)
b. Patient Health Questionnaire (PHQ-9)
c. Rapid Estimate of Adult Literacy in Medicine-Short Form (REALM-SF)
d. Newest Vital Sign (NVS)
ANS: D PTS: 1
10. The nurse is working with a 65-year-old patient who was recently diagnosed with
hypertension. The patient is concerned about their optimal health with their new diagnosis.
Which nursing action is necessary for health promotion with the patient?
a. Discussing appropriate stress management techniques
b. Sharing with the patient how to increase sodium consumption
c. Discussing with the patient exercises that increase heart rate
d. Emphasizing the importance of avoiding flu vaccinations
ANS: A PTS: 1
______________________________________________________________________________________________
2|Page
,______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
Unit 01, Chapter 5. Evidence-Based Care
MULTIPLE CHOICE
1. What is the goal of nursing research?
a. Make decisions regarding nursing education based on published literature
b. Determine topics that could develop nursing knowledge
c. Gather information from published literature to make decisions about application
to clinical practice
d. Conduct studies to develop a body of nursing knowledge
ANS: D PTS: 1
2. Which is the most important question to ask in evidence-based practice?
a. What findings constitute evidence?
b. How will the findings be used?
c. Is this a randomized controlled trial?
d. What theory is being utilized?
ANS: B PTS: 1
3. Nursing research should be utilized by:
a. Nurses at the bedside
b. Advanced practice nurses
c. Nurse researchers
d. Nurses at all levels of practice
ANS: D PTS: 1
4. A clinical guideline may be found useful if the guideline was:
a. Published 2 years ago
b. Created using one group
c. Authored by a relatively unknown source
d. Funded by an anonymous source
ANS: A PTS: 1
5. Practice guidelines are designed to:
a. Be inflexible
b. Be utilized in every circumstance
c. Provide a reference point for decision making
d. Be created by a professional organization to guide the practice of a profession
ANS: C PTS: 1
6. Which of the following is an example of determining whether a crucial element of a
guideline is applicable to your patients?
a. There are no intended specific patients in the guideline.
b. You are a primary-care provider and the guidelines were written for primary-care
providers.
______________________________________________________________________________________________
3|Page
,______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
c. Your patients have a much lower prevalence of a condition than the patients in the
guideline.
d. You are a pediatric oncologist and the guidelines were written for geriatric
specialists.
ANS: B PTS: 1
7. Which of the following would be considered the research design for Level I evidence?
a. Single, well-designed, randomized clinical trial
b. Systematic review of randomized clinical trial studies
c. Well-designed controlled trials without randomization
d. Systematic reviews of descriptive or qualitative studies
ANS: B PTS: 1
8. Which of the following would be considered the research design for Level II evidence?
a. Single descriptive or qualitative study
b. Well-designed case control or cohort studies
c. Single, well-designed, randomized clinical trial
d. Systematic review of randomized clinical trial studies
ANS: C PTS: 1
9. Which of the following would be considered the research design for Level III evidence?
a. Well-designed controlled trials without randomization
b. Systematic reviews of descriptive or qualitative studies
c. Systematic review of randomized clinical trial studies
d. Opinion of authorities and expert committees
ANS: A PTS: 1
10. Which of the following would be considered the research design for Level IV evidence?
a. Single descriptive or qualitative study
b. Opinion of authorities and expert committees
c. Systematic review of randomized clinical trial studies
d. Well-designed controlled trials without randomization
ANS: D PTS: 1
11. Which of the following would be considered the research design for Level V evidence?
a. Systematic review of randomized clinical trial studies
b. Well-designed controlled trials without randomization
c. Systematic reviews of descriptive or qualitative studies
d. Single descriptive or qualitative study
ANS: C PTS: 1
12. Which of the following would be considered the research design for Level VI evidence?
a. Systematic reviews of descriptive or qualitative studies
b. Opinion of authorities and expert committees
c. Well-designed case control or cohort studies
d. Single descriptive or qualitative study
______________________________________________________________________________________________
4|Page
,______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
ANS: C PTS: 1
13. Which of the following would be considered the research design for Level VII evidence?
a. Well-designed controlled trials without randomization
b. Opinion of authorities and expert committees
c. Well-designed case control or cohort studies
d. Single descriptive or qualitative study
ANS: B PTS: 1
______________________________________________________________________________________________
5|Page
,______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
Unit 02, Section 1. Neurological Problems
MULTIPLE CHOICE
1. Which statement about confusion is true?
a. Confusion is a disease process.
b. Confusion is always temporary.
c. Age is a reliable predictor of confusion.
d. Polypharmacy is a major contributor to confusion in older adults.
ANS: D PTS: 1
2. Which of the following indicates a diagnosis of dementia?
a. Onset after an infection
b. Abrupt onset over a week
c. Difficulty with long-term memory
d. Hard time finding words
ANS: D PTS: 1
3. Which of the following aspects of the patient history is a hallmark of delirium?
a. Patient has chronic kidney disease.
b. Patient has had aphasia for a year.
c. Patient has diabetes mellitus.
d. Patient has been getting lost driving home.
ANS: A PTS: 1
4. Which of the following may trigger migraines?
a. Taking an ibuprofen for muscle pain
b. A cup of coffee with regular sweetener
c. A glass of merlot wine
d. Drinking a cup of green tea
ANS: C PTS: 1
5. Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following
medications will help to decrease edema in the labyrinth of the ear?
a. Meclizine
b. Diphenhydramine
c. Diamox
d. Promethazine
ANS: C PTS: 1
6. The hallmark of an absence seizure is:
a. No activity at all
b. A blank stare
c. Urine is usually voided involuntarily
d. The attack usually lasts several minutes
______________________________________________________________________________________________
6|Page
, ______________________________________________________________________________________________
Test Bank - Primary Care: The Art and Science of Advanced Practice Nursing, 5th Edition (Dunphy, 2019)
ANS: B PTS: 1
7. Which of the following persons fits the classic description of a patient with multiple
sclerosis (MS)?
a. A teenage male
b. A 65-year-old male
c. A 25-year-old female
d. A 60-year-old female
ANS: C PTS: 1
8. Which of the following is a specific test to MS?
a. Magnetic resonance imaging (MRI)
b. Computed tomography (CT) scan
c. A lumbar puncture
d. There is no specific test
ANS: D PTS: 1
9. Over the course of 3 years, a patient has had two MS flares. The patient’s primary
complaints during the episodes are bilateral tingling and pain in their legs, depression, and
numbness in their right hand with complete recovery in between occurrences. Which MS
classification fits their disease process?
a. Clinically isolated syndrome
b. Relapsing-remitting
c. Primary progressive
d. Secondary progressive
ANS: B PTS: 1
10. A patient with MS is complaining of new-onset “electric tingling” in both their arms. Which
medication specifically treats these acute exacerbations?
a. Lemtrada
b. Aubagio
c. Zanaflex
d. Depo-Medrol
ANS: D PTS: 1
11. Which of the following is a risk factor for developing Alzheimer’s disease?
a. Having a master’s or doctoral degree
b. Patient is a physician
c. Patient has Down’s syndrome
d. History of neurological disease
ANS: C PTS: 1
12. Which drug for Alzheimer’s disease should be administered beginning at the time of
diagnosis?
a. Cholinesterase inhibitors
b. Anxiolytics
______________________________________________________________________________________________
7|Page
