Test Bank for Primary Care The Art and Science of Advanced Practice Nursing – an Interprofessional Approach 6th Edition by Dunphy, WinlandBrown, Porter, and Thomas

Test Bank for Primary Care The Art and Science of Advanced Practice Nursing – an Interprofessional Approach 6th Edition by Dunphy, WinlandBrown, Porter, and Thomas Sample Questions Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring 1. A professional nursing practitioner has conducted a literature review in an effort to identify the effect of handwashing on theincidence of nosocomial (hospital-acquired) infections in acute care settings. An article presented findings at a level of significance of <0.01. This indicates that A) the control group and the experimental group were more than 99% similar. B) the findings of the study have less than 1% chance of being attributable to chance. C) the effects of the intervention were nearly zero. D) the clinical significance of the findings was less than 1:100. CORRECT RESPOSE B DETAILED EXPLANATION The level ofsignificance is the level at which the researcher believes that the study resultsmost likely represent a nonchance event. A level of significance of <0.01 indicates that there is less than 1% probability that the result is due to chance. 2. A professional nursing practitioner has read a qualitative research paper in order to understand the lived experience of parentswho have a neonatal loss. Which of the following questions should the professional nursing practitioner prioritize when appraising the results of this study? A) How well did the authors capture the personal experiences of these parents? B) How well did the authors control for confounding variables that may have affected the findings? C) Did the authors use statistical measures that were appropriate to the phenomenon in question? D) Were the instruments that the researchers used statistically valid and reliable? CORRECT RESPOSE A DETAILED EXPLANATION Qualitative studies are judged on the basis of how well they capture and convey the subjective experiences of individuals. Statistical measures and variables are not dimensions of aqualitative methodology. 3. A professional nursing practitioner has expressed skepticism to a colleague about the value of nursing research, claiming thatnursing research has little relevance to practice. How can the professional nursing practitioners colleague best defend the importance of nursing research? A) The existence of nursing research means that professional nursing practitioners are now able to access federal grant money,something that didn’t use to be the case. B) Nursing research has allowed the development of masters and doctoral programs and has greatly increased the credibility of the profession. C) The growth of nursing research has caused nursing to be viewed as a true profession, rather than simply as a trade or a skill. D) The application of nursing research has the potential to improve nursing practice and client outcomes. CORRECT RESPOSE D DETAILED EXPLANATION The greatest value of nursing research lies in the potential to improve practice and, ultimately, to improve client outcomes. This supersedes the contributions of nursing research toeducation programs, grant funding, or the public view of the profession. 4. Tracy is A professional nursing practitioner with a baccalaureate degree who works in the labor and delivery unit of a busyurban hospital. She has noticed that many new mothers abandon breast-feeding their babies whenthey experience early challenges and wonders what could be done to encourage more women to continue breast-feeding. What role is Tracy most likely to play in a research project that tests an intervention aimed at promoting breast-feeding? A) Applying for grant funding for the research project B) Posing the clinical problem to one or more nursing researchers C) Planning the methodology of the research project D) Carrying out the intervention and submitting the results for publication CORRECT RESPOSE B DETAILED EXPLANATION A major role for staff professional nursing practitioners is to identify questions or problems for research. Grantapplications, methodological planning, and publication submission are normally carried out byprofessional nursing practitioners who have advanced degrees in nursing. 5. A client signed the informed consent form for a drug trial that was explained to client by a research assistant. Later, the client admitted to his professional nursing practitioner that he did not understand the researchassistants explanation or his own role in the study. How should this clients professional nursing practitioner respond to thisrevelation? A) Explain the research process to the client in greater detail. B) Describe the details of a randomized controlled trial for the client. C) Inform the research assistant that the clients consent is likely invalid. D) Explain to the client that his written consent is now legally binding. CORRECT RESPOSE C DETAILED EXPLANATION Just as the staff professional nursing practitioner is not responsible for medical consent, the staff professional nursing practitioner is not responsible for research consent. If clients who have agreed to participate exhibit ambivalence or uncertainty about participating, do not try to convince them to participate. Ask the person from the research team who is managing consents to speak with concerned clients about the study, even aftera client has signed the consent forms. Multiple Selection 6. A professional nursing practitioner leader is attempting to increase the awareness of evidencebased practice (EBP) among the professional nursing practitioners on a unit. A professional nursing practitioner who is implementing EBP integrates which of the following? (Select allthat apply.) A) Interdisciplinary consensus B) Nursing tradition C) Research studies D) Client preferences and values E) Clinical expertise CORRECT RESPOSE C, D, E DETAILED EXPLANATION Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-solving approach to the delivery of healthcare that integrates the best evidence from studies and client caredata with clinician expertise and client preferences and values. Multiple Choice 7. Mrs. Mayes is a 73-year-old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now poses a threat of osteomyelitis. The wound care professional nursing practitioner who has been working with Mrs. Mayes applies evidence-based practice (EBP) whenever possible and has proposed the useof maggot therapy to debride necrotic tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this treatment despite the sizable body of evidence supporting it. How shouldthe professional nursing practitioner reconcile Mrs. Mayes views with the principles of EBP? A) The professional nursing practitioner should explain that reliable and valid research evidence overrides the clients opinion. B) The professional nursing practitioner should explain the evidence to the client in greater detail. C) The professional nursing practitioner should integrate the client’s preferences into the plan of care. D) The professional nursing practitioner should involve the client’s family members in the decisionmaking process. CORRECT RESPOSE C DETAILED EXPLANATION Client preferences should be integrated into EBP and considered alongside research evidence and the professional nursing practitioners clinical expertise; evidence does not trump the clients’ preferences. Thefamily should be involved, but this is not an explicit dimension of EBP. Similarly, explaining theevidence in more detail is not a demonstration of EBP. 8. The administrators of a long-term care facility are considered the use of specialized, pressurereducing mattresses in order to reduce the incidence of pressure ulcers among residents. They have sought input from the professional nursing practitioners on the unit, all of whom are aware of the need to implement the principles of evidence-based practice (EBP) in this decision. Which of the following evidence sources should the professional nursing practitioners prioritize? A) A qualitative study that explores the experience of living with a pressure ulcer B) A case study that describes the measures that professional nursing practitioners on a geriatric unit took to reduce pressureulcers among clients C) Testimonials from experienced clinicians about the effectiveness of the mattress in question D) A randomized controlled trial that compared the pressure-reducing mattress with standard mattresses CORRECT RESPOSE D DETAILED EXPLANATION The most reliable evidence is considered RCTs. Qualitative studies, case studies, andexpert opinion are low on the hierarchy of evidence. 9. Hospital administrators are applying the principles of evidence-based practice (EBP) in their attempt to ascertain the most efficient and effective way to communicate between professional nursing practitioners who are ondifferent units, a project that will consider many types of evidence. Which of the following information sources should the administrators prioritize? A) A systematic review about communication in nursing contexts B) Professional nursing practitioners ideas about communication methods C) The results of a chart review D) The hospitals accreditation status CORRECT RESPOSE A DETAILED EXPLANATION Systematic reviews are assigned a high value in EBP. Reviews would be prioritized overprofessional nursing practitioners ideas or a chart review, though both are potential considerations. The hospitals accreditationstatus is not a relevant consideration. 10. A professional nursing practitioner has resolved to apply the evidence-based practice (EBP) process to the way that admission assessments are conducted and documented on a unit. How should the professional nursing practitioner begin theprocess of establishing EBP? A) Gather evidence showing the shortcomings of current practices B) Formulate a clear and concise question to be addressed C) Elicit support from the professional nursing practitioners who are most often responsible for admissions D) Search the literature for evidence that is potentially relevant to the practice need CORRECT RESPOSE B DETAILED EXPLANATION The first step in applying EBP is to ask a clear, focused question. This should precede asearch of the literature or the recruitment of participants. An assessment of the shortcomings of thecurrent system is not an explicit component of the EBP process. 11. Which of the following questions best exemplifies the PICOT format for asking evidence-based questions? A) What affect does parents alcohol use have on the alcohol use of their teenage children? B) Among postsurgical clients, what role does meditation rather than benzodiazepines have on anxiety levels during the 48 hours following surgery? C) Among high school students, what is the effectiveness of a sexual health campaign undertaken during the first 4 weeks of the fall semester as measured by incidence of new sexually transmitted infections? D) In children aged 68, is the effectiveness of a descriptive pain scale superior to a numeric rating scale in the emergency room context? DETAILED EXPLANATION The correct answer includes a population (postsurgical clients), intervention (meditation), comparison (benzodiazepines), outcome (anxiety levels), and a time frame (48 hours).No other option contains each of the five elements of a PICOT question. 12. A professional nursing practitioner has made plans to implement the University of North Carolina (UNC) model of 5 Asduring the process of applying evidence-based practice (EBP) to a practice problem. What is the final step that the professional nursing practitioner will take in applying this model? A) Analyze the results of the EBP process