,Primary Care: Art and Science of Advanced Practice Nursing (6e) –
Dunphy
Comprehensive Test Bank & Study Guide Table of Contents
I. Caring-Based Nursing: The Art
1. Primary Care in the Twenty-First Century: A Circle of Caring
2. Caring and the Role of the Advanced Practice Nurse
3. Health Promotion and Disease Prevention
4. The Art of Diagnosis and Therapeutic Decision-Making
5. Evidence-Based Practice in Advanced Nursing Care
II. Caring-Based Nursing: The Science
Section 1: Neurological Disorders
6. Common Neurological Presentations
7. Seizure Disorders
8. Neurodegenerative Disorders
9. Cerebrovascular Accident (Stroke)
10. Infectious and Inflammatory Neurological Conditions
Section 2: Dermatological Disorders
11. Common Skin Complaints
12. Parasitic Skin Infestations
13. Mucocutaneous Fungal Infections
14. Bacterial Skin Infections
15. Viral Skin Infections
16. Dermatitis and Inflammatory Skin Conditions
17. Evaluation of Skin Lesions
Section 3: Ophthalmologic Disorders
18. Common Eye Complaints
19. Eyelid and Conjunctival Pathology
20. Visual Disturbances and Impaired Vision
Section 4: Ear, Nose, and Throat Disorders
21. Common Ear, Nose, and Throat Complaints
22. Hearing and Balance Disorders
23. Inflammatory and Infectious Ear Disorders
, 24. Inflammatory and Infectious Disorders of the Nose, Sinuses, Mouth, and Throat
25. Epistaxis (Nosebleeds)
26. Temporomandibular Joint Disorders
27. Dysphonia and Voice Disorders
Section 5: Respiratory Disorders
28. Common Respiratory Complaints
29. Sleep Apnea
30. Infectious Respiratory Disorders
31. Inflammatory Respiratory Disorders
32. Lung Cancer
33. Smoking Addiction and Tobacco Use Disorder
Section 6: Cardiovascular Disorders
34. Common Cardiovascular Complaints
35. Cardiac and Associated Risk Disorders
36. Dysrhythmias and Valvular Heart Disorders
37. Peripheral Vascular Disorders
Section 7: Gastrointestinal Disorders
38. Common Abdominal Complaints
39. Infectious Gastrointestinal Disorders
40. Gastric and Intestinal Disorders
41. Gallbladder and Pancreatic Disorders
42. Cirrhosis and Liver Failure
Section 8: Renal and Urologic Disorders
43. Common Urinary Complaints
44. Urinary Tract Disorders
45. Kidney and Bladder Disorders
Section 9: Gender-Related Health Disorders
46. Common Reproductive System Complaints
47. Reproductive System Health Issues
48. Breast Disorders
49. Vaginal, Uterine, and Ovarian Disorders
50. Prostate Disorders
51. Penile and Testicular Disorders
52. Sexually Transmitted Infections (STIs)
Section 10: Musculoskeletal Disorders
53. Common Musculoskeletal Complaints
54. Spinal Disorders
55. Soft-Tissue Disorders
, 56. Osteoarthritis and Osteoporosis
Section 11: Endocrine and Metabolic Disorders
57. Common Endocrine and Metabolic Complaints
58. Glandular Disorders
59. Diabetes Mellitus
60. Metabolic Disorders
Section 12: Hematologic and Immunologic Disorders
61. Common Hematologic and Immunologic Complaints
62. Hematologic Disorders
63. Immunologic Disorders
64. Infectious Diseases
Section 13: Psychosocial and Mental Health Disorders
65. Common Psychological Complaints
66. Neurodevelopmental Disorders
67. Substance-Related and Addictive Disorders
68. Schizophrenia Spectrum and Other Psychotic Disorders
69. Mood Disorders
70. Anxiety Disorders and Post-Traumatic Stress Disorder
71. Obsessive-Compulsive and Related Disorders
72. Other Psychiatric Disorders
73. Sexual Assault
74. Human Trafficking
Section 14: Urgent and Emergent Care
75. Common Injuries
76. Toxic and Environmental Exposures
III. Caring-Based Nursing: The Practice
Section 1: Care of Vulnerable Populations
77. Primary Care of Adolescents
78. Sports Physicals and Pre-Participation Exams
79. Primary Care of Transgender Patients
80. Primary Care of Veterans
81. Primary Care of Patients with Cancer
82. Primary Care of Older Adults
83. Pain Management
Section 2: Special Topics in Advanced Practice (Online Only)
,84. Palliative and End-of-Life Care
85. Ethical and Legal Issues in Caring-Based Practice
86. Quality and Value-Based Payment in Health Care
87. Primary Care Approaches to Behavioral Health
88. Putting Caring into Practice: Self-Care for Advanced Practice Nurses
**Chapter 1
Primary Care in the Twenty-First Century: A Circle of Caring**
1) A nurse conducts a literature review examining the impact of handwashing on the
incidence of nosocomial (hospital-acquired) infections in acute care settings. A study
reports findings with a level of significance of p < 0.01. What does this indicate?
,A. The control and experimental groups were more than 99% similar
B. The study findings have less than a 1% probability of being due to chance
C. The intervention produced almost no measurable effect
D. The clinical importance of the findings is less than 1 in 100
Correct Answer: B
Rationale:
The level of significance reflects the likelihood that study results occurred by chance. A p-value < 0.01
means there is less than a 1% probability that the findings are attributable to chance, indicating strong
statistical significance.
2) A nurse reviews a qualitative research study exploring the lived experiences of parents
who have experienced neonatal loss. Which question should the nurse prioritize when
evaluating this study?
A. How accurately did the researchers portray the parents’ lived experiences?
B. How well were confounding variables controlled?
C. Were appropriate statistical analyses applied?
D. Were the measurement instruments statistically valid and reliable?
Correct Answer: A
Rationale:
Qualitative research focuses on meaning, perception, and lived experience, not statistical control or
measurement reliability. The primary criterion is how well the study captures and conveys participants’
subjective experiences.
3) A nurse questions the relevance of nursing research, suggesting it has little impact on
clinical practice. How can a colleague best justify the importance of nursing research?
A. It allows nurses to obtain federal research grants
B. It supports the development of graduate nursing programs
C. It enhances the professional image of nursing
D. It improves nursing practice and patient outcomes
Correct Answer: D
Rationale:
The primary purpose of nursing research is to generate evidence that enhances clinical practice and
improves patient outcomes. Professional recognition and educational advancement are secondary
benefits.
4) Tracy, a baccalaureate-prepared nurse working in labor and delivery, observes that
many mothers stop breastfeeding when early challenges arise. She wonders how
breastfeeding continuation can be improved. What role is Tracy most likely to play in a
related research project?
A. Applying for research grant funding
B. Identifying and proposing the clinical problem
C. Designing the study methodology
D. Implementing the intervention and publishing results
Correct Answer: B
,Rationale:
Staff nurses play a key role in identifying clinical problems and research questions. Tasks such as grant
writing, study design, and publication are typically handled by nurses with advanced degrees.
5) A patient signed an informed consent form for a drug trial after speaking with a
research assistant. Later, the patient tells the nurse that he did not understand the
explanation or his role in the study. How should the nurse respond?
A. Re-explain the research study in detail
B. Explain randomized controlled trials
C. Notify the research assistant that the consent may be invalid
D. Inform the patient that the consent is legally binding
Correct Answer: C
Rationale:
The nurse is not responsible for obtaining research consent. If a patient expresses misunderstanding
or uncertainty, the appropriate action is to notify the research team member responsible for consent
to reassess and clarify participation.
6) A nurse leader is promoting evidence-based practice (EBP) on a unit. Which elements
are integrated when a nurse applies EBP?
(Select all that apply.)
A. Interdisciplinary consensus
B. Nursing tradition
C. Research evidence
D. Patient preferences and values
E. Clinical expertise
Correct Answers: C, D, E
Rationale:
Evidence-based practice integrates best research evidence, clinical expertise, and patient preferences
and values. Tradition and consensus alone do not meet EBP criteria.
7) A nurse proposes maggot therapy for debriding a diabetic foot ulcer based on strong
evidence. The patient finds the treatment unacceptable and refuses. How should the
nurse apply EBP principles?
A. Emphasize that research evidence outweighs patient opinion
B. Provide additional explanation of the evidence
C. Incorporate the patient’s preferences into the care plan
D. Transfer decision-making to family members
Correct Answer: C
Rationale:
EBP requires balancing research evidence, clinical expertise, and patient values. Evidence does not
override patient autonomy or preferences.
8) Nurses are helping administrators decide whether to purchase pressure-reducing
mattresses to prevent pressure ulcers. Which evidence source should be prioritized?
A. A qualitative study on living with pressure ulcers
B. A descriptive case study from a geriatric unit
, C. Expert clinician testimonials
D. A randomized controlled trial comparing mattress types
Correct Answer: D
Rationale:
Randomized controlled trials (RCTs) provide the highest level of evidence when evaluating the
effectiveness of interventions.
9) Hospital administrators are applying EBP to improve communication between nurses
on different units. Which information source should they prioritize?
A. A systematic review on nursing communication
B. Nurses’ informal suggestions
C. Chart audit results
D. Hospital accreditation status
Correct Answer: A
Rationale:
Systematic reviews synthesize multiple high-quality studies and are considered one of the strongest
sources of evidence in EBP decision-making.
Dunphy
Comprehensive Test Bank & Study Guide Table of Contents
I. Caring-Based Nursing: The Art
1. Primary Care in the Twenty-First Century: A Circle of Caring
2. Caring and the Role of the Advanced Practice Nurse
3. Health Promotion and Disease Prevention
4. The Art of Diagnosis and Therapeutic Decision-Making
5. Evidence-Based Practice in Advanced Nursing Care
II. Caring-Based Nursing: The Science
Section 1: Neurological Disorders
6. Common Neurological Presentations
7. Seizure Disorders
8. Neurodegenerative Disorders
9. Cerebrovascular Accident (Stroke)
10. Infectious and Inflammatory Neurological Conditions
Section 2: Dermatological Disorders
11. Common Skin Complaints
12. Parasitic Skin Infestations
13. Mucocutaneous Fungal Infections
14. Bacterial Skin Infections
15. Viral Skin Infections
16. Dermatitis and Inflammatory Skin Conditions
17. Evaluation of Skin Lesions
Section 3: Ophthalmologic Disorders
18. Common Eye Complaints
19. Eyelid and Conjunctival Pathology
20. Visual Disturbances and Impaired Vision
Section 4: Ear, Nose, and Throat Disorders
21. Common Ear, Nose, and Throat Complaints
22. Hearing and Balance Disorders
23. Inflammatory and Infectious Ear Disorders
, 24. Inflammatory and Infectious Disorders of the Nose, Sinuses, Mouth, and Throat
25. Epistaxis (Nosebleeds)
26. Temporomandibular Joint Disorders
27. Dysphonia and Voice Disorders
Section 5: Respiratory Disorders
28. Common Respiratory Complaints
29. Sleep Apnea
30. Infectious Respiratory Disorders
31. Inflammatory Respiratory Disorders
32. Lung Cancer
33. Smoking Addiction and Tobacco Use Disorder
Section 6: Cardiovascular Disorders
34. Common Cardiovascular Complaints
35. Cardiac and Associated Risk Disorders
36. Dysrhythmias and Valvular Heart Disorders
37. Peripheral Vascular Disorders
Section 7: Gastrointestinal Disorders
38. Common Abdominal Complaints
39. Infectious Gastrointestinal Disorders
40. Gastric and Intestinal Disorders
41. Gallbladder and Pancreatic Disorders
42. Cirrhosis and Liver Failure
Section 8: Renal and Urologic Disorders
43. Common Urinary Complaints
44. Urinary Tract Disorders
45. Kidney and Bladder Disorders
Section 9: Gender-Related Health Disorders
46. Common Reproductive System Complaints
47. Reproductive System Health Issues
48. Breast Disorders
49. Vaginal, Uterine, and Ovarian Disorders
50. Prostate Disorders
51. Penile and Testicular Disorders
52. Sexually Transmitted Infections (STIs)
Section 10: Musculoskeletal Disorders
53. Common Musculoskeletal Complaints
54. Spinal Disorders
55. Soft-Tissue Disorders
, 56. Osteoarthritis and Osteoporosis
Section 11: Endocrine and Metabolic Disorders
57. Common Endocrine and Metabolic Complaints
58. Glandular Disorders
59. Diabetes Mellitus
60. Metabolic Disorders
Section 12: Hematologic and Immunologic Disorders
61. Common Hematologic and Immunologic Complaints
62. Hematologic Disorders
63. Immunologic Disorders
64. Infectious Diseases
Section 13: Psychosocial and Mental Health Disorders
65. Common Psychological Complaints
66. Neurodevelopmental Disorders
67. Substance-Related and Addictive Disorders
68. Schizophrenia Spectrum and Other Psychotic Disorders
69. Mood Disorders
70. Anxiety Disorders and Post-Traumatic Stress Disorder
71. Obsessive-Compulsive and Related Disorders
72. Other Psychiatric Disorders
73. Sexual Assault
74. Human Trafficking
Section 14: Urgent and Emergent Care
75. Common Injuries
76. Toxic and Environmental Exposures
III. Caring-Based Nursing: The Practice
Section 1: Care of Vulnerable Populations
77. Primary Care of Adolescents
78. Sports Physicals and Pre-Participation Exams
79. Primary Care of Transgender Patients
80. Primary Care of Veterans
81. Primary Care of Patients with Cancer
82. Primary Care of Older Adults
83. Pain Management
Section 2: Special Topics in Advanced Practice (Online Only)
,84. Palliative and End-of-Life Care
85. Ethical and Legal Issues in Caring-Based Practice
86. Quality and Value-Based Payment in Health Care
87. Primary Care Approaches to Behavioral Health
88. Putting Caring into Practice: Self-Care for Advanced Practice Nurses
**Chapter 1
Primary Care in the Twenty-First Century: A Circle of Caring**
1) A nurse conducts a literature review examining the impact of handwashing on the
incidence of nosocomial (hospital-acquired) infections in acute care settings. A study
reports findings with a level of significance of p < 0.01. What does this indicate?
,A. The control and experimental groups were more than 99% similar
B. The study findings have less than a 1% probability of being due to chance
C. The intervention produced almost no measurable effect
D. The clinical importance of the findings is less than 1 in 100
Correct Answer: B
Rationale:
The level of significance reflects the likelihood that study results occurred by chance. A p-value < 0.01
means there is less than a 1% probability that the findings are attributable to chance, indicating strong
statistical significance.
2) A nurse reviews a qualitative research study exploring the lived experiences of parents
who have experienced neonatal loss. Which question should the nurse prioritize when
evaluating this study?
A. How accurately did the researchers portray the parents’ lived experiences?
B. How well were confounding variables controlled?
C. Were appropriate statistical analyses applied?
D. Were the measurement instruments statistically valid and reliable?
Correct Answer: A
Rationale:
Qualitative research focuses on meaning, perception, and lived experience, not statistical control or
measurement reliability. The primary criterion is how well the study captures and conveys participants’
subjective experiences.
3) A nurse questions the relevance of nursing research, suggesting it has little impact on
clinical practice. How can a colleague best justify the importance of nursing research?
A. It allows nurses to obtain federal research grants
B. It supports the development of graduate nursing programs
C. It enhances the professional image of nursing
D. It improves nursing practice and patient outcomes
Correct Answer: D
Rationale:
The primary purpose of nursing research is to generate evidence that enhances clinical practice and
improves patient outcomes. Professional recognition and educational advancement are secondary
benefits.
4) Tracy, a baccalaureate-prepared nurse working in labor and delivery, observes that
many mothers stop breastfeeding when early challenges arise. She wonders how
breastfeeding continuation can be improved. What role is Tracy most likely to play in a
related research project?
A. Applying for research grant funding
B. Identifying and proposing the clinical problem
C. Designing the study methodology
D. Implementing the intervention and publishing results
Correct Answer: B
,Rationale:
Staff nurses play a key role in identifying clinical problems and research questions. Tasks such as grant
writing, study design, and publication are typically handled by nurses with advanced degrees.
5) A patient signed an informed consent form for a drug trial after speaking with a
research assistant. Later, the patient tells the nurse that he did not understand the
explanation or his role in the study. How should the nurse respond?
A. Re-explain the research study in detail
B. Explain randomized controlled trials
C. Notify the research assistant that the consent may be invalid
D. Inform the patient that the consent is legally binding
Correct Answer: C
Rationale:
The nurse is not responsible for obtaining research consent. If a patient expresses misunderstanding
or uncertainty, the appropriate action is to notify the research team member responsible for consent
to reassess and clarify participation.
6) A nurse leader is promoting evidence-based practice (EBP) on a unit. Which elements
are integrated when a nurse applies EBP?
(Select all that apply.)
A. Interdisciplinary consensus
B. Nursing tradition
C. Research evidence
D. Patient preferences and values
E. Clinical expertise
Correct Answers: C, D, E
Rationale:
Evidence-based practice integrates best research evidence, clinical expertise, and patient preferences
and values. Tradition and consensus alone do not meet EBP criteria.
7) A nurse proposes maggot therapy for debriding a diabetic foot ulcer based on strong
evidence. The patient finds the treatment unacceptable and refuses. How should the
nurse apply EBP principles?
A. Emphasize that research evidence outweighs patient opinion
B. Provide additional explanation of the evidence
C. Incorporate the patient’s preferences into the care plan
D. Transfer decision-making to family members
Correct Answer: C
Rationale:
EBP requires balancing research evidence, clinical expertise, and patient values. Evidence does not
override patient autonomy or preferences.
8) Nurses are helping administrators decide whether to purchase pressure-reducing
mattresses to prevent pressure ulcers. Which evidence source should be prioritized?
A. A qualitative study on living with pressure ulcers
B. A descriptive case study from a geriatric unit
, C. Expert clinician testimonials
D. A randomized controlled trial comparing mattress types
Correct Answer: D
Rationale:
Randomized controlled trials (RCTs) provide the highest level of evidence when evaluating the
effectiveness of interventions.
9) Hospital administrators are applying EBP to improve communication between nurses
on different units. Which information source should they prioritize?
A. A systematic review on nursing communication
B. Nurses’ informal suggestions
C. Chart audit results
D. Hospital accreditation status
Correct Answer: A
Rationale:
Systematic reviews synthesize multiple high-quality studies and are considered one of the strongest
sources of evidence in EBP decision-making.
