TEST BANK Primary Care The Art and Science of Advanced
i i i i i i i i i
Practice Nursing – An Interprofessional Approach 6th Edition
i i i i i i i
by Debera J. Dunphy| Complete Guide Chapter 1-82
i i i i i i i
•
Primary iCare: iArt iand iScience iof iAdvanced iPractice iNursing i- iAn
th i
iInterprofessional i Approach i5 edition iDunphy iTest iBank
Chapter i1. iPrimary iCare iin ithe iTwenty-First iCentury: iA iCircle iof iCaring
. iA inurse ileader iis iattempting ito iincrease ithe iawareness iof ievidence-based ipractice i(EBP) iamong
ithe i nurses ion ia iunit. iA inurse iwho iis iimplementing iEBP iintegrates iwhich iof ithe ifollowing?
i (Select iall i that iapply.)
A) Interdisciplinary iconsensus
B) Nursing itradition
C) Research istudies
D) Patient ipreferences iand ivalues
E) Clinical
i expertise i Ans: iC,
i D, iE
Feedback: iFineout-Overholt, iMelnyk, iStillwell, iand iWilliamson idefine iEBP ias ia iproblem-solving
i approach ito ithe idelivery iof ihealthcare ithat iintegrates ithe ibest ievidence ifrom istudies iand ipatient
icare i data iwith iclinician iexpertise iand ipatient ipreferences iand ivalues.
Multiple iChoice
. iMrs. iMayes iis ia i73-year-old iwoman iwho ihas ia idiabetic ifoot iulcer ithat ihas ibeen iextremely islow
ito i heal iand iwhich inow iposes ia ithreat iof iosteomyelitis. iThe iwound icare inurse iwho ihas ibeen
iworking i with iMrs. iMayes iapplies ievidence-based ipractice i(EBP) iwhenever ipossible iand ihas
iproposed ithe iuse i of imaggot itherapy ito idebride inecrotic itissue. iMrs. iMayes, ihowever, ifinds ithe
isuggestion irepugnant i and iadamantly iopposes ithis itreatment idespite ithe isizable ibody iof ievidence
isupporting iit. iHow ishould i the inurse ireconcile iMrs. iMayes iviews iwith ithe iprinciples iof iEBP?
,A) The inurse ishould iexplain ithat ireliable iand ivalid iresearch ievidence ioverrides ithe ipatients iopinion.
B) The inurse ishould iexplain ithe ievidence ito ithe ipatient iin igreater idetail.
C) The inurse ishould iintegrate ithe ipatients ipreferences iinto ithe iplan iof icare.
D) The inurse ishould iinvolve ithe ipatients ifamily imembers iin ithe idecision-making
process. i Ans: iC
i
Feedback: iPatient ipreferences ishould ibe iintegrated iinto iEBP iand iconsidered ialongside iresearch
i evidence iand ithe inurses iclinical iexpertise; ievidence idoes inot itrump ithe ipatients ipreferences. iThe
i family ishould ibe iinvolved, ibut ithis iis inot ian iexplicit idimension iof iEBP. iSimilarly, iexplaining ithe
i evidence iin imore idetail iis inot ia idemonstration iof iEBP.
1. A inurse ihas iconducted ia iliterature ireview iin ian ieffort ito iidentify ithe ieffect iof ihandwashing ion
ithe i incidence iof inosocomial i(hospital-acquired) iinfections iin iacute icare isettings. iAn iarticle
ipresented i findings iat ia ilevel iof isignificance iof i<0.01. iThis iindicates ithat
A) the icontrol igroup iand ithe iexperimental igroup iwere imore ithan i99% isimilar.
B) the ifindings iof ithe istudy ihave iless ithan i1% ichance iof ibeing iattributable ito ichance.
C) the ieffects iof ithe iintervention iwere inearly izero.
D) the iclinical isignificance iof ithe ifindings iwas iless ithan
i 1:100. i Ans: iB
Feedback: iThe ilevel iof isignificance iis ithe ilevel iat iwhich ithe iresearcher ibelieves ithat ithe istudy
iresults i most ilikely irepresent ia inonchance ievent. iA ilevel iof isignificance iof i<0.01 iindicates ithat
ithere iis iless i than i1% iprobability ithat ithe iresult iis idue ito ichance.
2. A inurse ihas iread ia iqualitative iresearch istudy iin iorder ito iunderstand ithe ilived iexperience iof
iparents i who ihave ia ineonatal iloss. iWhich iof ithe ifollowing iquestions ishould ithe inurse iprioritize
iwhen i appraising ithe iresults iof ithis istudy?
A) How iwell idid ithe iauthors icapture ithe ipersonal iexperiences iof ithese iparents?
B) How iwell idid ithe iauthors icontrol ifor iconfounding ivariables ithat imay ihave iaffected ithe ifindings?
C) Did ithe iauthors iuse istatistical imeasures ithat iwere iappropriate ito ithe iphenomenon iin iquestion?
D) Were ithe iinstruments ithat ithe iresearchers iused istatistically ivalid iand
i reliable? i Ans: iA
,Feedback: iQualitative istudies iare ijudged ion ithe ibasis iof ihow iwell ithey icapture iand iconvey ithe
i subjective iexperiences iof iindividuals. iStatistical imeasures iand ivariables iare inot idimensions iof ia
i qualitative imethodology.
3. A inurse ihas iexpressed iskepticism ito ia icolleague iabout ithe ivalue iof inursing iresearch, iclaiming
ithat i nursing iresearch ihas ilittle irelevance ito ipractice. iHow ican ithe inurses icolleague ibest idefend
ithe i importance iof inursing iresearch?
A) The iexistence iof inursing iresearch imeans ithat inurses iare inow iable ito iaccess ifederal igrant
imoney, i something ithat ididnt iuse ito ibe ithe icase.
B) Nursing iresearch ihas iallowed ithe idevelopment iof imasters iand idoctoral iprograms iand ihas
igreatly i increased ithe icredibility iof ithe iprofession.
C) The igrowth iof inursing iresearch ihas icaused inursing ito ibe iviewed ias ia itrue iprofession, irather
ithan i simply ias ia itrade ior ia iskill.
D) The iapplication iof inursing iresearch ihas ithe ipotential ito iimprove inursing ipractice iand
ipatient i outcomes.
Ans: iD
Feedback: iThe igreatest ivalue iof inursing iresearch ilies iin ithe ipotential ito iimprove ipractice iand,
i ultimately, ito iimprove ipatient ioutcomes. iThis isupersedes ithe icontributions iof inursing iresearch ito
i education iprograms, igrant ifunding, ior ithe ipublic iview iof ithe iprofession.
4. Tracy iis ia inurse iwith ia ibaccalaureate idegree iwho iworks iin ithe ilabor iand idelivery iunit iof ia
ibusy i urban ihospital. iShe ihas inoticed ithat imany inew imothers iabandon ibreast-feeding itheir
ibabies iwhen i they iexperience iearly ichallenges iand iwonders iwhat icould ibe idone ito iencourage
imore iwomen ito i continue ibreast-feeding. iWhat irole iis iTracy imost ilikely ito iplay iin ia iresearch
iproject ithat itests ian i intervention iaimed iat ipromoting ibreast-feeding?
A) Applying ifor igrant ifunding ifor ithe iresearch iproject
B) Posing ithe iclinical iproblem ito ione ior imore inursing iresearchers
C) Planning ithe imethodology iof ithe iresearch iproject
D) Carrying iout ithe iintervention iand isubmitting ithe iresults ifor
i publication i Ans: iB
Feedback: iA imajor irole ifor istaff inurses iis ito iidentify iquestions ior iproblems ifor iresearch.
iGrant i applications, imethodological iplanning, i and ipublication isubmission iare inormally
icarried iout iby i nurses iwho ihave iadvanced idegrees iin inursing.
, 5. A ipatient isigned ithe iinformed iconsent iform ifor ia idrug itrial ithat iwas iexplained ito ipatient iby
ia i research iassistant. iLater, ithe ipatient iadmitted ito ihis inurse ithat ihe idid inot iunderstand ithe
iresearch i assistants iexplanation ior ihis iown irole iin ithe istudy. iHow ishould ithis ipatients inurse
irespond ito ithis i revelation?
A) Explain ithe iresearch iprocess ito ithe ipatient iin igreater idetail.
B) Describe ithe idetails iof ia irandomized icontrolled itrial ifor ithe ipatient.
C) Inform ithe iresearch iassistant ithat ithe ipatients iconsent iis ilikely iinvalid.
D) Explain ito ithe ipatient ithat ihis iwritten iconsent iis inow ilegally
binding. i Ans: iC
i
Feedback: iJust ias ithe istaff inurse iis inot iresponsible ifor imedical iconsent, ithe istaff inurse iis inot
i responsible ifor iresearch iconsent. iIf ipatients iwho ihave iagreed ito iparticipate iexhibit iambivalence
ior i uncertainty iabout iparticipating, ido inot itry ito iconvince ithem ito iparticipate. iAsk ithe iperson
ifrom ithe i research iteam iwho iis imanaging iconsents ito ispeak iwith iconcerned ipatients iabout ithe
istudy, ieven iafter i a ipatient ihas isigned ithe iconsent iforms.
Multiple iSelection
8. The iadministrators iof ia ilong-term icare ifacility iare iconsidered ithe iuse iof ispecialized,
i pressurereducing imattresses iin iorder ito ireduce ithe iincidence iof ipressure iulcers iamong iresidents.
i They ihave isought iinput ifrom ithe inurses ion ithe iunit, iall iof iwhom iare iaware iof ithe ineed ito
iimplement i the iprinciples iof ievidence-based ipractice i(EBP) iin ithis idecision. iWhich iof ithe
ifollowing ievidence i sources ishould ithe inurses i prioritize?
A) A iqualitative istudy ithat iexplores ithe iexperience iof iliving iwith ia ipressure iulcer
B) A icase istudy ithat idescribes ithe imeasures ithat inurses ion ia igeriatric iunit itook ito ireduce
ipressure i ulcers iamong ipatients
C) Testimonials ifrom iexperienced iclinicians iabout ithe ieffectiveness iof ithe imattress iin iquestion
D) A irandomized icontrolled itrial ithat icompared ithe ipressure-reducing imattress iwith
istandard i mattresses
Ans: iD
Feedback: iThe imost ireliable ievidence iis iconsidered iRCTs. iQualitative istudies, icase istudies, iand
i expert iopinion iare ilow ion ithe ihierarchy iof ievidence.
9. Hospital iadministrators iare iapplying ithe iprinciples iof ievidence-based ipractice i(EBP) iin itheir
i attempt ito iascertain ithe imost iefficient iand ieffective iway ito icommunicate ibetween inurses iwho
iare ion
i i i i i i i i i
Practice Nursing – An Interprofessional Approach 6th Edition
i i i i i i i
by Debera J. Dunphy| Complete Guide Chapter 1-82
i i i i i i i
•
Primary iCare: iArt iand iScience iof iAdvanced iPractice iNursing i- iAn
th i
iInterprofessional i Approach i5 edition iDunphy iTest iBank
Chapter i1. iPrimary iCare iin ithe iTwenty-First iCentury: iA iCircle iof iCaring
. iA inurse ileader iis iattempting ito iincrease ithe iawareness iof ievidence-based ipractice i(EBP) iamong
ithe i nurses ion ia iunit. iA inurse iwho iis iimplementing iEBP iintegrates iwhich iof ithe ifollowing?
i (Select iall i that iapply.)
A) Interdisciplinary iconsensus
B) Nursing itradition
C) Research istudies
D) Patient ipreferences iand ivalues
E) Clinical
i expertise i Ans: iC,
i D, iE
Feedback: iFineout-Overholt, iMelnyk, iStillwell, iand iWilliamson idefine iEBP ias ia iproblem-solving
i approach ito ithe idelivery iof ihealthcare ithat iintegrates ithe ibest ievidence ifrom istudies iand ipatient
icare i data iwith iclinician iexpertise iand ipatient ipreferences iand ivalues.
Multiple iChoice
. iMrs. iMayes iis ia i73-year-old iwoman iwho ihas ia idiabetic ifoot iulcer ithat ihas ibeen iextremely islow
ito i heal iand iwhich inow iposes ia ithreat iof iosteomyelitis. iThe iwound icare inurse iwho ihas ibeen
iworking i with iMrs. iMayes iapplies ievidence-based ipractice i(EBP) iwhenever ipossible iand ihas
iproposed ithe iuse i of imaggot itherapy ito idebride inecrotic itissue. iMrs. iMayes, ihowever, ifinds ithe
isuggestion irepugnant i and iadamantly iopposes ithis itreatment idespite ithe isizable ibody iof ievidence
isupporting iit. iHow ishould i the inurse ireconcile iMrs. iMayes iviews iwith ithe iprinciples iof iEBP?
,A) The inurse ishould iexplain ithat ireliable iand ivalid iresearch ievidence ioverrides ithe ipatients iopinion.
B) The inurse ishould iexplain ithe ievidence ito ithe ipatient iin igreater idetail.
C) The inurse ishould iintegrate ithe ipatients ipreferences iinto ithe iplan iof icare.
D) The inurse ishould iinvolve ithe ipatients ifamily imembers iin ithe idecision-making
process. i Ans: iC
i
Feedback: iPatient ipreferences ishould ibe iintegrated iinto iEBP iand iconsidered ialongside iresearch
i evidence iand ithe inurses iclinical iexpertise; ievidence idoes inot itrump ithe ipatients ipreferences. iThe
i family ishould ibe iinvolved, ibut ithis iis inot ian iexplicit idimension iof iEBP. iSimilarly, iexplaining ithe
i evidence iin imore idetail iis inot ia idemonstration iof iEBP.
1. A inurse ihas iconducted ia iliterature ireview iin ian ieffort ito iidentify ithe ieffect iof ihandwashing ion
ithe i incidence iof inosocomial i(hospital-acquired) iinfections iin iacute icare isettings. iAn iarticle
ipresented i findings iat ia ilevel iof isignificance iof i<0.01. iThis iindicates ithat
A) the icontrol igroup iand ithe iexperimental igroup iwere imore ithan i99% isimilar.
B) the ifindings iof ithe istudy ihave iless ithan i1% ichance iof ibeing iattributable ito ichance.
C) the ieffects iof ithe iintervention iwere inearly izero.
D) the iclinical isignificance iof ithe ifindings iwas iless ithan
i 1:100. i Ans: iB
Feedback: iThe ilevel iof isignificance iis ithe ilevel iat iwhich ithe iresearcher ibelieves ithat ithe istudy
iresults i most ilikely irepresent ia inonchance ievent. iA ilevel iof isignificance iof i<0.01 iindicates ithat
ithere iis iless i than i1% iprobability ithat ithe iresult iis idue ito ichance.
2. A inurse ihas iread ia iqualitative iresearch istudy iin iorder ito iunderstand ithe ilived iexperience iof
iparents i who ihave ia ineonatal iloss. iWhich iof ithe ifollowing iquestions ishould ithe inurse iprioritize
iwhen i appraising ithe iresults iof ithis istudy?
A) How iwell idid ithe iauthors icapture ithe ipersonal iexperiences iof ithese iparents?
B) How iwell idid ithe iauthors icontrol ifor iconfounding ivariables ithat imay ihave iaffected ithe ifindings?
C) Did ithe iauthors iuse istatistical imeasures ithat iwere iappropriate ito ithe iphenomenon iin iquestion?
D) Were ithe iinstruments ithat ithe iresearchers iused istatistically ivalid iand
i reliable? i Ans: iA
,Feedback: iQualitative istudies iare ijudged ion ithe ibasis iof ihow iwell ithey icapture iand iconvey ithe
i subjective iexperiences iof iindividuals. iStatistical imeasures iand ivariables iare inot idimensions iof ia
i qualitative imethodology.
3. A inurse ihas iexpressed iskepticism ito ia icolleague iabout ithe ivalue iof inursing iresearch, iclaiming
ithat i nursing iresearch ihas ilittle irelevance ito ipractice. iHow ican ithe inurses icolleague ibest idefend
ithe i importance iof inursing iresearch?
A) The iexistence iof inursing iresearch imeans ithat inurses iare inow iable ito iaccess ifederal igrant
imoney, i something ithat ididnt iuse ito ibe ithe icase.
B) Nursing iresearch ihas iallowed ithe idevelopment iof imasters iand idoctoral iprograms iand ihas
igreatly i increased ithe icredibility iof ithe iprofession.
C) The igrowth iof inursing iresearch ihas icaused inursing ito ibe iviewed ias ia itrue iprofession, irather
ithan i simply ias ia itrade ior ia iskill.
D) The iapplication iof inursing iresearch ihas ithe ipotential ito iimprove inursing ipractice iand
ipatient i outcomes.
Ans: iD
Feedback: iThe igreatest ivalue iof inursing iresearch ilies iin ithe ipotential ito iimprove ipractice iand,
i ultimately, ito iimprove ipatient ioutcomes. iThis isupersedes ithe icontributions iof inursing iresearch ito
i education iprograms, igrant ifunding, ior ithe ipublic iview iof ithe iprofession.
4. Tracy iis ia inurse iwith ia ibaccalaureate idegree iwho iworks iin ithe ilabor iand idelivery iunit iof ia
ibusy i urban ihospital. iShe ihas inoticed ithat imany inew imothers iabandon ibreast-feeding itheir
ibabies iwhen i they iexperience iearly ichallenges iand iwonders iwhat icould ibe idone ito iencourage
imore iwomen ito i continue ibreast-feeding. iWhat irole iis iTracy imost ilikely ito iplay iin ia iresearch
iproject ithat itests ian i intervention iaimed iat ipromoting ibreast-feeding?
A) Applying ifor igrant ifunding ifor ithe iresearch iproject
B) Posing ithe iclinical iproblem ito ione ior imore inursing iresearchers
C) Planning ithe imethodology iof ithe iresearch iproject
D) Carrying iout ithe iintervention iand isubmitting ithe iresults ifor
i publication i Ans: iB
Feedback: iA imajor irole ifor istaff inurses iis ito iidentify iquestions ior iproblems ifor iresearch.
iGrant i applications, imethodological iplanning, i and ipublication isubmission iare inormally
icarried iout iby i nurses iwho ihave iadvanced idegrees iin inursing.
, 5. A ipatient isigned ithe iinformed iconsent iform ifor ia idrug itrial ithat iwas iexplained ito ipatient iby
ia i research iassistant. iLater, ithe ipatient iadmitted ito ihis inurse ithat ihe idid inot iunderstand ithe
iresearch i assistants iexplanation ior ihis iown irole iin ithe istudy. iHow ishould ithis ipatients inurse
irespond ito ithis i revelation?
A) Explain ithe iresearch iprocess ito ithe ipatient iin igreater idetail.
B) Describe ithe idetails iof ia irandomized icontrolled itrial ifor ithe ipatient.
C) Inform ithe iresearch iassistant ithat ithe ipatients iconsent iis ilikely iinvalid.
D) Explain ito ithe ipatient ithat ihis iwritten iconsent iis inow ilegally
binding. i Ans: iC
i
Feedback: iJust ias ithe istaff inurse iis inot iresponsible ifor imedical iconsent, ithe istaff inurse iis inot
i responsible ifor iresearch iconsent. iIf ipatients iwho ihave iagreed ito iparticipate iexhibit iambivalence
ior i uncertainty iabout iparticipating, ido inot itry ito iconvince ithem ito iparticipate. iAsk ithe iperson
ifrom ithe i research iteam iwho iis imanaging iconsents ito ispeak iwith iconcerned ipatients iabout ithe
istudy, ieven iafter i a ipatient ihas isigned ithe iconsent iforms.
Multiple iSelection
8. The iadministrators iof ia ilong-term icare ifacility iare iconsidered ithe iuse iof ispecialized,
i pressurereducing imattresses iin iorder ito ireduce ithe iincidence iof ipressure iulcers iamong iresidents.
i They ihave isought iinput ifrom ithe inurses ion ithe iunit, iall iof iwhom iare iaware iof ithe ineed ito
iimplement i the iprinciples iof ievidence-based ipractice i(EBP) iin ithis idecision. iWhich iof ithe
ifollowing ievidence i sources ishould ithe inurses i prioritize?
A) A iqualitative istudy ithat iexplores ithe iexperience iof iliving iwith ia ipressure iulcer
B) A icase istudy ithat idescribes ithe imeasures ithat inurses ion ia igeriatric iunit itook ito ireduce
ipressure i ulcers iamong ipatients
C) Testimonials ifrom iexperienced iclinicians iabout ithe ieffectiveness iof ithe imattress iin iquestion
D) A irandomized icontrolled itrial ithat icompared ithe ipressure-reducing imattress iwith
istandard i mattresses
Ans: iD
Feedback: iThe imost ireliable ievidence iis iconsidered iRCTs. iQualitative istudies, icase istudies, iand
i expert iopinion iare ilow ion ithe ihierarchy iof ievidence.
9. Hospital iadministrators iare iapplying ithe iprinciples iof ievidence-based ipractice i(EBP) iin itheir
i attempt ito iascertain ithe imost iefficient iand ieffective iway ito icommunicate ibetween inurses iwho
iare ion
