Primary Care: Art and Science of Advanced Practice Nursing - An Interprofessional Approach
LYNNE M. DUNPHY
Fifth Edition
, Primary Care: Art and Science of Advanced Practice Nursing - An
Interprofessional Approach 5th edition Dunphy Test Bank
Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring
1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on the
incidence 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.
Ans: B
Feedback: The level of significance is the level at which the researcher believes that the study results most
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 nurse has read a qualitative research study in order to understand the lived experience of parents who
have a neonatal loss. Which of the following questions should the nurse 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?
Ans: A
Feedback: 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 a qualitative methodology.
3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming that nursing
research has little relevance to practice. How can the nurses colleague best defend the 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,
something that didnt 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 patient
outcomes.
Ans: D
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimately, to
improve patient outcomes. This supersedes the contributions of nursing research to education programs,
grant funding, or the public view of the profession.
4. Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of a busy urban
hospital. She has noticed that many new mothers abandon breast-feeding their babies when they
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 Ans: B
Feedback: A major role for staff nurses is to identify questions or problems for research. Grant
applications, methodological planning, and publication submission are normally carried out by nurses
who have advanced degrees in nursing.
5. A patient signed the informed consent form for a drug trial that was explained to patient by a research
assistant. Later, the patient admitted to his nurse that he did not understand the research assistants
explanation or his own role in the study. How should this patients nurse respond to this revelation?
A) Explain the research process to the patient in greater detail.
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.
D) Explain to the patient that his written consent is now legally binding.
Ans: C
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsible for
research consent. If patients 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 patients about the study, even after a patient has signed the
consent forms.
Multiple Selection
6. A nurse leader is attempting to increase the awareness of evidence-based practice (EBP) among the nurses
on a unit. A nurse who is implementing EBP integrates which of the following? (Select all that apply.)
A) Interdisciplinary consensus
B) Nursing tradition
C) Research studies
D) Patient preferences and values
E) Clinical expertise
Ans: C, D, E
Feedback: 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 patient care data with clinician
expertise and patient 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 nurse who has been working with Mrs. Mayes
applies evidence-based practice (EBP) whenever possible and has proposed the use of 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 should the nurse reconcile Mrs. Mayes views
with the principles of EBP?
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
B) The nurse should explain the evidence to the patient in greater detail.
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