kr
, Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring
kr kr kr kr kr kr kr kr kr kr kr
1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on the in
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
cidence of nosocomial (hospital- kr kr kr
acquired) infections in acute care settings. An article presented findings at a level of significance of <
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
0.01. This indicates that
kr kr kr
A) the control group and the experimental group were more than 99% similar.
kr kr kr kr kr kr kr kr kr kr kr
B) the findings of the study have less than 1% chance of being attributable to chance.
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
C) the effects of the intervention were nearly zero.
kr kr kr kr kr kr kr
D) the clinical significance of the findings was less than 1:100.
kr kr kr kr kr kr kr kr kr
Ans: B kr
Feedback: The level of significance is the level at which the researcher believes that the study results m
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ost likely represent a nonchance event. A level of significance of <0.01 indicates that there is less than
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
1% probability that the result is due to chance.
kr kr kr kr kr kr kr kr
2. A nurse has read a qualitative research study in order to understand the lived experience of parents w
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ho have a neonatal loss. Which of the following questions should the nurse prioritize when appraising
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
the results of this study?
kr kr kr kr
A) How well did the authors capture the personal experiences of these parents?
kr kr kr kr kr kr kr kr kr kr kr
B) How well did the authors control for confounding variables that may have affected the findings?
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
C) Did the authors use statistical measures that were appropriate to the phenomenon in question?
kr kr kr kr kr kr kr kr kr kr kr kr kr
D) Were the instruments that the researchers used statistically valid and reliable?
kr kr kr kr kr kr kr kr kr kr
Ans: A kr
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the subjecti
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ve experiences of individuals. Statistical measures and variables are not dimensions of a qualitative me
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
thodology.
3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming that n
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ursing research has little relevance to practice. How can the nurses colleague best defend the importan
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ce of nursing research?
kr kr kr
,A) The existence of nursing research means that nurses are now able to access federal grant money, s
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
omething that didnt use to be the case. kr kr kr kr kr kr kr
B) Nursing research has allowed the development of masters and doctoral programs and has greatly i
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ncreased the credibility of the profession. kr kr kr kr kr
C) The growth of nursing research has caused nursing to be viewed as a true profession, rather than si
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
mply as a trade or a skill.
kr kr kr kr kr kr
D) The application of nursing research has the potential to improve nursing practice and patient o
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
utcomes.
Ans: D kr
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimate
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ly, to improve patient outcomes. This supersedes the contributions of nursing research to education pro
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
grams, grant funding, or the public view of the profession.
kr kr kr kr kr kr kr kr kr
4. Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of a busy ur
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ban hospital. She has noticed that many new mothers abandon breast-
kr kr kr kr kr kr kr kr kr kr
feeding their babies when they experience early challenges and wonders what could be done to enc
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ourage more women to continue breast-
kr kr kr kr kr
feeding. What role is Tracy most likely to play in a research project that tests an intervention aimed
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
at promoting breast-feeding?
kr kr kr
A) Applying for grant funding for the research project kr kr kr kr kr kr kr
B) Posing the clinical problem to one or more nursing researchers
kr kr kr kr kr kr kr kr kr
C) Planning the methodology of the research project kr kr kr kr kr kr
D) Carrying out the intervention and submitting the results for publicationkr kr kr kr kr kr kr kr kr kr
Ans: B kr
Feedback: A major role for staff nurses is to identify questions or problems for research. Grant a
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
pplications, methodological planning, and publication submission are normally carried out by nu
kr kr kr kr kr kr kr kr kr kr kr
rses who have advanced degrees in nursing.
kr kr kr kr kr kr
5. A patient signed the informed consent form for a drug trial that was explained to patient by a res
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
earch assistant. Later, the patient admitted to his nurse that he did not understand the research assi
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
stants explanation or his own role in the study. How should this patients nurse respond to this revela
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
tion?
A) Explain the research process to the patient in greater detail.kr kr kr kr kr kr kr kr kr
B) Describe the details of a randomized controlled trial for the patient.
kr kr kr kr kr kr kr kr kr kr
, C) Inform the research assistant that the patients consent is likely invalid.
kr kr kr kr kr kr kr kr kr kr
D) Explain to the patient that his written consent is now legally binding.
kr kr kr kr kr kr kr kr kr kr kr
Ans: C kr
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsib
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
le for research consent. If patients who have agreed to participate exhibit ambivalence or uncertainty a
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
bout participating, do not try to convince them to participate. Ask the person from the research team w
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ho is managing consents to speak with concerned patients about the study, even after a patient has signe
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
d the consent forms.
kr kr kr
Multiple Selection kr
6. A nurse leader is attempting to increase the awareness of evidence-
kr kr kr kr kr kr kr kr kr kr
based practice (EBP) among the nurses on a unit. A nurse who is implementing EBP integrates which
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
of the following? (Select all that apply.)
kr kr kr kr kr kr
A) Interdisciplinary consensus kr
B) Nursing tradition kr
C) Research studies kr
D) Patient preferences and values kr kr kr
E) Clinical expertise kr k
Ans: C, D, E
r kr kr kr
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-
kr kr kr kr kr kr kr kr kr kr
solving approach to the delivery of healthcare that integrates the best evidence from studies and patient
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
care data with clinician expertise and patient preferences and values.
kr kr kr kr kr kr kr kr kr
Multiple Choice kr
7. Mrs. Mayes is a 73-year- kr kr kr kr
old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now poses a t
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
hreat of osteomyelitis. The wound care nurse who has been working with Mrs. Mayes applies evidenc
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
e-
based practice (EBP) whenever possible and has proposed the use of maggot therapy to debride necroti
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
c tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this treatment d
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
espite the sizable body of evidence supporting it. How should the nurse reconcile Mrs. Mayes views wi
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
th the principles of EBP?
kr kr kr kr
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
kr kr kr kr kr kr kr kr kr kr kr kr kr
B) The nurse should explain the evidence to the patient in greater detail.
kr kr kr kr kr kr kr kr kr kr kr
, Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring
kr kr kr kr kr kr kr kr kr kr kr
1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on the in
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
cidence of nosocomial (hospital- kr kr kr
acquired) infections in acute care settings. An article presented findings at a level of significance of <
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
0.01. This indicates that
kr kr kr
A) the control group and the experimental group were more than 99% similar.
kr kr kr kr kr kr kr kr kr kr kr
B) the findings of the study have less than 1% chance of being attributable to chance.
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
C) the effects of the intervention were nearly zero.
kr kr kr kr kr kr kr
D) the clinical significance of the findings was less than 1:100.
kr kr kr kr kr kr kr kr kr
Ans: B kr
Feedback: The level of significance is the level at which the researcher believes that the study results m
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ost likely represent a nonchance event. A level of significance of <0.01 indicates that there is less than
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
1% probability that the result is due to chance.
kr kr kr kr kr kr kr kr
2. A nurse has read a qualitative research study in order to understand the lived experience of parents w
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ho have a neonatal loss. Which of the following questions should the nurse prioritize when appraising
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
the results of this study?
kr kr kr kr
A) How well did the authors capture the personal experiences of these parents?
kr kr kr kr kr kr kr kr kr kr kr
B) How well did the authors control for confounding variables that may have affected the findings?
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
C) Did the authors use statistical measures that were appropriate to the phenomenon in question?
kr kr kr kr kr kr kr kr kr kr kr kr kr
D) Were the instruments that the researchers used statistically valid and reliable?
kr kr kr kr kr kr kr kr kr kr
Ans: A kr
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the subjecti
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ve experiences of individuals. Statistical measures and variables are not dimensions of a qualitative me
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
thodology.
3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming that n
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ursing research has little relevance to practice. How can the nurses colleague best defend the importan
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ce of nursing research?
kr kr kr
,A) The existence of nursing research means that nurses are now able to access federal grant money, s
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
omething that didnt use to be the case. kr kr kr kr kr kr kr
B) Nursing research has allowed the development of masters and doctoral programs and has greatly i
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ncreased the credibility of the profession. kr kr kr kr kr
C) The growth of nursing research has caused nursing to be viewed as a true profession, rather than si
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
mply as a trade or a skill.
kr kr kr kr kr kr
D) The application of nursing research has the potential to improve nursing practice and patient o
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
utcomes.
Ans: D kr
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimate
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ly, to improve patient outcomes. This supersedes the contributions of nursing research to education pro
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
grams, grant funding, or the public view of the profession.
kr kr kr kr kr kr kr kr kr
4. Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of a busy ur
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ban hospital. She has noticed that many new mothers abandon breast-
kr kr kr kr kr kr kr kr kr kr
feeding their babies when they experience early challenges and wonders what could be done to enc
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ourage more women to continue breast-
kr kr kr kr kr
feeding. What role is Tracy most likely to play in a research project that tests an intervention aimed
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
at promoting breast-feeding?
kr kr kr
A) Applying for grant funding for the research project kr kr kr kr kr kr kr
B) Posing the clinical problem to one or more nursing researchers
kr kr kr kr kr kr kr kr kr
C) Planning the methodology of the research project kr kr kr kr kr kr
D) Carrying out the intervention and submitting the results for publicationkr kr kr kr kr kr kr kr kr kr
Ans: B kr
Feedback: A major role for staff nurses is to identify questions or problems for research. Grant a
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
pplications, methodological planning, and publication submission are normally carried out by nu
kr kr kr kr kr kr kr kr kr kr kr
rses who have advanced degrees in nursing.
kr kr kr kr kr kr
5. A patient signed the informed consent form for a drug trial that was explained to patient by a res
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
earch assistant. Later, the patient admitted to his nurse that he did not understand the research assi
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
stants explanation or his own role in the study. How should this patients nurse respond to this revela
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
tion?
A) Explain the research process to the patient in greater detail.kr kr kr kr kr kr kr kr kr
B) Describe the details of a randomized controlled trial for the patient.
kr kr kr kr kr kr kr kr kr kr
, C) Inform the research assistant that the patients consent is likely invalid.
kr kr kr kr kr kr kr kr kr kr
D) Explain to the patient that his written consent is now legally binding.
kr kr kr kr kr kr kr kr kr kr kr
Ans: C kr
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsib
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
le for research consent. If patients who have agreed to participate exhibit ambivalence or uncertainty a
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
bout participating, do not try to convince them to participate. Ask the person from the research team w
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
ho is managing consents to speak with concerned patients about the study, even after a patient has signe
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
d the consent forms.
kr kr kr
Multiple Selection kr
6. A nurse leader is attempting to increase the awareness of evidence-
kr kr kr kr kr kr kr kr kr kr
based practice (EBP) among the nurses on a unit. A nurse who is implementing EBP integrates which
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
of the following? (Select all that apply.)
kr kr kr kr kr kr
A) Interdisciplinary consensus kr
B) Nursing tradition kr
C) Research studies kr
D) Patient preferences and values kr kr kr
E) Clinical expertise kr k
Ans: C, D, E
r kr kr kr
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-
kr kr kr kr kr kr kr kr kr kr
solving approach to the delivery of healthcare that integrates the best evidence from studies and patient
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
care data with clinician expertise and patient preferences and values.
kr kr kr kr kr kr kr kr kr
Multiple Choice kr
7. Mrs. Mayes is a 73-year- kr kr kr kr
old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now poses a t
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
hreat of osteomyelitis. The wound care nurse who has been working with Mrs. Mayes applies evidenc
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
e-
based practice (EBP) whenever possible and has proposed the use of maggot therapy to debride necroti
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
c tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this treatment d
kr kr kr kr kr kr kr kr kr kr kr kr kr kr
espite the sizable body of evidence supporting it. How should the nurse reconcile Mrs. Mayes views wi
kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
th the principles of EBP?
kr kr kr kr
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
kr kr kr kr kr kr kr kr kr kr kr kr kr
B) The nurse should explain the evidence to the patient in greater detail.
kr kr kr kr kr kr kr kr kr kr kr
