TEST BANK Primary Care The Art and Science of Advanced Pr
m m m m m m m m m m
actice Nursing –
m m
An Interprofessional Approach 6th Edition by Debera J. Dunph
m m m m m m m m m
y| Complete Guide Chapter 1-82
m m m m
•
PrimarymCare:mArtmandmSciencemof mAdvancedmPracticemNursingm-
mAnmInterprofessionalmApproach m5
thm editionmDunphymTestmBank
Chapterm1.mPrimarymCareminmthemTwenty-FirstmCentury:mA mCirclemof mCaring
.mAmnursemleadermismattemptingmtomincreasemthemawarenessmof mevidence-
based mpracticem(EBP)mamongmthemnursesmonmamunit.mAmnursemwhomismimplementingmEBPmintegratesmw
hichmof mthemfollowing?m(Select mallmthat mapply.)
A) Interdisciplinarymconsensus
B) Nursingmtradition
C) Researchmstudies
D) Patient mpreferencesmand mvalues
E) Clinicalmexpertise
Ans:mC,mD,mE
m
Feedback:mFineout-Overholt,mMelnyk,mStillwell,mand mWilliamsonmdefinemEBPmasmamproblem-
solvingmapproachmtomthemdeliverymof mhealthcaremthat mintegratesmthembest mevidencemfrommstudiesmand mp
atient mcaremdatamwithmclinicianmexpertisemand mpatient mpreferencesmand mvalues.
MultiplemChoice
.mMrs.mMayesmismam73-year-
old mwomanmwhomhasmamdiabeticmfoot mulcermthat mhasmbeenmextremelymslow mtomhealmand mwhichmnowmpos
esmamthreat mof mosteomyelitis.mThemwound mcaremnursemwhomhasmbeenmworkingmwithmMrs.mMayesmapplie
smevidence-
based mpracticem(EBP)mwhenevermpossiblemand mhasmproposed mthemusemof mmaggot mtherapymtomdebridemne
croticmtissue.mMrs.mMayes,mhowever,mfindsmthemsuggestionmrepugnant mand madamantlymopposesmthismtre
atment mdespitemthemsizablembodymof mevidencemsupportingmit.mHow mshould mthemnursemreconcilemMrs.mM
ayesmviewsmwithmthemprinciplesmof mEBP?
,A) Themnursemshould mexplainmthat mreliablemand mvalid mresearchmevidencemoverridesmthempatientsmopinion.
B) Themnursemshould mexplainmthemevidencemtomthempatient minmgreatermdetail.
C) Themnursemshould mintegratemthempatientsmpreferencesmintomthemplanmof mcare.
D) Themnursemshould minvolvemthempatientsmfamilymmembersmin mthemdecision-makingmprocess.
Ans:mC
Feedback:mPatient mpreferencesmshould mbemintegrated mintomEBPmand mconsidered malongsidemresearchme
videncemand mthemnursesmclinicalmexpertise;mevidencemdoesmnot mtrumpmthempatientsmpreferences.mThemf
amilymshould mbeminvolved,mbut mthismismnot manmexplicit mdimensionmof mEBP.mSimilarly,mexplainingmthem
evidenceminmmoremdetailmismnot mamdemonstrationmof mEBP.
1. Amnursemhasmconducted mamliteraturemreview minmanmeffort mtomidentifymthemeffect mofmhandwashingmonm
themincidencemof mnosocomialm(hospital-
acquired)minfectionsminmacutemcaremsettings.mAnmarticlempresented mfindingsmat mamlevelmof msignificance
mof m<0.01.mThismindicatesmthat
A) themcontrolmgroupmand mthemexperimentalmgroupmweremmoremthanm99%msimilar.
B) themfindingsmof mthemstudymhavemlessmthanm1%mchancemof mbeingmattributablemtomchance.
C) themeffectsmof mtheminterventionmweremnearlymzero.
D) themclinicalmsignificancemof mthemfindingsmwasmlessmthanm1:100.
Ans:mB
Feedback:mThemlevelmof msignificancemismthemlevelmat mwhichmthemresearchermbelievesmthat mthemstudymresu
ltsmmost mlikelymrepresent mamnonchancemevent.mAmlevelmof msignificancemof m<0.01mindicatesmthat mtheremis
mlessmthanm1%mprobabilitymthat mthemresult mismduemtomchance.
2. Amnursemhasmread mamqualitativemresearchmstudyminmordermtomunderstand mthemlived mexperiencemof mpare
ntsmwhomhavemamneonatalmloss.mWhichmof mthemfollowingmquestionsmshould mthemnursemprioritizemwhenma
ppraisingmthemresultsmof mthismstudy?
A) How mwellmdid mthemauthorsmcapturemthempersonalmexperiencesmof mthesemparents?
B) How mwellmdid mthemauthorsmcontrolmformconfoundingmvariablesmthat mmaymhavemaffected mthemfindings?
C) Did mthemauthorsmusemstatisticalmmeasuresmthat mweremappropriatemtomthemphenomenonminmquestion?
D) Weremtheminstrumentsmthat mthemresearchersmused mstatisticallymvalid mand mreliable?
Ans:mA
,Feedback:mQualitativemstudiesmaremjudged monmthembasismof mhowmwellmtheymcapturemand mconveymthemsu
bjectivemexperiencesmof mindividuals.mStatisticalmmeasuresmand mvariablesmaremnot mdimensionsmof mamqua
litativemmethodology.
3. Amnursemhasmexpressed mskepticismmtomamcolleaguemabout mthemvaluemof mnursingmresearch,mclaimingmt
hat mnursingmresearchmhasmlittlemrelevancemtompractice.mHow mcanmthemnursesmcolleague mbest mdefend mthe
mimportancemof mnursingmresearch?
A) Themexistencemof mnursingmresearchmmeansmthat mnursesmaremnowmablemtomaccessmfederalmgrant mmon
ey,msomethingmthat mdidnt musemtombemthemcase.
B) Nursingmresearchmhasmallowed mthemdevelopment mof mmastersmand mdoctoralmprogramsmand mhasmgrea
tlymincreased mthemcredibilitymof mthemprofession.
C) Themgrowthmof mnursingmresearchmhasmcaused mnursingmtombemviewed masmamtruemprofession,mrathermt
hanmsimplymasmamtrademormamskill.
D) Themapplicationmof mnursingmresearchmhasmthempotentialmtomimprovemnursingmpracticemand mpatie
nt moutcomes.
Ans:mD
Feedback:mThemgreatest mvaluemof mnursingmresearchmlies minmthempotentialmtomimprovempracticemand,mult
imately,mtomimprovempatient moutcomes.mThismsupersedesmthemcontributionsmof mnursingmresearchmtomed
ucationmprograms,mgrant mfunding,mormthempublicmview mof mthemprofession.
4. Tracymismamnursemwithmambaccalaureatemdegreemwhomworksminmthemlabormand mdeliverymunit mof mamb
usymurbanmhospital.mShemhasmnoticed mthat mmanymnew mmothersmabandonmbreast-
feedingmtheirmbabiesmwhenmtheymexperiencemearlymchallengesmand mwondersmwhat mcould mbemdonemto
mencouragemmoremwomenmtomcontinuembreast-
feeding.mWhat mrolemismTracymmost mlikelymtomplayminm amresearchmproject mthat mtestsmanminterventionma
imed mat mpromotingmbreast-feeding?
A) Applyingmformgrant mfundingmformthemresearchmproject
B) Posingmthemclinicalmproblemmtomonemormmoremnursing mresearchers
C) Planningmthemmethodologymof mthemresearchmproject
D) Carryingmout mtheminterventionmand msubmittingmthemresultsmformpublicatio
nmAns:mB
Feedback:mAmmajormrolemformstaff mnursesmismtomidentifymquestionsmormproblemsmformresearch.mGr
ant mapplications,mmethodologicalmplanning,mand mpublicationmsubmissionmaremnormallymcarried m
out mbymnursesmwhomhavemadvanced mdegreesminmnursing.
, 5. Ampatient msigned mtheminformed mconsent mformmformamdrugmtrialmthat mwasmexplained mtompatient mby
mamresearchmassistant.mLater,mthempatient madmitted mtomhismnursemthat mhemdid mnot munderstand mthemres
earchmassistantsmexplanationmormhismownmroleminmthemstudy.mHow mshould mthismpatientsmnursemrespo
nd mtomthismrevelation?
A) Explainmthemresearchmprocessmtomthempatient minmgreatermdetail.
B) Describemthemdetailsmof mamrandomized mcontrolled mtrialmformthempatient.
C) Informmthemresearchmassistant mthat mthempatientsmconsent mismlikelyminvalid.
D) Explainmtomthempatient mthat mhismwrittenmconsent mismnow mlegallymbinding.
Ans:mC
Feedback:mJust masmthemstaff mnursemismnot mresponsiblemformmedicalmconsent,mthemstaff mnursemismnot mresp
onsiblemformresearchmconsent.mIf mpatientsmwhomhavemagreed mtomparticipatemexhibit mambivalencemormunc
ertaintymabout mparticipating,mdomnot mtrymtomconvincemthemmtomparticipate.mAskmthempersonmfrommthemre
searchmteammwhomismmanagingmconsentsmtomspeakmwithmconcerned mpatientsmabout mthemstudy,mevenmafte
rmampatient mhasmsigned mthemconsent mforms.
MultiplemSelection
8. Themadministratorsmof mamlong-
termmcaremfacilitymaremconsidered mthemusemof mspecialized,mpressurereducingmmattresses minmordermtomre
ducemthemincidencemof mpressuremulcersmamongmresidents.mTheymhavemsought minput mfrommthemnursesmo
nmthemunit,mallmof mwhommaremawaremof mthemneed mtomimplement mthemprinciplesmof mevidence-
based mpracticem(EBP)minmthismdecision.mWhichmof mthemfollowingmevidencemsourcesmshould mthemnurses
mprioritize?
A) A mqualitativemstudymthat mexploresmthemexperiencemof mlivingmwithmampressuremulcer
B) A mcasemstudymthat mdescribesmthemmeasuresmthat mnursesmonmamgeriatricmunit mtookmtomreducempress
uremulcersmamongmpatients
C) Testimonialsmfrommexperienced mcliniciansmabout mthemeffectivenessmof mthemmattressminmquestion
D) A mrandomized mcontrolled mtrialmthat mcompared mthempressure-
reducingmmattressmwithmstandard mmattresses
Ans:mD
Feedback:mThemmost mreliablemevidencemismconsidered mRCTs.mQualitativemstudies,mcasemstudies,mand me
xpert mopinionmaremlowmonmthemhierarchymof mevidence.
9. Hospitalmadministratorsmaremapplyingmthemprinciplesmof mevidence-
based mpracticem(EBP)minmtheirmattempt mtomascertainmthemmost mefficient mand meffectivemwaymtomcommun
icatembetweenmnursesmwhomaremon
m m m m m m m m m m
actice Nursing –
m m
An Interprofessional Approach 6th Edition by Debera J. Dunph
m m m m m m m m m
y| Complete Guide Chapter 1-82
m m m m
•
PrimarymCare:mArtmandmSciencemof mAdvancedmPracticemNursingm-
mAnmInterprofessionalmApproach m5
thm editionmDunphymTestmBank
Chapterm1.mPrimarymCareminmthemTwenty-FirstmCentury:mA mCirclemof mCaring
.mAmnursemleadermismattemptingmtomincreasemthemawarenessmof mevidence-
based mpracticem(EBP)mamongmthemnursesmonmamunit.mAmnursemwhomismimplementingmEBPmintegratesmw
hichmof mthemfollowing?m(Select mallmthat mapply.)
A) Interdisciplinarymconsensus
B) Nursingmtradition
C) Researchmstudies
D) Patient mpreferencesmand mvalues
E) Clinicalmexpertise
Ans:mC,mD,mE
m
Feedback:mFineout-Overholt,mMelnyk,mStillwell,mand mWilliamsonmdefinemEBPmasmamproblem-
solvingmapproachmtomthemdeliverymof mhealthcaremthat mintegratesmthembest mevidencemfrommstudiesmand mp
atient mcaremdatamwithmclinicianmexpertisemand mpatient mpreferencesmand mvalues.
MultiplemChoice
.mMrs.mMayesmismam73-year-
old mwomanmwhomhasmamdiabeticmfoot mulcermthat mhasmbeenmextremelymslow mtomhealmand mwhichmnowmpos
esmamthreat mof mosteomyelitis.mThemwound mcaremnursemwhomhasmbeenmworkingmwithmMrs.mMayesmapplie
smevidence-
based mpracticem(EBP)mwhenevermpossiblemand mhasmproposed mthemusemof mmaggot mtherapymtomdebridemne
croticmtissue.mMrs.mMayes,mhowever,mfindsmthemsuggestionmrepugnant mand madamantlymopposesmthismtre
atment mdespitemthemsizablembodymof mevidencemsupportingmit.mHow mshould mthemnursemreconcilemMrs.mM
ayesmviewsmwithmthemprinciplesmof mEBP?
,A) Themnursemshould mexplainmthat mreliablemand mvalid mresearchmevidencemoverridesmthempatientsmopinion.
B) Themnursemshould mexplainmthemevidencemtomthempatient minmgreatermdetail.
C) Themnursemshould mintegratemthempatientsmpreferencesmintomthemplanmof mcare.
D) Themnursemshould minvolvemthempatientsmfamilymmembersmin mthemdecision-makingmprocess.
Ans:mC
Feedback:mPatient mpreferencesmshould mbemintegrated mintomEBPmand mconsidered malongsidemresearchme
videncemand mthemnursesmclinicalmexpertise;mevidencemdoesmnot mtrumpmthempatientsmpreferences.mThemf
amilymshould mbeminvolved,mbut mthismismnot manmexplicit mdimensionmof mEBP.mSimilarly,mexplainingmthem
evidenceminmmoremdetailmismnot mamdemonstrationmof mEBP.
1. Amnursemhasmconducted mamliteraturemreview minmanmeffort mtomidentifymthemeffect mofmhandwashingmonm
themincidencemof mnosocomialm(hospital-
acquired)minfectionsminmacutemcaremsettings.mAnmarticlempresented mfindingsmat mamlevelmof msignificance
mof m<0.01.mThismindicatesmthat
A) themcontrolmgroupmand mthemexperimentalmgroupmweremmoremthanm99%msimilar.
B) themfindingsmof mthemstudymhavemlessmthanm1%mchancemof mbeingmattributablemtomchance.
C) themeffectsmof mtheminterventionmweremnearlymzero.
D) themclinicalmsignificancemof mthemfindingsmwasmlessmthanm1:100.
Ans:mB
Feedback:mThemlevelmof msignificancemismthemlevelmat mwhichmthemresearchermbelievesmthat mthemstudymresu
ltsmmost mlikelymrepresent mamnonchancemevent.mAmlevelmof msignificancemof m<0.01mindicatesmthat mtheremis
mlessmthanm1%mprobabilitymthat mthemresult mismduemtomchance.
2. Amnursemhasmread mamqualitativemresearchmstudyminmordermtomunderstand mthemlived mexperiencemof mpare
ntsmwhomhavemamneonatalmloss.mWhichmof mthemfollowingmquestionsmshould mthemnursemprioritizemwhenma
ppraisingmthemresultsmof mthismstudy?
A) How mwellmdid mthemauthorsmcapturemthempersonalmexperiencesmof mthesemparents?
B) How mwellmdid mthemauthorsmcontrolmformconfoundingmvariablesmthat mmaymhavemaffected mthemfindings?
C) Did mthemauthorsmusemstatisticalmmeasuresmthat mweremappropriatemtomthemphenomenonminmquestion?
D) Weremtheminstrumentsmthat mthemresearchersmused mstatisticallymvalid mand mreliable?
Ans:mA
,Feedback:mQualitativemstudiesmaremjudged monmthembasismof mhowmwellmtheymcapturemand mconveymthemsu
bjectivemexperiencesmof mindividuals.mStatisticalmmeasuresmand mvariablesmaremnot mdimensionsmof mamqua
litativemmethodology.
3. Amnursemhasmexpressed mskepticismmtomamcolleaguemabout mthemvaluemof mnursingmresearch,mclaimingmt
hat mnursingmresearchmhasmlittlemrelevancemtompractice.mHow mcanmthemnursesmcolleague mbest mdefend mthe
mimportancemof mnursingmresearch?
A) Themexistencemof mnursingmresearchmmeansmthat mnursesmaremnowmablemtomaccessmfederalmgrant mmon
ey,msomethingmthat mdidnt musemtombemthemcase.
B) Nursingmresearchmhasmallowed mthemdevelopment mof mmastersmand mdoctoralmprogramsmand mhasmgrea
tlymincreased mthemcredibilitymof mthemprofession.
C) Themgrowthmof mnursingmresearchmhasmcaused mnursingmtombemviewed masmamtruemprofession,mrathermt
hanmsimplymasmamtrademormamskill.
D) Themapplicationmof mnursingmresearchmhasmthempotentialmtomimprovemnursingmpracticemand mpatie
nt moutcomes.
Ans:mD
Feedback:mThemgreatest mvaluemof mnursingmresearchmlies minmthempotentialmtomimprovempracticemand,mult
imately,mtomimprovempatient moutcomes.mThismsupersedesmthemcontributionsmof mnursingmresearchmtomed
ucationmprograms,mgrant mfunding,mormthempublicmview mof mthemprofession.
4. Tracymismamnursemwithmambaccalaureatemdegreemwhomworksminmthemlabormand mdeliverymunit mof mamb
usymurbanmhospital.mShemhasmnoticed mthat mmanymnew mmothersmabandonmbreast-
feedingmtheirmbabiesmwhenmtheymexperiencemearlymchallengesmand mwondersmwhat mcould mbemdonemto
mencouragemmoremwomenmtomcontinuembreast-
feeding.mWhat mrolemismTracymmost mlikelymtomplayminm amresearchmproject mthat mtestsmanminterventionma
imed mat mpromotingmbreast-feeding?
A) Applyingmformgrant mfundingmformthemresearchmproject
B) Posingmthemclinicalmproblemmtomonemormmoremnursing mresearchers
C) Planningmthemmethodologymof mthemresearchmproject
D) Carryingmout mtheminterventionmand msubmittingmthemresultsmformpublicatio
nmAns:mB
Feedback:mAmmajormrolemformstaff mnursesmismtomidentifymquestionsmormproblemsmformresearch.mGr
ant mapplications,mmethodologicalmplanning,mand mpublicationmsubmissionmaremnormallymcarried m
out mbymnursesmwhomhavemadvanced mdegreesminmnursing.
, 5. Ampatient msigned mtheminformed mconsent mformmformamdrugmtrialmthat mwasmexplained mtompatient mby
mamresearchmassistant.mLater,mthempatient madmitted mtomhismnursemthat mhemdid mnot munderstand mthemres
earchmassistantsmexplanationmormhismownmroleminmthemstudy.mHow mshould mthismpatientsmnursemrespo
nd mtomthismrevelation?
A) Explainmthemresearchmprocessmtomthempatient minmgreatermdetail.
B) Describemthemdetailsmof mamrandomized mcontrolled mtrialmformthempatient.
C) Informmthemresearchmassistant mthat mthempatientsmconsent mismlikelyminvalid.
D) Explainmtomthempatient mthat mhismwrittenmconsent mismnow mlegallymbinding.
Ans:mC
Feedback:mJust masmthemstaff mnursemismnot mresponsiblemformmedicalmconsent,mthemstaff mnursemismnot mresp
onsiblemformresearchmconsent.mIf mpatientsmwhomhavemagreed mtomparticipatemexhibit mambivalencemormunc
ertaintymabout mparticipating,mdomnot mtrymtomconvincemthemmtomparticipate.mAskmthempersonmfrommthemre
searchmteammwhomismmanagingmconsentsmtomspeakmwithmconcerned mpatientsmabout mthemstudy,mevenmafte
rmampatient mhasmsigned mthemconsent mforms.
MultiplemSelection
8. Themadministratorsmof mamlong-
termmcaremfacilitymaremconsidered mthemusemof mspecialized,mpressurereducingmmattresses minmordermtomre
ducemthemincidencemof mpressuremulcersmamongmresidents.mTheymhavemsought minput mfrommthemnursesmo
nmthemunit,mallmof mwhommaremawaremof mthemneed mtomimplement mthemprinciplesmof mevidence-
based mpracticem(EBP)minmthismdecision.mWhichmof mthemfollowingmevidencemsourcesmshould mthemnurses
mprioritize?
A) A mqualitativemstudymthat mexploresmthemexperiencemof mlivingmwithmampressuremulcer
B) A mcasemstudymthat mdescribesmthemmeasuresmthat mnursesmonmamgeriatricmunit mtookmtomreducempress
uremulcersmamongmpatients
C) Testimonialsmfrommexperienced mcliniciansmabout mthemeffectivenessmof mthemmattressminmquestion
D) A mrandomized mcontrolled mtrialmthat mcompared mthempressure-
reducingmmattressmwithmstandard mmattresses
Ans:mD
Feedback:mThemmost mreliablemevidencemismconsidered mRCTs.mQualitativemstudies,mcasemstudies,mand me
xpert mopinionmaremlowmonmthemhierarchymof mevidence.
9. Hospitalmadministratorsmaremapplyingmthemprinciplesmof mevidence-
based mpracticem(EBP)minmtheirmattempt mtomascertainmthemmost mefficient mand meffectivemwaymtomcommun
icatembetweenmnursesmwhomaremon
