,TEST BANK for Primary Care The Art and Science of Advanced
Practice Nursing – An Interprofessional Approach 6th Edition by
Debera J. Dunphy
Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring
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1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on t
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he incidence of nosocomial (hospital-
22 22 22 22
acquired) infections in acute care settings. An article presented findings at a level of significance
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of <0.01. This indicates that
22 22 22 22 22
A) the control group and the experimental group were more than 99% similar.
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B) the findings of the study have less than 1% chance of being attributable to chance.
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C) the effects of the intervention were nearly zero.
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D) the clinical significance of the findings was less than 1:100.
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Ans: B 22
Feedback: The level of significance is the level at which the researcher believes that the study resul
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
ts most likely represent a nonchance event. A level of significance of <0.01 indicates that there is
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 2
2less than 1% probability that the result is due to chance.
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2. A nurse has read a qualitative research study in order to understand the lived experience of pare
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nts who have a neonatal loss. Which of the following questions should the nurse prioritize when
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appraising the results of this study? 22 22 22 22 22
A) How well did the authors capture the personal experiences of these parents?
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B) How well did the authors control for confounding variables that may have affected the findings?
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C) Did the authors use statistical measures that were appropriate to the phenomenon in question?
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D) Were the instruments that the researchers used statistically valid and reliable?
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Ans: A 22
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the su
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
bjective experiences of individuals. Statistical measures and variables are not dimensions of a qualit
22 22 22 22 22 22 22 22 22 22 22 22 22
ative methodology.
22
3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming th
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
at nursing research has little relevance to practice. How can the nurses colleague best defend the
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importance of nursing research?
2 22 22 22
,A) The existence of nursing research means that nurses are now able to access federal grant mone
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
y, something that didnt use to be the case.
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B) Nursing research has allowed the development of masters and doctoral programs and has great
22 22 22 22 22 22 22 22 22 22 22 22 22
ly increased the credibility of the profession.
22 22 22 22 22 22
C) The growth of nursing research has caused nursing to be viewed as a true profession, rather th
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
an simply as a trade or a skill.
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D) The application of nursing research has the potential to improve nursing practice and patie
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nt outcomes.
22
Ans: D 22
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ulti
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mately, to improve patient outcomes. This supersedes the contributions of nursing research to educa
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tion programs, grant funding, or the public view of the profession.
22 22 22 22 22 22 22 22 22 22
4. Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of a b
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usy urban hospital. She has noticed that many new mothers abandon breast-
22 22 22 22 22 22 22 22 22 22 22
feeding their babies when they experience early challenges and wonders what could be done t
22 22 22 22 22 22 22 22 22 22 22 22 22 22
o encourage more women to continue breast-
22 22 22 22 22 22
feeding. What role is Tracy most likely to play in a research project that tests an intervention
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aimed at promoting breast-feeding?
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A) Applying for grant funding for the research project22 22 22 22 22 22 22
B) Posing the clinical problem to one or more nursing researchers
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C) Planning the methodology of the research project 22 22 22 22 22 22
D) Carrying out the intervention and submitting the results for publicatio
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n Ans: B
22 22
Feedback: A major role for staff nurses is to identify questions or problems for research. Gr
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
ant applications, methodological planning, and publication submission are normally carried o
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ut by nurses who have advanced degrees in nursing.
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5. A patient signed the informed consent form for a drug trial that was explained to patient b
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
y a research assistant. Later, the patient admitted to his nurse that he did not understand the re
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
search assistants explanation or his own role in the study. How should this patients nurse respo
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nd to this revelation?
22 22 22
A) Explain the research process to the patient in greater detail.
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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.
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D) Explain to the patient that his written consent is now legally binding.
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Ans: C 22
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not resp
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onsible for research consent. If patients who have agreed to participate exhibit ambivalence or un
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certainty about participating, do not try to convince them to participate. Ask the person from the r
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
esearch team who is managing consents to speak with concerned patients about the study, even afte
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
r a patient has signed the consent forms.
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Multiple Selection 22
6. A nurse leader is attempting to increase the awareness of evidence-
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based practice (EBP) among the nurses on a unit. A nurse who is implementing EBP integrates w
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
hich of the following? (Select all that apply.)
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A) Interdisciplinary consensus 22
B) Nursing tradition 22
C) Research studies 22
D) Patient preferences and values 22 22 22
E) Clinical expertise 22
Ans: C, D, E
22 22 22 22
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-
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solving approach to the delivery of healthcare that integrates the best evidence from studies and pat
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
ient care data with clinician expertise and patient preferences and values.
22 22 22 22 22 22 22 22 22 22
Multiple Choice 22
7. Mrs. Mayes is a 73-year- 22 22 22 22
old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now po
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
ses a threat of osteomyelitis. The wound care nurse who has been working with Mrs. Mayes appli
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
es evidence-
22
based practice (EBP) whenever possible and has proposed the use of maggot therapy to debride ne
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
crotic tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this tre
22 22 22 22 22 22 22 22 22 22 22 22 22
atment despite the sizable body of evidence supporting it. How should the nurse reconcile Mrs. M
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
ayes views with the principles of EBP?
22 22 22 22 22 22
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
22 22 22 22 22 22 22 22 22 22 22 22 22
B) The nurse should explain the evidence to the patient in greater detail.
22 22 22 22 22 22 22 22 22 22 22
Practice Nursing – An Interprofessional Approach 6th Edition by
Debera J. Dunphy
Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring
22 22 22 22 22 22 22 22 22 22 22
1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on t
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
he incidence of nosocomial (hospital-
22 22 22 22
acquired) infections in acute care settings. An article presented findings at a level of significance
22 22 22 22 22 22 22 22 22 22 22 22 22 22
of <0.01. This indicates that
22 22 22 22 22
A) the control group and the experimental group were more than 99% similar.
22 22 22 22 22 22 22 22 22 22 22
B) the findings of the study have less than 1% chance of being attributable to chance.
22 22 22 22 22 22 22 22 22 22 22 22 22 22
C) the effects of the intervention were nearly zero.
22 22 22 22 22 22 22
D) the clinical significance of the findings was less than 1:100.
22 22 22 22 22 22 22 22 22
Ans: B 22
Feedback: The level of significance is the level at which the researcher believes that the study resul
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
ts most likely represent a nonchance event. A level of significance of <0.01 indicates that there is
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 2
2less than 1% probability that the result is due to chance.
22 22 22 22 22 22 22 22 22 22
2. A nurse has read a qualitative research study in order to understand the lived experience of pare
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
nts who have a neonatal loss. Which of the following questions should the nurse prioritize when
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
appraising the results of this study? 22 22 22 22 22
A) How well did the authors capture the personal experiences of these parents?
22 22 22 22 22 22 22 22 22 22 22
B) How well did the authors control for confounding variables that may have affected the findings?
22 22 22 22 22 22 22 22 22 22 22 22 22 22
C) Did the authors use statistical measures that were appropriate to the phenomenon in question?
22 22 22 22 22 22 22 22 22 22 22 22 22
D) Were the instruments that the researchers used statistically valid and reliable?
22 22 22 22 22 22 22 22 22 22
Ans: A 22
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the su
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
bjective experiences of individuals. Statistical measures and variables are not dimensions of a qualit
22 22 22 22 22 22 22 22 22 22 22 22 22
ative methodology.
22
3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming th
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
at nursing research has little relevance to practice. How can the nurses colleague best defend the
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 2
importance of nursing research?
2 22 22 22
,A) The existence of nursing research means that nurses are now able to access federal grant mone
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
y, something that didnt use to be the case.
22 22 22 22 22 22 22 22
B) Nursing research has allowed the development of masters and doctoral programs and has great
22 22 22 22 22 22 22 22 22 22 22 22 22
ly increased the credibility of the profession.
22 22 22 22 22 22
C) The growth of nursing research has caused nursing to be viewed as a true profession, rather th
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
an simply as a trade or a skill.
22 22 22 22 22 22 22
D) The application of nursing research has the potential to improve nursing practice and patie
22 22 22 22 22 22 22 22 22 22 22 22 22
nt outcomes.
22
Ans: D 22
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ulti
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
mately, to improve patient outcomes. This supersedes the contributions of nursing research to educa
22 22 22 22 22 22 22 22 22 22 22 22 22
tion programs, grant funding, or the public view of the profession.
22 22 22 22 22 22 22 22 22 22
4. Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of a b
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
usy urban hospital. She has noticed that many new mothers abandon breast-
22 22 22 22 22 22 22 22 22 22 22
feeding their babies when they experience early challenges and wonders what could be done t
22 22 22 22 22 22 22 22 22 22 22 22 22 22
o encourage more women to continue breast-
22 22 22 22 22 22
feeding. What role is Tracy most likely to play in a research project that tests an intervention
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
aimed at promoting breast-feeding?
22 22 22
A) Applying for grant funding for the research project22 22 22 22 22 22 22
B) Posing the clinical problem to one or more nursing researchers
22 22 22 22 22 22 22 22 22
C) Planning the methodology of the research project 22 22 22 22 22 22
D) Carrying out the intervention and submitting the results for publicatio
22 22 22 22 22 22 22 22 22
n Ans: B
22 22
Feedback: A major role for staff nurses is to identify questions or problems for research. Gr
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
ant applications, methodological planning, and publication submission are normally carried o
22 22 22 22 22 22 22 22 22 22
ut by nurses who have advanced degrees in nursing.
22 22 22 22 22 22 22 22
5. A patient signed the informed consent form for a drug trial that was explained to patient b
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
y a research assistant. Later, the patient admitted to his nurse that he did not understand the re
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
search assistants explanation or his own role in the study. How should this patients nurse respo
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
nd to this revelation?
22 22 22
A) Explain the research process to the patient in greater detail.
22 22 22 22 22 22 22 22 22
B) Describe the details of a randomized controlled trial for the patient.
22 22 22 22 22 22 22 22 22 22
, C) Inform the research assistant that the patients consent is likely invalid.
22 22 22 22 22 22 22 22 22 22
D) Explain to the patient that his written consent is now legally binding.
22 22 22 22 22 22 22 22 22 22 22
Ans: C 22
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not resp
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
onsible for research consent. If patients who have agreed to participate exhibit ambivalence or un
22 22 22 22 22 22 22 22 22 22 22 22 22 22
certainty about participating, do not try to convince them to participate. Ask the person from the r
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
esearch team who is managing consents to speak with concerned patients about the study, even afte
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
r a patient has signed the consent forms.
22 22 22 22 22 22 22
Multiple Selection 22
6. A nurse leader is attempting to increase the awareness of evidence-
22 22 22 22 22 22 22 22 22 22
based practice (EBP) among the nurses on a unit. A nurse who is implementing EBP integrates w
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
hich of the following? (Select all that apply.)
22 22 22 22 22 22 22
A) Interdisciplinary consensus 22
B) Nursing tradition 22
C) Research studies 22
D) Patient preferences and values 22 22 22
E) Clinical expertise 22
Ans: C, D, E
22 22 22 22
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-
22 22 22 22 22 22 22 22 22 22
solving approach to the delivery of healthcare that integrates the best evidence from studies and pat
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
ient care data with clinician expertise and patient preferences and values.
22 22 22 22 22 22 22 22 22 22
Multiple Choice 22
7. Mrs. Mayes is a 73-year- 22 22 22 22
old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now po
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
ses a threat of osteomyelitis. The wound care nurse who has been working with Mrs. Mayes appli
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
es evidence-
22
based practice (EBP) whenever possible and has proposed the use of maggot therapy to debride ne
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
crotic tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this tre
22 22 22 22 22 22 22 22 22 22 22 22 22
atment despite the sizable body of evidence supporting it. How should the nurse reconcile Mrs. M
22 22 22 22 22 22 22 22 22 22 22 22 22 22 22
ayes views with the principles of EBP?
22 22 22 22 22 22
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
22 22 22 22 22 22 22 22 22 22 22 22 22
B) The nurse should explain the evidence to the patient in greater detail.
22 22 22 22 22 22 22 22 22 22 22
