,Primary Care The Art and Science of Advanced Practice Nursing an Interprofessional Approach 6th Edition Dunphy
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
est Bank
cn
Table of Contents cn cn
Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring
cn cn cn cn cn cn cn cn cn cn cn
1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on the i
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ncidence of nosocomial (hospital- cn cn cn
acquired) infections in acute care settings. An article presented findings at a level of significance of
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
<0.01. This indicates that cn cn cn
A) the control group and the experimental group were more than 99% similar
cn cn cn cn cn cn cn cn cn cn cn
B) the findings of the study have less than 1% chance of being attributable to chance.
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
C) the effects of the intervention were nearly
cn cn cn cn cn cn
D) the clinical significance of the findings was less than 1:100.
cn cn cn cn cn cn cn cn cn
Ans: B cn
Feedback: The level of significance is the level at which the researcher believes that the study results
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
most likely represent a nonchance event. A level of significance of <0.01 indicates that there is less t
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
han 1% probability that the result is due to chance.
cn cn cn cn cn cn cn cn cn
2. A nurse has read a qualitative research study in order to understand the lived experience of parents
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
who have a neonatal loss. Which of the following questions should the nurse prioritize when appraisi
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ng the results of this study?
cn cn cn cn cn
A) How well did the authors capture the personal experiences of these parHow well did the authors
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
control for confounding variables that may have affected the findings?
cn cn cn cn cn cn cn cn cn
B) Did the atuhors use statistical measures that were appropriate to the phenomenon in question?
cn cn cn cn cn cn cn cn cn cn cn cn cn
C) Were the instruments that the researchers used statistically valid and reliable?
cn cn cn cn cn cn cn cn cn cn
Ans: A cn
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the subjec
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
tive experiences of individuals. Statistical measures and variables are not dimensions of a qualitative
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
methodology.
3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming that
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
nursing research has little relevance to practice. How can the nurses colleague best defend the impor
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
tance of nursing research?
cn cn cn
,A) The existence of nursing research means that nurses are now able to access federal grant money,
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
something that didnt use to be the case. cn cn cn cn cn cn cn
B) Nursing research has allowed the development of masters and doctoral programs and has greatly i
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ncreased the credibility of the profession.
cn cn cn cn cn
C) The growth of nursing research has caused nursing to be viewed as a true profession, rather than
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
simply as a trade or a skill.
cn cn cn cn cn cn
D) The application of nursing research has the potential to improve nursing practice and patient
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
outcomes.
Ans: D cn
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimat
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ely, to improve patient outcomes. This supersedes the contributions of nursing research to education p
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
rograms, grant funding, or the public view of the profession.
cn cn cn cn cn cn cn cn cn
4. Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of a busy u
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
rban hospital. She has noticed that many new mothers abandon breast-
cn cn cn cn cn cn cn cn cn cn
feeding their babies when they experience early challenges and wonders what could be done to en
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
courage more women to continue breast-
cn cn cn cn cn
feeding. What role is Tracy most likely to play in a research project that tests an intervention aime
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
d at promoting breast-feeding?
cn cn cn
A) Applying for grant funding for the research project cn cn cn cn cn cn cn
B) Posing the clinical problem to one or more nursing researchers
cn cn cn cn cn cn cn cn cn
C) Planning the methodology of the research project cn cn cn cn cn cn
D) Carrying out the intervention and submitting the results for publication
cn cn cn cn cn cn cn cn cn cn
Ans: B cn
Feedback: A major role for staff nurses is to identify questions or problems for research. Grant
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
applications, methodological planning, and publication submission are normally carried out by
cn cn cn cn cn cn cn cn cn cn cn
nurses who have advanced degrees in nursing.
cn cn cn cn cn cn
5. A patient signed the informed consent form for a drug trial that was explained to patient by a r
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
esearch assistant. Later, the patient admitted to his nurse that he did not understand the research a
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ssistants explanation or his own role in the study. How should this patients nurse respond to this re
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
velation?
A) Explain the research process to the patient in greater detail.
cn cn cn cn cn cn cn cn cn
B) Describe the details of a randomized controlled trial for the patient.
cn cn cn cn cn cn cn cn cn cn
, C) Inform the research assistant that the patients consent is likely invalid.
cn cn cn cn cn cn cn cn cn cn
D) Explain to the patient that his written consent is now legally binding.
cn cn cn cn cn cn cn cn cn cn cn
Ans: C cn
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsi
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ble for research consent. If patients who have agreed to participate exhibit ambivalence or uncertaint
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
y about participating, do not try to convince them to participate. Ask the person from the research tea
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
m who is managing consents to speak with concerned patients about the study, even after a patient has
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn c
signed the consent forms.
n cn cn cn
Multiple Selection cn
6. A nurse leader is attempting to increase the awareness of evidence-
cn cn cn cn cn cn cn cn cn cn
based practice (EBP) among the nurses on a unit. A nurse who is implementing EBP integrates which
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
of the following? (Select all that apply.)
cn cn cn cn cn cn
A) Interdisciplinary consensus cn
B) Nursing tradition cn
C) Research studies cn
D) Patient preferences and values cn cn cn
E) Clinical expertise cn c
n Ans: C, D, E cn cn cn
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-
cn cn cn cn cn cn cn cn cn cn
solving approach to the delivery of healthcare that integrates the best evidence from studies and patien
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
t care data with clinician expertise and patient preferences and values.
cn cn cn cn cn cn cn cn cn cn
Multiple Choice cn
7. Mrs. Mayes is a 73-year- cn cn cn cn
old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now poses a
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn c
threat of osteomyelitis. The wound care nurse who has been working with Mrs. Mayes applies evide
n cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
nce-
based practice (EBP) whenever possible and has proposed the use of maggot therapy to debride necro
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
tic tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this treatmen
cn cn cn cn cn cn cn cn cn cn cn cn cn
t despite the sizable body of evidence supporting it. How should the nurse reconcile Mrs. Mayes view
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
s with the principles of EBP?
cn cn cn cn cn
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
cn cn cn cn cn cn cn cn cn cn cn cn cn
B) The nurse should explain the evidence to the patient in greater detail.
cn cn cn cn cn cn cn cn cn cn cn
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
est Bank
cn
Table of Contents cn cn
Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring
cn cn cn cn cn cn cn cn cn cn cn
1. A nurse has conducted a literature review in an effort to identify the effect of handwashing on the i
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ncidence of nosocomial (hospital- cn cn cn
acquired) infections in acute care settings. An article presented findings at a level of significance of
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
<0.01. This indicates that cn cn cn
A) the control group and the experimental group were more than 99% similar
cn cn cn cn cn cn cn cn cn cn cn
B) the findings of the study have less than 1% chance of being attributable to chance.
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
C) the effects of the intervention were nearly
cn cn cn cn cn cn
D) the clinical significance of the findings was less than 1:100.
cn cn cn cn cn cn cn cn cn
Ans: B cn
Feedback: The level of significance is the level at which the researcher believes that the study results
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
most likely represent a nonchance event. A level of significance of <0.01 indicates that there is less t
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
han 1% probability that the result is due to chance.
cn cn cn cn cn cn cn cn cn
2. A nurse has read a qualitative research study in order to understand the lived experience of parents
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
who have a neonatal loss. Which of the following questions should the nurse prioritize when appraisi
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ng the results of this study?
cn cn cn cn cn
A) How well did the authors capture the personal experiences of these parHow well did the authors
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
control for confounding variables that may have affected the findings?
cn cn cn cn cn cn cn cn cn
B) Did the atuhors use statistical measures that were appropriate to the phenomenon in question?
cn cn cn cn cn cn cn cn cn cn cn cn cn
C) Were the instruments that the researchers used statistically valid and reliable?
cn cn cn cn cn cn cn cn cn cn
Ans: A cn
Feedback: Qualitative studies are judged on the basis of how well they capture and convey the subjec
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
tive experiences of individuals. Statistical measures and variables are not dimensions of a qualitative
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
methodology.
3. A nurse has expressed skepticism to a colleague about the value of nursing research, claiming that
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
nursing research has little relevance to practice. How can the nurses colleague best defend the impor
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
tance of nursing research?
cn cn cn
,A) The existence of nursing research means that nurses are now able to access federal grant money,
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
something that didnt use to be the case. cn cn cn cn cn cn cn
B) Nursing research has allowed the development of masters and doctoral programs and has greatly i
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ncreased the credibility of the profession.
cn cn cn cn cn
C) The growth of nursing research has caused nursing to be viewed as a true profession, rather than
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
simply as a trade or a skill.
cn cn cn cn cn cn
D) The application of nursing research has the potential to improve nursing practice and patient
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
outcomes.
Ans: D cn
Feedback: The greatest value of nursing research lies in the potential to improve practice and, ultimat
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ely, to improve patient outcomes. This supersedes the contributions of nursing research to education p
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
rograms, grant funding, or the public view of the profession.
cn cn cn cn cn cn cn cn cn
4. Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of a busy u
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
rban hospital. She has noticed that many new mothers abandon breast-
cn cn cn cn cn cn cn cn cn cn
feeding their babies when they experience early challenges and wonders what could be done to en
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
courage more women to continue breast-
cn cn cn cn cn
feeding. What role is Tracy most likely to play in a research project that tests an intervention aime
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
d at promoting breast-feeding?
cn cn cn
A) Applying for grant funding for the research project cn cn cn cn cn cn cn
B) Posing the clinical problem to one or more nursing researchers
cn cn cn cn cn cn cn cn cn
C) Planning the methodology of the research project cn cn cn cn cn cn
D) Carrying out the intervention and submitting the results for publication
cn cn cn cn cn cn cn cn cn cn
Ans: B cn
Feedback: A major role for staff nurses is to identify questions or problems for research. Grant
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
applications, methodological planning, and publication submission are normally carried out by
cn cn cn cn cn cn cn cn cn cn cn
nurses who have advanced degrees in nursing.
cn cn cn cn cn cn
5. A patient signed the informed consent form for a drug trial that was explained to patient by a r
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
esearch assistant. Later, the patient admitted to his nurse that he did not understand the research a
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ssistants explanation or his own role in the study. How should this patients nurse respond to this re
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
velation?
A) Explain the research process to the patient in greater detail.
cn cn cn cn cn cn cn cn cn
B) Describe the details of a randomized controlled trial for the patient.
cn cn cn cn cn cn cn cn cn cn
, C) Inform the research assistant that the patients consent is likely invalid.
cn cn cn cn cn cn cn cn cn cn
D) Explain to the patient that his written consent is now legally binding.
cn cn cn cn cn cn cn cn cn cn cn
Ans: C cn
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is not responsi
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
ble for research consent. If patients who have agreed to participate exhibit ambivalence or uncertaint
cn cn cn cn cn cn cn cn cn cn cn cn cn cn
y about participating, do not try to convince them to participate. Ask the person from the research tea
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
m who is managing consents to speak with concerned patients about the study, even after a patient has
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn c
signed the consent forms.
n cn cn cn
Multiple Selection cn
6. A nurse leader is attempting to increase the awareness of evidence-
cn cn cn cn cn cn cn cn cn cn
based practice (EBP) among the nurses on a unit. A nurse who is implementing EBP integrates which
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
of the following? (Select all that apply.)
cn cn cn cn cn cn
A) Interdisciplinary consensus cn
B) Nursing tradition cn
C) Research studies cn
D) Patient preferences and values cn cn cn
E) Clinical expertise cn c
n Ans: C, D, E cn cn cn
Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-
cn cn cn cn cn cn cn cn cn cn
solving approach to the delivery of healthcare that integrates the best evidence from studies and patien
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
t care data with clinician expertise and patient preferences and values.
cn cn cn cn cn cn cn cn cn cn
Multiple Choice cn
7. Mrs. Mayes is a 73-year- cn cn cn cn
old woman who has a diabetic foot ulcer that has been extremely slow to heal and which now poses a
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn c
threat of osteomyelitis. The wound care nurse who has been working with Mrs. Mayes applies evide
n cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
nce-
based practice (EBP) whenever possible and has proposed the use of maggot therapy to debride necro
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
tic tissue. Mrs. Mayes, however, finds the suggestion repugnant and adamantly opposes this treatmen
cn cn cn cn cn cn cn cn cn cn cn cn cn
t despite the sizable body of evidence supporting it. How should the nurse reconcile Mrs. Mayes view
cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn cn
s with the principles of EBP?
cn cn cn cn cn
A) The nurse should explain that reliable and valid research evidence overrides the patients opinion.
cn cn cn cn cn cn cn cn cn cn cn cn cn
B) The nurse should explain the evidence to the patient in greater detail.
cn cn cn cn cn cn cn cn cn cn cn
