1
TEST BANK FOR PRIMARY CARE ART AND SCIENCE OF ADVANCED PRACTICE
NURSING – AN INTERPROFESSIONAL APPROACH 6TH EDITION DUNPHY
, 2
TEST BANK FOR PRIMARY CARE ART AND SCIENCE OF ADVANCED PRACTICE NURSING – AN
INTERPROFESSIONAL APPROACH 6TH EDITION DUNPHY
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
handwashi ng 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.
Answer: B
Feedback: The level of significance is the level at which the researcher believes that the
study results most likely represent a no chance 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
hi
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?
Answer: A
Feedback: Qualitative studies are judged on the basis of how well they capture and convey
the su bjective experiences of individuals. Statistical measures and variables are not
dimensions of a quali tative methodology.
3. A nurse has expressed skepticism to a colleague about the value of nursing
research, cla iming that nursing research has little relevance to practice. How can the
nurses colleague best de fend the importance of nursing research?
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.
, 3
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.
Answer: D
Feedback: The greatest value of nursing research lies in the potential to improve practice
h
and, ulti mately, to improve patient outcomes. This supersedes the contributions of
nursing research to educ ation 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 e ncourage more women to continue breast-
feeding. What role is Tracy most likely to play in a research project that tests an
intervention ai med at promoting breast-feeding?
A) Applying for grant funding for the research project
hi
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 Answer: 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
hi
patient by a research assistant. Later, the patient admitted to his nurse that he did not
understand the re search assistants explanation or his own role in the study. How
should this patients nurse respo nd to this revelation?
A) Explain the research process to the patient in greater detail.
hi
B) Describe the details of a randomized controlled trial for the patient.
hi
C) Inform the research assistant that the patients consent is likely invalid.
hi
D) Explain to the patient that his written consent is now legally binding.
Answer: C
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is
, 4
not res ponsible for research consent. If patients who have agreed to participate exhibit
ambivalence or u ncertainty about participating, do not try to convince them to
participate. Ask the person from th e research team who is managing consents to speak
with concerned patients about the study, eve n 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
Answer: 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
hi hi h
now pos es a threat of osteomyelitis. The wound care nurse who has been working with
Mrs. Mayes appli es 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 thi s treatment despite the sizable body of evidence supporting it.
How should the nurse reconcile M rs. 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.
C) The nurse should integrate the patients preferences into the plan of care.
D) The nurse should involve the patients family members in the decision-making process.
Answer: C
TEST BANK FOR PRIMARY CARE ART AND SCIENCE OF ADVANCED PRACTICE
NURSING – AN INTERPROFESSIONAL APPROACH 6TH EDITION DUNPHY
, 2
TEST BANK FOR PRIMARY CARE ART AND SCIENCE OF ADVANCED PRACTICE NURSING – AN
INTERPROFESSIONAL APPROACH 6TH EDITION DUNPHY
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
handwashi ng 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.
Answer: B
Feedback: The level of significance is the level at which the researcher believes that the
study results most likely represent a no chance 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
hi
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?
Answer: A
Feedback: Qualitative studies are judged on the basis of how well they capture and convey
the su bjective experiences of individuals. Statistical measures and variables are not
dimensions of a quali tative methodology.
3. A nurse has expressed skepticism to a colleague about the value of nursing
research, cla iming that nursing research has little relevance to practice. How can the
nurses colleague best de fend the importance of nursing research?
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.
, 3
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.
Answer: D
Feedback: The greatest value of nursing research lies in the potential to improve practice
h
and, ulti mately, to improve patient outcomes. This supersedes the contributions of
nursing research to educ ation 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 e ncourage more women to continue breast-
feeding. What role is Tracy most likely to play in a research project that tests an
intervention ai med at promoting breast-feeding?
A) Applying for grant funding for the research project
hi
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 Answer: 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
hi
patient by a research assistant. Later, the patient admitted to his nurse that he did not
understand the re search assistants explanation or his own role in the study. How
should this patients nurse respo nd to this revelation?
A) Explain the research process to the patient in greater detail.
hi
B) Describe the details of a randomized controlled trial for the patient.
hi
C) Inform the research assistant that the patients consent is likely invalid.
hi
D) Explain to the patient that his written consent is now legally binding.
Answer: C
Feedback: Just as the staff nurse is not responsible for medical consent, the staff nurse is
, 4
not res ponsible for research consent. If patients who have agreed to participate exhibit
ambivalence or u ncertainty about participating, do not try to convince them to
participate. Ask the person from th e research team who is managing consents to speak
with concerned patients about the study, eve n 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
Answer: 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
hi hi h
now pos es a threat of osteomyelitis. The wound care nurse who has been working with
Mrs. Mayes appli es 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 thi s treatment despite the sizable body of evidence supporting it.
How should the nurse reconcile M rs. 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.
C) The nurse should integrate the patients preferences into the plan of care.
D) The nurse should involve the patients family members in the decision-making process.
Answer: C
