TEST BANK Primary Care The Art and Science of Advanced Pra
n n n n n n n n n n
ctice Nursing –
n n
An Interprofessional Approach 6th Editionby Debera J. Dunph
n n n n n n n n n
y| Complete Guide Chapter 1-82
n n n n
PrimarynCare:nArtnandnSciencenofnAdvancednPracticenNursingn-
Approachn5thn editionnDunphynTestnBank
nAnnInterprofessionaln
Chaptern1.nPrimarynCareninnthenTwenty-FirstnCentury:nAnCirclenofnCaring
.nAnnursenleadernisnattemptingntonincreasenthenawarenessnofnevidence-
basednpracticen(EBP)namongnthennursesnonnanunit.nAnnursenwhonisnimplementingnEBPnintegratesnwhichn
ofnthenfollowing?n(Selectnallnthatnapply.)
A) Interdisciplinarynconsensus
B) Nursingntradition
C) Researchnstudies
D) Patientnpreferencesnandnvalues
E) Clinicalnexpertisen
Ans:nC,nD,nE
Feedback:nFineout-Overholt,nMelnyk,nStillwell,nandnWilliamsonndefinenEBPnasnanproblem-
solvingnapproachntonthendeliverynofnhealthcarenthatnintegratesnthenbestnevidencenfromnstudiesnandnpatie
ntncarendatanwithncliniciannexpertisenandnpatientnpreferencesnandnvalues.
MultiplenChoice
.nMrs.nMayesnisnan73-year-
oldnwomannwhonhasnandiabeticnfootnulcernthatnhasnbeennextremelynslowntonhealnandnwhichnnownposesnant
hreatnofnosteomyelitis.nThenwoundncarennursenwhonhasnbeennworkingnwithnMrs.nMayesnappliesnevidenc
e-
basednpracticen(EBP)nwhenevernpossiblenandnhasnproposednthenusenofnmaggotntherapyntondebridennecroti
cntissue.nMrs.nMayes,nhowever,nfindsnthensuggestionnrepugnantnandnadamantlynopposesnthisntreatmentnd
espitenthensizablenbodynofnevidencensupportingnit.nHownshouldnthennursenreconcilenMrs.nMayesnviewsnwi
thnthenprinciplesnofnEBP?
,A) Thennursenshouldnexplainnthatnreliablenandnvalidnresearchnevidencenoverridesnthenpatientsnopinion.
B) Thennursenshouldnexplainnthenevidencentonthenpatientninngreaterndetail.
C) Thennursenshouldnintegratenthenpatientsnpreferencesnintonthenplannofncare.
D) Thennursenshouldninvolventhenpatientsnfamilynmembersninnthendecision-makingnprocess.
Ans:nC
Feedback:nPatientnpreferencesnshouldnbenintegratednintonEBPnandnconsiderednalongsidenresearchne
videncenandnthennursesnclinicalnexpertise;nevidencendoesnnotntrumpnthenpatientsnpreferences.nThenfa
milynshouldnbeninvolved,nbutnthisnisnnotnannexplicitndimensionnofnEBP.nSimilarly,nexplainingnthenevi
denceninnmorendetailnisnnotnandemonstrationnofnEBP.
1. Annursenhasnconductednanliteraturenreviewninnanneffortntonidentifyntheneffectnofnhandwashingnonntheni
ncidencenofnnosocomialn(hospital-
acquired)ninfectionsninnacutencarensettings.nAnnarticlenpresentednfindingsnatnanlevelnofnsignificancenofn<
0.01.nThisnindicatesnthat
A) thencontrolngroupnandnthenexperimentalngroupnwerenmorenthann99%nsimilar.
B) thenfindingsnofnthenstudynhavenlessnthann1%nchancenofnbeingnattributablentonchance.
C) theneffectsnofntheninterventionnwerennearlynzero.
D) thenclinicalnsignificancenofnthenfindingsnwasnlessnthann1:100.
Ans:nB
Feedback:nThenlevelnofnsignificancenisnthenlevelnatnwhichnthenresearchernbelievesnthatnthenstudynresultsn
mostnlikelynrepresentnannonchancenevent.nAnlevelnofnsignificancenofn<0.01nindicatesnthatntherenisnlessnth
ann1%nprobabilitynthatnthenresultnisnduentonchance.
2. Annursenhasnreadnanqualitativenresearchnstudyninnorderntonunderstandnthenlivednexperiencenofnparentsnw
honhavenanneonatalnloss.nWhichnofnthenfollowingnquestionsnshouldnthennursenprioritizenwhennappraisingn
thenresultsnofnthisnstudy?
A) Hownwellndidnthenauthorsncapturenthenpersonalnexperiencesnofnthesenparents?
B) Hownwellndidnthenauthorsncontrolnfornconfoundingnvariablesnthatnmaynhavenaffectednthenfindings?
C) Didnthenauthorsnusenstatisticalnmeasuresnthatnwerenappropriatentonthenphenomenonninnquestion?
D) Werentheninstrumentsnthatnthenresearchersnusednstatisticallynvalidnandnreliable?
Ans:nA
,Feedback:nQualitativenstudiesnarenjudgednonnthenbasisnofnhownwellntheyncapturenandnconveynthensu
bjectivenexperiencesnofnindividuals.nStatisticalnmeasuresnandnvariablesnarennotndimensionsnofnanqua
litativenmethodology.
3. Annursenhasnexpressednskepticismntonancolleaguenaboutnthenvaluenofnnursingnresearch,nclaimingnthatnn
ursingnresearchnhasnlittlenrelevancentonpractice.nHowncannthennursesncolleaguenbestndefendnthenimporta
ncenofnnursingnresearch?
A) Thenexistencenofnnursingnresearchnmeansnthatnnursesnarennownablentonaccessnfederalngrantnmoney,ns
omethingnthatndidntnusentonbenthencase.
B) Nursingnresearchnhasnallowednthendevelopmentnofnmastersnandndoctoralnprogramsnandnhasngreatlyni
ncreasednthencredibilitynofnthenprofession.
C) Thengrowthnofnnursingnresearchnhasncausednnursingntonbenviewednasnantruenprofession,nrathernthannsi
mplynasnantradenornanskill.
D) Thenapplicationnofnnursingnresearchnhasnthenpotentialntonimprovennursingnpracticenandnpatientno
utcomes.
Ans:nD
Feedback:nThengreatestnvaluenofnnursingnresearchnliesninnthenpotentialntonimprovenpracticenand,nulti
mately,ntonimprovenpatientnoutcomes.nThisnsupersedesnthencontributionsnofnnursingnresearchntoneduc
ationnprograms,ngrantnfunding,nornthenpublicnviewnofnthenprofession.
4. Tracynisnannursenwithnanbaccalaureatendegreenwhonworksninnthenlabornandndeliverynunitnofnanbusynu
rbannhospital.nShenhasnnoticednthatnmanynnewnmothersnabandonnbreast-
feedingntheirnbabiesnwhenntheynexperiencenearlynchallengesnandnwondersnwhatncouldnbendonentonenc
ouragenmorenwomenntoncontinuenbreast-
feeding.nWhatnrolenisnTracynmostnlikelyntonplayninnanresearchnprojectnthatntestsnanninterventionnaimed
natnpromotingnbreast-feeding?
A) Applyingnforngrantnfundingnfornthenresearchnproject
B) Posingnthenclinicalnproblemntononenornmorennursingnresearchers
C) Planningnthenmethodologynofnthenresearchnproject
D) Carryingnoutntheninterventionnandnsubmittingnthenresultsnfornpublicationn
Ans:nB
Feedback:nAnmajornrolenfornstaffnnursesnisntonidentifynquestionsnornproblemsnfornresearch.nGrantna
pplications,nmethodologicalnplanning,nandnpublicationnsubmissionnarennormallyncarriednoutnbynn
ursesnwhonhavenadvancedndegreesninnnursing.
, 5. Anpatientnsignedntheninformednconsentnformnfornandrugntrialnthatnwasnexplainedntonpatientnbynanres
earchnassistant.nLater,nthenpatientnadmittedntonhisnnursenthatnhendidnnotnunderstandnthenresearchnassi
stantsnexplanationnornhisnownnroleninnthenstudy.nHownshouldnthisnpatientsnnursenrespondntonthisnrevel
ation?
A) Explainnthenresearchnprocessntonthenpatientninngreaterndetail.
B) Describenthendetailsnofnanrandomizedncontrolledntrialnfornthenpatient.
C) Informnthenresearchnassistantnthatnthenpatientsnconsentnisnlikelyninvalid.
D) Explainntonthenpatientnthatnhisnwrittennconsentnisnnownlegallynbinding.
Ans:nC
Feedback:nJustnasnthenstaffnnursenisnnotnresponsiblenfornmedicalnconsent,nthenstaffnnursenisnnotnresponsib
lenfornresearchnconsent.nIfnpatientsnwhonhavenagreedntonparticipatenexhibitnambivalencenornuncertaintyna
boutnparticipating,ndonnotntryntonconvincenthemntonparticipate.nAsknthenpersonnfromnthenresearchnteamnw
honisnmanagingnconsentsntonspeaknwithnconcernednpatientsnaboutnthenstudy,nevennafternanpatientnhasnsign
ednthenconsentnforms.
MultiplenSelection
8. Thenadministratorsnofnanlong-
termncarenfacilitynarenconsiderednthenusenofnspecialized,npressurereducingnmattressesninnorderntonreduc
enthenincidencenofnpressurenulcersnamongnresidents.nTheynhavensoughtninputnfromnthennursesnonnthenuni
t,nallnofnwhomnarenawarenofnthenneedntonimplementnthenprinciplesnofnevidence-
basednpracticen(EBP)ninnthisndecision.nWhichnofnthenfollowingnevidencensourcesnshouldnthennursesnprio
ritize?
A) Anqualitativenstudynthatnexploresnthenexperiencenofnlivingnwithnanpressurenulcer
B) Ancasenstudynthatndescribesnthenmeasuresnthatnnursesnonnangeriatricnunitntookntonreducenpressurenu
lcersnamongnpatients
C) Testimonialsnfromnexperiencedncliniciansnaboutntheneffectivenessnofnthenmattressninnquestion
D) Anrandomizedncontrolledntrialnthatncomparednthenpressure-
reducingnmattressnwithnstandardnmattresses
Ans:nD
Feedback:nThenmostnreliablenevidencenisnconsiderednRCTs.nQualitativenstudies,ncasenstudies,nandne
xpertnopinionnarenlownonnthenhierarchynofnevidence.
9. Hospitalnadministratorsnarenapplyingnthenprinciplesnofnevidence-
basednpracticen(EBP)ninntheirnattemptntonascertainnthenmostnefficientnandneffectivenwayntoncommunicat
enbetweennnursesnwhonarenon
n n n n n n n n n n
ctice Nursing –
n n
An Interprofessional Approach 6th Editionby Debera J. Dunph
n n n n n n n n n
y| Complete Guide Chapter 1-82
n n n n
PrimarynCare:nArtnandnSciencenofnAdvancednPracticenNursingn-
Approachn5thn editionnDunphynTestnBank
nAnnInterprofessionaln
Chaptern1.nPrimarynCareninnthenTwenty-FirstnCentury:nAnCirclenofnCaring
.nAnnursenleadernisnattemptingntonincreasenthenawarenessnofnevidence-
basednpracticen(EBP)namongnthennursesnonnanunit.nAnnursenwhonisnimplementingnEBPnintegratesnwhichn
ofnthenfollowing?n(Selectnallnthatnapply.)
A) Interdisciplinarynconsensus
B) Nursingntradition
C) Researchnstudies
D) Patientnpreferencesnandnvalues
E) Clinicalnexpertisen
Ans:nC,nD,nE
Feedback:nFineout-Overholt,nMelnyk,nStillwell,nandnWilliamsonndefinenEBPnasnanproblem-
solvingnapproachntonthendeliverynofnhealthcarenthatnintegratesnthenbestnevidencenfromnstudiesnandnpatie
ntncarendatanwithncliniciannexpertisenandnpatientnpreferencesnandnvalues.
MultiplenChoice
.nMrs.nMayesnisnan73-year-
oldnwomannwhonhasnandiabeticnfootnulcernthatnhasnbeennextremelynslowntonhealnandnwhichnnownposesnant
hreatnofnosteomyelitis.nThenwoundncarennursenwhonhasnbeennworkingnwithnMrs.nMayesnappliesnevidenc
e-
basednpracticen(EBP)nwhenevernpossiblenandnhasnproposednthenusenofnmaggotntherapyntondebridennecroti
cntissue.nMrs.nMayes,nhowever,nfindsnthensuggestionnrepugnantnandnadamantlynopposesnthisntreatmentnd
espitenthensizablenbodynofnevidencensupportingnit.nHownshouldnthennursenreconcilenMrs.nMayesnviewsnwi
thnthenprinciplesnofnEBP?
,A) Thennursenshouldnexplainnthatnreliablenandnvalidnresearchnevidencenoverridesnthenpatientsnopinion.
B) Thennursenshouldnexplainnthenevidencentonthenpatientninngreaterndetail.
C) Thennursenshouldnintegratenthenpatientsnpreferencesnintonthenplannofncare.
D) Thennursenshouldninvolventhenpatientsnfamilynmembersninnthendecision-makingnprocess.
Ans:nC
Feedback:nPatientnpreferencesnshouldnbenintegratednintonEBPnandnconsiderednalongsidenresearchne
videncenandnthennursesnclinicalnexpertise;nevidencendoesnnotntrumpnthenpatientsnpreferences.nThenfa
milynshouldnbeninvolved,nbutnthisnisnnotnannexplicitndimensionnofnEBP.nSimilarly,nexplainingnthenevi
denceninnmorendetailnisnnotnandemonstrationnofnEBP.
1. Annursenhasnconductednanliteraturenreviewninnanneffortntonidentifyntheneffectnofnhandwashingnonntheni
ncidencenofnnosocomialn(hospital-
acquired)ninfectionsninnacutencarensettings.nAnnarticlenpresentednfindingsnatnanlevelnofnsignificancenofn<
0.01.nThisnindicatesnthat
A) thencontrolngroupnandnthenexperimentalngroupnwerenmorenthann99%nsimilar.
B) thenfindingsnofnthenstudynhavenlessnthann1%nchancenofnbeingnattributablentonchance.
C) theneffectsnofntheninterventionnwerennearlynzero.
D) thenclinicalnsignificancenofnthenfindingsnwasnlessnthann1:100.
Ans:nB
Feedback:nThenlevelnofnsignificancenisnthenlevelnatnwhichnthenresearchernbelievesnthatnthenstudynresultsn
mostnlikelynrepresentnannonchancenevent.nAnlevelnofnsignificancenofn<0.01nindicatesnthatntherenisnlessnth
ann1%nprobabilitynthatnthenresultnisnduentonchance.
2. Annursenhasnreadnanqualitativenresearchnstudyninnorderntonunderstandnthenlivednexperiencenofnparentsnw
honhavenanneonatalnloss.nWhichnofnthenfollowingnquestionsnshouldnthennursenprioritizenwhennappraisingn
thenresultsnofnthisnstudy?
A) Hownwellndidnthenauthorsncapturenthenpersonalnexperiencesnofnthesenparents?
B) Hownwellndidnthenauthorsncontrolnfornconfoundingnvariablesnthatnmaynhavenaffectednthenfindings?
C) Didnthenauthorsnusenstatisticalnmeasuresnthatnwerenappropriatentonthenphenomenonninnquestion?
D) Werentheninstrumentsnthatnthenresearchersnusednstatisticallynvalidnandnreliable?
Ans:nA
,Feedback:nQualitativenstudiesnarenjudgednonnthenbasisnofnhownwellntheyncapturenandnconveynthensu
bjectivenexperiencesnofnindividuals.nStatisticalnmeasuresnandnvariablesnarennotndimensionsnofnanqua
litativenmethodology.
3. Annursenhasnexpressednskepticismntonancolleaguenaboutnthenvaluenofnnursingnresearch,nclaimingnthatnn
ursingnresearchnhasnlittlenrelevancentonpractice.nHowncannthennursesncolleaguenbestndefendnthenimporta
ncenofnnursingnresearch?
A) Thenexistencenofnnursingnresearchnmeansnthatnnursesnarennownablentonaccessnfederalngrantnmoney,ns
omethingnthatndidntnusentonbenthencase.
B) Nursingnresearchnhasnallowednthendevelopmentnofnmastersnandndoctoralnprogramsnandnhasngreatlyni
ncreasednthencredibilitynofnthenprofession.
C) Thengrowthnofnnursingnresearchnhasncausednnursingntonbenviewednasnantruenprofession,nrathernthannsi
mplynasnantradenornanskill.
D) Thenapplicationnofnnursingnresearchnhasnthenpotentialntonimprovennursingnpracticenandnpatientno
utcomes.
Ans:nD
Feedback:nThengreatestnvaluenofnnursingnresearchnliesninnthenpotentialntonimprovenpracticenand,nulti
mately,ntonimprovenpatientnoutcomes.nThisnsupersedesnthencontributionsnofnnursingnresearchntoneduc
ationnprograms,ngrantnfunding,nornthenpublicnviewnofnthenprofession.
4. Tracynisnannursenwithnanbaccalaureatendegreenwhonworksninnthenlabornandndeliverynunitnofnanbusynu
rbannhospital.nShenhasnnoticednthatnmanynnewnmothersnabandonnbreast-
feedingntheirnbabiesnwhenntheynexperiencenearlynchallengesnandnwondersnwhatncouldnbendonentonenc
ouragenmorenwomenntoncontinuenbreast-
feeding.nWhatnrolenisnTracynmostnlikelyntonplayninnanresearchnprojectnthatntestsnanninterventionnaimed
natnpromotingnbreast-feeding?
A) Applyingnforngrantnfundingnfornthenresearchnproject
B) Posingnthenclinicalnproblemntononenornmorennursingnresearchers
C) Planningnthenmethodologynofnthenresearchnproject
D) Carryingnoutntheninterventionnandnsubmittingnthenresultsnfornpublicationn
Ans:nB
Feedback:nAnmajornrolenfornstaffnnursesnisntonidentifynquestionsnornproblemsnfornresearch.nGrantna
pplications,nmethodologicalnplanning,nandnpublicationnsubmissionnarennormallyncarriednoutnbynn
ursesnwhonhavenadvancedndegreesninnnursing.
, 5. Anpatientnsignedntheninformednconsentnformnfornandrugntrialnthatnwasnexplainedntonpatientnbynanres
earchnassistant.nLater,nthenpatientnadmittedntonhisnnursenthatnhendidnnotnunderstandnthenresearchnassi
stantsnexplanationnornhisnownnroleninnthenstudy.nHownshouldnthisnpatientsnnursenrespondntonthisnrevel
ation?
A) Explainnthenresearchnprocessntonthenpatientninngreaterndetail.
B) Describenthendetailsnofnanrandomizedncontrolledntrialnfornthenpatient.
C) Informnthenresearchnassistantnthatnthenpatientsnconsentnisnlikelyninvalid.
D) Explainntonthenpatientnthatnhisnwrittennconsentnisnnownlegallynbinding.
Ans:nC
Feedback:nJustnasnthenstaffnnursenisnnotnresponsiblenfornmedicalnconsent,nthenstaffnnursenisnnotnresponsib
lenfornresearchnconsent.nIfnpatientsnwhonhavenagreedntonparticipatenexhibitnambivalencenornuncertaintyna
boutnparticipating,ndonnotntryntonconvincenthemntonparticipate.nAsknthenpersonnfromnthenresearchnteamnw
honisnmanagingnconsentsntonspeaknwithnconcernednpatientsnaboutnthenstudy,nevennafternanpatientnhasnsign
ednthenconsentnforms.
MultiplenSelection
8. Thenadministratorsnofnanlong-
termncarenfacilitynarenconsiderednthenusenofnspecialized,npressurereducingnmattressesninnorderntonreduc
enthenincidencenofnpressurenulcersnamongnresidents.nTheynhavensoughtninputnfromnthennursesnonnthenuni
t,nallnofnwhomnarenawarenofnthenneedntonimplementnthenprinciplesnofnevidence-
basednpracticen(EBP)ninnthisndecision.nWhichnofnthenfollowingnevidencensourcesnshouldnthennursesnprio
ritize?
A) Anqualitativenstudynthatnexploresnthenexperiencenofnlivingnwithnanpressurenulcer
B) Ancasenstudynthatndescribesnthenmeasuresnthatnnursesnonnangeriatricnunitntookntonreducenpressurenu
lcersnamongnpatients
C) Testimonialsnfromnexperiencedncliniciansnaboutntheneffectivenessnofnthenmattressninnquestion
D) Anrandomizedncontrolledntrialnthatncomparednthenpressure-
reducingnmattressnwithnstandardnmattresses
Ans:nD
Feedback:nThenmostnreliablenevidencenisnconsiderednRCTs.nQualitativenstudies,ncasenstudies,nandne
xpertnopinionnarenlownonnthenhierarchynofnevidence.
9. Hospitalnadministratorsnarenapplyingnthenprinciplesnofnevidence-
basednpracticen(EBP)ninntheirnattemptntonascertainnthenmostnefficientnandneffectivenwayntoncommunicat
enbetweennnursesnwhonarenon
