TEST BANK FOR PRIMARY CARE ART AND SCIENC
d d d d d d d
E OF ADVANCED PRACTICE NURSING 6th EDITION
d d d d d d
Chapterd1.dPrimarydCaredindthedTwenty-FirstdCentury:dAdCircledofdCaring
1. Adnursedhasdconducteddadliteraturedreviewdindandeffortdtodidentifydthedeffectdofdhandwashingdondthedi
ncidencedofdnosocomiald(hospital-
acquired)dinfectionsdindacutedcaredsettings.dAndarticledpresenteddfindingsdatdadleveldofdsignificancedofd<
0.01.dThisdindicatesdthat
A) thedcontroldgroupdanddthedexperimentaldgroupdweredmoredthand99%dsimilar.
B) thedfindingsdofdthedstudydhavedlessdthand1%dchancedofdbeingdattributabledtodchance.
C) thedeffectsdofdthedinterventiondwerednearlydzero.
D) thedclinicaldsignificancedofdthedfindingsdwasdlessdthand1:100.
Ans:dB
Feedback:dThedleveldofdsignificancedisdthedleveldatdwhichdthedresearcherdbelievesdthatdthedstudydresultsd
mostdlikelydrepresentdadnonchancedevent.dAdleveldofdsignificancedofd<0.01dindicatesdthatdtheredisdlessdth
and1%dprobabilitydthatdthedresultdisdduedtodchance.
2. Adnursedhasdreaddadqualitativedresearchdstudydindorderdtodunderstanddthedliveddexperiencedofdparentsd
whodhavedadneonataldloss.dWhichdofdthedfollowingdquestionsdshoulddthednursedprioritizedwhendappraisin
gdthedresultsdofdthisdstudy?
A) Howdwellddiddthedauthorsdcapturedthedpersonaldexperiencesdofdthesedparents?
B) Howdwellddiddthedauthorsdcontroldfordconfoundingdvariablesdthatdmaydhavedaffecteddthedfindings?
C) Diddthedauthorsdusedstatisticaldmeasuresdthatdweredappropriatedtodthedphenomenondindquestion?
D) Weredthedinstrumentsdthatdthedresearchersduseddstatisticallydvaliddanddreliable?
Ans:dA
Feedback:dQualitativedstudiesdaredjudgeddondthedbasisdofdhowdwelldtheydcapturedanddconveydthedsubject
ivedexperiencesdofdindividuals.dStatisticaldmeasuresdanddvariablesdarednotddimensionsdofdadqualitativedm
ethodology.
,3. Adnursedhasdexpresseddskepticismdtodadcolleaguedaboutdthedvaluedofdnursingdresearch,dclaimingdthatdn
ursingdresearchdhasdlittledrelevancedtodpractice.dHowdcandthednursesdcolleaguedbestddefenddthedimporta
ncedofdnursingdresearch?
A) Thedexistencedofdnursingdresearchdmeansdthatdnursesdarednowdabledtodaccessdfederaldgrantd
money,dsomethingdthatddidntdusedtodbedthedcase.
B) Nursingdresearchdhasdalloweddtheddevelopmentdofdmastersdandddoctoraldprogramsdanddhasd
greatlydincreaseddthedcredibilitydofdthedprofession.
C) Thedgrowthdofdnursingdresearchdhasdcauseddnursingdtodbedvieweddasdadtruedprofession,dratherdt
handsimplydasdadtradedordadskill.
D) Thedapplicationdofdnursingdresearchdhasdthedpotentialdtodimprovednursingdpracticedanddpatientdo
utcomes.
Ans:dD
Feedback:dThedgreatestdvaluedofdnursingdresearchdliesdindthedpotentialdtodimprovedpracticedand,dultimate
ly,dtodimprovedpatientdoutcomes.dThisdsupersedesdthedcontributionsdofdnursingdresearchdtodeducationdpr
ograms,dgrantdfunding,dordthedpublicdviewdofdthedprofession.
4. Tracydisdadnursedwithdadbaccalaureateddegreedwhodworksdindthedlabordandddeliverydunitdofdadbusydu
rbandhospital.dShedhasdnoticeddthatdmanydnewdmothersdabandondbreast-
feedingdtheirdbabiesdwhendtheydexperiencedearlydchallengesdanddwondersdwhatdcoulddbeddonedtodenc
ouragedmoredwomendtodcontinuedbreast-
feeding.dWhatdroledisdTracydmostdlikelydtodplaydindadresearchdprojectdthatdtestsdandinterventiondaimed
datdpromotingdbreast-feeding?
A) Applyingdfordgrantdfundingdfordthedresearchdproject
B) Posingdthedclinicaldproblemdtodonedordmorednursingdresearchers
C) Planningdthedmethodologydofdthedresearchdproject
D) Carryingdoutdthedinterventiondanddsubmittingdthedresultsdfordpublicationd
Ans:dB
Feedback:dAdmajordroledfordstaffdnursesdisdtodidentifydquestionsdordproblemsdfordresearch.dGrantda
pplications,dmethodologicaldplanning,danddpublicationdsubmissiondarednormallydcarrieddoutdbydn
ursesdwhodhavedadvancedddegreesdindnursing.
5. Adpatientdsigneddthedinformeddconsentdformdfordaddrugdtrialdthatdwasdexplaineddtodpatientdbydadre
searchdassistant.dLater,dthedpatientdadmitteddtodhisdnursedthatdheddiddnotdunderstanddthedresearch
,assistantsdexplanationdordhisdowndroledindthedstudy.dHowdshoulddthisdpatientsdnursedresponddtodthisdrevel
ation?
A) Explaindthedresearchdprocessdtodthedpatientdindgreaterddetail.
B) Describedtheddetailsdofdadrandomizeddcontrolleddtrialdfordthedpatient.
C) Informdthedresearchdassistantdthatdthedpatientsdconsentdisdlikelydinvalid.
D) Explaindtodthedpatientdthatdhisdwrittendconsentdisdnowdlegallydbinding.
Ans:dC
Feedback:dJustdasdthedstaffdnursedisdnotdresponsibledfordmedicaldconsent,dthedstaffdnursedisdnotdresponsi
bledfordresearchdconsent.dIfdpatientsdwhodhavedagreeddtodparticipatedexhibitdambivalencedorduncertaint
ydaboutdparticipating,ddodnotdtrydtodconvincedthemdtodparticipate.dAskdthedpersondfromdthedresearchdtea
mdwhodisdmanagingdconsentsdtodspeakdwithdconcerneddpatientsdaboutdthedstudy,devendafterdadpatientdha
sdsigneddthedconsentdforms.
MultipledSelection
6. Adnursedleaderdisdattemptingdtodincreasedthedawarenessdofdevidence-
baseddpracticed(EBP)damongdthednursesdondadunit.dAdnursedwhodisdimplementingdEBPdintegratesdwhi
chdofdthedfollowing?d(Selectdalldthatdapply.)
A) Interdisciplinarydconsensus
B) Nursingdtradition
C) Researchdstudies
D) Patientdpreferencesdanddvalues
E) Clinicaldexpertise
d Ans:dC,dD,dE
Feedback:dFineout-Overholt,dMelnyk,dStillwell,danddWilliamsonddefinedEBPdasdadproblem-
solvingdapproachdtodtheddeliverydofdhealthcaredthatdintegratesdthedbestdevidencedfromdstudiesdanddpatien
tdcareddatadwithdcliniciandexpertisedanddpatientdpreferencesdanddvalues.
MultipledChoice
7. Mrs.dMayesdisdad73-year-
olddwomandwhodhasdaddiabeticdfootdulcerdthatdhasdbeendextremelydslowdtodhealdanddwhichdnowdposesdad
threatdofdosteomyelitis.dThedwounddcarednursedwhodhasdbeendworking
, withdMrs.dMayesdappliesdevidence-
baseddpracticed(EBP)dwheneverdpossibledanddhasdproposeddthedusedofdmaggotdtherapydtoddebridednecrot
icdtissue.dMrs.dMayes,dhowever,dfindsdthedsuggestiondrepugnantdanddadamantlydopposesdthisdtreatmentd
despitedthedsizabledbodydofdevidencedsupportingdit.dHowd shoulddthednursedreconciledMrs.dMayesdviews
dwithdthedprinciplesdofdEBP?
A) Thednursedshoulddexplaindthatdreliabledanddvaliddresearchdevidencedoverridesdthedpatientsdopinion.
B) Thednursedshoulddexplaindthedevidencedtodthedpatientdindgreaterddetail.
C) Thednursedshoulddintegratedthedpatientsdpreferencesdintodthedplandofdcare.
D) Thednursedshoulddinvolvedthedpatientsdfamilydmembersdindtheddecision-makingdprocess.
Ans:dC
Feedback:dPatientdpreferencesdshoulddbedintegrateddintodEBPdanddconsidereddalongsidedresearchdevide
ncedanddthednursesdclinicaldexpertise;devidenceddoesdnotdtrumpdthedpatientsdpreferences.dThedfamilydsho
ulddbedinvolved,dbutdthisdisdnotdandexplicitddimensiondofdEBP.dSimilarly,dexplainingdthedevidencedindmor
eddetaildisdnotdaddemonstrationdofdEBP.
8. Thedadministratorsdofdadlong-
termdcaredfacilitydaredconsidereddthedusedofdspecialized,dpressurereducingdmattressesdindorderdtodreduc
edthedincidencedofdpressuredulcersdamongdresidents.dTheydhavedsoughtdinputdfromdthednursesdondtheduni
t,dalldofdwhomdaredawaredofdthedneeddtodimplementdthedprinciplesdofdevidence-
baseddpracticed(EBP)dindthisddecision.dWhichdofdthedfollowingdevidencedsourcesdshoulddthednursesdprio
ritize?
A) Adqualitativedstudydthatdexploresdthedexperiencedofdlivingdwithdadpressuredulcer
B) Adcasedstudydthatddescribesdthedmeasuresdthatdnursesdondadgeriatricdunitdtookdtodreducedpressuredu
lcersdamongdpatients
C) Testimonialsdfromdexperienceddcliniciansdaboutdthedeffectivenessdofdthedmattressdindquestion
D) Adrandomizeddcontrolleddtrialdthatdcompareddthedpressure-
reducingdmattressdwithdstandarddmattresses
Ans:dD
Feedback:dThedmostdreliabledevidencedisdconsidereddRCTs.dQualitativedstudies,dcasedstudies,danddexpert
dopiniondaredlowdondthedhierarchydofdevidence.
9. Hospitaldadministratorsdaredapplyingdthedprinciplesdofdevidence-
baseddpracticed(EBP)dindtheirdattemptdtodascertaindthedmostdefficientdanddeffectivedwaydtodcommunicate
dbetweendnursesdwhodaredonddifferentdunits,dadprojectdthatdwilldconsiderdmanydtypesdofdevidence.dWhic
hdofdthedfollowingdinformationdsourcesdshoulddthedadministratorsdprioritize?
d d d d d d d
E OF ADVANCED PRACTICE NURSING 6th EDITION
d d d d d d
Chapterd1.dPrimarydCaredindthedTwenty-FirstdCentury:dAdCircledofdCaring
1. Adnursedhasdconducteddadliteraturedreviewdindandeffortdtodidentifydthedeffectdofdhandwashingdondthedi
ncidencedofdnosocomiald(hospital-
acquired)dinfectionsdindacutedcaredsettings.dAndarticledpresenteddfindingsdatdadleveldofdsignificancedofd<
0.01.dThisdindicatesdthat
A) thedcontroldgroupdanddthedexperimentaldgroupdweredmoredthand99%dsimilar.
B) thedfindingsdofdthedstudydhavedlessdthand1%dchancedofdbeingdattributabledtodchance.
C) thedeffectsdofdthedinterventiondwerednearlydzero.
D) thedclinicaldsignificancedofdthedfindingsdwasdlessdthand1:100.
Ans:dB
Feedback:dThedleveldofdsignificancedisdthedleveldatdwhichdthedresearcherdbelievesdthatdthedstudydresultsd
mostdlikelydrepresentdadnonchancedevent.dAdleveldofdsignificancedofd<0.01dindicatesdthatdtheredisdlessdth
and1%dprobabilitydthatdthedresultdisdduedtodchance.
2. Adnursedhasdreaddadqualitativedresearchdstudydindorderdtodunderstanddthedliveddexperiencedofdparentsd
whodhavedadneonataldloss.dWhichdofdthedfollowingdquestionsdshoulddthednursedprioritizedwhendappraisin
gdthedresultsdofdthisdstudy?
A) Howdwellddiddthedauthorsdcapturedthedpersonaldexperiencesdofdthesedparents?
B) Howdwellddiddthedauthorsdcontroldfordconfoundingdvariablesdthatdmaydhavedaffecteddthedfindings?
C) Diddthedauthorsdusedstatisticaldmeasuresdthatdweredappropriatedtodthedphenomenondindquestion?
D) Weredthedinstrumentsdthatdthedresearchersduseddstatisticallydvaliddanddreliable?
Ans:dA
Feedback:dQualitativedstudiesdaredjudgeddondthedbasisdofdhowdwelldtheydcapturedanddconveydthedsubject
ivedexperiencesdofdindividuals.dStatisticaldmeasuresdanddvariablesdarednotddimensionsdofdadqualitativedm
ethodology.
,3. Adnursedhasdexpresseddskepticismdtodadcolleaguedaboutdthedvaluedofdnursingdresearch,dclaimingdthatdn
ursingdresearchdhasdlittledrelevancedtodpractice.dHowdcandthednursesdcolleaguedbestddefenddthedimporta
ncedofdnursingdresearch?
A) Thedexistencedofdnursingdresearchdmeansdthatdnursesdarednowdabledtodaccessdfederaldgrantd
money,dsomethingdthatddidntdusedtodbedthedcase.
B) Nursingdresearchdhasdalloweddtheddevelopmentdofdmastersdandddoctoraldprogramsdanddhasd
greatlydincreaseddthedcredibilitydofdthedprofession.
C) Thedgrowthdofdnursingdresearchdhasdcauseddnursingdtodbedvieweddasdadtruedprofession,dratherdt
handsimplydasdadtradedordadskill.
D) Thedapplicationdofdnursingdresearchdhasdthedpotentialdtodimprovednursingdpracticedanddpatientdo
utcomes.
Ans:dD
Feedback:dThedgreatestdvaluedofdnursingdresearchdliesdindthedpotentialdtodimprovedpracticedand,dultimate
ly,dtodimprovedpatientdoutcomes.dThisdsupersedesdthedcontributionsdofdnursingdresearchdtodeducationdpr
ograms,dgrantdfunding,dordthedpublicdviewdofdthedprofession.
4. Tracydisdadnursedwithdadbaccalaureateddegreedwhodworksdindthedlabordandddeliverydunitdofdadbusydu
rbandhospital.dShedhasdnoticeddthatdmanydnewdmothersdabandondbreast-
feedingdtheirdbabiesdwhendtheydexperiencedearlydchallengesdanddwondersdwhatdcoulddbeddonedtodenc
ouragedmoredwomendtodcontinuedbreast-
feeding.dWhatdroledisdTracydmostdlikelydtodplaydindadresearchdprojectdthatdtestsdandinterventiondaimed
datdpromotingdbreast-feeding?
A) Applyingdfordgrantdfundingdfordthedresearchdproject
B) Posingdthedclinicaldproblemdtodonedordmorednursingdresearchers
C) Planningdthedmethodologydofdthedresearchdproject
D) Carryingdoutdthedinterventiondanddsubmittingdthedresultsdfordpublicationd
Ans:dB
Feedback:dAdmajordroledfordstaffdnursesdisdtodidentifydquestionsdordproblemsdfordresearch.dGrantda
pplications,dmethodologicaldplanning,danddpublicationdsubmissiondarednormallydcarrieddoutdbydn
ursesdwhodhavedadvancedddegreesdindnursing.
5. Adpatientdsigneddthedinformeddconsentdformdfordaddrugdtrialdthatdwasdexplaineddtodpatientdbydadre
searchdassistant.dLater,dthedpatientdadmitteddtodhisdnursedthatdheddiddnotdunderstanddthedresearch
,assistantsdexplanationdordhisdowndroledindthedstudy.dHowdshoulddthisdpatientsdnursedresponddtodthisdrevel
ation?
A) Explaindthedresearchdprocessdtodthedpatientdindgreaterddetail.
B) Describedtheddetailsdofdadrandomizeddcontrolleddtrialdfordthedpatient.
C) Informdthedresearchdassistantdthatdthedpatientsdconsentdisdlikelydinvalid.
D) Explaindtodthedpatientdthatdhisdwrittendconsentdisdnowdlegallydbinding.
Ans:dC
Feedback:dJustdasdthedstaffdnursedisdnotdresponsibledfordmedicaldconsent,dthedstaffdnursedisdnotdresponsi
bledfordresearchdconsent.dIfdpatientsdwhodhavedagreeddtodparticipatedexhibitdambivalencedorduncertaint
ydaboutdparticipating,ddodnotdtrydtodconvincedthemdtodparticipate.dAskdthedpersondfromdthedresearchdtea
mdwhodisdmanagingdconsentsdtodspeakdwithdconcerneddpatientsdaboutdthedstudy,devendafterdadpatientdha
sdsigneddthedconsentdforms.
MultipledSelection
6. Adnursedleaderdisdattemptingdtodincreasedthedawarenessdofdevidence-
baseddpracticed(EBP)damongdthednursesdondadunit.dAdnursedwhodisdimplementingdEBPdintegratesdwhi
chdofdthedfollowing?d(Selectdalldthatdapply.)
A) Interdisciplinarydconsensus
B) Nursingdtradition
C) Researchdstudies
D) Patientdpreferencesdanddvalues
E) Clinicaldexpertise
d Ans:dC,dD,dE
Feedback:dFineout-Overholt,dMelnyk,dStillwell,danddWilliamsonddefinedEBPdasdadproblem-
solvingdapproachdtodtheddeliverydofdhealthcaredthatdintegratesdthedbestdevidencedfromdstudiesdanddpatien
tdcareddatadwithdcliniciandexpertisedanddpatientdpreferencesdanddvalues.
MultipledChoice
7. Mrs.dMayesdisdad73-year-
olddwomandwhodhasdaddiabeticdfootdulcerdthatdhasdbeendextremelydslowdtodhealdanddwhichdnowdposesdad
threatdofdosteomyelitis.dThedwounddcarednursedwhodhasdbeendworking
, withdMrs.dMayesdappliesdevidence-
baseddpracticed(EBP)dwheneverdpossibledanddhasdproposeddthedusedofdmaggotdtherapydtoddebridednecrot
icdtissue.dMrs.dMayes,dhowever,dfindsdthedsuggestiondrepugnantdanddadamantlydopposesdthisdtreatmentd
despitedthedsizabledbodydofdevidencedsupportingdit.dHowd shoulddthednursedreconciledMrs.dMayesdviews
dwithdthedprinciplesdofdEBP?
A) Thednursedshoulddexplaindthatdreliabledanddvaliddresearchdevidencedoverridesdthedpatientsdopinion.
B) Thednursedshoulddexplaindthedevidencedtodthedpatientdindgreaterddetail.
C) Thednursedshoulddintegratedthedpatientsdpreferencesdintodthedplandofdcare.
D) Thednursedshoulddinvolvedthedpatientsdfamilydmembersdindtheddecision-makingdprocess.
Ans:dC
Feedback:dPatientdpreferencesdshoulddbedintegrateddintodEBPdanddconsidereddalongsidedresearchdevide
ncedanddthednursesdclinicaldexpertise;devidenceddoesdnotdtrumpdthedpatientsdpreferences.dThedfamilydsho
ulddbedinvolved,dbutdthisdisdnotdandexplicitddimensiondofdEBP.dSimilarly,dexplainingdthedevidencedindmor
eddetaildisdnotdaddemonstrationdofdEBP.
8. Thedadministratorsdofdadlong-
termdcaredfacilitydaredconsidereddthedusedofdspecialized,dpressurereducingdmattressesdindorderdtodreduc
edthedincidencedofdpressuredulcersdamongdresidents.dTheydhavedsoughtdinputdfromdthednursesdondtheduni
t,dalldofdwhomdaredawaredofdthedneeddtodimplementdthedprinciplesdofdevidence-
baseddpracticed(EBP)dindthisddecision.dWhichdofdthedfollowingdevidencedsourcesdshoulddthednursesdprio
ritize?
A) Adqualitativedstudydthatdexploresdthedexperiencedofdlivingdwithdadpressuredulcer
B) Adcasedstudydthatddescribesdthedmeasuresdthatdnursesdondadgeriatricdunitdtookdtodreducedpressuredu
lcersdamongdpatients
C) Testimonialsdfromdexperienceddcliniciansdaboutdthedeffectivenessdofdthedmattressdindquestion
D) Adrandomizeddcontrolleddtrialdthatdcompareddthedpressure-
reducingdmattressdwithdstandarddmattresses
Ans:dD
Feedback:dThedmostdreliabledevidencedisdconsidereddRCTs.dQualitativedstudies,dcasedstudies,danddexpert
dopiniondaredlowdondthedhierarchydofdevidence.
9. Hospitaldadministratorsdaredapplyingdthedprinciplesdofdevidence-
baseddpracticed(EBP)dindtheirdattemptdtodascertaindthedmostdefficientdanddeffectivedwaydtodcommunicate
dbetweendnursesdwhodaredonddifferentdunits,dadprojectdthatdwilldconsiderdmanydtypesdofdevidence.dWhic
hdofdthedfollowingdinformationdsourcesdshoulddthedadministratorsdprioritize?
