Test Bank For Primary Care, Art and Science
of Advanced Practice Nursing 5th Edition by
Dunphy (complete questions/answers
Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring
• A nurse has conducted a literature review in an effort to identify the
effect of handwashing 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.
Ans: B
Feedback: The level of significance is the level at which the researcher
believes that the study results most likely represent a nonchance event. A
,level of significance of <0.01 indicates that there is less than 1% probability
that the result is due to chance.
• 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 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?
Ans: A
Feedback: Qualitative studies are judged on the basis of how well they
capture and convey the subjective experiences of individuals. Statistical
measures and variables are not dimensions of a qualitative methodology.
• A nurse has expressed skepticism to a colleague about the value of
nursing research, claiming that nursing research has little relevance to
practice. How can the nurses colleague best defend 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.
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.
Ans: D
Feedback: The greatest value of nursing research lies in the potential to
improve practice and, ultimately, to improve patient outcomes. This
, supersedes the contributions of nursing research to education programs, grant
funding, or the public view of the profession.
• 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 encourage more women to
continue breast-feeding. What role is Tracy most likely to play in a
research project that tests an intervention aimed at promoting breast-
feeding?
A. Applying for grant funding for the research project
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
Ans: 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.
• A patient signed the informed consent form for a drug trial that was
explained to patient by a research assistant. Later, the patient admitted to
his nurse that he did not understand the research assistants explanation or
his own role in the study. How should this patients nurse respond to this
revelation?
A. Explain the research process to the patient in greater detail.
B. Describe the details of a randomized controlled trial for the patient.
C. Inform the research assistant that the patients consent is likely invalid.
D. Explain to the patient that his written consent is now legally binding.
Ans: C
Feedback: Just as the staff nurse is not responsible for medical consent, the
staff nurse is not responsible for research consent. If patients who have
agreed to participate exhibit ambivalence or uncertainty about participating,
do not try to convince them to participate. Ask the person from the research
, team who is managing consents to speak with concerned patients about the
study, even after a patient has signed the consent forms.
Multiple Choice
• Mrs. Mayes is a 73-year-old woman who has a diabetic foot ulcer that has
been extremely slow to heal and which now poses a threat of osteomyelitis.
The wound care nurse who has been working with Mrs. Mayes applies
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 this treatment despite the
sizable body of evidence supporting it. How should the nurse reconcile Mrs.
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.
Ans: C
Feedback: Patient preferences should be integrated into EBP and considered
alongside research evidence and the nurses clinical expertise; evidence does
not trump the patients preferences. The family should be involved, but this is
not an explicit dimension of EBP. Similarly, explaining the evidence in more
detail is not a demonstration of EBP.
• The administrators of a long-term care facility are considered the use of
specialized, pressure- reducing mattresses in order to reduce the incidence
of pressure ulcers among residents. They have sought input from the
nurses on the unit, all of whom are aware of the need to implement the
principles of evidence-based practice (EBP) in this decision. Which of the
following evidence sources should the nurses prioritize?
A. A qualitative study that explores the experience of living with a pressure ulcer
B. A case study that describes the measures that nurses on a geriatric unit
took to reduce pressure ulcers among patients
C. Testimonials from experienced clinicians about the effectiveness of the
mattress in question
D. A randomized controlled trial that compared the pressure-
reducing mattress with standard mattresses
Ans: D
of Advanced Practice Nursing 5th Edition by
Dunphy (complete questions/answers
Chapter 1. Primary Care in the Twenty-First Century: A Circle of Caring
• A nurse has conducted a literature review in an effort to identify the
effect of handwashing 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.
Ans: B
Feedback: The level of significance is the level at which the researcher
believes that the study results most likely represent a nonchance event. A
,level of significance of <0.01 indicates that there is less than 1% probability
that the result is due to chance.
• 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 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?
Ans: A
Feedback: Qualitative studies are judged on the basis of how well they
capture and convey the subjective experiences of individuals. Statistical
measures and variables are not dimensions of a qualitative methodology.
• A nurse has expressed skepticism to a colleague about the value of
nursing research, claiming that nursing research has little relevance to
practice. How can the nurses colleague best defend 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.
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.
Ans: D
Feedback: The greatest value of nursing research lies in the potential to
improve practice and, ultimately, to improve patient outcomes. This
, supersedes the contributions of nursing research to education programs, grant
funding, or the public view of the profession.
• 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 encourage more women to
continue breast-feeding. What role is Tracy most likely to play in a
research project that tests an intervention aimed at promoting breast-
feeding?
A. Applying for grant funding for the research project
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
Ans: 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.
• A patient signed the informed consent form for a drug trial that was
explained to patient by a research assistant. Later, the patient admitted to
his nurse that he did not understand the research assistants explanation or
his own role in the study. How should this patients nurse respond to this
revelation?
A. Explain the research process to the patient in greater detail.
B. Describe the details of a randomized controlled trial for the patient.
C. Inform the research assistant that the patients consent is likely invalid.
D. Explain to the patient that his written consent is now legally binding.
Ans: C
Feedback: Just as the staff nurse is not responsible for medical consent, the
staff nurse is not responsible for research consent. If patients who have
agreed to participate exhibit ambivalence or uncertainty about participating,
do not try to convince them to participate. Ask the person from the research
, team who is managing consents to speak with concerned patients about the
study, even after a patient has signed the consent forms.
Multiple Choice
• Mrs. Mayes is a 73-year-old woman who has a diabetic foot ulcer that has
been extremely slow to heal and which now poses a threat of osteomyelitis.
The wound care nurse who has been working with Mrs. Mayes applies
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 this treatment despite the
sizable body of evidence supporting it. How should the nurse reconcile Mrs.
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.
Ans: C
Feedback: Patient preferences should be integrated into EBP and considered
alongside research evidence and the nurses clinical expertise; evidence does
not trump the patients preferences. The family should be involved, but this is
not an explicit dimension of EBP. Similarly, explaining the evidence in more
detail is not a demonstration of EBP.
• The administrators of a long-term care facility are considered the use of
specialized, pressure- reducing mattresses in order to reduce the incidence
of pressure ulcers among residents. They have sought input from the
nurses on the unit, all of whom are aware of the need to implement the
principles of evidence-based practice (EBP) in this decision. Which of the
following evidence sources should the nurses prioritize?
A. A qualitative study that explores the experience of living with a pressure ulcer
B. A case study that describes the measures that nurses on a geriatric unit
took to reduce pressure ulcers among patients
C. Testimonials from experienced clinicians about the effectiveness of the
mattress in question
D. A randomized controlled trial that compared the pressure-
reducing mattress with standard mattresses
Ans: D
