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Primary Care: Art and Science of Advanced Practice Nursing - An Interprofessional Approach 5th edition Dunphy Test Bank

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Chapter 1. Primary Care in the Twenty-First Century: ACircle of Caring1. A nurse has conducted a literature review in an effort to identify the effect of handwashingontheincidence of nosocomial (hospi... tal-acquired) infections in acute care settings. An articlepresentedfindings 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 thestudyresultsmost likely represent a nonchance event. A level of significance of <0.01 indicates that thereislessthan 1% probability that the result is due to chance. 2. A nurse has read a qualitative research study in order to understand the lived experienceofparentswho have a neonatal loss. Which of the following questions should the nurse prioritizewhenappraising 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 affectedthefindings?C) Did the authors use statistical measures that were appropriate to the phenomenoninquestion?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 andconveythesubjective experiences of individuals. Statistical measures and variables are not dimensionsofaqualitative methodology. 3. A nurse has expressed skepticism to a colleague about the value of nursing research, claimingthatnursing research has little relevance to practice. How can the nurses colleague best defendtheimportance 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 andhasgreatlyincreased the credibility of the profession. C) The growth of nursing research has caused nursing to be viewed as a true profession, ratherthansimply as a trade or a skill. D) The application of nursing research has the potential to improve nursing practice andpatientoutcomes. Ans: D Feedback: The greatest value of nursing research lies in the potential to improve practiceand,ultimately, to improve patient outcomes. This supersedes the contributions of nursingresearchtoeducation 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 deliveryunit ofabusyurban hospital. She has noticed that many new mothers abandon breast-feeding their babieswhenthey experience early challenges and wonders what could be done to encourage morewomentocontinue breast-feeding. What role is Tracy most likely to play in a research project that testsanintervention 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. Grantapplications, methodological planning, and publication submission are normally carriedout bynurses who have advanced degrees in nursing. 5. A patient signed the informed consent form for a drug trial that was explained topatient byaresearch assistant. Later, the patient admitted to his nurse that he did not understandtheresearchassistants explanation or his own role in the study. How should this patients nurse respondtothisrevelation? 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 nurseisnotresponsible for research consent. If patients who have agreed to participate exhibit ambivalenceoruncertainty about participating, do not try to convince them to participate. Ask the personfromtheresearch team who is managing consents to speak with concerned patients about the study, evenaftera patient has signed the consent forms. Multiple Selection 6. A nurse leader is attempting to increase the awareness of evidence-based practice (EBP)amongthe nurses on a unit. A nurse who is implementing EBP integrates which of the following?(Selectallthat apply.) A) Interdisciplinary consensus B) Nursing tradition C) Research studies D) Patient preferences and values E) Clinical expertise Ans: C, D, E Feedback: Fineout-Overholt, Melnyk, Stillwell, and Williamson define EBP as a problem-solvingapproach to the delivery of healthcare that integrates the best evidence fromstudies andpatientcaredata 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 beenextremelyslowtoheal and which now poses a threat of osteomyelitis. The wound care nurse who has beenworkingwith Mrs. Mayes applies evidence-based practice (EBP) whenever possible and has proposedtheuseof maggot therapy to debride necrotic tissue. Mrs. Mayes, however, finds the suggestionrepugnantand adamantly opposes this treatment despite the sizable body of evidence supportingit. Howshouldthe nurse reconcile Mrs. Mayes views with the principles of EBP? A) The nurse should explain that reliable and valid research evidence overrides the patientsopinion.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 alongsideresearchevidence and the nurses clinical expertise; evidence does not trump the patients preferences. Thefamily should be involved, but this is not an explicit dimension of EBP. Similarly, explainingtheevidence in more detail is not a demonstration of EBP. 8. The administrators of a long-term care facility are considered the use of specialized, pressurereducing mattresses in order to reduce the incidence of pressure ulcers among residents. Theyhavesought input from the nurses on the unit, all of whom are aware of the need to implement theprinciples of evidence-based practice (EBP) in this decision. Which of the followingevidencesources 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 reducepressureulcers among patients C) Testimonials from experienced clinicians about the effectiveness of the mattress inquestionD) A randomized controlled trial that compared the pressure-reducing mattress withstandardmattresses Ans: D Feedback: The most reliable evidence is considered RCTs. Qualitative studies, case studies, andexpert opinion are low on the hierarchy of evidence. [Show More]

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