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Complete Guide A+ Test Bank Primary Care Art and Science of Advanced Practice Nursing - An Interprofessional Approach 5th Edition / Chapter 1-88
Table of Contents
Chapter 1 Primary Care in the Twenty-First Century: A Circle of Caring
Chapter 2 Caring and the Advanced Practice Nurse
Chapter 3 He...
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TEST BANK FOR
PRIMARY CARE ART AND SCIENCE OF ADVANCED PRACTICE
NURSING – AN INTERPROFESSIONAL APPROACH 5TH EDITION
DUNPHY
Table of Contents
Chapter 1 Primary Care in the Twenty-First Century: A Circle of Caring
Chapter 2 Caring and the Advanced Practice Nurse
Chapter 3 Health Promotion
Chapter 4 The Art of Diagnosis and Treatment
Chapter 5 Evidence-Based Practice
Chapter 6 Common Neurological Complaints
Chapter 7 Seizure Disorders
Chapter 8 Degenerative Disorders
Chapter 9 Cerebrovascular Accident (Stroke)
Chapter 10 Infectious and Inflammatory Neurological Disorders
Chapter 11 Common Skin Complaints
Chapter 12 Parasitic Skin Infestations
Chapter 13 Fungal Skin Infections
Chapter 14 Bacterial Skin Infections
Chapter 15 Viral Skin Infections
Chapter 16 Dermatitis
Chapter 17 Skin Lesions
Chapter 18 Common Eye Complaints
Chapter 19 Lid and Conjunctival Pathology
Chapter 20 Visual Disturbances and Impaired Vision
Chapter 21 Common Ear, Nose, and Throat Complaints
Chapter 22 Hearing and Balance Disorders
Chapter 23 Inflammatory and Infectious Disorders of the Ear
Chapter 24 Inflammatory and Infectious Disorders of the Nose, Sinuses, Mouth, and Throat
Chapter 25 Epistaxis
Chapter 26 Temporomandibular Disorders
Chapter 27 Dysphonia
Chapter 28 Common Respiratory Complaints
Chapter 29 Sleep Apnea
Chapter 30 Infectious Respiratory Disorders
Chapter 31 Inflammatory Respiratory Disorders
Chapter 32 Lung Cancer
Chapter 33 Smoking Addiction
Chapter 34 Common Cardiovascular Complaints
Chapter 35 Cardiac and Associated Risk Disorders
Chapter 36 Arrhythmias and Valvular Disorders
Chapter 37 Disorders of the Vascular System
Chapter 38 Common Abdominal Complaints
Chapter 39 Infectious Gastrointestinal Disorders
Chapter 40 Gastric and Intestinal Disorders
Chapter 41 Gall Bladder and Pancreatic Disorders
Chapter 42 Cirrhosis and Liver Failure
Chapter 43 Common Urinary Complaints
Chapter 44 Urinary Tract Disorders
Chapter 45 Kidney and Bladder Disorders
Chapter 46 Common Reproductive System Complaints
Chapter 47 Common Reproductive System Issues
Chapter 48 Breast Disorders
Chapter 49 Vaginal, Uterine, and Ovarian Disorders
Chapter 50 Prostate Disorders
Chapter 51 Penile and Testicular Disorders
Chapter 52 Sexually Transmitted Infections
Chapter 53 Common Musculoskeletal Complaints
Chapter 54 Spinal Disorders
Chapter 55 Soft-Tissue Disorders
Chapter 56 Osteoarthritis and Osteoporosis
Chapter 57 Common Endocrine and Metabolic Complaints
,Chapter 58 Glandular Disorders
Chapter 59 Diabetes Mellitus
Chapter 60 Metabolic Disorders
Chapter 61 Common Hematological and Immunological Complaints
Chapter 62 Hematological Disorders
Chapter 63 Immunological Disorders
Chapter 64 Infectious Disorders
Chapter 65 Common Psychological Complaints
Chapter 66 Neurodevelopmental Disorders
Chapter 67 Substance-Related and Addictive Disorders
Chapter 68 Schizophrenia Spectrum and other Psychotic Disorders
Chapter 69 Mood Disorders
Chapter 70 Anxiety Disorders and Post Traumatic Stress Disorder
Chapter 71 Obsessive-Compulsive and Related Disorders
Chapter 72 Other Psychiatric Disorders
Chapter 73 Sexual Assault
Chapter 74 Human Trafficking
Chapter 75 Common Injuries
Chapter 76 Toxic and Environmental Exposures
Chapter 77 Primary Care of Adolescents
Chapter 78 Sports Physicals
Chapter 79 Primary Care of Patients who are Transgender
Chapter 80 Primary Care of Veterans
Chapter 81 Primary Care of the Patient with Cancer
Chapter 82 Primary Care of Older Adults
Chapter 83 Palliative and End-of-life Care
Chapter 84 Pain Management
Chapter 85 Ethical and Legal Issues of a Caring-Based Practice
Chapter 86 Quality & Value-Based Payment: Making an Economic Impact on Health Care
Chapter 87 Primary Care Approaches to Behavioral Health
Chapter 88 Putting Caring Into Practice: Caring for Self
Primary Care: Art and Science of Advanced Practice Nursing - An
Interprofessional Approach 5th edition Dunphy Test Bank
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 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.
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 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.
3. 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.
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 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.
5. 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 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
Ans: 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 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.
8. 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
Feedback: The most reliable evidence is considered RCTs. Qualitative studies, case studies, and
expert opinion are low on the hierarchy of evidence.
9. Hospital administrators are applying the principles of evidence-based practice (EBP) in their
attempt to ascertain the most efficient and effective way to communicate between nurses who are on
different units, a project that will consider many types of evidence. Which of the following
information sources should the administrators prioritize?
A) A systematic review about communication in nursing contexts
, B) Nurses ideas about communication methods
C) The results of a chart review
D) The hospitals accreditation status
Ans: A
Feedback: Systematic reviews are assigned a high value in EBP. Reviews would be prioritized over
nurses ideas or a chart review, though both are potential considerations. The hospitals accreditation
status is not a relevant consideration.
10. A nurse has resolved to apply the evidence-based practice (EBP) process to the way that
admission assessments are conducted and documented on a unit. How should the nurse begin the
process of establishing EBP?
A) Gather evidence showing the shortcomings of current practices
B) Formulate a clear and concise question to be addressed
C) Elicit support from the nurses who are most often responsible for admissions
D) Search the literature for evidence that is potentially relevant to the practice need
Ans: B
Feedback: The first step in applying EBP is to ask a clear, focused question. This should precede a
search of the literature or the recruitment of participants. An assessment of the shortcomings of the
current system is not an explicit component of the EBP process.
11. Which of the following questions best exemplifies the PICOT format for asking evidence-based
questions?
A) What affect does parents alcohol use have on the alcohol use of their teenage children?
B) Among postsurgical patients, what role does meditation rather than benzodiazepines have on
anxiety levels during the 48 hours following surgery?
C) Among high school students, what is the effectiveness of a sexual health campaign undertaken
during the first 4 weeks of the fall semester as measured by incidence of new sexually transmitted
infections?
D) In children aged 68, is the effectiveness of a descriptive pain scale superior to a numeric rating
scale in the emergency room context?
Feedback: The correct answer includes a population (postsurgical patients), intervention
(meditation), comparison (benzodiazepines), outcome (anxiety levels), and a time frame (48 hours).
No other option contains each of the five elements of a PICOT question.
12. A nurse has made plans to implement the University of North Carolina (UNC) model of 5 As
during the process of applying evidence-based practice (EBP) to a practice problem. What is the
final step that the nurse will take in applying this model?
A) Analyze the results of the EBP process
B) Advocate for others to embrace the identified change
C) Adopt the changes identified in the review process
D) Assess the outcomes of the new practice
Ans: D
Feedback: The final step in the UNC rubric is to Assess the change using the quality improvement
process in place in the institution.
13. A nurse has been asked to make a presentation to a group of high school students on the subject
of sexual health. However, the nurse does not have a background in this practice area and requires
rapid access to evidence-based guidelines. Which of the following strategies is most likely to
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