(Test Bank) Primary Care: Art and Science of Advanced Practice Nursing - An Interprofessional Approach

Dunphy, 5

Nursing

Test Bank

5th Edition

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Test Bank for Primary Care: Art and Science of Advanced Practice Nursing - An Interprofessional Approach, The downloadable file consists of 492 pages, and the total size of the file is 0.95 MB. Purchase now only for highly discounted price.

Author(s): Dunphy

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Study Note Preview

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 onthe incidence of nosocomial (hospital-acquired) infections in acute care settings. An article presented findings at a level of significance of <0.01. This indicatesthat 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 tochance. C)the effects of the intervention were nearlyzero. D)the clinical significance of the findings was less than1:100. 2.A nurse has read a qualitative research study in order to understand the lived experience ofparents who have a neonatal loss. Which of the following questions should the nurse prioritize when appraising the results of thisstudy? A)How well did the authors capture the personal experiences of theseparents? B)How well did the authors control for confounding variables that may have affected thefindings? C)Did the authors use statistical measures that were appropriate to the phenomenon inquestion? D)Were the instruments that the researchers used statistically valid andreliable? 3.A nurse has expressed skepticism to a colleague about the value of nursing research, claimingthat nursing research has little relevance to practice. How can the nurses colleague best defend the importance of nursingresearch? Your text here 1A)The existence of nursing research means that nurses are now able to access federal grant money, something that didnt use to be thecase. B)Nursing research has allowed the development of masters and doctoral programs and hasgreatly increased the credibility of theprofession. C)The growth of nursing research has caused nursing to be viewed as a true profession, rather than simply as a trade or askill. D)The application of nursing research has the potential to improve nursing practice andpatient outcomes. 4.Tracy is a nurse with a baccalaureate degree who works in the labor and delivery unit of abusy 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 promotingbreast-feeding? A)Applying for grant funding for the researchproject B)Posing the clinical problem to one or more nursingresearchers C)Planning the methodology of the researchproject D)Carrying out the intervention and submitting the results for publication . 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 greaterdetail. B)Describe the details of a randomized controlled trial for thepatient.C)Inform the research assistant that the patients consent is likelyinvalid. D)Explain to the patient that his written consent is now legallybinding. 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 thatapply.) A)Interdisciplinaryconsensus B)Nursingtradition C)Researchstudies D)Patient preferences andvalues E)Clinical expertise 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 ofEBP? 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 greaterdetail.C)The nurse should integrate the patients preferences into the plan ofcare. D)The nurse should involve the patients family members in the decision-makingprocess. 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 nursesprioritize? A)A qualitative study that explores the experience of living with a pressureulcer B)A case study that describes the measures that nurses on a geriatric unit took to reduce pressure ulcers amongpatients C)Testimonials from experienced clinicians about the effectiveness of the mattress inquestion D)A randomized controlled trial that compared the pressure-reducing mattress with standard mattresses 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 administratorsprioritize? A)A systematic review about communication in nursingcontexts B)Nurses ideas about communicationmethods C)The results of a chartreview D)The hospitals accreditation status. 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 establishingEBP? A)Gather evidence showing the shortcomings of currentpractices B)Formulate a clear and concise question to beaddressed C)Elicit support from the nurses who are most often responsible foradmissions D)Search the literature for evidence that is potentially relevant to the practice need 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 teenagechildren? B)Among postsurgical patients, what role does meditation rather than benzodiazepines haveon anxiety levels during the 48 hours followingsurgery? 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 roomcontext? 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 thismodel? A)Analyze the results of the EBPprocessB)Advocate for others to embrace the identifiedchange C)Adopt the changes identified in the reviewprocess D)Assess the outcomes of the new practice 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 provide the nurse with valid and reliable evidence in a time-efficientmanner? A)Search the Cochrane Library of SystematicReviews B)Google search terms such as sexual health teens and sexualeducation C)Search Medline using PubMed and order relevantarticles D)Scan the most recent issues of nursing journals that address this area ofpractice 14.The nurses at a university hospital have been informed that a computerized record system will be implemented over the next 12 months. The nurses should be aware that such as system presents particular challenges in the areaof A)vulnerability to errors in charting and the inability to makechanges. B)patient privacy and confidentiality ofrecords. C)enforcing compliance with the system on the part ofnurses. D)ensuring compatibility with different computer operatingsystems. 15.A nurse is nervous about the impeding introduction of computerized nursing care records atthe hospital because he does not consider himself to be technologically adept. How should this nurse best respond to thissituation? A)Take courses in advanced practice nursing to build hisknowledge. B)Explore employment opportunities in settings that use written documentationsystems. C)Advocate for a delay in the introduction of the proposedsystem. D)Seek out opportunities to learn the relevant knowledge and practice the necessaryskills. Chapter 2. Caring and the Advanced Practice Nurse Multiple Choice1.A goal of community nursing is to provide primary prevention from disease. Which ofthe following nursing actions reflect thisgoal? A)A nurse creates a pamphlet discussing heart-healthy foods and distributes it in the neighborhood communitycenter. B)A nurse starts an intravenous line on a dehydrated baby who has been brought to theemergency department. C)A nurse performs range-of-motion exercises for a patient intraction. D)A nurse repositions an elderly patient confined to a wheelchair to avoid the formation of pressure ulcers.2.A nurse decides to pursue a career in community-based nursing. Which of the following statements represents the environment in which the nurse will beworking? A)Community-based nursing is limited to work in public clinics, schools, andindustry. B)The key to community-based settings is that the nurse is incharge. C)The nurse serves as an educator, guide, and resource person and determines the action takenby the client. D)Care in the community iscost-effective. 3.The movement of a client from acute care to a long-term nursing care facility involves planningto provide continuity of care. What is the term for this type ofplanning? A)Dischargeplanning B)Comprehensiveplanning C)Ongoing planning D)Transition planning4.A nurse is called into work to perform triage in the aftermath of an earthquake. Which of the following are the expected responsibilities of thisnurse? A)Set up and monitor IVlines. B)Prepare the emergency room for multiplevictims. C)Screen victims to prioritizetreatment. D)Check available blood products and assist withtransfusions. 5.A client asks a nurse for help in obtaining an alternative healthcare provider. Which of the following is an accurate fact regarding alternative care that the nurse should share with thisclient? A)Most alternative healthcare practitioners do not have education-based credentials to practice their medicine. B)Alternative providers are not usually included in the federal HIPAA legislation that mandates confidentiality in conventional healthcaresettings. C)The cost of alternative therapy is never covered by insurance carriers or healthcareplans. D)It is easy to find accurate safety and efficacy data for alternative medicine on theInternet.6.There is an increasing trend for nursing care to move from the hospital setting into the community. Nurses who are to provide excellent care in a community setting should prioritize which of thefollowing? A)Integrating culture and family into the planning and delivery ofcare B)Becoming more assertive in client education and the planning of clientcare C)Encouraging clients to limit their interactions withphysicians D)Teaching clients to replace biomedical interventions with complementary therapies 7.In spite of the important role that hospitals play in American healthcare, there is growing importance of community-based healthcare and community-based nursing. Which of the following statements best conveys a central aspect of the philosophy of communitycare? A)The client is in charge of his or her health and healthcare in thecommunity. B)Nurses maximize their scope of practice in noninstitutionalsettings. C)Community settings allow for the greatest number and variety of treatmentoptions. D)The nurse becomes the key member of the healthcare team in a communitysetting.8.Mr. Hammond is a 70-year-old man with a diagnosis of type 1 diabetes who developed a diabetic foot ulcer earlier this year. He has recently been discharged from the hospital and now requires regular wound care. Karen is a community health nurse who provides wound care for Mr.Hammond twice weekly. Which of Karens actions is most likely to empower Mr.Hammond? A)Encourage Mr. Hammond to acknowledge his contribution to the development of hiswound. B)Provide information to Mr. Hammond that matches his expressedneeds. C)Encourage Mr. Hammond to involve members of his family in hiscare. D)Delegate wound care to Mr. Hammond and reduce the frequency of hervisits. 9.An elderly female client who resides in the community tends to defer decisions regarding her care to her eldest son. How should the community health nurse respond to the clients reluctance to make independentdecisions? A)Discuss this observation with the client and her son in an open manner and explorealternatives. B)Organize care so that it takes place at times when the son is not present in thehome. C)Accommodate this aspect of the clients family dynamics when planning and carrying outcare.D)Teach the client assertiveness skills that she can apply in her interactions with herson. 10.A client with a long-standing diagnosis of chronic obstructive pulmonary disease (COPD) has been enrolled in a disease management program. Which of the following activities will beprioritized in thisprogram? A)Providing comprehensive and evidence-based care of the clientsCOPD B)Creating collaborative relationships between the client and the careteam C)Ensuring that the client qualifies for Medicare andMedicaid D)Liaising between the client and his health maintenance organization (HMO) 11.One of the expressed goals of Healthy People 2020 is to achieve health equity and eliminate disparities. What health indicator can most accurately gauge whether this goal is beingachieved? A)Environmentalquality B)Injury andviolence C)Mentalhealth D)Access to healthcareservices12.Nurses have the potential to positively impact the health of communities. Which of thefollowing actions is most likely to improve the health of acommunity? A)Publicizing the consequences of unhealthylifestyles B)Advocating politically for laws and policies that foster communityhealth C)Ensuring that nurses are practicing to the full extent of their scope ofpractice D)Providing nursing care to individuals who are not patients or clients 13.A nurse who provides care in an acute medical unit is aware of the importance of thorough discharge planning. The discharge planning process shouldbegin A)once the patient has stabilized and is assured of positiveoutcomes. B)as soon as possible after the patient isadmitted. C)once the patient has received a discharge order from his or her primary careprovider. D)48 to 72 hours before the projected date ofdischarge.14.A hospital patient has discussed with the nurse her use of visualization, biofeedback, and relaxation exercises in managing the chronic pain that results from her fibromyalgia. The nurse should recognize this patients use of what category of complementary/alternative medicine(CAM)? A)Biologically-basedpractices B)Manipulativepractices C)Traditional indigenousmedicine D)Mind-body 15.A hospital patient who suffered a spinal cord injury has expressed an interest in exploring complementary/alternative therapies. The nurse should encourage the patient to begin this processby doing which of the followingactivities? A)Asking practitioners of different therapies to provide lists of satisfiedclients B)Asking the patients primary care provider for permission to explore nonbiomedicaltreatments C)Finding reliable evidence regarding the safety and effectiveness oftherapies D)Determining whether the patients health insurance would cover the cost of alternative/complementarytherapiesChapter 3. Health Promotion Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Which of the following is a primary prevention measure for a 76-year-old man newly diagnosed with a testosteronedeficiency? a.Calciumsupplementation b.Testicularself-examination c.Bone densitytest d.Digital rectalexamination 2. Which of the following is an example of secondary prevention in a 50-year-oldwoman? a.Yearlymammogram b.Low animal fatdiet c.Use of seatbelt d.Daily application ofsunscreen 3. Which of the following is an example of tertiary prevention in a patient with chronic renalfailure? a.Fluidrestriction b.Hemodialysis 4 days aweek c.High-proteindiet d.Maintenance of blood pressure at120/80 4. Immunizations are an example of which type ofprevention? a.Primary b.Secondary c.Tertiary True/False Indicate whether the statement is true or false.