Primary Care A Collaborative Practice 5th Edition by Terry Mahan Buttaro – Test Bank

Complete Test Bank With Answers

Sample Questions Posted Below

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 3: Translating Research Into Clinical Practice Test Bank

Multiple Choice

1. 1. Which is the most appropriate research design for a Level III research study?

1. 1. a. Epidemiological studies
   2. b. Experimental design
   3. c. Qualitative studies
   4. d. Randomized clinical trials

ANS: B

The experimental design is the most appropriate design for a Level III study. Epidemiological studies are appropriate for Level II studies. Qualitative designs are useful for Level I studies. Randomized clinical trials are used for Level IV studies. REF: Level III Research/Experimental Design

1. 1. 2. What is the purpose of clinical research trials in the spectrum of translational research?

1. 1. a. Adoption of interventions and clinical practices into routine clinical care
   2. b. Determination of the basis of disease and various treatment options
   3. c. Examination of safety and effectiveness of various interventions
   4. d. Exploration of fundamental mechanisms of biology, disease, or behavior

ANS: C

Clinical research trials are concerned with determining the safety and effectiveness of interventions. Adoption of interventions and practices is part of clinical implementation. Determination of the basis of disease and treatment options is part of the pre-clinical research phase. Exploration of the fundamental mechanisms of biology, disease, or behavior is part of the basic research stage. REF: Translational Science Spectrum

1. 1. 3. What is the purpose of Level II research?

1. 1. a. To define characteristics of interest of groups of patients
   2. b. To demonstrate the effectiveness of an intervention or treatment
   3. c. To describe relationships among characteristics or variables
   4. d. To evaluate the nature of relationships between two variables ANS: C

Test Bank 2

Level II research is concerned with describing the relationships among characteristics or variables. Level I research is conducted to define the characteristics of groups of patients. Level II research evaluates the nature of the relationships between variables. Level IV research is conducted to demonstrate the effectiveness of interventions or treatments. REF: Level II Research

Buttaro: Primary Care, A Collaborative Practice, 5th Ed. Chapter 5: Population-Based Care for Primary Care Providers Test Bank

Multiple Choice

1. 1. Which are key components of the Patient-Centered Medical Home? Select all that apply.

1. 1. a. Access to care
   2. b. Comprehensive care
   3. c. Coordination of care
   4. d. Provision of care by a single provider
   5. e. Storage of medical records

ANS: A, B, C

The Patient-Centered Medical Home is a team-based approach to providing care that is accessible, comprehensive, coordinated, longitudinal and high quality. It is not provided by a single provider, but is managed as a team. The original concept had to do with where medical records are stored, but this is not the working definition today. REF: The Patient-Centered Medical Home

1. 1. 2. The chronic care model (CCM) was developed to manage patients with complicated chronic conditions because the traditional acute care model

1. 1. a. could not provide efficient and cost-effective chronic care.
   2. b. did not meet longitudinal health care needs for this population.
   3. c. did not offer ambulatory care services for these patients.
   4. d. put patients and families at the center of care.

ANS: B

The chronic care model was developed based on the recognition that the traditional acute care model did not meet longitudinal health care needs of patients with chronic and complicated conditions, not because of inefficiencies or costs. The traditional model does include ambulatory care, but that is not the focus. The traditional model does not typically place patients at the center of care. REF: Chronic Care Model

1. 1. 3. What are functions of patient registries in the chronic care model? Select all that apply.

1. 1. a. Alerting providers to medication interactions

Test Bank 2

1. 1. b. Identifying appropriate specialists for referral
   2. c. Recommending routine screenings
   3. d. Reminding providers about immunizations
   4. e. Transmitting clinical data about patients

ANS: A, C, D, E

Patient registries are used to help manage patients at risk and include alerting providers about medication interactions, recommending routine screenings, reminders for immunizations, and transmitting clinical data. They are not used to identify or recommend providers or specialists. REF: Chronic Care Model/Clinical Information Systems

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 9: Adolescent Issues Test Bank

Multiple Choice

1. 1. Which behavior is most characteristic of early adolescence?

1. 1. a. Arguing with parents and teachers
   2. b. Assimilating adult roles and thinking
   3. c. Exhibiting fatigue more frequently
   4. d. Experimenting with sex and risky behaviors

ANS: A

Early adolescents challenge authority, experience wide mood swings, reject the ideation of childhood, and can be argumentative and disobedient. Middle adolescents experience fatigue and begin experimenting with sex and risky behaviors. Late adolescents begin to assimilate adult roles. REF: Introduction

1. 1. 2. What is the initial sign of puberty in the adolescent male?

1. 1. a. Deepening of the voice
   2. b. Elongation of the penis
   3. c. Nocturnal emissions
   4. d. Testicular enlargement

ANS: D

Testicular enlargement is the initial sign of puberty in adolescent males. Penile growth and nocturnal emissions occur later as does deepening of the voice. REF: Physical Development

1. 1. 3. A parent reports that an adolescent child does well in school but seems to consistently make poor decisions about activities with friends. What will the practitioner recommend as an approach to help the adolescent make better decisions?

1. 1. a. Correcting the adolescent’s decisions and judgments
   2. b. Listening without making suggestions about choices
   3. c. Making decisions for the adolescent to provide guidance
   4. d. Providing factual information about appropriate behavior ANS: B

Test Bank 2

Listening without correcting is the best approach to help adolescents learn to make good decisions. Correcting the decisions, making decisions for the adolescent, or giving information that is unsolicited are not recommended. REF: Cognitive Development

Buttaro: Primary Care, A Collaborative Practice, 5th Ed.

Chapter 14: Palliative and End-of Life Care Test Bank

Multiple Choice

1. 1. A patient who is near death is exhibiting signs of agitation, anxiety, and intractable pain. When discussing palliative sedation with this patient’s family, what will be discussed?

Select all that apply.

1. 1. a. The chance that refractory symptoms will be alleviated
   2. b. The fact that this is an intervention of last resort
   3. c. The likelihood that the patient will develop dependence on the drugs
   4. d. The need for informed consent from the patient and family
   5. e. The possibility that this measure may hasten death

ANS: B, D, E

Palliative sedation is used as a treatment of last resort for patients whose symptoms are intolerable or refractory. Patients, if possible, and family members must give informed consent. This treatment has the possibility of hastening death by inhibiting respirations. Symptoms will not be alleviated by using the measure. The chance of drug dependence is irrelevant in this situation. REF: Palliative Sedation for Management of Intractable Symptoms in Patients Near Death

1. 1. 2. When should palliative care be initiated by a primary care provider?

1. 1. a. After an ill patient asks for Hospice services
   2. b. As part of routine health maintenance
   3. c. When a patient is diagnosed with a serious disease
   4. d. When an interdisciplinary team is formed to manage a disease

ANS: B

Palliative care support begins with an understanding of a patient’s preferences and helping the patient to identify goals of care. Health care providers should initiate such discussions as a component of the initial history of adults regardless of age or health status. Palliative care services may be ordered when a patient is diagnosed with a serious disease; waiting until the patient asks for Hospice services or when an interdisciplinary team is formed increases the chances of providing end-of-life care that does not meet the patient’s needs. REF: Palliative Care/Advance Care Planning

1. 1. 3. When using the “Five Wishes” approach to documenting patient preferences for end-of-life care, the provider will document which types of preferences?

Test Bank 2

Select all that apply.

1. 1. a. A directive to avoid calling 911 at the time of death
   2. b. A specific list of treatments the patient does not want
   3. c. How much information to give various family members
   4. d. The level of sedation versus alertness the patient desires
   5. e. The people designated to make care decisions for the patient

ANS: C, D, E

The Five Wishes approach addresses the type of care a patient wants as a disease progresses and is less defensive than the traditional advance directive which indicates the type of care a patient does not want. Calling 911 may be done without requiring resuscitation if the patient has an appropriate advanced directive in place. REF: Advance Care Planning