Nursing Research Methods And Critical Appraisal For Evidence Based Practice 9th Edition By LoBiondo-

Nursing Research 9th Edition LoBiondo-Wood Test Bank Chapter 01: Integrating Research, Evidence-Based Practice, and Quality Improvement Processes LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. Nursing research is significant to the profession of nursing because it promotes: a. more specifically defined nursing practice responsibilities. b. decreased liability within the practice of nursing. c. generation of a specialized body of nursing knowledge for use in nursing practice. d. expansion of the scope of nursing practice into other disciplines.

ANS: C

A

B C

D

Feedback Research aids in documenting accountability of nurses, but professional guidelines already exist regarding responsibility. Each state has a Nurse Practice Act with rules and regulations that define scope of practice.

Liability is a legal concept related to a nurse’s legal scope of practice and professional standards of practice. Research does not change a nurse’s liability.

Nursing research generates a specialized scientific knowledge base that empowers the nursing profession to anticipate and meet constantly shifting challenges of health care delivery to multiple populations. It provides a foundation for evidence-based nursing care and quality improvement activities.

Although research can doN cuUmReS ntInNuG rsT inB g. acCcO ouMntability, each state’s Nurse Practice Act defines the scope of nursing practice for that state.

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2. An aspect of the scientific investigation of nursing practice that is also a fundamental concept

of American Nurses Association (ANA)’s Code for Nurses is: a. professional accountability. b. standards of care. c. legal scope of practice. d. advanced practice nursing activities.

ANS: A

A B

C D

Feedback Scientific investigation promotes accountability, a hallmark of the nursing profession and a fundamental concept of the ANA’s Code for Nurses.

Standards of care are defined by ANA, as well as specialty nursing organizations.

The Code for Nurses states that nurses should conform to standards, but standards per se are not part of the Code.

Legal scope of practice is defined by each state’s Nurse Practice Act and elaborated in its rules and regulations.

The ANA Code applies to nursing practice in general, not advanced practice.

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Cognitive Level: Remembering (Knowledge)

3. Nurses need to be able to understand the nursing research process: a. to identify potential subjects for clinical research studies. b. to assist as accurate data collectors in clinical research studies. c. to teach patients and families the importance of participating in research. d. to evaluate nursing research reports for relevance to their own clinical practice.

ANS: D

A B C D

Feedback Subject identification is determined by the nurse researcher.

Data collectors need to understand their role in the study; they do not need to understand the entire research process.

Subject recruitment is the responsibility of the nurse researcher.

Nurses need to understand the research process in order to critically read research reports and determine if nursing practice should incorporate the research findings as valid evidence.

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4. The action that demonstrates the role of a knowledgeable consumer of nursing research is: a. designing a nursing research study. b. analyzing data to determineNaUsR tuSdI y’Ns G ouTtB co.mCeO s.M c. evaluating the credibility of research findings. d. implementing an intervention found to be effective in one clinical case study.

ANS: C

A B C D

Feedback A consumer uses and applies research to practice but is not responsible for designing a study.

A consumer does not conduct data analysis of a study; the study’s primary investigator analyzes data.

A consumer of nursing research needs to understand the research process to determine the merit and relevance of evidence presented in research studies.

A consumer would not implement an intervention on the basis of a single case study.

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5. Members of the nursing staff are to participate in a unit-based clinical research study. Which

research-related actions would be expected of a nurse with a baccalaureate nursing degree? a. Using critical appraisal skills to understand and assess the steps of the research process b. Providing expert nursing consultation about the way in which clinical services are

delivered c. Developing research methods to monitor and evaluate the quality of nursing

practice in the clinical setting d. Providing leadership in the application of scientific knowledge to nursing practice ANS: A

A B

C D

Feedback A baccalaureate-prepared nurse should be able to use skills of critical appraisal to both understand and appraise the steps of the research process.

Nurses prepared at the baccalaureate level in nursing are at the bedside implementing protocols, whereas expert consultation is generally reserved for nurses prepared at the master’s or higher-degree level (advanced education).

Developing research methods is generally reserved for nurses with advanced education.

Providing leadership in research application is generally reserved for nurses with advanced education.

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6. Which statement describes the role of the nurse in research? a. Nurses must be prepared at the baccalaureate or higher level of education to have

any role in nursing research. b. Nurses with master’s or higher levels of education are solely responsible for applying research to clinical practice. c. The research role of nursesNpU reR paSrI edNaGt T boBth.C baOcM calaureate and master’s levels of education includes critical appraisal skills. d. Regardless of the nursing education level, only the nurse with the most comprehensive understanding of statistical methods should interpret research findings.

ANS: C

A B

C

D

Feedback Having a role in nursing research or implementing findings is not limited to nurses with baccalaureate or higher levels of education.

Nurses with master’s or higher levels of education provide leadership to supervise how research findings are applied in the clinical area. However, all levels of nurses can apply research findings to practice.

To use research in evidence-based practice, the nurse must not necessarily be able to conduct research but should be able to understand and appraise the steps of the research process to read the research literature critically and use it to inform clinical decisions.

Data analysis is usually conducted by nurses with master’s or higher levels of education. However, interpretation of research findings can be performed by any nurse who can critically analyze the research performed.

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7. What is the primary value of evidence-based nursing practice? a. Implementing the most cost-effective nursing practices when providing patient

care b. Incorporating research findings with clinical expertise when individualizing patient

care c. Separating nursing research as unique from the research of other disciplines d. Developing new nursing theories to promote the growth of nursing science ANS: B

A B

C

D

Feedback Cost-effective nursing interventions can occur based on evidence, but it is not the primary value of evidence-based nursing practice.

Evidence-based practice allows the nurse to systematically integrate the best available research evidence with individual clinical expertise, as well as the patient’s values and preferences, when making clinical decisions.

Developing a unique body of nursing knowledge is important, but it is not the primary value of developing evidence-based nursing practice. Also, nurse researchers should be able to collaborate with researchers in other disciplines.

Developing abstract nursing theory is important, but evidence-based nursing is focused on the more concrete application of knowledge in clinical practice.

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8. A novice nurse researcher is coN mUpR arS inIgNthGeTpB ro.cC esOseMs used in nursing research and in

evidence-based practice. What differences, if any, exist between the two processes? a. As scientific processes, they are fundamentally the same and should result in parallel outcomes. b. Both processes involve testing a question with an appropriate design and specific methodology. c. In a research study the question is tested with an appropriate design and specific methodology, whereas in evidence-based practice, the question is used to search the research literature to find answers. d. In evidence-based practice, qualitative studies are critically appraised to answer a clinical question, whereas in nursing research, quantitative studies are reviewed to provide a foundation for the study.

ANS: C

A B C

Feedback The research process and the evidence-based practice process, though similar, have fundamental differences as well.

This definition applies to the research process, not the evidence-based practice process.

Nursing research includes developing a design for a study, whether quantitative or qualitative, reviewing the literature, and carrying out a specific methodology to find answers to a question. In contrast, evidence-based practice includes a review of completed research studies to identify answers to a clinical question.

D

Both the research process and the evidence-based practice process include critical review of quantitative and qualitative studies.

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9. A nurse is analyzing a research article. Where in the article is the nurse likely to find the

research question and study purpose? a. Introduction b. Data analysis c. Findings d. Data collection ANS: A

A

B C D

Feedback The research question and study purpose is generally found early in the report: in the abstract, the introduction, or at the end of the literature review or conceptual framework section.

The research question and study purpose are defined before the data analysis section of the research article.

The research question and study purpose are defined before the findings section of the research article.

The research question and study purpose are defined before the data-collection section of the research article.

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CogN niU tivReSLI evNelG :T UnBd. erC stO anMding (Comprehension)

10. The nurse researcher is conducting a research study using subjects who will be interviewed

regarding their experience with postpartum depression. Why would the researcher select a qualitative, rather than a quantitative, research design? a. Quantitative research is usually conducted in natural settings using data that are words rather than numbers. b. Qualitative research seeks to explain cause-and-effect relationships between variables. c. Quantitative research typically uses a convenience sample, seeking to answer a clinical question about a human experience. d. Qualitative research collects data from a small number of subjects, allowing for in-depth study of a phenomenon.

ANS: D

A B C

Feedback Qualitative, not quantitative, research is usually conducted in natural settings using data that are words rather than numbers.

Quantitative, not qualitative, research seeks to explain cause-and-effect relationships between variables.

Qualitative, not quantitative, research seeks to answer a question about a human experience.

D

Qualitative research typically collects data from a small number of subjects, thus allowing for in-depth study of a phenomenon while using a subjective approach.

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11. The nurse is analyzing a research article. To determine if an integrative review was performed

as part of the study, the nurse must understand that this type of review is: a. a summary of research studies on a focused topic that used a specific statistical methodology. b. a synthesis of the research and theoretical literature on a specific area without a statistical analysis. c. a synthesis of qualitative articles on a focused topic using a specific qualitative methodology. d. a summary of articles in an attempt to develop a clinical practice statement or clinical guidelines.

ANS: B

A B

C D

Feedback Meta-analysis summarizes articles on a focused topic that used a specific methodology.

An integrative review is a synthesis of research or theoretical literature on a specific area that follows specific steps of literature integration without statistical analysis.

Meta-synthesis is a synthesis of qualitative articles on a focused topic using specific qualitative methodNoU loR gyS Clinical guidelines are practice statements designed to assist clinicians about health care decisions for specific conditions or situations.

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12. When assessing the strength of a body of evidence used in a research study for consistency,

the nurse should determine: a. extent to which the study’s design, implementation, and analysis minimize bias. b. number of studies that have evaluated the research question, including overall sample size across studies. c. degree to which studies with similar and different designs investigated the same research questions and report similar findings. d. significance of the findings based on the statistical methods used for data analysis.

ANS: C

A B C

Feedback Quality refers to the extent to which the study’s design, implementation, and analysis minimize bias.

Quantity refers to the number of studies that have evaluated the research question, including overall sample size across studies.

Consistency is the degree to which studies that had similar and different designs

D

(but investigate the same research question) reported similar findings.

Quantity refers to the strength of the findings in the statistical analyses.

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13. The nurse is analyzing a qualitative research article. In which section of the article is the nurse

likely to find a summary of legal-ethical issues considered in the study? a. Data collection or procedures b. Findings or results c. Discussion or implications d. Abstract or introduction ANS: A

A B C D

Feedback Legal-ethical issues are typically discussed in the article’s data-collection or procedures section, usually when discussing the sample.

The research results are typically found in the findings or results sections.

Recommendations are typically found in the discussion or implications sections.

The research question and study purpose are typically found in the abstract or introduction.

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14. The nurse is analyzing a qualitaNtiUvR eS reI seNarGcT hB ar. tiC clO e.MIn which section of the article should the

nurse expect to find a discussion of the research findings? a. Procedures b. Methods c. Sample d. Results ANS: D

A B C D

Feedback Data analysis is typically included in the data analysis or procedures section.

Instruments and their validity and reliability are included in the methods or instruments sections.

The research sample and legal-ethical issues are included in the sample or subjects section.

The discussion of the findings will be located in the results or discussion section.

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15. The nurse is using the critical reading process to analyze a research article. The nurse

identifies the main theme of the article and states it in two sentences, using the nurse’s own words. The nurse is using a strategy to promote which type of understanding? a. Preliminary

b. Comprehensive c. Analysis d. Synthesis ANS: B

A B C D

Feedback Strategies for preliminary understanding include activities such as using a dictionary and identifying key variables of the study.

Strategies for comprehensive understanding include restating the main idea or theme of the article in one’s own words.

Strategies for analysis understanding include using criteria to critique the steps of the research process used in the study.

Strategies for synthesis understanding include writing a summary of the strengths and weaknesses of the study.

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16. The nurse is using the critical reading process to analyze a research article. The nurse is using

a list of criteria to determine how well the researcher performed each step of the research process. The nurse is using a strategy to promote which type of understanding? a. Preliminary b. Comprehensive c. Analysis d. Synthesis ANS: C

A B C D

Feedback Strategies for preliminary understanding include activities such as highlighting or underlining identified steps of the research process.

Strategies for comprehensive understanding include restating the main idea or theme of the article in one’s own words.

Strategies for analysis understanding include using criteria to critique the steps of the research process used in the study.

Strategies for synthesis understanding include writing a summary of the strengths and weaknesses of the study.

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17. Which of the following is a critical step for the quality improvement process in health care

settings? a. Outlining general long-range goals b. Identifying current successful practices c. Testing practice changes slowly and tentatively d. Adopting a practice change as a new standard of care ANS: D

A B C D

Feedback Quality improvement includes identifying specific, immediate goals, not long-range goals.

The quality improvement process includes identifying practices that pose problems, rather than identifying successful practices.

Quality improvement includes testing practice changes rapidly, not slowly.

The goal of quality improvement activities is to bring about changes in practice that will make a positive difference in patient care. Therefore, adopting a practice change is a critical step in the process.

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MULTIPLE RESPONSE 1. Which statements describe the actions of the baccalaureate nurse graduate as a participant in

the nursing research process? (Select all that apply.) a. Administering care at the bedside according to a research protocol b. Providing leadership by helping others apply scientific knowledge to practice c. Sharing with nursing colleagues research findings that are pertinent to practice d. Designing and conducting nursing research studies e. Functioning as a primary investigator for a research study ANS: A, C Feedback Correct

Incorrect

Following a researcN hU prRoS toI coNlGatTtB he.bCeO dsMide is an activity consistent with the practice of a nurse prepared at the baccalaureate level.

Sharing research evidence with colleagues is an activity consistent with the practice of a nurse prepared at the baccalaureate level.

Leadership related to scientific investigation is more appropriate for a nurse prepared at the master’s or higher-degree level.

Designing and conducting research studies are activities more appropriate for a nurse with doctoral preparation.

Functioning as a primary investigator is an activity appropriate for a nurse with doctoral preparation.

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2. Which aspects of the nursing research process are common to nurses at all educational levels?

(Select all that apply.) a. Disseminating research findings in research reports b. Maintaining the protection of patients who are subjects in a study c. Using one’s expertise to develop theoretical explanations for findings d. Knowing the relationship between research and nursing practice e. Being a member of a collaborative team that applies research to practice ANS: B, D, E

Feedback Correct

Incorrect

All nurses are responsible for protecting the rights of patients.

All nurses should be aware that research is related to practice.

All nurses can be a part of a clinical team that applies research to practice.

Disseminating research in scientific reports is an activity generally performed by nurses with master’s or higher educational preparation.

Developing theoretical explanations for findings is an activity generally performed by nurses with master’s or higher educational preparation.

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3. For the baccalaureate nursing student, education in nursing research should result in: (Select

all that apply.) a. mastering the development of research protocols. b. gaining basic understanding of the research process. c. learning how research is related to clinical nursing practice. d. developing skill as a primary investigator in research. e. becoming a knowledgeable consumer of nursing research.

ANS: B, C, E Feedback Correct

The student should gain an initial understanding of the importance of research in nursing practice.

The student should learn how research is related to clinical nursing practice.

The student should learn skills in the critical analysis of research to assist in decisions about applying research findings in nursing practice.

Incorrect

Mastery of research protocol development is generally attained at the master’s or higher-degree level of education.

Developing skill as a primary investigator is generally attained at the doctoral level of education.

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4. Developing nurse researchers at a younger age is a priority for the future in the nursing

profession because it should: (Select all that apply.) a. enhance the discipline’s scientific development. b. increase the longevity of research careers. c. receive more research funding for professional organizations. d. promote mentoring opportunities for novice researchers. e. increase nursing’s role in pharmaceutical research.

ANS: A, B, D Feedback Correct

Developing young researchers increases the number of researchers contributing to the science of the discipline.

Introducing nurses to research at a younger age allows them sufficient

Incorrect

time to develop in-depth research programs in their careers.

Introducing nurses to research at a younger age allows them time and opportunity to be mentored by experienced researchers, as well as to learn to become mentors themselves.

Younger researchers do not guarantee research monies.

Pharmaceutical studies are medical research and are not considered nursing research studies.

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Chapter 02: Research Questions, Hypotheses, and Clinical Questions LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. The difference between a research question and a hypothesis is: a. a research question is practice based, and a hypothesis is theory based. b. a hypothesis attempts to answer the question posed by the research problem. c. a research problem defines clinical research and a hypothesis defines basic

research. d. there is no difference between a research problem and a hypothesis.

ANS: B

A

B C D

Feedback Although a hypothesis is sometimes theory based, sometimes it is not. Similarly, research questions are not always practice based. Sometimes they originate in educational theory that relates to nursing education research, and sometimes they originate in basic, rather than applied, research.

A hypothesis attempts to answer the research question.

Research problems are present in all types of research, and a hypothesis may be present in basic or applied research.

Hypotheses and research questions are not identical. Hypotheses flow from research questions and suggest the ways the questions can be investigated.

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2. How is a hypothesis related to a theory? a. Hypotheses can be developed in the absence of a theoretical framework. b. Hypotheses must be consistent with an existing theoretical framework. c. A theory can determine the validity of a hypothesis. d. A theory can be used to evaluate the merit of a hypothesis.

ANS: B

A B C D

Feedback A hypothesis is a bridge between a theoretical framework and the real world of empirical testing. Therefore, a theoretical framework is required.

A sound hypothesis is consistent with an existing body of theory and research findings.

When tested, a hypothesis can help determine the validity of a theory’s assumptions—the reverse of option C. When tested, a hypothesis can help evaluate a theory’s merit—the opposite of option D.

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3. A nurse makes these statements. Which one has the greatest potential as an area of nursing

research? a. “Most of our hospital’s admissions come in at night.” b. “It is difficult to find personnel willing to work the nightshift.” c. “It seems that most of the patient falls on our unit occur during the nightshift.” d. “The personnel on the nightshift are not attending promptly to the needs of our patients.”

ANS: C

A B

C D

Feedback This statement is broad and not specific to patient care. It would need to be defined in much more detail to have potential for nursing research.

This broad statement is important to managers responsible for staffing a health care facility. However, it does not show potential for investigation that would contribute to the body of nursing knowledge.

This statement identifies a specific, important patient problem. Its exploration has potential to contribute to the body of nursing knowledge.

This is a broad subjective observation that does not suggest any approach for investigation or potential for contributing to the body of nursing knowledge.

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Cognitive Level: Applying (Application)

4. The nurse has identified a clinical problem as a potential research question. The next step

should be: a. identify the variables. b. formulate the research hypothesis. c. perform a literature review. d. determine financial resources for the research project.

ANS: C

A B

C

D

Feedback It is too early to identify variables. They will be confirmed by the literature review.

Although the researcher may have a preliminary hunch about the hypothesis, it cannot be formulated until the research question is formalized after the literature review is completed.

The literature review helps to further define the research question by identifying gaps in the literature, the need for replication of prior research, or the need to extend the knowledge base in a particular research area. It also identifies variables essential to consider in refining the research question.

The financial resources needed for the project cannot be determined until the study’s design and methodology are finalized.

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5. In a research study, properties of interest that differ in value are: a. variables. b. concepts. c. hypotheses. d. assumptions.

ANS: A

A B C D

Feedback This is the widely accepted and often-cited definition of variables.

A concept is an abstraction that names an object or phenomenon.

A hypothesis is a prediction that helps to answer a research question.

Assumptions are statements accepted as true.

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6. A nurse researcher proposes a study of teenage mothers and their experience with postpartum

depression. Considerations that would affect the feasibility of the study would be: a. availability of participants. b. direction of the hypotheses. c. gaps in the literature. d. design of the study.

ANS: A

A B C D

A study’s feasibility is determined by practical considerations, such as availability of subjects, equipment, facilities, and money.

The direction of the hypothesis is irrelevant to a study’s feasibility.

Gaps in the literature provide support for the research study and do not affect its feasibility.

The design of the study is shaped by the research question and is not directly related to the study’s feasibility.

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7. The most significant difference between independent and dependent variables is: a. the dependent variable should change in response to manipulation by the

independent variable. b. the independent variable should change in response to manipulation by the dependent variable. c. although both the dependent and independent variables are manipulated, only the dependent variable is considered an intervention. d. although both the dependent and independent variables are manipulated, only the independent variable is considered an intervention.

ANS: A

Feedback

A B C D

Dependent variables change in response to manipulation of independent variables in experimental research.

The reverse is accurate. Dependent variables change in response to manipulation of independent variables in experimental research.

The independent variable alone is considered an intervention; the dependent variable is the consequence or presumed effect.

The independent variable alone is considered an intervention; the dependent variable is the consequence or presumed effect.

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8. When designing a research study, the nurse should recognize regarding independent and

dependent variables a. All research problem statements should contain a dependent and an independent variable. b. There should only be one dependent variable associated with a single independent variable. c. The relationship between the independent and the dependent variable in any study should be causal. d. A given characteristic or situation may be the dependent variable in one study and the independent variable in another.

ANS: D

A B C D

Feedback Some descriptive studies m NaUyRhSaI veNoGnT eB va.riCabOlM e only, and qualitative studies do not include independent and dependent variables.

Many studies include more than one independent variable and more than one dependent variable.

The relationship between independent and dependent variables is not necessarily causal. An association between variables need not indicate causality.

Depending on the particular study, a specific variable may be the dependent or the independent variable. The causal or associative direction between variables determines the classification of the variables as independent or dependent.

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9. A nurse’s research question is, “How does maternal employment among health care

professionals affect infant health during the first 6 months of life?” In this question, the dependent variable is: a. infant health. b. maternal employment. c. first 6 months of life. d. health care professionals.

ANS: A

Feedback

A B

C D

Infant health is the consequence or presumed effect that changes regarding maternal employment. Thus it is the dependent variable.

Maternal employment is presumed to effect a change in the infant’s behavior (the dependent variable). Thus, maternal employment is the independent variable.

The first 6 months of life refers to the time the subjects (mothers and infants) will be observed in the study.

Health care professionals constitute the population to be studied.

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10. A nurse has defined the research question as, “How does oral nutritional supplementation

during dialysis treatments affect the serum albumin levels of adult patients who have chronic kidney disease Stage 5?” In this question, the independent variable is: a. adult patients with chronic kidney disease Stage 5. b. oral nutritional supplementation. c. during dialysis treatments. d. serum albumin levels.

ANS: B

A B

C D

Feedback The population being studied is adult patients with chronic kidney disease Stage 5.

Oral nutritional supplementation is the intervention administered to effect a URaS NiGnTleBv.elCs.OTMhus oral nutritional change in the patients’ serN um lbI um supplementation is the independent variable.

The time of the intervention is defined as during dialysis treatments.

The study expects to affect the serum albumin levels of patients who receive the intervention. Thus serum albumin levels constitute the dependent variable.

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11. A nurse has defined the research question as, “Is there a relationship between self-esteem and

body weight among postmenopausal women?” What type of research-question format (or research design) is implied by this question? a. Correlational non-experimental b. Comparative non-experimental c. Quantitative experimental d. Phenomenological non-experimental ANS: A

A B

Feedback Self-esteem and body weight are variables that are related in an associative way.

The word relationship strongly suggests correlational design studies.

A comparative non-experimental study would compare differences between two or more groups.

C D

A quantitative experimental study would include an intervention and measure its effect numerically.

A phenomenological design would measure the meaning or impact of a phenomenon; “the lived experience.”

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Cognitive Level: Applying (Application)

12. A nurse has defined the research question as, “What is the lived experience of late-stage

pregnancy loss among women older than 35 years?” What type of research-question format (or research design) is implied by this question? a. Correlational non-experimental b. Comparative non-experimental c. Quantitative experimental d. Phenomenological non-experimental ANS: D

A B C D

Feedback This research question does not indicate an association between variables, which would be studied in a correlational design.

A comparative non-experimental study would compare differences between two or more groups.

A quantitative experimental study would include an intervention and measure its effect numerically.

The question concerns “lived experience,” which implies a grounded-theory study design.

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Cognitive Level: Applying (Application)

13. Which research question is testable as currently written? a. Should parents addicted to crack cocaine be permitted to raise their children? b. Is the classroom an appropriate place to teach sex education to 10-year-old

children? c. Are older adults living in assisted-living facilities satisfied with their level of social

interaction? d. Is a positive HIV/AIDS status a sufficient reason for limiting the employment of

elementary school teachers?

ANS: C

A B C

D

Feedback This question suggests a value statement that is not testable.

This question suggests a value statement that is not testable.

This example implies variables that can be measured and suggests a comparative non-experimental design study. The independent variable is residing in assisted-living facilities, as compared with not residing in assisted-living facilities. The dependent variable is social interaction.

This question suggests a value statement that is not testable.

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14. What is the purpose of a hypothesis for any study? a. To identify the dependent and independent variables b. To provide direction for the study by indicating the expected outcomes c. To define the appropriate measures needed to test the research problem d. To provide a means of determining the feasibility of the proposed study ANS: B

A B C

D

Feedback A hypothesis does not define the variables but makes a statement about the relationship between two or more variables.

A hypothesis is a declarative statement about two or more variables that predicts an expected outcome.

A hypothesis does not define the appropriate measures needed to test the research question. The hypothesis does provide direction for the analysis and interpretation of data.

A hypothesis does not determine the feasibility of a research problem. A study’s feasibility is determined by practical considerations such as availability of subjects, equipment, facilities, and money.

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15.1 Which hypothesis fails to meet the criteria of testability?

5 a. Proper handwashing prevents the spread of infection. . b. Consistent practice of low-impact aerobic exercise will increase coordination

among older adults. c. Patients who used guided imagery during magnetic resonance imaging (MRI)

procedures will have reduced perceptions of emotional distress compared with patients who do not use guided imagery during MRI. d. Postoperative patients who receive around-the-clock scheduled analgesics will have lower levels of pain compared with postoperative patients who receive analgesics on an as-needed (PRN) schedule.

ANS: A

A

B C D

Feedback This statement does not suggest that there is a predicted outcome as specifically as the other examples. The term proper is value laden and nonspecific. Both proper handwashing and spread of infection require more specific definition.

This hypothesis includes a predicted outcome.

This hypothesis includes a predicted outcome.

This hypothesis includes a predicted outcome.

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DIF: Cognitive Level: Analyzing (Analysis)

16. Which hypothesis is non-directional? a. Hospitals with an infection-control nurse will have fewer instances of sepsis

among inpatients than hospitals without an infection-control nurse. b. There will be a greater weight loss among dieting patients who receive a weekly

supportive telephone call from a dietitian than among dieting patients who do not receive a weekly supportive phone call. c. There will be a difference in stage of disease for prostate cancer among men who had an abnormal prostate-specific antigen screening compared with men who had an abnormal digital rectal examination screening. d. Children who receive weekly counseling for 1 year after the death of a parent will perform better in school than children who do not receive weekly counseling after the death of a parent.

ANS: C

A B C D

Feedback This hypothesis gives the expected direction (i.e., fewer).

This hypothesis gives the expected direction (i.e., greater).

This hypothesis has no expected direction. It suggests a difference but does not indicate the direction of the difference.

This hypothesis gives the expected direction (i.e., better).

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DIF:

Cognitive Level: Applying (Application)

17. The nurse has defined the hypoN thUeR siS s aIsN , “GTThB er. eC wO ilM l be no difference in the number of

adverse events among patients discharged 2 days after an abdominal hysterectomy compared with patients discharged 4 days after an abdominal hysterectomy.” This statement is an example of what? a. Directional hypothesis b. Non-directional hypothesis c. Research hypothesis d. Null hypothesis ANS: D

A B

C D

Feedback Because no direction is indicated, this is not a directional hypothesis.

A non-directional hypothesis indicates the existence of a relationship between variables but does not indicate the direction. This hypothesis indicates no relationship between variables.

A research (or scientific) hypothesis is a statement of the expected relationship of the variables. This hypothesis indicates no relationship between variables.

This is a null (or statistical) hypothesis, stating that there is no relationship between the independent (postoperative days) and dependent (adverse events) variables. If in the statistical analysis a significant relationship is found, the null hypothesis would be rejected.

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DIF:

Cognitive Level: Applying (Application)

REF: Page 36 18. The nurse notes these statements in a research article:

This study explores changes in coping and emotion that occur between the preoperative and the postoperative period. Further, the relationships between coping and emotion preoperatively and postoperatively are evaluated. Finally, the influence of preoperative coping and emotion on postoperative emotion is documented.

This section represents which part of a research study? a. Results b. Methods c. Purpose d. Hypothesis ANS: C

A B C D

Feedback No results were described in the passage.

Although methods are implied, the passage does not include the specific methodology.

The statements describe the aims or goals that the investigator hoped to achieve with the research and thus reflect the purpose of the study.

The passage does not state the hypothesis of the study.

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DIF:

Cognitive Level: Applying (Application)

19. A nurse states the purpose of aN reUseRaS rcIhNstGuT dyBa.sC , “OTM his study will compare the effect of warm

and cold applications on the resolution of intravenous (IV) infiltrations in hospitalized older-adult patients in the early postoperative period.” In this statement, what constitutes the independent variable(s)? a. Postoperative older adult patients b. Early postoperative period c. Warm and cold applications d. Resolution of IV infiltrations ANS: C

A B C

D

Feedback Postoperative older adult patients represent the population to be studied.

Early postoperative period indicates the timing of the intervention.

Warm and cold applications represent the independent variables, which will be manipulated and influence the dependent (outcome) variable resolution of IV infiltrations.

Resolution of IV infiltrations represents the dependent (outcome) variable of the study.

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DIF:

Cognitive Level: Applying (Application)

20. A nurse describes the hypothesis of a research study as, “There is a positive relationship

between nurses’ attitudes toward AIDS patients and the number of AIDS patients they have cared for in practice.” This statement is an example of: a. null hypothesis. b. non-directional hypothesis. c. directional hypothesis. d. causal hypothesis.

ANS: C

A B C D

Feedback The statement is not a null hypothesis because a null hypothesis specifies no relationship.

The statement is a directional hypothesis, not a non-directional hypothesis.

Because a positive relationship is specified, the hypothesis is directional.

Because the statement indicates a relationship between variables, the hypothesis indicates an association, rather than a cause-and-effect relationship, between variables.

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DIF:

Cognitive Level: Applying (Application)

21. The nurse has identified a patient situation that may be an area for study. The initial review of

the literature helps the investigator to identify what? a. The number of subjects required for the study b. The appropriate statistical tests to analyze the data c. The need to extend knowleN dgUeRinSaIpNaG rtT icB ul. arCaOreMa d. The instruments needed to collect data during the study ANS: C

A B C

D

Feedback The number of subjects needed for a study is part of methodology, determined after the research question and hypotheses are determined.

Statistical tests are part of methodology, determined after the research question and hypotheses are determined.

The initial literature review helps further define the research question by identifying gaps in the literature, the need for replication of prior research, or the need to extend the knowledge base in a particular research area. It also identifies variables essential to consider in refining the research question.

The instruments to be used in the study part of methodology, determined after the research question and hypotheses are determined.

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DIF:

Cognitive Level: Understanding (Comprehension)

22. Which hypothesis would be classified as a statistical hypothesis? a. Oxygen inhalation at 2 L/min by nasal catheter will decrease oral temperature

measured with an electronic thermometer. b. Oxygen inhalation at 2 L/min by nasal catheter will not affect oral temperature

measured with an electronic thermometer. c. There will be a greater decrease in anxiety scores in patients receiving

informational videos before open heart surgery than in patients who receive standard written information. d. There will be a difference in anxiety scores in patients receiving informational videos before open heart surgery and patients who receive standard written information.

ANS: B

A B

C D

Feedback This hypothesis is a directional hypothesis rather than a statistical (null) hypothesis.

A statistical (or null) hypothesis indicates no relationship between variables, as represented in this statement. If in the statistical analysis, a significant relationship is found, the null hypothesis would be rejected.

This hypothesis is a directional hypothesis rather than a statistical (null) hypothesis.

This hypothesis is a nondirectional hypothesis rather than a statistical (null) hypothesis.

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Cognitive Level: Applying (Application)

23. Which of these statements is correctly phrased as a clinical question for evidence-based

practice? a. What is the best method to N inUseRrtSaInNeG ntT erB al.fC eeOdM ing tube in an adult patient? b. Are there differences in the characteristics of various brands of enteral feeding tubes? c. In addition to aspiration, what are the most problematic complications of enteral tube feedings? d. What method of determining stomach placement of enteral feeding tubes helps to prevent aspiration in adult patients?

ANS: D

A B C D

Feedback This statement includes an intervention (insertion of an enteral feeding tube) and a population (adult patients) but does not include the other PICO elements.

This statement includes comparison (differences between feeding tubes) but does not include the other PICO elements.

This statement includes only a problem and needs to be further refined to include the PICO elements.

This statement is worded as a clinical question and includes the four PICO elements: population (adult patients), intervention (methods of determining stomach placement), comparison (among methods), and outcome (prevent aspiration).

PTS: 1 REF: Page 39

DIF: Cognitive Level: Applying (Application)

NURSINGTB.COM

Chapter 03: Gathering and Appraising the Literature LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. The review of literature is important to the research process because: a. it guides all steps of the research process. b. it provides a vehicle to disseminate the findings of the study. c. it guides only the conceptualization of the problem statement. d. it identifies only gaps or inconsistencies in the knowledge base.

ANS: A

A B

C D

Feedback The review of the literature is important throughout all stages of a research study.

A completed study may be published to disseminate the findings of a study and thus become one citation in a literature review for future studies. However, the literature review does not ensure this.

The review of the literature guides the problem statement as it is defined along with all other parts and stages of a research study.

The review of the literature contributes to consistencies in the literature, locates instruments used to measure variables, identifies experts on topics, etc.

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DIF:

CogN niU tivReSLI evNelG :T UB nd. erC stO anMding (Comprehension)

2. The nurse researcher locates a preappraised commentary for a source of literature. The next

step for the researcher should be: a. move on to another literature source that does not have a commentary. b. discard the commentary unless the source is a systematic review. c. decide whether to locate and critically appraise the primary source. d. recognize that such commentaries are not relevant for the novice researcher.

ANS: C

A B C D

Feedback The commentary can be very useful and should not be readily discarded.

The commentary can be useful regardless of the source being a systematic review.

After reading the commentary, the researcher can decide if the primary source is relevant to the PICO question and should be located and read in its entirety.

Although there are limitations to the use of commentaries, they certainly can be useful to the novice researcher by indicating if a primary source should be located and read.

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DIF:

Cognitive Level: Applying (Application)

3. A nurse researcher includes refereed journals in the literature review because: a. the articles are critiqued by a panel of external reviewers. b. the articles selected for publication are related to a specific field of knowledge. c. the journals encourage competition among authors to have their articles published. d. the journals publish only articles that are primary sources of research findings.

ANS: A

A B C D

Feedback The articles are critiqued by a panel of external expert readers.

Articles selected for publication are sources of the latest information about a great variety of fields of knowledge.

There is no overt competition among authors because refereed journals have blinded reviews in most cases.

Refereed journals are often the first source of primary research findings, but they may also include other types of research articles.

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DIF:

Cognitive Level: Understanding (Comprehension)

4. A research article has undergone a blind review for a peer-reviewed journal. The nurse

reading the research article should understand which of the following about this review process? a. The reviewers of the article did not know the identity of the other reviewers. b. The reviewers of the article did not know the identity of the author. c. The criteria used to review N thUeRarStiI clN e GwTerBe.nC otOkM nown to the author. d. The criteria used to review the article were determined by the reviewers.

ANS: B

A B C D

Feedback The reviewers of the article may or may not know the identity of the other reviewers.

In a blind review, the manuscript to be reviewed does not include the name of the author.

A standard set of scholarly criteria is used to review the article. The criteria are usually known to the author.

The criteria used to review the article are established by expert reviewers appointed by the publication’s editors.

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DIF:

Cognitive Level: Understanding (Comprehension)

5. For which of these reasons would a nurse researcher decide to use secondary sources in a

review of the literature? a. They provide material written by the person who conducted the study. b. They provide a different way of looking at specific issues or problems. c. They define the relationship of two or more variables affecting an outcome. d. They supplement the body of nursing knowledge in a specific area of practice.

ANS: D

A B

C D

Feedback Secondary sources are authored by an individual other than the researcher who conducted the study.

The evidence is distilled by an expert and usually provides a critical evaluation or response to a study, not necessarily a different way of looking at specific issues or problems.

The relationship of two or more variables affecting an outcome defines a hypothesis.

Secondary sources published in refereed journals usually include implications for practice and the work’s contributions to the development of nursing science.

PTS: 1 DIF: REF: Page 48, Table 3-1

Cognitive Level: Understanding (Comprehension)

6. Which is an example of a primary source in a literature review? a. A video recorded interview of a nurse researcher b. A critique of a nursing research study c. An edited textbook on nursing research d. A review of theoretical frameworks used in nursing research ANS: A

A B C D

Feedback Primary sources include articles, books, diaries, films, and oral histories of the person who conducted theNsU tuR dySI orNdGevTeB lo.pC edOtM he theory.

A critique of a nursing research study is a secondary source.

An edited textbook on nursing research is a secondary source.

A review of theoretical frameworks is a secondary source.

PTS: 1 DIF: REF: Page 48, Table 3-1

Cognitive Level: Understanding (Comprehension)

7. Which is an example of a secondary source in a literature review? a. An oral history of a nurse researcher b. An investigator’s report of a research study c. A summary and critique of another’s scholarly work d. An autobiography of a developer of a nursing theory ANS: C

A B C D

Feedback An oral history of a nurse researcher is a primary source.

An investigator’s report of a research study is a primary source.

Secondary sources include materials written by persons other than the person who conducted a research study or developed a particular theory.

An autobiography of a developer of a nursing theory is a primary source.

PTS: 1

DIF:

Cognitive Level: Understanding (Comprehension)

REF: Page 48, Table 3-1 8. Which of these electronic databases is the most relevant and frequently used source for

nursing literature? a. MEDLINE b. CINAHL c. Cochrane Collaboration d. National Guideline Clearinghouse ANS: B

A B C D

Feedback MEDLINE includes some nursing sources, but it is not the most comprehensive database for nursing.

CINAHL is the most relevant and frequently used source for nursing literature, covering nursing and related literature from 1956 to the present.

The Cochrane Collaboration provides access to abstracts from Cochrane Database of Systematic Reviews but is not a nursing literature source.

The National Guideline Clearinghouse provides evidence-based clinical practice guidelines but is not a nursing literature source.

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DIF:

Cognitive Level: Remembering (Knowledge)

9. When comparing MEDLINE and CINAHL databases, which of these differences will the

nurse find? a. The coverage of MEDLINENU daRteSs I baNcG kTtoB1.9C 75O,Mwhereas the coverage of CINAHL dates back to 1980. b. MEDLINE’s journal coverage includes more than 10,000 biomedical journals, whereas CINAHL’s coverage includes more than 5000 journals. c. MEDLINE’s database size is more than 21 million records, whereas CINAHL’s database size is more than 3.2 million records. d. MEDLINE has more than 500 Evidence-Based Care Sheets, whereas CINAHL has more than 50 Evidence-Based Care Sheets.

ANS: C

A B C D

Feedback The coverage of MEDLINE dates back to 1947, whereas the coverage of CINAHL dates back to 1937.

MEDLINE’s journal coverage includes more than 5600 biomedical journals, whereas CINAHL’s coverage includes more than 5000 journals.

MEDLINE’s database size is more than 21 million records, whereas CINAHL’s database size is more than 3.2 million records.

CINAHL has more than 130 Evidence-Based Care Sheets, whereas MEDLINE has a Clinical Queries tool to filter for systematic reviews.

PTS: 1 DIF: REF: Page 52, Table 3-3

Cognitive Level: Understanding (Comprehension)

10. A general timeline for a literature search for an academic paper or project is to go back how

far in the literature? a. At least the last 6 months to 2 years b. At least the past 3 to 5 years c. At least the past 6 to 10 years d. At least the past 12 to 15 years ANS: B

A B

C D

Feedback The most recent 6 months to 2 years is an insufficient timeline for an academic paper or project.

The past 3 to 5 years is a sufficient timeline for an academic paper or project because recent literature is relevant and may include classic references in reference lists.

Six to 10 years is probably longer than the timeline needed for the search.

Twelve to 15 years is likely to be much longer than the timeline needed for the search.

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DIF:

Cognitive Level: Understanding (Comprehension)

11. A nurse is encouraged to use a Boolean operator to more efficiently perform an electronic

search of the literature. A Boolean operator is: a. a specialized reference librarian who can assist in searches of electronic medical and nursing databases. b. a software program that enaNbU leRs S coImNbGinTaB tio.nCs O ofMpermissions and restrictions for a database search. c. a definition of the relationship between words or groups of words in a literature search such as “and.” d. a clinical query that can be performed to focus on a particular clinical issue or practice question.

ANS: C

A B C D

Feedback Although reference librarians can be helpful for electronic database searches, they are not Boolean operators.

A Boolean operator is not a software program but refers to variables that define an electronic database search.

A Boolean operator defines the relationships between words or groups of words in the literature search. These include the words, “and,” “or,” and “not.”

A Boolean operator is not a query for a clinical issue or practice question.

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DIF:

Cognitive Level: Understanding (Comprehension)

12. Which command is an example of a Boolean connection used when ordering an electronic

literature search? a. Explode topic

b. Limit search to abstracts c. Search from years 2003 to 2013 d. Search diabetes diagnosis and treatment ANS: D

A B C D

Feedback “Explode topic” is a search strategy, not a Boolean connection.

Limiting the search to abstracts is not a Boolean connection.

Specifying the time limit of the search is not a Boolean connection.

Boolean connections include the terms “and,” “not,” and “or,” which link thesaurus terms and influence the search.

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DIF:

Cognitive Level: Understanding (Comprehension)

13. Which website is an important source for clinical evidence but limited as a provider of

primary documents for literature reviews? a. CINAHL b. MEDLINE c. Cochrane Library d. PsycINFO ANS: C

A B C D

Feedback CINAHL contains many primary source citations.

MEDLINE contains many primary source citations.

The Cochrane Library is important as a source for clinical evidence but limited as a provider of primary documents for literature reviews.

PsycINFO includes professional and academic literature in psychology.

PTS: 1 DIF: REF: Page 56, Table 3-4

Cognitive Level: Understanding (Comprehension)

14. What is considered to be essential to a thorough and relevant review of the literature? a. Use of both published and unpublished sources b. Critical evaluation of mainly primary sources c. Liberal use of secondary sources d. Evaluation of both quantitative and qualitative sources ANS: B

A B C D

Feedback Although both published and unpublished sources may be used, it is the evaluation of primary published sources that is most important.

A thorough and accurate evaluation of mainly primary sources of information is necessary for a thorough and relevant literature review.

Secondary sources may be used, but they should be used sparingly.

Although both quantitative and qualitative sources may be used, it is not

necessary to include both in a review of the literature.

PTS: 1 DIF: REF: Page 48, Table 3-1

Cognitive Level: Understanding (Comprehension)

15. Which objective of a review of the literature is unique to a review for research purposes,

rather than a review for evidence-based practice? a. Discover conceptual frameworks used to examine problems. b. Generate useful research questions and hypotheses. c. Determine what is unknown about a subject, as well as what requires clarification. d. Uncover a new practice intervention or gain support for current interventions and policies.

ANS: B

A B

C D

Feedback Conceptual frameworks are useful for both formal research and evidence-based practice.

For research purposes, the literature review focuses the study by discovering gaps or conflicts in the literature and identifying areas where little research evidence exists. This helps define the research questions and hypotheses.

Both formal research and evidence-based practice are concerned with what is known about a subject, as well as what requires clarification.

Uncovering new practice interventions or gaining support for current practices is primarily in the realm of evidence-based practice.

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DIF:

CogN niU tivReSLI evNelG :T UnBd. erC stO anMding (Comprehension)

16. Which of these factors limits the usefulness of the World Wide Web as a source of

information for research consumers? a. Downloading from the Web can be a slow process. b. Non-text capabilities reduce the professionalism of presentations. c. There is little quality control over the information on many websites. d. Much of the available information is too technical to be understood by the casual reader.

ANS: C

A B C D

Feedback Downloading is often a rapid process.

This is not an accurate statement about the professionalism of presentations and non-text capabilities.

Many sources are not data based and primary sources. It is not always evident which sources are data based and which are not.

Much information on the Web is comprehensible to the casual reader.

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DIF:

Cognitive Level: Understanding (Comprehension)

17. When the nurse researcher conducts an electronic literature search, the search yields more

than 7000 citations for the topic. The researcher interprets these findings as: a. the search was comprehensive. b. the key words were not sufficiently narrowed. c. the topic does not require additional investigation. d. the topic has broad application across health care disciplines.

ANS: B

A B C D

Feedback The search was too broad and included too many citations to scroll through.

Limiting the focus is necessary using thesaurus terms.

The topic required a more manageable number of retrievals.

The topic is too broad and may or may not apply across various health care disciplines.

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DIF:

Cognitive Level: Understanding (Comprehension)

18. Why would a nurse researcher choose to use multiple online fee-based databases such as

CINAHL and MEDLINE? a. The charges for these services are minimal. b. Databases are updated weekly or monthly. c. An independent professional critique of each work accompanies the full text. d. The service provides translations to English of articles written in other languages.

ANS: B

A B C D

NURSINGTB.COM

Feedback Libraries pay for database use through subscriptions.

Databases are updated monthly or weekly.

Critiques do not necessarily accompany full texts of all citations.

Translations are not provided; citations may be excluded by specifying the preferred language.

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DIF:

Cognitive Level: Understanding (Comprehension)

19. A study published in a nursing research journal is titled, “Effects of nocturnal hemodialysis on

physiological and psychological parameters of patients with end-stage kidney disease.” The nurse should recognize that this study belongs to which of these types of reference? a. Primary b. Secondary c. Tertiary d. Historical ANS: A

A

Feedback The example is a research study, a primary source.

B C D

This is not a secondary source but a primary source.

The example is a primary source, not a tertiary source.

The example is a primary source of a research study, not a historical study.

PTS: 1 DIF: REF: Page 48, Table 3-1

Cognitive Level: Understanding (Comprehension)

20. Literature reviews are usually organized according to: a. the order in which materials are retrieved. b. the conceptual or theoretical concepts. c. the importance or credibility of authors. d. the variables being studied.

ANS: D

A

B C D

Feedback Some retrieved citations are not useful and must be discarded. The order in which materials are retrieved may not be a logical sequence for a formal, written review of the literature.

The conceptual or theoretical framework does not necessarily organize the literature review. Usually, it introduces the topic, prior to the review of literature.

At times, unknown authors are essential to a thorough literature review.

The variables being studied provide a useful organizational approach to the literature review.

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DIF:

Cognitive Level: Understanding (Comprehension)

Chapter 04: Theoretical Frameworks for Research LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. Which phrase correctly defines a theory? a. The operational definition of the study’s conceptual framework b. The assumptions and beliefs of the worldview of the researcher c. A set of interrelated concepts that provides a systematic view of a phenomenon d. A researcher’s best guess of the direction of the relationship between variables ANS: C

A B C D

Feedback The operational definition of the study specifies how the findings will be measured.

The assumptions and beliefs of the worldview of the researcher is the paradigm or philosophical framework of the researcher.

A theory is a set of interrelated concepts that provides a systematic view of a phenomenon.

The researcher’s best guess of the direction of the relationship between variables is a hypothesis.

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2. How are theory and practice interrelated for the hospital-based nurse researcher? a. Practice is the operational definition of theory. b. Practice provides the opportunity to test theory. c. Theory provides the evidence on which practice is based. d. Theory generates questions that are used to refine practice.

ANS: B

A B C D

Feedback Theory is abstract and is not operationally defined as practice.

Practice environments provide settings in which to test theory.

Theory is a guide for research, and research provides evidence for practice.

Research helps to refine questions related to practice.

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DIF:

Cognitive Level: Understanding (Comprehension)

3. Which nursing theory is classified as a Grand Nursing Theory? a. Polk’s Theory of Resilience b. Mishel’s Uncertainty in Illness Theory c. Orem’s Self-Care Deficit Nursing Theory d. Im’s Theory of Caucasians’ Cancer Pain Experience

ANS: C

A

B C D

Feedback Polk’s Theory of Resilience is considered a Middle-Range Nursing Theory because it contains a limited number of concepts and is focused on a limited aspect of reality.

Michel’s Uncertainty in Illness Theory is considered a Middle-Range Nursing Theory for the reasons described for option A. Orem’s theory is a Grand Nursing Theory since it is an all-inclusive conceptual structure that includes views on person, health, and environment.

Im’s Theory of Caucasians’ Cancer Pain Experience is considered a Situation-Specific Nursing Theory because it is narrow in scope and explains a small aspect of the phenomena of interest to nurses.

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Cognitive Level: Understanding (Comprehension)

4. Situation-specific nursing theories are becoming more popular in nursing research due to: a. increased emphasis on evidence-based practice. b. increased need for broad and generalizable models to explain phenomena. c. decreased resources for funding of grand theory development. d. decreased use of theories borrowed from other disciplines.

ANS: A

A B C D

Feedback Situation-specific theories N prUoR viS deIcNloGsT erBl. inC ksObMetween theory and practice, which is important because of the increased demand for evidence-based practice.

At present, there is no increase in need for grand nursing theories that are generalizable across populations, health, and environments.

Resources for funding grand theory development in nursing have always been limited.

Nursing frequently borrows concepts, models, and theories from many other disciplines.

PTS: 1 REF: Pages 72-73

DIF:

Cognitive Level: Understanding (Comprehension)

5. A graphic or symbolic representation of a phenomenon not directly observable, which allows

the reader to visualize key constructs and their interrelationships, is: a. a concept. b. a conceptual definition. c. an operational definition. d. a model.

ANS: D

A

Feedback A concept is an image or symbolic representation of an abstract idea that can be concrete (e.g., weight) or abstract (e.g., hope).

B C D

A conceptual framework defines or explains the concept as it is rooted in the theoretical literature.

The operational definition specifies how a concept will be measured.

A model is a graphic or symbolic representation of a phenomenon that allows a reader to visualize the key concepts/constructs and their identified interrelationships.

PTS: 1 DIF: REF: Page 69, Box 4.1

Cognitive Level: Remembering (Knowledge)

6. How is a model related to a concept or concepts? a. A model tests conceptual theories. b. A concept defines the purpose of a model. c. Relationships between or among concepts are demonstrated in a model. d. Concepts generate the theoretical basis for knowledge depicted in a model.

ANS: C

A B C D

Feedback A model does not test theories.

A concept does not define a model.

A model allows the reader to visualize the key concepts and their identified interrelationships.

Concepts do not generate theory for knowledge depicted in a model.

PTS: 1 DIF: REF: Page 77, Box 4.4

Cognitive Level: Understanding (Comprehension)

NURSINGTB.COM

7. Pender’s health promotion model is an example of what type of theory? a. Grand nursing theory b. Middle-range nursing theory c. Situation-specific nursing theory d. Another discipline’s theory applied to nursing ANS: B

A B C D

Feedback Pender’s health promotion model is not a grand nursing theory or all-inclusive model to describe nursing as a whole.

Pender’s health promotion model is a middle-range nursing theory focused on a limited aspect of reality.

Pender’s health promotion model is not a situation-specific theory or narrow in scope, explaining a small aspect of a phenomenon.

Pender’s health promotion model is not a theory from another discipline applied to nursing; it is a nursing model.

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DIF:

Cognitive Level: Understanding (Comprehension)

8. Which statement is an operational definition of a concept?

a. Death anxiety is an uncomfortable feeling on contemplation of one’s own death,

measured by Templar’s Death Anxiety Scale (Templar, 1986). b. Pain is a pattern of responses to protect the organism from harm (Sternbach, 1979). c. Maternal identity entails maternal cognitions and affect with regard to the maternal-infant relational system (Walker & Montgomery, 1994). d. Spirituality is a way of being or experiencing that comes about through an awareness of a transcendent dimension and one’s identifiable values with regard to self, other, nature, and whatever one considers to be ultimate (Elkins, 1988).

ANS: A

A B C D

Feedback An operational definition of death anxiety is provided because it states how death anxiety will be measured.

This statement is a conceptual definition of pain.

This statement is a conceptual definition of maternal identity.

This statement is a conceptual definition of spirituality.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Pages 69-70, Box 4.1, Table 4.1 9. When reading a report of results of a nursing research study, the nurse notices that the

theoretical framework is drawn from a discipline other than nursing. When critiquing the theoretical framework, the question that should be of highest priority is: a. Does the research have implications across disciplines? b. Is the researcher a recognized leader in the discipline of nursing? c. Does the author have speciaNlUex rtiNseGoTrBe. duCcO atM ion in the discipline from which RpSeI the theoretical framework is derived? d. Has the author clearly indicated the meaning of the theoretical framework to the study and linked it to nursing?

ANS: D

A B C D

Feedback The author should cite the implications of the research for nursing.

The author of a research article need not be a recognized leader in nursing.

The author should have an understanding of the framework but does not need to have expertise in the discipline from which it is derived.

The theoretical framework does not have to come from nursing but should be linked to the practice of nursing.

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10. Which research report title suggests that theory was generated as the outcome of the study,

rather than being used as the framework for the study? a. Women’s experiences of undergoing coronary artery bypass graft surgery (Banner, D., et al., 2011) b. Couple functioning and posttraumatic stress symptoms in U.S. army couples: The role of resilience (Melvin, K.C., et al., 2011)

c. A randomized, clinical trial of education or motivational-interviewing-based

coaching compared to usual care to improve cancer pain management (Thomas, M.L., et al., 2012) d. A predictive and moderating model of psychosocial resilience in adolescents (Tusaie, K., et al., 2007) ANS: A

A

B C

D

Feedback The study of women’s experiences of a specific cardiac surgical procedure suggests a qualitative research study and the generation of a situation-specific theory or model.

The title suggests the use of several models or middle-range theories (resilience, posttraumatic stress disorder) as a framework to study couple functioning.

The title describes a quantitative study regarding the effect on cancer pain management (dependent variable) of two approaches—educational coaching vs standard care (independent variables). Thus the implied theoretical framework has to do with motivational-interviewing-based coaching.

The title suggests the use of the theoretical framework of stress, coping, and resilience as applied to adolescents.

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11. Which research report title suggests that theory was used as the framework for the study,

rather than being generated as the outcome of the study? a. The experiences of nurse prNaU ctR itiS onIeNrsGpTroBv.idCinOgMhealth care to the homeless (Seilor, A.J. & Moss, V.A., 2012) b. A transformative decision-making process for mammography screening among rural, low-income women (Purtzer, M.S., 2012) c. A randomized, clinical trial of education or motivational-interviewing-based coaching compared to usual care to improve cancer pain management (Thomas, M.L., et al., 2012) d. Older adults’ perceptions of feeling safe in an intensive care unit (Lasiter, S., 2011) ANS: C

A

B

C

D

Feedback The title states that the lived experiences of nurse practitioners were examined, indicating a qualitative study with findings that could become part of a framework for nurse practitioners to use and for other researchers to study.

The title indicates that the experience regarding mammography screening decisions of a specific group (rural, low-income women) was studied to identify themes and develop a model, the transformative decision-making process.

The title describes a quantitative study regarding the effect on cancer pain management (dependent variable) of two approaches—educational coaching vs standard care (independent variables). Thus the theoretical framework for the study has to do with motivational-interviewing-based coaching.

The title indicates that the lived experience of a specific group (older adults) in a

specific context (intensive care unit) was studied in regard to their feeling safe.

This is a qualitative study to identify themes that form a model for future studies of the phenomenon.

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MULTIPLE RESPONSE 1. When critiquing a research study’s theoretical framework, the nurse should keep in mind

which information? (Select all that apply.) a. Theoretical frameworks guide hypothesis formulation in qualitative and quantitative research studies. b. Theoretical frameworks can be implicitly or explicitly stated in a research report. c. A theoretical framework of a nursing research study must be based on nursing theories or models. d. A theoretical framework may not be identified in all types of nursing research.

ANS: B, D Feedback Correct

Incorrect

A theoretical framework can be implicitly or explicitly stated, depending on the type of research performed.

Not all research studies have a stated theoretical framework. In fact, qualitative research reports rarely cite theoretical frameworks.

Theoretical frameworks guide hypothesis formation in quantitative studies, not in qualiN taU tivReSsI tuN diGeT s. B.COM Theories from other disciplines may be used as long as they can be linked to the practice of nursing.

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Chapter 05: Introduction to Qualitative Research LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. A characteristic of qualitative research is data that are: a. in text form. b. dichotomous. c. free of patterns. d. inappropriate for analysis.

ANS: A

A B C D

Feedback A distinctive characteristic of qualitative research studies is that data consist of text (words), not numbers as in quantitative research.

Dichotomous data are nominal and frequently found in quantitative studies.

Patterns emerge from qualitative research data.

The data generated by qualitative studies are appropriate for content analysis.

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2. A nurse researcher who is considering whether to use a qualitative research design should be

aware that the focus of qualitatN ivU eR reSseIaN rcG hT isB : .COM a. measuring one or more human characteristics. b. controlling variables that interfere with the phenomenon being studied. c. viewing human beings as composites of many body systems. d. studying human experiences that occur within a person’s natural setting.

ANS: D

A B C D

Feedback Measuring variables (one or more human characteristics) is not a focus of qualitative research.

Control of variables is consistent with quantitative research design.

Qualitative studies view human beings in a holistic way, not as the sum of parts.

Human experience occurring in a person’s natural setting is the focus of qualitative studies, although investigators may not always go to the setting where the person experienced the phenomenon.

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3. The determining factor for a researcher in selecting a qualitative research approach should be: a. the need to test a theory. b. the nature of the research question. c. the age and gender of the research participants.

d. the availability of valid instruments to measure the phenomenon.

ANS: B

A B C D

Feedback Qualitative studies are often represented as theory-generating, not theory-testing, studies.

Each research method originates in a philosophy of research and matches the nature of the research question.

These demographic variables may be characteristics of subjects or participants in quantitative or qualitative research studies.

Instruments to measure variables are not used in qualitative research studies.

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4. Which of these terms is synonymous with paradigm? a. Empiricism b. Worldview c. Holism d. Viewpoint ANS: B

A B C D

Feedback Empiricism refers to the reliance on observation and experimentation, i.e., quantitative research.

A paradigm is a worldview, a philosophical or theoretical framework.

Holism is a theory that the universe and living nature are correctly seen as interacting wholes, more than the sum of their parts.

A viewpoint is a way of looking at or thinking about a subject.

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5. In which of these circumstances should a nurse researcher select a qualitative research design

instead of a quantitative design? a. The time for data collection is limited. b. The research question is clinical in nature. c. The goal is to view the phenomenon in the same way as those who experience it. d. The researcher is a novice with minimal experience in scientific problem solving.

ANS: C

A B C

Feedback Some qualitative studies take extended times to complete.

Both qualitative and quantitative research designs may be used to answer research questions that are clinical in nature.

This describes qualitative research designs. The interpretive, naturalistic approach values the lived experience from the perspectives of participants and

D

informants.

Novice researchers are challenged by both qualitative and quantitative research studies.

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6. Which research topic would most likely be studied through a qualitative research approach? a. The meaning of health and health promotion among low-income Southern rural

women. b. Changes in hope and coping in older adults during rehabilitation after hip fracture. c. Exercise effects on fatigue and emotional distress during radiation therapy for

breast cancer. d. Older adults and HIV/AIDS: The relationship of perceived risk and willingness to

interact with individuals with HIV/AIDS. ANS: A

A B C D

Feedback Qualitative research focuses on what experiences mean to people.

This topic suggests a descriptive study design.

This topic suggests an experimental study design.

This topic suggests an ex post facto or correlational study design.

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NURSINGTB.COM

7. A nurse’s research question is, “What is the grief experience of women older than 30 years

from rural Mexico who have a late-stage pregnancy loss?” The aspect of the question that represents the study’s context is: a. late-stage pregnancy loss. b. women older than 30 years. c. grief experience. d. rural Mexico.

ANS: D

A B C D

Feedback “Late-term pregnancy loss” describes the precipitating cause of the topic (grief) to be studied.

“Gender and age” designate demographic characteristics of participants.

“Grief experience” is the phenomenon to be studied.

“Rural Mexico” is the location (context) where the experience occurred for the participants.

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8. Which aim of research is characteristic of or appropriate for qualitative research methods? a. Control

b. Prediction c. Explanation d. Understanding ANS: D

A B C D

Feedback A characteristic of quantitative or empirical research is the control of variables.

A characteristic of quantitative or empirical research is prediction of outcomes.

A characteristic of quantitative or empirical research is providing explanation of events.

Meaning and understanding of human experience are characteristics of qualitative research.

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9. Which research study characteristic would be inappropriate for qualitative methods? a. Testing a new hypothesis b. Using an intensive approach to data collection c. Employing inductive analysis of the data d. Examining individual responses to a nonmodifiable situation ANS: A

A B C D

Feedback New hypotheses are tested by quantitative, not qualitative, studies.

Both quantitative and qualitative studies use intensive data-collection approaches.

Inductive analysis is appropriate for some types of qualitative studies.

Qualitative studies examine the meaning of an experience to individuals.

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10. How is the number of subjects for participation determined for a qualitative study? a. Data are collected from new subjects until data saturation is reached. b. The number of subjects is the number available at a specific location. c. The number of subjects is the number available within the researcher’s specified

time frame. d. A power analysis of data collected in a pilot study is used to determine the number.

ANS: A

A B C

Feedback Researchers generally continue to recruit participants until they have reached data saturation, which means that nothing new is emerging from the interviews.

At times the researcher may have to locate additional subjects at various locations until saturation is achieved.

The number of subjects is not related to time frame because data will need to be

D

collected until saturation is reached.

Power analysis is used to determine sample size in quantitative research studies.

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11. A description typical of a qualitative research study is: a. deductive reasoning is used. b. truth is a subject’s perception of reality. c. sample size is determined before the study begins. d. one or more variables are measured in a context-free setting.

ANS: B

A B C D

Feedback Deductive reasoning is typical of quantitative studies.

Qualitative studies attempt to interpret phenomena in terms of the meaning people bring to them. Thus truth is the subject’s perception/expression of reality.

Sample size is predetermined in quantitative studies.

Measurement is characteristic of quantitative studies.

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12. How does the nurse researcher know when data saturation has been reached? a. When the participants all agree on the themes derived from the study b. When the ideas or informatN ioUnRcS om froBm IiNngGT .CneOwMparticipants have been expressed

previously by other participants c. When the emerging themes are congruent with those developed as a result of

previous studies of the same phenomenon d. When the participants are no longer interested or willing to discuss their

experiences or feelings ANS: B

A B C

D

Feedback Participant agreement on themes is not an influence on data saturation.

Data saturation occurs when the researcher recognizes that he or she has heard themes before in multiple prior interviews.

Phenomenologists do not use previous studies to determine data saturation because each new group of participants has its own unique set of subjective experiences compared with past groups in similar studies.

Lack of interest of participants does not indicate data saturation.

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13. A nurse reads a qualitative study concerning the grief process. Later, the nurse explains to a

grieving widow that grief is a process and that many others have successfully made their way through the process. The nurse is using which clinical application of research?

a. b. c. d.

Insight or empathy Assessment of status or progress Anticipatory guidance Coaching

ANS: C

A B C

D

Feedback Insight or empathy means that the nurse would be better able to understand the behaviors of a patient.

Assessment of status or progress means that the nurse can assess how the patient is moving through the grief process.

Anticipatory guidance means that the nurse can explain the various stages of grief to the patient and reassure her that others have successfully made their way through the grief process.

Coaching would involve coaching the patient to recognize signs that she is progressing from one stage of the grief process to another.

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Cognitive Level: Applying (Application)

14. The findings of a qualitative research study describe the main essence of an experience but

also show how the experience varies, depending on the individual or context. These results fall into which of Kearney’s categories of qualitative research findings? a. Restricted by a priori frameworks b. Descriptive categories c. Shared pathway or meaningNURSINGTB.COM d. Description of experiential variation ANS: D

A B

C

D

Feedback The category “restricted by a priori frameworks” refers to a discovery aborted because the researcher has obscured the findings with an existing theory.

The category “descriptive categories” refers to a phenomenon vividly portrayed from a new perspective, which provides a map into previously uncharted territory.

The category “shared pathway or meaning” refers to the synthesis of a shared experience or process, as well as the integration of concepts that provide a complex picture of a phenomenon.

The findings describe the category “description of experiential variation.”

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Cognitive Level: Understanding (Comprehension)

15. A type of clinical application of qualitative research that would help a nurse describe the

trajectory of an illness is: a. insight or empathy. b. assessment of status or progress. c. anticipatory guidance.

d. coaching.

ANS: B

A B C D

Feedback The mode “insight or empathy” would help a nurse to understand patients better and to offer more sensitive support.

The mode of clinical application “assessment of status or progress” enables a nurse to describe the trajectory of an illness.

The mode “anticipatory guidance” enables a nurse to share qualitative findings with the patient.

The mode “coaching” enables a nurse to advise patients of steps they can take to reduce distress or improve adjustment to an illness according to the evidence in the study.

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Cognitive Level: Applying (Application)

16. Which of Kearney’s categories of qualitative findings describes a phenomenon portrayed

vividly from a new perspective? a. Restricted by a priori frameworks b. Descriptive categories c. Shared pathway or meaning d. Depiction of experiential variation ANS: B

A B C

D

NURSINGTB.COM Feedback The category “restricted by a priori frameworks” describes a discovery aborted because the researcher has obscured the findings with an existing theory.

The category “descriptive categories” describes a phenomenon to be vividly portrayed from a new perspective.

The category “shared pathway or meaning” describes a synthesis of a shared experience or process or integration of concepts that provides a complex picture of a phenomenon.

The category “depiction of experiential variation” describes the main essence of an experience but also shows how the experience varies, depending on the individual or context.

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Cognitive Level: Applying (Application)

17. Which of Kearney’s categories of qualitative findings describes a synthesis of a shared

experience or process or integration of concepts that provides a complex picture of a phenomenon? a. Restricted by a priori frameworks b. Descriptive categories c. Shared pathway or meaning d. Depiction of experiential variation ANS: C

A B C

D

Feedback The category “restricted by a priori frameworks” describes a discovery being aborted because the researcher has obscured the findings with an existing theory.

The category “descriptive categories” describes a phenomenon vividly portrayed from a new perspective.

The category “shared pathway or meaning” describes a synthesis of a shared experience or process or integration of concepts that provides a complex picture of a phenomenon.

The category “depiction of experiential variation” describes the main essence of an experience, but it also shows how the experience varies, depending on the individual or context.

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18. A description of how adolescent girls recovering from addiction to prescription narcotics

might or might not move forward to create a new life is an example of which of Kearney’s category of qualitative findings? a. Restricted by a priori frameworks b. Descriptive categories c. Shared pathway or meaning d. Depiction of experiential variation ANS: D

A

B C

D

Feedback NURSINGTB.COM This is not an example of “restricted by a priori frameworks,” which describes a discovery being aborted because the researcher has obscured the findings with an existing theory.

This is not an example of “descriptive categories,” which describes a phenomenon vividly portrayed from a new perspective.

This is not an example of “shared pathway or meaning,” which describes a synthesis of a shared experience or process or integration of concepts that provides a complex picture of a phenomenon.

This is an example of the category “depiction of experiential variation,” which describes the main essence of an experience but also shows how the experience varies, depending on the individual or context.

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19. An older adult’s description of pain, including descriptors, attributed causes, and what

constitutes good care during a painful episode, would be an example of which category of qualitative findings? a. Restricted by a priori frameworks b. Descriptive categories c. Shared pathway or meaning d. Depiction of experiential variation

ANS: B

A

B C

D

Feedback This is not an example of “restricted by a priori frameworks,” which describes a discovery being aborted because the researcher has obscured the findings with an existing theory.

This is an example of “descriptive categories,” which describes a phenomenon vividly portrayed from a new perspective.

This is not an example of “shared pathway or meaning,” which describes a synthesis of a shared experience or process or integration of concepts that provides a complex picture of a phenomenon.

This is not an example of “depiction of experiential variation,” which describes the main essence of an experience but also shows how the experience varies, depending on the individual or context.

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20. Computer management of qualitative data can assist a nurse researcher with: a. organization of data. b. interpretation of data. c. credibility of data. d. synthesis of data.

ANS: A

A

B C D

Feedback NURSINGTB.COM Computer management of qualitative data allows easier coding of data and assists with grouping or organizing data, as well as finding patterns in the interviews and field notes.

Interpretation of data must be performed by the researchers.

Credibility of data must be established by the researchers.

Synthesis of data must be performed by the researchers.

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MULTIPLE RESPONSE 1. Which are steps in the qualitative research process? (Select all that apply.) a. Sample selection b. Data collection c. Review of the literature d. Evaluation e. Description of findings f. Implementation of findings g. Discussion of conclusions ANS: A, B, C, E, G

Feedback Correct

Incorrect

Sample selection is a step in the qualitative research process.

Data collection is a step in the qualitative research process.

Review of the literature is a step in the qualitative research process.

Description of findings is a step in the qualitative research process.

Discussion of conclusions is a step in the qualitative research process.

Evaluation is not a step in the qualitative research process.

Implementation of findings is not a step in the qualitative research process.

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Chapter 06: Qualitative Approaches to Research LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. Which qualitative research approach is used by researchers for the purpose of theory building? a. Case study b. Phenomenology c. Grounded theory d. Ethnographical method ANS: C

A B C D

Feedback A case study focuses on the peculiarities or commonalities of specific clinical scenarios or situations.

Phenomenology focuses on the lived experience of persons dealing with a particular phenomenon.

Grounded theory is associated with building of theory about basic social processes. The theory evolves or emerges during data collection and analysis.

Ethnographical methods focus on cultures or subcultures within larger social contexts.

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2. Which qualitative approach would be most appropriate for a nurse researcher to use when

studying the daily experience of women undergoing radiation treatment for breast cancer? a. Case study b. Phenomenology c. Grounded theory d. Ethnographical method ANS: B

A B C D

Feedback A case study focuses on the peculiarities or commonalities of specific clinical scenarios or situations.

Phenomenology is most appropriate because it focuses on the day-to-day lived experiences of persons dealing with a situation or phenomenon.

Grounded theory is focused on social interactions in a particular context or situation.

Ethnographical methods focus on cultures or subcultures within larger social contexts.

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3. When a researcher analyzes data from a phenomenological study, the final synthesis of

participants’ reported experiences is: a. description of the lived experience. b. identification of thought sequences. c. generalization of the findings. d. classification of recurring themes.

ANS: A

A B C D

Feedback The final synthesis of a phenomenological study elaborates the lived experience of participants as a narrative.

Identification of thought sequences refers to the auditability of the study.

Qualitative results are not generalized.

Classification of reoccurring themes occurs during data analysis.

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4. When reviewing the report of a phenomenological study, the nurse finds there is no section

that describes or reports the research question. The research question can be determined by: a. examination of the themes that emerged from the study. b. examination of the data analysis methods used in the study. c. examination of the questions or statements posed to the study participants. d. examination and critical analysis of the articles reported in the literature review.

ANS: C

A B C D

NURSINGTB.COM

Feedback Themes do not provide information about the research question. They pertain to results of the study.

Data analysis methods do not indicate the research question.

Examination of questions posed to participants tells the reader what human phenomenon is of interest to the researcher.

Research articles can provide insight into the topic but not the specific research question.

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5. When reading a report of a phenomenological study, the nurse finds direct quotes from the

participants threaded throughout the narrative. This is significant because: a. the researcher is supporting the study’s findings. b. the researcher is attempting to make the report more personal. c. the technique violates the protection of human subjects. d. the technique ensures that the proper level of data saturation has been reached.

ANS: A

Feedback

A B C D

Direct quotes allow the reader to evaluate what the participants said and how the researcher labeled what was said.

Using quotes is not a researcher’s attempt to make a report personal. Using direct quotes in consistent with phenomenological method.

Using direct quotes does not violate human subject rights as long as the researcher does not cite the participant’s real name.

Use of direct quotes is a part of data reporting and not related to data saturation.

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6. The foundation for the grounded theory method of qualitative research is: a. philosophy. b. spirituality. c. cultural anthropology. d. social science.

ANS: D

A B C D

Feedback Ethnographical studies emerged from cultural anthropology.

Spirituality is not a source of research.

Phenomenology stems from philosophy.

Grounded theory was originally developed as a tool to study interactions in social settings.

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CogN niU tivReSLI evNelG :T UB nd. erC stO anMding (Comprehension)

7. The purpose of grounded theory is: a. to expand the scope of nursing practice into areas formerly reserved for other

disciplines. b. to provide an exhaustive description of how individuals or groups have

experienced an event. c. to examine patterns of action and interaction between and among various types of

social units. d. to identify precepts and mores common to all members of a distinct cultural or

ethnic group.

ANS: C

A B C D

Feedback Expanding research into other disciplines is not a focus of grounded theory.

Phenomenology examines lived human experience.

Grounded theorists are interested in social process and human interaction.

Ethnographical studies examine cultural aspects.

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8. Why is the literature review often limited in a study using grounded theory methods? a. Research using grounded theory methods is sparse. b. Grounded theory is more sensitive to cultural values than to the researcher’s

values. c. Theories are expected to emerge directly from the data and not from previous research. d. Limiting the literature review ensures that the researcher’s personal biases are bracketed.

ANS: C

A B C D

Feedback Grounded theory studies are not sparse.

Grounded theory does not focus specifically on cultural values.

Grounded theory emerges from the data and reflects the contextual values that are integral to the social processes being studied.

Limiting the literature review is not necessary for a researcher to bracket preconceived notions of a phenomenon.

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9. Which feature is characteristic of the grounded theory method of qualitative research? a. Data gathering and data analysis occur simultaneously. b. The researcher has also experienced the phenomenon being studied. c. A grounded theory study is based on only a single research question. d. Participants in a grounded tN hU eoRrySsItuNdG yTmBu. stCeO xpMerience the phenomenon

currently, during the study.

ANS: A

A B C D

Feedback Data analysis and data gathering occur simultaneously. Emerging patterns are identified by the researcher.

The researcher does not need to have experienced the phenomenon of interest.

Grounded theory studies often have multiple questions as the data emerge.

Study participants do not have to be currently experiencing the phenomenon.

The participants can provide a present account of a past experience.

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10. Which statement is consistent with an emic view of a factor or situation? a. Health care provider’s statement that Native Americans are stoic in the experience

of pain b. Kindergarten teacher’s statement that there are fewer discipline problems among

Asian children c. The National Cancer Institute’s report that the incidence rate of prostate cancer is

high among African American men d. White teenager’s statement that being “skinny” is more socially acceptable than

having a higher weight ANS: D

A B C D

Feedback The health care provider’s statement provides an outsider’s view or etic view.

The kindergarten teacher’s statement provides an etic view.

The National Cancer Institute’s report provides an etic view.

Emic refers to an “insider’s” view. The teenager’s statement provides a view on weight as it is experienced by the teenager.

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11. Which title suggests an ethnographical study? a. The phenomenon of breast self-examination among African American women b. The lived experience of breast cancer in postmenopausal women c. The need for culturally sensitive cancer prevention patient education materials d. The challenge of retaining femininity after mastectomy ANS: A

A B C D

Feedback Researchers use the ethnographical method to examine cultural variations in health. The other answers do not refer to issues of cultural behavior.

Lived experience is consistent with phenomenology research.

The need for culturally senNsU itR ivS eI edNuG caTtiB on.aC lO mM aterial is a patient need but not a research study.

Femininity after mastectomy is not a research topic that specifically addresses issues of cultural variations.

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12. What criterion of scientific rigor for qualitative research is met when the research report leads

the reader from the research question and raw data through the steps of analysis and interpretation of the data? a. Confirmability b. Auditability c. Fittingness d. Credibility ANS: B

A B C

Feedback “Confirmability” refers to the degree the research findings can be confirmed or corroborated by other studies.

“Auditability” refers to the adequacy of information that leads a reader through the steps of data analysis to interpretation of the findings.

“Fittingness” refers to the study’s faithfulness to everyday reality (e.g., if the

D

findings “ring true” to the reader).

“Credibility” refers to measures taken to ensure the accuracy of the findings, usually by cross-checking information with the participants.

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13. Which factor in a research report indicates that the study used a qualitative design? a. Hypotheses are stated in the report. b. The sample is described as convenient. c. People who participated in the study are described as informants. d. Participants completed a questionnaire to measure their understanding of the topic.

ANS: C

A B C D

Feedback Hypotheses are stated in correlational and experimental quantitative research studies.

The sample in qualitative studies is purposive, meeting specific inclusion and exclusion criteria.

The term “informants” points to a qualitative study, specifically ethnographical design studies.

Questionnaires suggest survey research or tests to measure knowledge, which are associated with quantitative, not qualitative, research.

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14. The nurse planning to conduct a qualitative research study. Which statement is most accurate

regarding ethical issues in naturalistic settings? a. It is not possible to obtain informed consent from study participants. b. The emerging nature of the research design may require ongoing negotiation of consent. c. The researcher-participant interaction is intentionally therapeutic in nature. d. Validation of data by cross-checking research findings with participants taints the study.

ANS: B

A B C D

Feedback Informed consent is required for studies in naturalistic settings.

The emerging nature of the design might require ongoing consent related to possible risks posed by the study.

The intent of the researcher is not to be therapeutic because this is not a treatment relationship.

Data validation by participants often occurs in studies, but it varies on the basis of the research approach.

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15. A nurse researcher has chosen to use the phenomenological method. What feature

distinguishes the intensive dialogue the researcher will use in this method from a simple interview? a. Notes are made about the participant’s responses during the interview. b. The researcher is fully engaged, becoming a thoughtful presence during the interview. c. The questions posed during the interview were developed before the actual interview occurred. d. The researcher completes the questionnaire for the participant to avoid misunderstanding or confusion.

ANS: B

A B C D

Feedback Notes can be taken in both an intensive dialogue and a simple interview.

Dialogue extends beyond the simple interview because the interviewer is actively present and engaged in the dialogue.

Questions can be developed beforehand for both an intensive dialogue and a simple interview.

Researchers do not complete questionnaires for participants because the goal is to hear the lived experience through the words of the participant.

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16. The nurse researcher has optedNtoUu unTdB ed.tChO eoMry as the research method. Compared RsSe IgrNoG

with phenomenological research, which data-gathering technique is unique to grounded theory research? a. Face-to-face interviews b. Tape-recorded interviews c. Participant-written responses to written questions d. Skilled observation of individuals in a social setting ANS: D

A B C D

Feedback Phenomenologists can use face-to-face interviews.

Phenomenologists can use tape-recorded interviews.

Phenomenologists can use participant-written responses.

Grounded theorists observe participants in their natural settings. This observation practice is referred to as “fieldwork.” Phenomenologists do not use fieldwork.

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17. A research question appropriate for a grounded theory approach is: a. How do incarcerated prisoners interact with fellow prisoners who are known

pedophiles?

b. How do Native American teenage girls select a method of contraception? c. What percent of primary education teachers also have a degree in nursing? d. How is the total number of clinical hours in a nursing program related to National

Council Licensure Examination (NCLEX) pass rates?

ANS: A

A B C D

Feedback The research question is appropriate because it focuses on human interaction.

The question does not focus on social processes related to human interactions.

The question does not focus on social processes related to human interactions.

The question does not focus on social processes related to human interactions.

PTS: 1 DIF: REF: Pages 108-109

Cognitive Level: Applying (Application)

18. The nurse researcher opts to use grounded theory as the research method. Which action or

behavior should be avoided in such a study? a. Following hunches about emerging patterns before data collection is completed b. Expressing the researcher’s opinions or values to the participants c. Changing the way experiences are collected or selected after the study has been initiated d. Expanding codes or data categories as the study progresses ANS: B

NURSINGTB.COM A B C D

Grounded theorists often pursue hunches as data emerge.

Researchers want to observe participants interacting in natural social settings.

Interjection of the researcher’s opinions and values disrupts the natural setting.

Emerging data can cause a researcher to change how experiences are observed or how data are collected.

Expanding data codes and categories is expected as data emerge.

PTS: 1 DIF: REF: Pages 106-107

Cognitive Level: Applying (Application)

19. Computer management of qualitative data can assist a nurse researcher in the research process

through: a. interpretation of data. b. organization of data. c. credibility of data. d. synthesis of data.

ANS: B

A B

Feedback Interpretation of data must be done by researchers.

Computer management of qualitative data allows for easier coding of data and assists with the grouping or organizing of data. Some computer software can

C D

also assist in finding patterns in the interviews or field notes.

Credibility of data is established by researchers.

Analysis of the meaning of data is accomplished by researchers.

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20. In an ethnographical study titled, “How do rural Appalachian families with preschool children

define and practice health?” the researcher gathered data from mothers who were identified as the primary directors of health care within the family unit. What role did the mothers have in this study? a. Community informants b. General informants c. Local informants d. Key informants ANS: D

A B C D

Feedback “Community informants” is not the proper term for the participants.

“General informants” is not the proper term for these participants.

“Local informants” is not the proper term for these participants.

Key informants are individuals who have special knowledge and, therefore, can teach the ethnographer about a phenomenon.

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21. Which research question will indicate to the nurse researcher that an ethnographical approach

was used in the research study? a. In what ways do Puerto Rican women learn about health information? b. What is the quality of life for persons living with human immunodeficiency virus (HIV)? c. What was Nightingale’s involvement in sanitary reforms during the 1860s? d. How do individuals who have heart disease experience anger?

ANS: A

A

B C D

Feedback Ethnographical studies address questions that concern how cultural knowledge, norms, values, and other contextual variables influence a person’s health experience.

Quality of life is a day-to-day experience, more consistent with phenomenology than ethnography.

An examination of Nightingale would be a historical study.

The experience of anger is consistent with a phenomenological approach.

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MULTIPLE RESPONSE 1. A nurse researcher conducts a grounded theory study examining the process of social support

that occurs within interactions between nursing students and clinical faculty in the hospital setting. Which research activities are consistent with a grounded theory study? (Select all that apply.) a. Using theoretical sampling b. Having one set of predetermined interview questions c. Visiting the archives at the school of nursing d. Changing approaches to data collection as data emerge e. Asking only one research question to avoid confusing participants ANS: A, D Feedback Correct

Incorrect

Theoretical sampling is used in grounded theory research.

The researcher in a grounded theory study may change approaches to data collection.

A grounded theory study may have multiple questions as data are collected and interpreted.

Visiting archives would be consistent with a historical study.

The researcher in a grounded theory study may develop multiple questions as data are collected.

PTS: 1 DIF: REF: Pages 108-109

Cognitive Level: Applying (Application)

2. A nurse researcher is critiquingNaUrR esSeI arN chGrT epBo.rtCoOf M a phenomenological study that examined

the lived experience of domestic violence. The nurse should recognize which elements as consistent with a phenomenological research report? (Select all that apply.) a. Open-ended questions were used to ask participants to describe experiences with domestic violence. b. Data about domestic violence reported by participants are presented in the form of narrative text. c. The natural setting in which fieldwork was conducted is described in detail. d. The data analysis section discusses use of a statistical software package. e. The sampling section indicates the criteria for participation included a current unstable domestic relationship.

ANS: A, B Feedback Correct

Incorrect

Open-ended questions are used in phenomenological studies to encourage participants to describe their experiences in their own words.

Phenomenological studies present data in the form of narrative text.

Fieldwork is more commonly associated with ethnographical research.

Statistical analysis is conducted in quantitative research.

Participants would not be required to be in a violent domestic relationship at the present time. Phenomenologists believe that past experiences can also be shared in the present moment.

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3. Which are ethical concerns that the nurse must consider when evaluating qualitative research?

(Select all that apply.) a. Researchers can focus on the emic, rather than the etic, view of participants’ experiences. b. Researchers and participants may develop relationships that blur boundaries of their interactions. c. Researchers may want to speak to participants on more than one occasion. d. Researchers serve as instruments for data interpretation. e. Researchers may change the research design as knowledge emerges, thus altering risks to participants.

ANS: B, D, E Feedback Correct

Incorrect

Designs that require interactions between participants and researchers over time can result in blurred relationship boundaries.

Researchers serve as instruments for data interpretation, so personal viewpoints can blur proper interpretation of participant accounts.

An emergent design, such as grounded theory, might cause the researcher to change the approaches of the study and, therefore, alter risks to participants.

The researcher’s goal is to describe participant experiences from the emic perspective.

It is not unusual forNpU arR tiS ciI paNnG tsTtoBb.eCint erviewed more than once in OM qualitative studies.

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4. Criteria are used to judge a qualitative study’s scientific rigor include: (Select all that apply.) a. reality based. b. credibility. c. confidentiality of participants. d. auditability. e. recordkeeping. f. fittingness.

ANS: B, D, F Feedback Correct

This is the truth of the findings as judged by the participants and others within the discipline.

This is accountability as judged by the adequacy of the information leading the reader from the research question and raw data through various steps of analysis to the interpretation of findings.

This is faithfulness to everyday reality of the participants, described so that others in the discipline can evaluate importance for their own practice, research, and theory development.

Incorrect

“Reality based” is not a criterion used to judge a study’s scientific rigor.

“Confidentiality of participants” is not a criterion used to judge a study’s scientific rigor.

“Recordkeeping” is not a criterion used to judge a study’s scientific rigor.

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5. A nurse researcher critiques a phenomenological study for fittingness. The researcher will

examine the study to see whether the study included: (Select all that apply.) a. queried participants to confirm identified themes. b. documented the bracketing process used to maintain proper perspective. c. described the experiences of participants in a way that “rings true” for the reader. d. presented narrative in a way that captures everyday reality of participants. e. discussed in detail the process through which identified themes emerged.

ANS: C, D Feedback Correct

Incorrect

Describing the experiences in a way that “rings true” is an example of fittingness.

Using narrative helps to keep the research faithful to the experience of participants and provides support for fittingness.

Cross-checking with participants helps to support credibility of the study.

Bracketing also helps to support credibility of the study.

Detailing the process by which themes emerge is part of the study’s auditability.

NURSINGTB.COM

PTS: 1 DIF: REF: Page 120, Table 6-2

Cognitive Level: Understanding (Comprehension)

6. What similarities exist between grounded theory and ethnographical studies? (Select all that

apply.) a. Participants are observed in natural settings. b. Researchers immerse themselves in the culture of study participants. c. Researchers bracket their personal opinions and biases during the study. d. Data gathering and data analysis occur simultaneously. e. Techniques for data collection can change as the study progresses.

ANS: A, C, D, E Feedback Correct

Incorrect

PTS: 1

In both methods, researchers encounter participants in natural settings.

In both methods, researchers set aside or bracket their personal biases.

In both methods, data gathering and data analysis occur simultaneously.

In both methods, researchers use a variety of data-collection methods as studies progress.

Immersion into the culture of participants is consistent only with ethnography.

DIF:

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REF: Pages 106-107

NURSINGTB.COM

Chapter 07: Appraising Qualitative Research LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. In the report of a qualitative research study, a theme represents: a. a guideline for evaluating the appropriateness of the study. b. the operational definition of the study’s conceptual framework. c. a label that describes key ideas shared by study participants. d. the relationship between the study’s hypotheses and the research questions.

ANS: C

A B C D

Feedback A theme is not a guideline for evaluation of the study.

Conceptual frameworks are found in reports of quantitative, not qualitative, studies.

A theme is a label (concept or phrase) that describes in a condensed way a key idea shared by study participants, usually derived from interviews.

Hypotheses are characteristics of quantitative, not qualitative, studies.

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im anNt G wT heBn.rC evOieMwing findings of a qualitative research 2. The identification of themes is N UpRoSrtI report because themes: a. reflect congruence between the questions asked and the methodology. b. allow description of a large quantity of data in a condensed format. c. demonstrate both the emic and etic views of a topic. d. explain the nature of differences reported by participants experiencing a common phenomenon.

ANS: B

A B C D

Feedback Themes do not reflect congruence between the study’s questions and methods.

Themes allow a condensed representation of quotes or indicators of the same idea from multiple participants.

Themes reflect emic, not etic, perspectives.

Differences reported by participants are not reflected in a single theme.

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3. Which of these titles of a research report indicates the study is qualitative, rather than

quantitative? a. Predicting the treatment choice for women older than age 50 experiencing breast cancer

b. Evaluating nursing interventions for complex oncology clinical phenomena c. Using virtual reality as a distraction method during chemotherapy d. Transcending pain during bone marrow aspiration ANS: D

A B C D

Feedback This title suggests a quantitative study in which statistical analysis is used.

This title suggests a quantitative study that predicts a treatment choice.

This title suggests a quantitative study in which virtual reality is the experimental variable.

This title suggests a qualitative study because it describes responses to a human experience.

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4. Which outcome or overall purpose would be consistent with a qualitative study? a. Development of creative solutions to practical problems b. Prediction and control of a human phenomenon c. Description of behavior within a context-free theoretical framework d. Use of statistical analyses to determine significant differences between variables ANS: A

A B C

D

Feedback A characteristic of many qualitative research studies is the development of new NURSINGTB.COM and creative solutions to practical problems.

Prediction and control of phenomena are characteristics of quantitative research.

Both quantitative and qualitative research studies must be interpreted within context. Theoretical frameworks are consistent with both qualitative and quantitative research.

Statistical analysis to determine significant differences is characteristic of quantitative studies.

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Cognitive Level: Applying (Application)

5. Which criterion helps to determine whether the results of a qualitative study can be applied

beyond the study sample or population? a. Evidence of fittingness or transferability of the findings b. Evidence of trustworthiness or validity of the findings c. Credentials and experience of the person applying the findings d. Statistical significance and reliability of the findings ANS: A

A

Feedback The findings of qualitative studies should not be applied beyond the study sample unless evidence is provided for the study’s transferability or fittingness.

B C D

Evidence of trustworthiness or validity of the findings applies to the study, only, and does not imply transferability beyond the study population.

Although credentials of the person applying the findings are important, they do not guarantee that the application beyond the study population is appropriate.

The statistical significance and reliability measurements of findings are characteristics of quantitative research findings.

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6. Before applying the results of a qualitative study in practice, the nurse should take several

actions including: a. use triangulation to combine quantitative and qualitative methods in a replication study. b. evaluate the credentials and experience of the researcher who conducted the study. c. determine if the concepts/themes identified in the study support the work completed by other researchers. d. be sure that the study’s findings were significant at the 0.05 or greater level of probability.

ANS: C

A

B C D

Feedback Triangulation is used to strengthen the research design of a study by combining multiple measures (e.g., qualitative and quantitative methods). The consumer of research need not replicate a study before using the findings.

Although credentials of thN eU inRvS esI tiN gaGtoTrBar.eCim OpMortant, they do not ensure the applicability of a study in actual practice.

One way to determine generalizability of findings is to determine if the study supports the work completed by other researchers.

Statistical significance generally is not measured in qualitative studies.

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7. What information in the report of a qualitative research study indicates to the nurse that the

research meets the criterion of auditability? a. The study’s participants recognize the experience described as their own. b. The results are meaningful to individuals beyond those in the study population. c. The projected significance of the study to nursing is described. d. The researcher documented how the data led to the conclusions.

ANS: D

A B C

Feedback The participants’ recognition of the experience described as their own is part of the study’s credibility.

The application of findings to persons beyond the study sample is part of the study’s transferability.

The significance of the study to nursing is part of the study’s implications.

D

Auditability is determined by the researcher’s documentation of the research process leading to the study’s conclusions.

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8. The nurse researcher reports that after data collection was completed, a follow-up focus group

session with participants was used to validate that the participants agreed the findings were true to their own experiences. What aspect of the study does this support? a. The study’s credibility b. The study’s auditability c. The study’s transferability d. The study’s fittingness ANS: A

A B C D

Feedback The participants’ agreement with the study’s findings supports the study’s credibility.

Auditability of the study requires that others can follow the evidence trail of the primary researcher.

Transferability refers to the usefulness of the study beyond the sample population.

Fittingness is another term for transferability, which refers to the usefulness of the study beyond the sample population.

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CogN niU tivReSLI evNelG :T UnBd. erC stO anMding (Comprehension)

9. Qualitative research is designed to describe: a. results of hypothesis testing. b. definitive conclusions to research questions. c. insiders’ views of a human phenomenon. d. findings derived from a large, randomly selected sample.

ANS: C

A B C D

Feedback Hypothesis testing is characteristic of quantitative studies.

Definitive conclusions are typical of quantitative studies.

Qualitative research studies insider or emic knowledge of a phenomenon.

Large, random samples are typical of quantitative studies.

PTS: 1 DIF: REF: Pages 125-127 10.

Cognitive Level: Remembering (Knowledge)

Which activity represents attention to credibility in a qualitative study? a. Ensuring that all subjects self-identified with a specific ethnic group b. Providing direct quotations from study participants c. Identifying the basic social psychological process (BSP) under study

d. Determining usefulness of the data outside of the study ANS: B

A B C D

Feedback Ensuring subject identification with an ethnic group helps to identify the characteristics of the study sample.

Using selected quotes of participants to support themes enhances a study’s credibility.

The BSP, or core variable, under study characterizes grounded theory studies.

Determining the usefulness of the data outside of the study is related to transferability of the study’s findings.

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11. During the critique of a qualitative research study, the nurse notes the statement, “Saturation

was achieved at the completion of 20 interviews.” What is the significance of this statement? a. The investigator should collect additional data. b. The data-collection period has ended. c. Purposive sampling is now required. d. Random sampling should be initiated.

ANS: B

A B

C D

Feedback There is no need to collect additional data once saturation has been achieved.

Saturation refers to the end of data collection because the results become repetitive, indicating that no additional knowledge is to be gained by continuing to add participants.

Purposive sampling is done from the initiation of data collection.

Random sampling is a characteristic of quantitative research studies.

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12. One outcome of collecting evidence about a phenomenon of interest in a qualitative research

study may be what? a. Triangulation of methodology b. Participant cross-checking c. Use of meta-synthesis d. Giving a voice to disenfranchised individuals ANS: D

A B C

Feedback Triangulation is used to strengthen the research design of a study by combining multiple measures in the study’s methodology.

Cross-checking participants’ data helps in establishing a study’s credibility.

Meta-synthesis is a method of synthesizing findings from a number of

D

qualitative research studies.

Because application of qualitative findings is context-bound, a qualitative study can give a voice to disenfranchised individuals who previously had no documented history.

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13. Which study characteristic would indicate that a grounded theory approach, rather than a

phenomenological approach, was used? a. Data were collected by more than one person. b. Participants reviewed and evaluated the transcripts for accuracy. c. The focus was on the process elements of the phenomenon. d. It studied a lived human experience.

ANS: C

A B C D

Feedback Collection of data by more than one person is a characteristic of many types of study.

Checking of participants’ transcripts for accuracy is used in many types of qualitative study.

Grounded theory focuses on identifying the process elements of a phenomenon, not only on describing the phenomenon.

All types of qualitative study including phenomenology are focused on lived human experience.

NURSINGTB.COM PTS: 1 DIF: REF: Pages 125-126

Cognitive Level: Understanding (Comprehension)

14. The nurse is critiquing a qualitative research study. Which question would be appropriate for

the nurse to ask when critiquing the study’s methodology? a. Are the informants who were chosen appropriate to inform the research? b. If a particular approach is used to guide the inquiry, does the researcher complete the study according to the processes described? c. Does the researcher address the credibility, auditability, and fittingness of the data? d. Does the researcher place the report in the context of what is already known about the phenomenon (e.g., the existing literature)?

ANS: B

A B C D

Feedback A question about the informants chosen concerns the study’s sample selection.

A question about the study’s approach or processes for conducting the study concerns its methodology.

Questions about credibility, auditability, and fittingness concern the analysis of data.

A question about placing the report in the context of what is already known concerns the study’s findings.

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15. The nurse is critiquing a qualitative research study. Which question would be appropriate for

the nurse to ask when critiquing the study’s sample selection? a. Are the informants who were chosen appropriate to inform the research? b. If a particular approach is used to guide the inquiry, does the researcher complete the study according to the processes described? c. Does the researcher address the credibility, auditability, and fittingness of the data? d. Does the researcher place the report in the context of what is already known about the phenomenon (e.g., the existing literature)?

ANS: A

A B C D

Feedback A question about the informants who were chosen concerns the study’s sample selection.

A question about the study’s approach or processes for conducting the study concerns its methodology.

Questions about credibility, auditability, and fittingness concern the analysis of data.

A question about placing the report in the context of what is already known concerns the study’s findings.

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NURSINGTB.COM 16. The nurse is critiquing a qualitative research study. Which question would be appropriate for

the nurse to ask when critiquing the study’s credibility? a. Has adequate time been allowed to fully understand the phenomenon? b. Are the results meaningful to individuals not involved in the research? c. Does the investigator document the research process? d. What is the projected significance of the research to nursing?

ANS: A

A B

C D

Feedback The study’s credibility is addressed in a question about sufficient time to fully understand the phenomenon.

A study’s fittingness (transferability) is addressed in a question about the meaningfulness of the study’s results to persons not involved in the research concerns.

A study’s auditability is addressed in a question about documentation of the research process.

A study’s purpose is addressed in a question about the significance of the study to nursing.

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17. The nurse is critiquing a qualitative research study. Which question would be appropriate for

the nurse to ask when critiquing the study’s fittingness? a. Has adequate time been allowed to fully understand the phenomenon? b. Are the results meaningful to individuals not involved in the research? c. Does the investigator document the research process? d. What is the projected significance of the research to nursing?

ANS: B

A B

C D

Feedback The study’s credibility is addressed in a question about sufficient time to fully understand the phenomenon.

A study’s fittingness (transferability) is addressed in a question about the meaningfulness of the study’s results to persons not involved in the research concerns.

A study’s auditability is addressed in a question about documentation of the research process.

A study’s purpose is addressed in a question about the significance of the study to nursing.

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18. When critiquing a report of a qualitative research study, the nurse asks, “How has the

researcher made explicit the significance of the study to nursing theory, research, or practice?”

This question is critiquing what section of the report? a. Data analysis b. Data collection c. Statement of the phenomenon of interest d. Conclusions, implications, and recommendations ANS: D

A B C D

Feedback This question does not address the study’s data analysis.

This question does not address the study’s data collection.

This question does not address the statement of the phenomenon of interest.

This question addresses the study’s conclusions, implications, and recommendations.

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19. When critiquing a report of a qualitative research study, the nurse asks, “Is protection of

human participants addressed?” This question is critiquing what section of the report? a. Data analysis b. Data collection c. Statement of the phenomenon of interest d. Conclusions, implications, and recommendations ANS: B

A B C D

Feedback This question does not address the study’s data analysis.

This question addresses the study’s data collection.

This question does not address the statement of the phenomenon of interest.

This question does not address the study’s conclusions, implications, and recommendations.

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20. When critiquing a qualitative research study, the nurse asks, “Has the researcher remained

true to the data?” This question is critiquing which area of the report? a. Method b. Data collection c. Data analysis d. Findings ANS: C

A B C D

Feedback This question does not address the study’s methods.

This question does not address the study’s data collection.

This question addresses the study’s data analysis.

This question does not address the study’s findings.

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CogN niU tivReSLI evNelG :T UB nd. erC stO anMding (Comprehension)

MULTIPLE RESPONSE 1. Which of the following elements would the nurse expect to see in a report of a grounded

theory study? (Select all that apply.) a. Hypotheses b. Independent variable c. Themes d. Basic social psychological process e. Statistical procedures f. Participant quotes g. Purposive sample ANS: C, D, F, G Feedback Correct

Themes are identified in a grounded research study.

A basic social psychological process (BSP) is defined in a grounded research study.

Participant quotes are included in a grounded research study to fully describe the phenomenon in a grounded research study.

A purposive sample is selected for a grounded research study.

Incorrect

Hypotheses are used in quantitative, not qualitative, research studies.

Independent and dependent variables are found in quantitative, not qualitative, research studies.

Statistical procedures are used in quantitative studies but generally are not used in qualitative studies.

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NURSINGTB.COM

Chapter 08: Introduction to Quantitative Research LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. The measures used by a nurse researcher to maintain uniformity of conditions in a quantitative

research study refer to: a. accuracy. b. methods. c. control. d. validity.

ANS: C

A B C D

Feedback Accuracy refers to all aspects of a study systematically and logically following from the research question.

Methods refers to sections of the research study that include sampling, data collection, and data analysis.

Control is the term used for measures taken by the researcher to keep the conditions of a study uniform.

Validity refers to the truthfulness or soundness of a study.

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NURSINGTB.COM

2. The overall purpose of the research design in a quantitative research study is: a. to determine sample size. b. to identify the problem statement. c. to assist the researcher in identifying gaps in the knowledge base. d. to provide the plan for answering the research question.

ANS: D

A B C D

Feedback Sample size is determined by the chosen design or by a power analysis.

The problem statement describes the general focus of the research study.

Gaps in knowledge should be identified and synthesized in the literature review.

The purpose of the research design is to provide the plan for answering the research question(s).

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3. In which of these ways does the nurse researcher’s literature review help select the appropriate

study design? a. By enlarging the scope of the study’s hypotheses b. By objectively assessing available knowledge of the area

c. By comparing current findings with previous study findings d. By ensuring faithfulness to the study’s purpose ANS: B

A B C

D

Feedback The literature review gives the researcher clues about the direction and nature of the hypotheses but not necessarily their scope.

Objectivity in the conceptualization of the research question is derived from a thorough review of the literature.

The literature review does give information about past studies, but the research design is obtained by considering the best approach to answer the research question.

The literature review does not ensure fidelity to study purpose; the research design serves this role.

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4. When reviewing a research report, the nurse determines that all aspects of a study

systematically and logically follow from the research problem. Which condition has been met? a. Accuracy b. Feasibility c. Internal validity d. External validity ANS: A

A B C D

Feedback Accuracy indicates that all aspects of a study systematically and logically flow from the research question.

Feasibility refers to a study’s pragmatic concerns (e.g., availability of subjects, time required).

Internal validity refers to whether the independent variable made the change in the dependent variable.

External validity refers to the generalizability of the investigation’s findings to additional populations and other environmental conditions.

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5. Which factor is most likely to be a mediating (extraneous) variable in a study to determine if

high doses of vitamin C help reduce the subjects’ susceptibility to influenza? a. The subjects’ use of influenza vaccine b. The subject’ knowledge of vitamin C’s functions c. The gender of the potential subjects d. The marital status of the potential subjects ANS: A

A

B C D

Feedback An extraneous or mediating variable is one that interferes with the operations of the variables being studied, such as the study’s outcome, which is susceptibility to influenza.

A subject’s knowledge of vitamin C’s functions is not likely to act as a mediating variable in this study.

The gender of participants is not likely to act as a mediating variable in this instance.

The marital status of subjects is not likely to act as a mediating variable in this scenario.

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6. A nurse researcher is designing a quantitative research study involving a specific group of

patients admitted to local hospitals. Which factor would negatively affect the feasibility of this study? a. The local region has a high percentage of families that could participate in the study. b. Potential study subjects represented less than 1% of hospital admissions during the year previous to the study. c. Study participants who were hospitalized children younger than 5 years could not give direct informed consent to participate in the study. d. A comprehensive review of the literature revealed no studies were conducted that examined this question during the past 15 years.

ANS: B

A B C D

Feedback The wide availability of subjects could positively affect the feasibility of the study.

Feasibility refers to the pragmatic considerations of a study (e.g., availability of subjects, cost).

Informed consent for children would not affect the availability of subjects.

Lack of previous studies would suggest a need for the study but does not influence feasibility.

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7. A nurse is designing a study to determine whether a videotape or a written pamphlet is more

effective in teaching young women how to perform breast self-examination (BSE). Which of these actions would provide the best control for a mediating (extraneous) variable? a. Include identical content in both BSE teaching methods. b. Exclude subjects who already perform BSE on a regular basis. c. Limit the study subjects to women who are heterosexual. d. Determine what breast cancer means to the individual participants.

ANS: B

A B C D

Feedback Identical content would help control the experimental variables by standardizing content, but it would not control mediating variables.

Subjects who were already performing BSE would not be appropriate to include in the study.

Sexual orientation does not affect a woman’s need to perform BSE; it is not a mediating variable.

The meaning of breast cancer to participants would not control a mediating variable in this situation.

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8. How would a nurse researcher ensure that the sample used in a quantitative study is

homogeneous? a. Use eligibility criteria to limit extraneous variables relevant to the study. b. Randomly assign subjects to either the experimental or the control group. c. Assign one research assistant to collect data from all subjects. d. Collect data from all subjects at the same time of day.

ANS: A

A B C D

Feedback Homogeneity of a sample is ensured by restricting eligibility criteria.

Random assignment to experimental or control groups helps avoid bias but does not ensure homogeneity of the sample.

Data collection by one resN eaUrcRhS erIhNeG lpT sB en.sC urO eM consistency in data collection but does not ensure a homogenous sample.

Uniform timing of data collection helps ensure consistency of data collection but does not ensure a homogeneous sample.

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9. How could a nurse researcher’s use of a homogeneous sample weaken a research study? a. By decreasing the reliability of the findings b. By decreasing the generalizability of the findings c. By changing the statistical significance of findings d. By increasing the risk that the findings were the result of chance alone ANS: B

A B C D

Feedback Homogeneity of a sample would not necessarily affect reliability.

Homogeneity of a sample can decrease the generalizability of the findings to other populations.

Homogeneity of a sample does not mandate a larger sample size.

Homogeneity does not increase the likelihood of chance findings.

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REF: Page 153 10. Why should a nurse researcher want to limit or eliminate extraneous (mediating) variables in a

study? a. More research questions would be required to account for the extraneous variables. b. Extensive statistical analysis would be required to justify the presence of extraneous variables. c. Extraneous variables compete with the independent variables as explanations of the study’s outcome. d. Manipulation of the extraneous variables increases the risk for researcher bias in the study’s outcomes.

ANS: C

A B C D

Feedback Research questions are not necessarily linked to or controlling of extraneous variables.

Statistical analysis cannot justify the presence of extraneous variables, although it may be able to estimate the magnitude of their effect.

Extraneous or mediating variables interfere with analyzing the effect of the independent variables on the dependent variable.

Manipulation of extraneous variables does not necessarily increase (or decrease) the risk for researcher bias.

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NURSINGTB.COM 11. When should a nurse researcher include an extraneous (mediating) variable as part of a

study’s design? a. When excluding the variable would limit the study’s generalizability b. When the variable is an important consideration for the study’s outcome c. When the researcher is limited by time or monetary constraints d. When it would not make a difference in the overall study outcome ANS: B

A

B C D

Feedback Excluding extraneous variables frequently limits a study’s generalizability to a larger population. This is often necessary in order to have meaningful, unambiguous study outcomes.

If the researcher believes that an extraneous variable is important to the outcome, it should be included in the design.

Time and financial demands should not solely influence the inclusion of extraneous variables in a study’s design.

Extraneous or mediating variables are a concern only if they may influence the outcome of a study. If a variable has no relationship to the study’s outcome, it would be superfluous to include it in the study design.

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12. A study is examining the effect of a new antilipemic drug, compared with placebo, on

lipoprotein levels in postmenopausal women. Which of these actions represents the researcher’s attempt at constancy in data collection to control extraneous (mediating) variables? a. Drawing the serum lipoprotein levels of all subjects at the same time of day b. Having the same phlebotomist draw serum lipoprotein levels of all subjects c. Using the same room for drawing blood for lipoprotein levels of all subjects d. Ensuring that all subjects are postmenopausal women taking lipid-lowering medication ANS: A

A

B C D

Feedback Constancy in data collection (e.g., identical timing of collecting blood samples) helps maintain control in the research design because lipid levels may fluctuate throughout the day.

In this scenario, it is not necessary for the same person drawing blood samples to maintain constancy of measurement.

The same room for blood draws is not necessary to maintain constancy of measurement.

If subjects were already receiving antilipemic medication, it would be extremely difficult to distinguish the effects of the new treatment.

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NURSINGTB.COM 13. A nurse researcher assigns half a study sample to an experimental group and the other half to

a control group. What does this action represent? a. Instrumentation of the independent variable b. Manipulation of the mediating variable c. Elimination of the mediating variable d. Manipulation of the independent variable ANS: D

A B C D

Feedback Separating subjects into treatment and control groups does not represent instrumentation of the independent variable.

A mediating or extraneous variable is usually controlled rather than manipulated.

Separation of study subjects into treatment and control groups does not by itself eliminate mediating variables.

Administration of a treatment or intervention to an experimental (treatment) group and not to a control group represents manipulation of the independent variable.

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14. For which of these reasons would a nurse researcher choose to assign subjects randomly to

groups in a study? a. To help ensure that all groups within a study are representative of the larger population b. To increase the chance that the study groups will be different from each other with regard to extraneous variables c. To help ensure that current events do not influence the outcomes of the study d. To eliminate the need for establishing specific study criteria and subject eligibility ANS: A

A B C D

Feedback The purpose of randomization is to help ensure that subjects in the study’s groups represent the larger population.

Randomization helps to ensure that study groups will be approximately equal, not different with regard to extraneous variables.

Randomization cannot control current historical events.

Randomization does not eliminate the need for study criteria and subject eligibility factors.

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15. A nurse researcher assigns subjects to experimental and control groups in such a manner that

each subject in a population has an equal chance of being selected. What is the researcher using? a. Selection bias b. Convenience sampling c. Randomization d. Internal validity ANS: C

A B C D

Feedback Selection bias occurs when precautions are not used to gain a representative sample.

Convenience sampling refers to the sampling method in which subjects who are available are used. These subjects do not necessarily represent the population.

Randomization is the process of obtaining subjects so that each has an equal chance of being selected for experimental or control groups.

Internal validity refers to confidence that the independent variable made the difference in the dependent variable, not some extraneous, intervening variable.

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16. Which situation represents a threat to internal validity in an experimental study measuring the

effect of a videotape of discharge instructions for patients who underwent coronary artery bypass graft (CABG) surgery? a. Both men and women undergoing CABG surgery were included as subjects in the

study. b. Two new surgeons began performing CABG surgery during the study period. c. Patients in the experimental group discussed aspects of the videotape with patients

in the control group. d. Data collection for the videotape and control groups took 1 year.

ANS: C

A B C

D

Feedback Including both genders would strengthen the design and would not threaten internal validity.

Personnel factors like surgeons’ newly performing the procedure should not directly affect the treatment and threaten internal validity.

Sharing aspects of the videotape with control group members interferes with interpretation of the true effect of the independent variable on the dependent variable(s).

Duration of data collection does not threaten internal validity, provided the control processes were standardized.

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17. The nurse researcher designed a study examining anxiety among elementary school children.

If a widely publicized murder of a child occurred in the city during the time frame of the study, what type of threat to internal validity would the murder represent? a. Maturation b. Instrumentation c. Selection bias d. Historical ANS: D

A B C D

Feedback Maturation represents developmental, biological, or psychological processes within individuals occurring or changing as a function of time.

Instrumentation threats refer to changes in the measurement of variables or observational techniques that may change obtained measurement.

Selection bias occurs when precautions are not used to obtain a representative sample.

The murder would represent a historical event threatening internal validity.

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18. A nurse researcher should consider mortality a threat to the study’s internal validity because: a. there is concern that the intervention may have harmful effects on subjects. b. those who dropped out of the study may be different than those who remained in

the study. c. those who participated in the study may have died as a result of being in the study. d. there is concern that the design is inappropriate for the study question if a large

number of participants drop out of a study.

ANS: B

A B C D

Feedback Mortality does not refer to harmful aspects of an intervention but to attrition of subjects in a study.

Subjects who drop out or who are otherwise lost from a study may differ in some important way from remaining subjects and therefore threaten internal validity.

Mortality does not refer to treatment-related negative consequences in a study.

Loss of a large number of subjects does not necessarily make a design inappropriate for the study question.

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19. A nurse researcher can control for selection bias in a study by taking which of these actions? a. Allow subjects to self-select into an experimental or a control group. b. Handpick the subjects for group assignment. c. Use defined selection criteria for approaching potential subjects. d. Have someone other than the researcher select the subjects for the study.

ANS: C

A B C D

Feedback Self-selection could worsen selection bias, rather than control it.

Researcher bias in selectioNnUsR ubSjeIcN tsGcT ouBld.C wO orM sen selection bias.

Selection criteria (inclusive and exclusive) that are consistently applied help obtain a representative sample and decrease the risk of selection bias.

The researcher can select subjects, providing subjects meet specified selection criteria.

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20. External validity refers to: a. the relationship existing between the independent variable and the study outcomes. b. the influence of a specific event on the independent variable. c. the degree to which extraneous or mediating variables interfere with the study

outcomes. d. the degree to which findings are generalizable to populations beyond those studied.

ANS: D

A B

Feedback Internal validity refers to the relationship between the independent variable and the study outcomes.

Influence of a specific event (historical threat) on the study affects the dependent variable or outcome of the study. Thus it threatens internal validity and, ultimately, external validity.

C D

Extraneous or mediating variables are threats to internal validity because they may interfere with the treatment (independent variable) effects.

External validity deals with possible problems of generalizability of the investigation’s findings to other populations or environments.

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21. Which of these situations describes a reactive (Hawthorne) effect? a. Control subjects in an intervention study to reduce anxiety also experience a

reduction in anxiety. b. The subjects in an intervention support group continue the support group after the

study has ended. c. Subjects become concerned after learning that they received a placebo, not the

treatment, during the study. d. Study subjects want to know the outcomes of the study after it is completed.

ANS: A

A B C D

Feedback Reactivity occurs when control subjects respond to the investigator not because of the treatment but because of the fact they were being studied.

Continuing a treatment after a study is over is not necessarily related to reactive effects.

After a treatment is finished and the study is over, concern about the use of a placebo would not be a reactive effect.

TeBs.aC The desire to know about N stU udRySoIuN tcG om fteOrMthe study is finished is not a reactive effect.

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22. A nurse researcher is investigating the effect of type of operating room mattress and surgical

position on tissue interface pressures in healthy young adults. Which component of research is most affected by the choice of subjects? a. Mortality b. Instrumentation c. Internal validity d. External validity ANS: D

A B C D

Feedback Attrition of subjects (mortality) would not be affected by the choice of subjects.

Instrumentation to measure interface pressures would not be affected by the choice of subjects.

Internal validity would not be affected by the choice of subjects.

Subject selection affects external validity (generalizability), especially because most surgical patients are not healthy young adults.

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23. What action by a nurse researcher will help eliminate bias on the dependent variable? a. Establishing strict eligibility criteria for the study participants b. Ensuring that all data are collected by a single researcher c. Formulating at least two hypotheses for each research question d. Developing a strong theoretical framework for the study ANS: A

A

B C D

Feedback Strict eligibility criteria help reduce extraneous or mediating variables that compete with the study (independent) variables for impact on the dependent variable.

Collection of data by a single researcher would provide constancy in data collection but would not control bias if poor sampling techniques were used.

Formulating two hypotheses would not eliminate bias.

Testing of a theoretical framework does not by itself control bias.

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MULTIPLE RESPONSE 1. A nurse researcher is planning to write a proposal for a research study using a quantitative

design. To maintain control in N thU eR stS udIyN , tGhT eB nu.rsCeOsM hould include which elements? (Select all that apply.) a. Valid, reliable collection methods b. Subjects of all ages c. Trained data collectors d. Standardized data-collection processes e. Analysis of data by words or text only ANS: A, C, D Feedback Correct

Incorrect

Control requires valid, reliable instruments.

Trained research assistants help maintain standardized procedures and promote control.

Data-collection processes that are standardized promote control.

Subjects of all ages are not required for control.

Analysis of data by words or text is characteristic of qualitative designs.

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2. A nursing student is reviewing a research study in which researchers used a pretest/posttest

design to examine the effect of an AIDS education intervention on teenagers’ knowledge about the condition over a school year. What threats to internal validity could be present?

(Select all that apply.) a. Maturation b. Selection effects c. Reactivity d. Hawthorne effect e. Testing ANS: A, E Feedback Correct

Incorrect

Maturation could be an issue because the students may learn about AIDS from other sources over the school year.

Testing is a threat to internal validity because the use of a pretest may affect subjects’ subsequent responses to a posttest.

Selection effects affect external validity or generalizability of findings.

Reactivity, or the subjects’ responses to being studied, affects external validity.

The Hawthorne effect is another name for reactivity.

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3. What should the nurse researcher consider when determining the feasibility of a research

question? (Select all that applyN .)URSINGTB.COM a. Time b. Selection effects c. Reactive effects d. Measurement effects e. Subject availability f. Cost ANS: A, E, F Feedback Correct

Incorrect

The research question must be one that can be studied within a realistic time period.

The researcher must determine whether a sufficient number of eligible subjects will be available and willing to participate in the study.

Before embarking on a study, the researcher should itemize the expenses and project the total cost of the project.

Effects of selection occur when the researcher cannot attain the ideal sample population. This limits generalizability (external validity), not the feasibility of the study.

Reactivity is the subjects’ responses to being studied. It can be minimized by paying equal attention to the control group. It is not related to a study’s feasibility.

Measurement effects occur when a pretest affects the posttest results within a study.

They are not related to a study’s feasibility.

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4. Which factors would be considered threats to internal validity? (Select all that apply.) a. Time b. Selection effects c. History d. Testing e. Subject availability f. Cost g. Selection bias ANS: C, D, G Feedback Correct

Incorrect

History refers to events occurring outside the study setting that can affect the dependent variable.

Testing can affect the dependent variable because the effect of taking a pretest may affect the subjects’ posttest performance (the dependent variable).

Selection bias occurs if precautions are not taken to obtain a representative sample. Randomly assigning subjects to groups helps to minimize selection bias.

Time is a pragmatic consideration when determining the feasibility of a research question.

Selection effects occur when the researcher cannot attain the ideal sample population. This limits generalizability (external validity).

Subject availability is a pragmatic consideration when determining the feasibility of a research question.

Cost is a pragmatic consideration when determining the feasibility of a research question.

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5. Elements of intervention fidelity include: (Select all that apply.) a. design. b. randomization. c. training. d. delivery.

ANS: A, C, D Feedback Correct Incorrect

PTS: 1

The elements of intervention fidelity include design, training, delivery, receipt, and enactment.

The elements of intervention fidelity do not include randomization.

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REF: Pages 152-154

NURSINGTB.COM

Chapter 09: Experimental and Quasi-Experimental Designs LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. The nurse is critiquing a research study that used an experimental design. How can the nurse

determine if the study’s results are able to infer causality? a. The relationship between independent and dependent variables must be reciprocal. b. The relationship between independent and dependent variables must not be explainable by any other variable. c. Both independent and dependent variables should be characterized by reactive effects. d. Both independent and dependent variables should change as a result of the treatment.

ANS: B

A B C D

Feedback The relationship between independent and dependent variables is not necessarily reciprocal.

Critical to causality is the control of extraneous variables that may influence changes in the dependent variable.

Reactive effects are the subjects’ responses to being studied, which interfere with establishing a cause-and-effect relationship.

In a cause-and-effect relatiN onUsR hiS p,ItN heGiT ndBe. peCnO deMnt variable changes the dependent variable.

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2. The nurse is critiquing a research study that involves subjects undergoing chemotherapy for

breast cancer. Which finding would meet a criterion for inferring causality between performance of exercise and adaptive behavior of the subjects receiving chemotherapy? a. Adaptive behavior began before the exercise program was initiated. b. Adaptive behavior occurred in the control group over time. c. The level of adaptive behavior increased in direct proportion to an increase in the intensity of the exercise. d. No difference in adaptive behavior was observed between subjects in the experimental group and subjects in the control group.

ANS: C

A B C

Feedback A change in the dependent variable before treatment began would interfere with a cause-and-effect explanation of change.

A change in adaptive behavior in the control (no treatment) group would interfere with a cause-and-effect explanation of change.

Causality is supported by a clear proportional change in the dependent variable

D

(adaptive behavior) following a clear proportional change in the independent variable (exercise).

A lack of difference between groups would indicate that the independent variable (treatment) was not causally related to change in the dependent variable.

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3. The experimental treatment initiated by a researcher can be described as what kind of

variable? a. Independent b. Dependent c. Extraneous d. Outcome ANS: A

A B C D

Feedback The experimental treatment is the independent variable.

The dependent variable is the outcome variable.

An extraneous or intervening variable can interfere with establishing causality between the independent and dependent variable.

The outcome variable is the dependent variable.

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4. Which of these criteria is most important when evaluating the results of an experimental

research study? a. The size of the experimental group compared with the size of the control group. b. The validity that the experimental treatment caused the desired effect on the outcome. c. The congruence of research questions to the purpose and hypotheses. d. The ability of the researcher to apply the findings to clinical or practice settings.

ANS: B

A B C D

Feedback Although the groups should not be markedly different in size, findings of an experimental study are not ultimately judged by comparing group sizes.

The validity of experimental study results depends on how well the researcher has controlled alternative explanatory variables.

Although important, congruence of research questions, hypotheses, etc. is not the ultimate criterion for evaluating an experimental effect.

Clinical applicability does not guarantee the validity of experimental results.

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5. Compared with a quasi-experimental design, which of these characteristics should a nurse

expect to see only in a true experimental design? a. Experimental treatment b. Informed consent c. Hypotheses d. Random assignment ANS: D

A B C D

Feedback Experimental treatment is present in both quasi-experimental and true experimental designs.

Informed consent is required for all types of research involving human subjects.

Hypotheses are included in both quasi-experimental and true experimental designs.

Random assignment to groups is not present in a quasi-experimental study.

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6. Which factor should be the primary consideration when determining the validity of

experimental study findings? a. The extent to which the researcher controlled intervening variables b. The number of subjects who dropped out of the control and experimental groups c. The credentials and previous experience of the researcher d. The number of persons involved in the data-collection process

NURSINGTB.COM

ANS: A

A B C D

Feedback Control is the ultimate criterion in experimental research.

Although mortality (dropout rate) is important, it is not the primary consideration in determining the validity of the findings.

Although researcher credentials are important, they do not ensure experimental control.

The number of data collectors is not the primary criterion for determining the validity of conclusions.

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7. In which way is the independent variable handled differently in a study with a true

experimental design when compared with a study with a quasi-experimental design? a. An experimental design requires an independent variable, whereas a quasi-experimental design neither identifies nor requires an independent variable. b. Although both designs identify an independent variable, the nature of the groups (randomized vs non-randomized) means that manipulation may result in different results. c. Experimental designs demonstrate that the independent variable is related to the outcome, and quasi-experimental studies allow for independent variables that stand

alone. d. Although both designs identify an independent variable, experimental designs

identify it before the research is initiated, whereas quasi-experimental designs identify it after the data are analyzed.

ANS: B

A B C D

Feedback A quasi-experimental design includes both dependent and independent variables.

The major difference between experimental and quasi-experimental designs is the randomization of groups. Independent variables are manipulated in both designs.

Both experimental and quasi-experimental designs examine the relationship of dependent and independent variables.

In both experimental and quasi-experimental designs, variables are identified before the study begins.

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8. Random assignment of subjects to experimental and control groups produces which effect? a. Minimizes mortality within groups. b. Maximizes variance between groups. c. Decreases systematic bias. d. Increases selection bias.

ANS: C

A B

C

D

NURSINGTB.COM Feedback Randomization has no effect on mortality (dropout rate).

Randomization minimizes pretreatment variance between groups, rather than maximizing variance. This helps to ensure that posttreatment differences are related to the independent (treatment) variable alone.

Random assignment to groups helps to ensure that other (extraneous) variables that could affect changes in the dependent variable are equally distributed within groups, thus reducing systematic bias.

Randomization reduces selection bias, rather than increasing it.

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9. How does randomization strengthen an experimental study? a. It reduces the risk that a subject will be harmed by participation in the study. b. It ensures that the experimental group and the control group have the same number

of participants. c. It allows the study to proceed without the researcher knowing which group is the

experimental treatment group. d. It increases the likelihood that the differences in outcomes between the groups are

not related to chance alone.

ANS: D

A B C D

Feedback Randomization does not protect a research subject from harm.

Sampling techniques such as quota sampling ensure equal group size, not randomization.

Randomization does not blind the researcher to treatment group vs control group.

Randomization helps to ensure that any group differences that emerge in a study are related to the treatment condition and not to chance alone.

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10. Why is control important in an experimental research study? a. It ensures maintenance of participant confidentiality. b. It introduces one or more constants into the experimental situation. c. It prevents data collection from extending beyond the original time specified for

the study. d. It ensures a cause-and-effect relationship between independent and dependent

variables.

ANS: B

A B

C D

Feedback Participant confidentiality is protected by the researcher’s coding of subjects to mask their identity.

Control is essential to minimize the effects of extraneous variables on the interaction of the identified independent and dependent variables. Control of variables makes it possibleNtU oR exSpI laN inGaTsB tu. dyC’O sM findings with accuracy.

Control in an experimental design is not related to the time period of the study.

Control does not ensure a cause-and-effect relationship between the treatment variable and the outcome.

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11. In a true experimental study, the control group is the group that: a. receives the experimental treatment. b. receives the placebo treatment. c. experiences the adverse results. d. experiences the reactive effects.

ANS: B

A B C D

Feedback The group that receives the experimental treatment is the experimental group, not the control group.

In true experimental research, the control group is the group that receives the usual or a placebo treatment, rather than the experimental one.

The occurrence of adverse results is not confined to the control group and, in fact, is more likely in the treatment group.

Reactive (Hawthorne) effects are the effects of being studied, which can occur in

both experimental and control groups.

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12. Which action would increase the control of an experimental study? a. Establishing strict criteria for subject selection b. Allowing participants to decide whether or not to be in the experimental group c. Ensuring that subjects do not know the purpose of the experimental study d. Increasing the number of assistants involved in data collection ANS: A

A B C D

Feedback Strict subject selection criteria help to minimize bias and limit extraneous variables.

Self-selection for the treatment group would be likely to decrease control, increase bias, and limit the validity of study outcomes.

Subjects are entitled to know the purpose of a study via informed consent.

Increasing the number of research assistants to collect data can decrease control if they are not specially trained.

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13. A study of a program to help people quit cigarette smoking had three groups of subjects. The

first group received one supporN tiU veRpShI onNeGcT alB l.

10CdOaM ys after attending a program on strategies to resist smoking. A second group received a supportive phone call every week for 6 weeks after attending the program. A third group received no supportive phone calls after attending the program.

In the above scenario, which of these properties of experimental research is evident? a. Quasi-experimental design with no control group b. Random assignment to research groups c. Manipulation of the treatment dose d. Control of extraneous variables ANS: C

A B C D

Feedback The group receiving no phone call is the control group.

The scenario does not describe whether random assignment was used.

The scenario describes manipulation of the independent variable by varying the interventions (doses) of phone calls.

The scenario does not describe control of extraneous variables.

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Cognitive Level: Applying (Application)

14. A study of a program to help people quit cigarette smoking had three groups of subjects. The

first group received one supportive phone call 10 days after attending a program on strategies to resist smoking. A second group received a supportive phone call every week for 6 weeks after attending the program. A third group received no supportive phone calls after attending the program.

What is the dependent variable in the research scenario? a. Program on strategies to resist smoking b. Elimination of cigarette smoking c. Weekly supportive phone call d. No supportive phone call ANS: B

A B C D

Feedback The program of strategies to resist smoking was the independent variable.

The dependent (outcome) variable is quitting cigarette smoking.

The weekly supportive phone call was part of the treatment (independent) variable.

The control group received no supportive phone call.

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15. What type of threat to validity is minimized by the use of a Solomon four-group design? a. Mortality b. Selection bias c. Testing NURSINGTB.COM d. Antecedent variable ANS: C

A B

C D

Feedback Use of four groups does not control subject mortality (attrition rate).

The Solomon four-group design will not by itself minimize selection bias. Strict selection criteria and random assignment to groups are necessary to minimize selection bias.

Testing threats to internal validity are minimized by the Solomon four-group design.

Because antecedent variables such as motivation to learn existed prior to the study, they should be identified and measured before the study; differences can be statistically controlled. The Solomon four-group design, however, does not control antecedent variables.

PTS: 1 DIF: REF: Pages 170-172

Cognitive Level: Understanding (Comprehension)

16. An after-only non-equivalent control group design would be appropriate to study which of

these research questions? a. What is the effect of the cause of spousal death on widows’ self-esteem? b. What is the effect of preoperative teaching on vascular complications after

orthopedic surgery? c. What is the effect of a mentorship program on improvement of students’ clinical

performance in a baccalaureate nursing program? d. What is the effect of a videotaped teaching method on knowledge of adolescent

males about the warning signs of testicular cancer?

ANS: B

A B

C D

Feedback A qualitative approach would be appropriate to study the effect of the cause of spousal death on widows’ self-esteem.

After-only non-equivalent control group design is used when outcomes (e.g., vascular complications) cannot be measured before the intervention (e.g., preoperative teaching) and randomization is not used to assign subjects to groups.

It makes the assumption that the two groups are equivalent and comparable before the introduction of the intervention.

Because student performance can be measured before and after the intervention, an after-only approach would not be appropriate.

Because knowledge of testicular cancer can be measured before and after the intervention, an after-only approach would not be appropriate.

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DIF:

Cognitive Level: Applying (Application)

17. A quasi-experimental study design would be a better choice for a research study than an

experimental study design in which of these situations? a. The study is to be conducteN d UinRaSlI abNoG raTtoBry.C seO ttiMng. b. An experimental treatment is not part of the study. c. The researcher has not conducted research before. d. Full experimental control is not possible.

ANS: D

A B C D

Feedback A laboratory setting would not preclude and, in fact, would facilitate an experimental design because it is conducive to control of variables.

If no experimental treatment is used, the study is not quasi-experimental.

Researcher’s inexperience should not influence the choice of design.

When full experimental control is not possible, it is appropriate for the researcher to select a quasi-experimental design.

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Cognitive Level: Understanding (Comprehension)

18. The nurse researcher is planning a study in which subjects will not be randomly assigned to

groups. Which type of design would be appropriate for this study? a. Non-equivalent control group design b. Posttest-only control group design c. Solomon four-group design d. True experimental design

ANS: A

A B C D

Feedback A non-equivalent control group design is a quasi-experimental design in which subjects are not randomly assigned to groups.

A posttest-only control group design consists of two randomly assigned groups but neither group is pretested.

A Solomon four-group design is an experimental design that requires random assignment to groups.

True experimental design requires random assignment of groups.

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DIF:

Cognitive Level: Understanding (Comprehension)

19. A planned quasi-experimental study using a non-equivalent control group design has several

extraneous variables that threaten its internal validity. The nurse researcher’s actions should be based on which understanding? a. The results of the study will not be statistically significant. b. The random assignment of subjects to groups will nullify the intervening variables. c. The study should be strengthened by controlling intervening variables. d. Because observation rather than causation is the purpose of the study, no action is necessary.

ANS: C

A B

C D

Feedback The statistical significanceNoU fR thS eI stN udGyTwBil.l C noOtMnecessarily be affected by the extraneous variables.

By definition, a non-equivalent control group design indicates no random assignment was done. When extraneous variables are identified as threats to the study, they should be controlled using other approaches. For example, if experimental and control groups differ systematically on an important intervening variable (e.g., socioeconomic status), a better match of groups should be attempted.

Identifying and controlling threats to internal validity will strengthen the study’s design.

Causation is being examined because this is a quasi-experimental study.

PTS: 1 DIF: REF: Pages 174-175

Cognitive Level: Applying (Application)

20. A quasi-experimental research design would be preferable to an experimental design in which

of these situations? a. A smaller sample size is sufficient to obtain significant results. b. Demonstration of a cause-and-effect relationship is the desired outcome. c. Descriptive statistics will be used to analyze the data. d. Data will need to be collected in a real-world setting.

ANS: D

A B C

D

Feedback Sample size is not a determinant of research design.

An experimental design is stronger than a quasi-experimental design for establishing a cause-and-effect relationship.

Descriptive statistics are used to analyze data in both quasi-experimental and experimental studies, although additional, inferential statistics are used in the analysis of experimental studies.

Quasi-experimental studies are more appropriate in real-world settings, where randomization is difficult or impossible.

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DIF:

Cognitive Level: Understanding (Comprehension)

21. A study was conducted to determine if videotaped instruction was more effective than written

instruction (a pamphlet) to teach menopausal women the benefits of regular mammograms.

Which condition would be considered an antecedent variable? a. There were 38 subjects in the pamphlet group and 34 subjects in the videotape group. b. During the study, 50% of the videotape group received flu shots, whereas 25% of those in the pamphlet group received flu shots. c. Four members of the pamphlet group had mothers who had been diagnosed with breast cancer, but no members of the videotape group had mothers who had been diagnosed with breast cancer. d. While participating in the study, five members of the videotape group began performing breast self-examination (BSE), while two members of the pamphlet group began performing BSNEU. ANS: C

A B C D

Feedback The sample size is a factor occurring during the study, not before it.

Because influenza immunization occurred during the study, it is not an antecedent variable.

An antecedent variable is something that occurred before the study but can affect the outcome and confound results.

Because BSE occurred during the study, it is not an antecedent variable.

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Cognitive Level: Applying (Application)

22. In a study using a true experimental design, which of these methods would control for

antecedent variables? a. Manipulation of the independent variable b. After-only data collection c. Intervention fidelity d. Random assignment to groups ANS: D

Feedback

A B C D

Manipulation of the independent variable cannot control a factor that occurred before the study.

After-only data collection would not control preexisting variables.

Systematically delivering the intervention would not control preexisting variables.

Random assignment to groups helps ensure that antecedent (preexisting) variables will be similarly distributed between groups.

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DIF:

Cognitive Level: Understanding (Comprehension)

23. How are threats to validity affected when studies are conducted in real-world settings? a. Threats to both internal and external validity are increased. b. Threats to both internal and external validity are decreased. c. Threats to internal validity are decreased, whereas threats to external validity are

increased. d. Threats to internal validity are increased, while threats to external validity are decreased.

ANS: D

A B C D

Feedback Studies conducted in real-world settings have fewer threats to external validity.

Studies conducted in real-world settings have more threats to internal validity.

Studies conducted in real-world settings have more threats to internal validity and fewer threats to external validity.

Studies conducted in real-world settings have fewer threats to external validity (generalizability) but haveNmUoR reSthIrN eaGtsTtB o. inCteOrnMal validity (control issues).

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DIF:

Cognitive Level: Understanding (Comprehension)

24. How are threats to validity affected when studies are conducted in laboratory settings? a. Threats to both internal and external validity are increased. b. Threats to both internal and external validity are decreased. c. Threats to internal validity are decreased, whereas threats to external validity are

increased. d. Threats to internal validity are increased, whereas threats to external validity are

decreased.

ANS: C

A B C

D

Feedback Studies conducted in laboratory settings have fewer threats to internal validity.

Studies conducted in laboratory settings have more threats to external validity.

Studies conducted in laboratory settings have fewer threats to internal validity (control issues) and more threats to external validity (generalizability to other populations).

Studies conducted in laboratory settings have fewer threats to internal validity and more threats to external validity.

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DIF:

Cognitive Level: Understanding (Comprehension)

MULTIPLE RESPONSE 1. Which are characteristics of quasi-experimental research designs that are considered

weaknesses, compared with experimental designs? (Select all that apply.) a. Cost of implementation b. Confidence in making causal assertions c. Subject to contamination of internal validity d. Disruptive to the usual routine of the setting e. Difficult to perform in a particular clinical setting f. Findings due to interference of extraneous variables ANS: B, C, F Feedback Correct

Incorrect

The primary weakness of quasi-experimental designs, compared with experimental designs, is the weakened confidence in making causal assertions.

Quasi-experimental designs are particularly subject to contamination of internal validity by extraneous variables.

Findings of quasi-experimental studies may be due to the influence of extraneous variables, rather than the experimental treatment (independent variable).

The costs associated with quasi-experimental designs are generally much lower than the costsNoUf R exSpI erNim GeTnBta.l dCeOsiMgns.

Quasi-experimental designs are much less disruptive to the usual routine of the setting than experimental designs.

Quasi-experimental designs are easier to perform in a particular clinical setting than experimental designs.

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Cognitive Level: Understanding (Comprehension)

2. A research study in a laboratory setting incorporates four groups (two control and two

experimental) in which only one experimental group and one control group are pretested, while all four groups are posttested. Which descriptions of the design are accurate? (Select all that apply.) a. Experimental design b. After-only experimental design c. Real-world experimental design d. Quasi-experimental design e. Solomon four-group design ANS: A, E Feedback Correct

The example describes a type of experimental design, a Solomon four-group design.

Incorrect

The example describes a Solomon four-group design.

An after-only experimental design does not include any pretesting.

A real-world experimental design would be conducted in an actual practice setting, not a laboratory.

The example describes an experimental study conducted in a laboratory. A quasi-experimental design would be conducted in a real-world setting.

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Cognitive Level: Understanding (Comprehension)

3. A nurse researcher is planning a quantitative (experimental) research study to test the effect of

a new wound product on wound healing. Which of these factors is necessary to implement an experimental pretest-posttest design? (Select all that apply.) a. Inclusion of a second control group b. Ability to collect pretest data c. Use of two post-treatment data-collection times d. Subjects randomized to the control group only e. Random assignment of subjects to treatment and control groups ANS: B, E Feedback Correct

Incorrect

To implement a pretest-posttest design, it must be possible to collect pretest data.

Random assignment must be possible for both treatment and control groups.

There is no need forNaUsR ecSoI ndNG coTnB tro.lCgO roMup for a pretest-posttest design.

There is no need for two post-treatment data-collection times; only one is needed.

Randomization must be possible for both treatment and control groups.

PTS: 1 DIF: REF: Pages 166, 174

Cognitive Level: Applying (Application)

4. A research study is planned to determine the effect of nutritional supplementation and type of

support surface on the rate of wound healing in sacral myocutaneous flap failures. Which is an independent variable in this study? (Select all that apply.) a. Rate of wound healing b. Sacral myocutaneous flap c. Retailer source of protein supplement d. Type of support surface e. Nutritional supplementation ANS: D, E Feedback Correct

Incorrect

The type of support surface is one of the specified interventions or treatments (independent variables).

Nutritional supplementation is one of the specified interventions or treatments (independent variables).

Rate of wound healing is the dependent variable.

Sacral myocutaneous flap failure is the type of wound being studied.

The retailer of the protein supplement is not an independent variable in this study. It would be an independent variable if two different retailers’ supplements were being compared.

PTS: 1 REF: Page 168

DIF:

Cognitive Level: Understanding (Comprehension)

5. Which research designs could be classified as experimental? (Select all that apply.) a. Solomon four-group design b. After-only design c. Non-equivalent control group design d. After-only non-equivalent control group design e. One-group pretest-posttest design f. True experimental pretest-posttest control group design g. Time-series design ANS: A, B, F Feedback Correct

Incorrect

The Solomon four-group design is an experimental design.

The after-only design is an experimental design.

A true experimental pretest-posttest control group design is an experimental design.

A non-equivalent control group design is a quasi-experimental design.

An after-only non-equivalent control group design is a quasi-experimental design.

NURSINGTB.COM A one-group pretest-posttest design is a quasi-experimental design.

A time-series design is a quasi-experimental design.

PTS: 1 DIF: REF: Pages 170-174

Cognitive Level: Understanding (Comprehension)

6. Which of these research designs could be classified as quasi-experimental? (Select all that

apply.) a. Solomon four-group design b. After-only design c. Non-equivalent control group design d. After-only non-equivalent control-group design e. One-group pretest-posttest design f. True experimental pretest-posttest group design g. Time-series design ANS: C, D, E, G Feedback Correct

A non-equivalent control group design is a quasi-experimental design.

After-only non-equivalent control-group design is a quasi-experimental design.

A one-group pretest-posttest design is a quasi-experimental design.

A times-series design is a quasi-experimental design.

Incorrect

A Solomon four-group design is an experimental design.

An after-only design is an experimental design.

A true experimental pretest-posttest design is an experimental design.

PTS: 1 REF: Page 175

DIF: Cognitive Level: Understanding (Comprehension)

NURSINGTB.COM

Chapter 10: Non-experimental Designs LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. What is the first question that should be asked in determining whether a cross-sectional design

or a longitudinal design should be used in a quantitative study? a. Is there an independent variable? b. What is the nature of the problem being studied? c. Will a measurement tool or instrument be needed? d. Can statistical analysis be applied to the study data?

ANS: B

A B C D

Feedback Independent variables are used in both cross-sectional and longitudinal studies.

The nature of the research problem determines whether a cross-sectional or longitudinal design should be used.

A measurement tool or instrument can be used in both cross-sectional and longitudinal designs.

Statistical analyses can be used in both cross-sectional and longitudinal designs.

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DIF:

Cognitive Level: Understanding (Comprehension)

2. Which method of data collection is most appropriate for a nurse researcher to use in a survey

study? a. Video recording of people-to-people interactions b. Direct participant observation c. Unstructured interview d. Questionnaires ANS: D

A B C D

Feedback Video recording of interpersonal interactions is more common for observational and focus group studies.

Direct participant observation is used in qualitative and observational-type studies.

Unstructured interviews are not usually appropriate for survey design.

Questionnaires are the best method for a survey study.

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DIF:

Cognitive Level: Understanding (Comprehension)

3. Why would a nurse researcher choose to use research studies that examine the associations or

relationships between variables? a. A causal relationship can be determined between the variables. b. Greater manipulation of the variables is possible in this type of study.

c. Randomization of participants allows for increased generalizability. d. There is application in clinical settings and a foundation for future experimental

studies.

ANS: D

A B C D

Feedback Causal relationships are usually determined by experimental and quasi-experimental designs.

Correlational or association-type designs do not involve manipulation of variables.

Randomization can be used in various levels of research and is not reserved for associative design research.

Advantages of correlational studies include their application to clinical settings and a foundation for future experimental designs.

PTS: 1 DIF: REF: Pages 184-185

Cognitive Level: Remembering (Knowledge)

4. Why would a nurse researcher choose not to use a survey study design? a. Data analysis is limited with a survey design. b. Information collected is relatively superficial. c. Results are never applicable beyond the study population. d. More subjects are required to reach statistical significance than for other study

designs.

ANS: B

A B C D

NURSINGTB.COM Feedback Survey design can yield extensive data for analysis.

Information obtained in a survey tends to be superficial.

Survey design does not necessarily limit generalizability.

A survey design does not necessarily increase the need for a larger sample size.

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DIF:

Cognitive Level: Understanding (Comprehension)

5. A nurse researcher would choose to use a correlational study of multiple variables for which

purpose? a. To identify the independent variable b. To test whether one variable causes another variable c. To examine relationships between or among variables d. To distinguish how different one variable is from another variable ANS: C

A B C

Feedback The independent variable(s) should be identified by the researcher planning a study.

Causation cannot be established by correlational design.

A multivariate correlational study examines relationships between or among

D

variables.

Correlational design will not help distinguish variables from other variables.

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DIF:

Cognitive Level: Understanding (Comprehension)

6. Why would a nurse researcher choose to use a correlational design for a non-experimental

study? a. It represents an efficient and effective method of collecting a large amount of data about a problem. b. Many questionnaires and instruments are already developed and have been determined to be valid and reliable. c. Generalizability is greater than for results of studies using experimental designs. d. It allows flexibility in the manipulation of more than one variable.

ANS: A

A B C D

Feedback A correlational design permits collection of a large amount of data about a problem.

Questionnaires and instruments are used in all levels of research, not only for correlational studies.

Experimental studies are usually considered to have a stronger design and to be generalizable if sampling is appropriately designed.

No variable is manipulated in a correlational study because it is considered non-experimental.

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DIF:

Cognitive Level: Understanding (Comprehension)

7. A nurse researcher chooses to use a developmental study design to: a. allow comparison of the results of qualitative studies of a phenomenon to the

results of quantitative studies of the same phenomenon. b. allow reanalysis of existing data for a secondary purpose not stated in the original

research. c. allow exploration of the changing nature of relationships between variables over

time. d. allow development or refinement of a tool or instrument.

ANS: C

A B C D

Feedback Comparison of studies would be a component of the literature review.

Reanalysis of existing data for a secondary purpose is the definition of secondary analysis.

Developmental design permits exploration of the changing nature of relationships of variables over time.

Development or refinement of a tool or instrument is the purpose of methodological research.

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DIF:

Cognitive Level: Remembering (Knowledge)

8. Which statement about cross-sectional studies is most accurate? a. More than one group can be compared. b. Only descriptive data can be measured. c. Data are collected retrospectively rather than prospectively. d. Data collection and data analysis can occur simultaneously.

ANS: A

A B C D

Feedback Cross-sectional design allows multiple group comparison.

Cross-sectional analysis is not reserved for descriptive data.

In cross-sectional design, data are collected across groups at one point in time.

Data analysis would follow data collection in cross-sectional studies.

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DIF:

Cognitive Level: Understanding (Comprehension)

9. A nurse researcher would decide to use a longitudinal or prospective design because: a. it is associated with data that are focused and deep. b. it allows the overall study to be more manageable for the researcher. c. it allows the issue of maturation to be avoided as a threat to internal validity. d. it allows the nurse researcher to avoid the use of tools or instrumentation.

ANS: A

A B C D

Feedback Longitudinal or prospective designs are associated with more in-depth, focused data collection.

A longitudinal design can be more difficult for the researcher given the length of time involved.

Maturation is a threat to internal validity in longitudinal design.

Longitudinal design often requires the use of measurement tools or instruments.

PTS: 1 DIF: REF: Pages 186-187

Cognitive Level: Understanding (Comprehension)

10. A nurse researcher would decide to use a retrospective or ex post facto study because: a. obtaining informed consent is not an important issue. b. there is maximal opportunity to manipulate the independent variable. c. the dependent variable is measured at multiple times to examine maturation. d. the dependent variable has already been affected by the independent variable.

ANS: D

A B

Feedback Informed consent may be necessary in retrospective studies given some research topics.

A retrospective study does not involve the manipulation of variables.

C D

Effect on the dependent variable has occurred already, so maturation is not an issue.

In an ex post facto study the dependent variable has already been affected.

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DIF:

Cognitive Level: Understanding (Comprehension)

11. A nurse researcher will choose an ex post facto design over more a correlational design

because: a. it is easier to implement. b. the independent variable can be manipulated. c. there is a greater degree of control in the design. d. there is increased flexibility when variable relationships are complex.

ANS: C

A B C D

Feedback An ex post facto design is not inherently easier than correlational design.

No variable is manipulated in an ex post facto design.

A retrospective or ex post facto study offers a higher level of control than a correlational study.

Complex interrelationships usually decrease flexibility in a study.

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DIF:

Cognitive Level: Understanding (Comprehension)

12. Which type of study should beN uU seR d SwI hN enGdTaB ta.aC reOcM ollected at only one point in time? a. Cross-sectional b. Retrospective c. Longitudinal d. Prospective ANS: A

A B C D

Feedback Cross-sectional design is associated with data collection at one point in time.

Retrospective design is analysis of data that has already been collected.

Longitudinal design involves data collection over a specific period.

Prospective design involves data collection over time into the future.

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DIF:

Cognitive Level: Remembering (Knowledge)

13. Data-collection instruments were sent to the same sample of women at six different times

during the first year of living with breast cancer. What type of study design does this exemplify? a. Cross-sectional b. Retrospective c. Longitudinal d. Correlational

ANS: C

A B C D

Feedback Cross-sectional design is data collection at one point in time.

In retrospective design, relationships are examined about past events to analyze possible effects on current variables.

Longitudinal design involves data collection from the same group(s) at different points in time.

Correlational design examines interrelationships among variables usually at one point in time.

PTS: 1 REF: Page 186

DIF:

Cognitive Level: Applying (Application)

14. What threat to internal validity is most closely associated with a longitudinal design? a. Instrumentation effects b. Mortality effects c. History effects d. Selection bias ANS: B

A B C D

Feedback Instrumentation effects or testing effects can occur in many types of research design and are not more likely in longitudinal design.

A major disadvantage of longitudinal design is loss of research subjects.

History effects can occur inNU anRySkI inN dGoT f rBes.eC arO chMdesign.

Selection bias is due to problems with sampling processes rather than design issues.

PTS: 1 DIF: REF: Pages 186-187

Cognitive Level: Understanding (Comprehension)

15. What study design allows study participants to serve as their own controls, allowing early

trends in the data to emerge? a. Cross-sectional b. Ex post facto c. Retrospective d. Longitudinal ANS: D

A B C

Feedback Cross-sectional design does not allow for intraparticipant comparisons because data are collected at one point in time.

In ex post facto research, events have already occurred; intraparticipant comparison is not involved.

Retrospective studies are similar to ex post facto research. In ex post facto research, events have already occurred; intraparticipant comparison is not involved.

D

In longitudinal studies, subjects serve as their own controls, and trends in the data can emerge.

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DIF:

Cognitive Level: Understanding (Comprehension)

16. The longitudinal study and the prospective study are similar because: a. each moves forward in time. b. each has an experimental focus. c. each is able to establish causal relationships. d. each selects different samples from the same population at various periods of time.

ANS: A

A B C D

Feedback Longitudinal and prospective designs both move forward in time for data collection.

Longitudinal and prospective studies are not necessarily experimental in design.

Longitudinal and prospective designs do not necessarily establish causation; the design could be preexperimental, like descriptive design.

Longitudinal and prospective studies collect from the same group at different points in time.

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DIF:

Cognitive Level: Understanding (Comprehension)

17. What type of research will assiN stUaRnS urI seNrGesTeB ar. chCeO rM in focusing on the theory and development

of measurement instruments? a. Meta-analysis b. Psychometrics c. Methodology d. Data management ANS: B

A B C D

Feedback Meta-analysis is a research method quantitatively summarizing the results of many research studies.

Psychometrics deals with the theory and development of measurement instruments.

Methodology is the section of a research report containing the design, sample, setting, instrumentation, and procedures.

Data management is a generic term for organizing and analyzing collected data.

PTS: 1 REF: Page 190

DIF:

Cognitive Level: Remembering (Knowledge)

18. How does an experimental research design differ from a nonexperimental research design? a. Experimental designs allow observation of a phenomenon as it naturally occurs,

and nonexperimental designs permit environmental manipulation.

b. Non-experimental designs manipulate the dependent variable, and experimental

designs manipulate the independent variable. c. Non-experimental designs attempt to test differences among variables, and experimental designs attempt to establish cause-and-effect relationships. d. Experimental designs are scientific, and non-experimental designs have no scientific basis.

ANS: C

A B C D

Feedback Non-experimental designs allow observation of phenomena; experimental designs permit environmental (variable) manipulation.

Non-experimental designs involve no manipulation of variables.

Experimental designs seek to establish cause-and-effect relationships by active manipulation of variables (e.g., treatments).

Non-experimental designs should have a scientific basis or rationale.

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DIF:

Cognitive Level: Understanding (Comprehension)

MULTIPLE RESPONSE 1. Advantages to use of correlational design for a study include: (Select all that apply.) a. efficiency and effectiveness in data collection. b. flexibility for investigating complex relationships. c. multivariate manipulation of variables. d. strong potential for clinicalN(rUeR alS -wIoNrlG d)TaBp. plC icO atM ion. e. increased potential for generalizability.

ANS: A, B, D Feedback Correct

Incorrect

Correlational design is associated with efficient and effective data collection for a large amount of data.

Correlational design increases flexibility when investigating complex relationships among variables.

Correlational design is associated with the advantage of increased potential for real-world (clinical) application.

Variables are not manipulated in non-experimental research.

Because preexisting groups are used in correlational design, generalizability is decreased.

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DIF:

Cognitive Level: Applying (Application)

2. What features identify a study as methodological in design? (Select all that apply.) a. A description of how the tool’s items were formulated b. A description of the experimental treatment c. A clear definition of how the construct was measured d. A reporting on the tool’s tested reliability and validity

e. A statistical table showing the effect of the independent variable ANS: A, C, D Feedback Correct

Incorrect

A methodological study includes formulation of the tool’s items.

A methodological study includes a definition of how the construct/concept was measured.

A methodological study is designed to test a new instrument’s or tool’s validity and reliability.

Experimental treatments are not used in methodological design.

Methodological studies do not involve experimental treatments.

PTS: 1 REF: Page 191

DIF:

Cognitive Level: Analyzing (Analysis)

3. What can a nurse researcher address in a study using a survey design? (Select all that apply.) a. Interrelationships of variables b. Description of variables c. Assessment of differences between variables d. Determination of causation e. Prediction of treatment outcomes ANS: A, B, C Feedback Correct

Incorrect

Survey design is excellent for exploring interrelationships of variables.

Description of variaN bU leR s cSaI nN bG ew el. l eCliO ciM ted by survey design.

TB Survey design is helpful in assessing differences between variables.

Survey design is not appropriate to determine causation.

Survey design is not able to predict treatment outcomes because a variable is not being manipulated.

PTS: 1 DIF: REF: Pages 182-183

Cognitive Level: Applying (Application)

4. Which types of research designs are considered to be survey studies? (Select all that apply.) a. Descriptive b. Exploratory c. Correlational d. Developmental e. Comparative f. Cross-sectional ANS: A, B, E Feedback Correct

Incorrect

A descriptive study is considered to be a survey design.

An exploratory study is considered to be a survey design.

A comparative study is considered to be a survey design.

A correlational study is not considered to be a survey design.

A developmental study is not considered to be a survey design.

A cross-sectional study is not considered to be a survey design.

PTS: 1 REF: Page 182

DIF:

Cognitive Level: Understanding (Comprehension)

5. Which types of research designs are considered to be relationship-difference studies? (Select

all that apply.) a. Descriptive b. Exploratory c. Correlational d. Developmental e. Comparative f. Cross-sectional ANS: C, D, F Feedback Correct

Incorrect

A correlational study is considered to be a relationship-difference study.

A developmental study is considered to be a relationship-difference study.

A cross-sectional study is considered to be a relationship-difference study.

A descriptive study is not considered to be a relationship-difference study.

An exploratory study is not considered to be a relationship-difference study A comparative study is not considered to be a relationship-difference study.

NURSINGTB.COM PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 181, Box 10.1 6. Which types of research designs are considered to be developmental studies? (Select all that

apply.) a. Cross-sectional b. Comparative c. Exploratory d. Longitudinal e. Prospective f. Cohort g. Descriptive ANS: A, D, E, F Feedback Correct

Incorrect

A cross-sectional design is considered to be a developmental study.

A longitudinal design is considered to be a developmental study.

A prospective design is considered to be a developmental study.

A cohort design is considered to be a developmental study.

A comparative design is not considered to be a developmental study.

An exploratory design is not considered to be a developmental study.

A descriptive design is not considered to be a developmental study.

PTS: 1 DIF: REF: Pages 185-187

Cognitive Level: Remembering (Knowledge)

NURSINGTB.COM

Chapter 11: Systematic Reviews and Clinical Practice Guidelines LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. Which of the following terms means a summation and assessment of research studies found in

the literature based on a clearly focused question? a. Meta-analysis b. Systematic review c. Cochrane collaboration d. Integrative review ANS: B

A

B

C D

Feedback A meta-analysis is a systematic summary using statistical techniques to assess and combine studies of the same design to obtain a precise estimate of effect (impact of an intervention on the dependent variable/outcomes or association between variables).

A systematic review is a summation and assessment of research studies found in the literature based on a clearly focused question that uses systematic and explicit methods to identify, select, critically appraise, and analyze relevant data from the selected studies to summarize the findings in a focused area.

The Cochrane Collaboration is an international organization that prepares and NaUtiRcSreIvNieGwTs B maintains a body of system th. atCfO ocMus on health care interventions.

An integrative review is the broadest category of review. It can include theoretical literature, research literature, or both, and may include methodology studies, a theory review, or the results of differing research studies with wide-ranging clinical implications.

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DIF: Cognitive Level: Understanding (Comprehension)

2. The highest level of evidence is known to be provided by: a. Meta-analysis b. Systematic review c. Effect size d. Integrative review ANS: A

A B C

Feedback Meta-analysis provides Level I evidence, the highest level of evidence, as it statistically analyzes and integrates the results of many studies.

Systematic review is not known to provide the same level of evidence as meta-analysis.

Effect sizes are calculated using the difference in the averages scores between the intervention and control groups from each study.

D

Integrative review is not known to provide the same level of evidence as meta-analysis.

PTS: 1 DIF: REF: Pages 202-203

Cognitive Level: Understanding (Comprehension)

3. What is known to contain bibliographical information on articles and books on reviewing

research and methodological studies? a. Cochrane Database of Systematic Reviews b. Database of Abstracts of Review of Effects c. Cochrane Central Register of Controlled Trials d. Cochrane Methodology Register ANS: D

A B

C

D

Feedback The Cochrane Database of Systematic Reviews contains full text Cochrane reviews.

The Database of Abstracts of Review of Effects (DARE) contains critical assessments and abstracts of other systematic reviews that conform to quality criteria.

The Cochrane Central Register of Controlled Trials (CENTRAL) contains information on studies published in conference proceedings and other sources not available in other databases.

The Cochrane Methodology Register is known to contain bibliographical information on articles and books on reviewing research and methodological studies.

NURSINGTB.COM

PTS: 1 DIF: REF: Page 205, Box 11.3

Cognitive Level: Understanding (Comprehension)

4. What source contains information on studies published in conference proceedings and other

sources not available in other databases? a. Cochrane Database of Systematic Reviews b. Database of Abstracts of Review of Effects c. Cochrane Central Register of Controlled Trials d. Cochrane Methodology Register ANS: C

A B

C

D

Feedback The Cochrane Database of Systematic Reviews contains full text Cochrane reviews.

The Database of Abstracts of Review of Effects (DARE) contains critical assessments and abstracts of other systematic reviews that conform to quality criteria.

The Cochrane Central Register of Controlled Trials (CENTRAL) contains information on studies published in conference proceedings and other sources not available in other databases.

The Cochrane Methodology Register is known to contain bibliographical

information on articles and books on reviewing research and methodological studies.

PTS: 1 DIF: REF: Page 205, Box 11.3

Cognitive Level: Understanding (Comprehension)

MULTIPLE RESPONSE 1. Which are methods for searching and integrating the literature related to a specific clinical

issue? (Select all that apply.) a. Meta-analysis b. Systematic review c. Cochrane collaboration d. Integrative review ANS: B, D Feedback Correct

Incorrect

Systematic and integrative reviews are not designs per se but rather methods for searching and integrating the literature related to a specific clinical issue.

A meta-analysis is a systematic summary using statistical techniques to assess and combine studies of the same design to obtain a precise estimate of effect (impact of an intervention on the dependent variable/outcomes or association between variables).

The Cochrane Collaboration is an international organization that prepares GaTtiBc.reCvO and maintains a bodNyUoR fS syI stN em ieM ws that focus on health care interventions.

PTS: 1 REF: Page 205

DIF: Cognitive Level: Understanding (Comprehension)

ORDERING 1. Put the following in order from first to last.

data collection plain language summary type of studies reviewed authors and contact person abstract background of the question types of participants objectives of the search implications for research and practice methods for selecting studies for review search methods for finding studies analysis of the located studies results references and tables

discussion ANS:

10, 3, 7, 1, 2, 4, 8, 5, 14, 6, 9, 11, 12, 15, 13 PTS: 1

Chapter 12: Sampling LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. What is the process of selecting representative units of a population for study in a research

investigation? a. Sampling b. Snowballing c. Delimination d. Random assignment ANS: A

A B C D

Feedback Sampling is the process of selecting representative units of a population for a research study.

Snowballing is a sampling technique using social networks.

Delimination is the specification of sample characteristics.

Random assignment is the process of assigning subjects to groups.

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DIF:

Cognitive Level: Remembering (Knowledge)

xpReS ctIaNsG am iffer from a population?

2. How should a nurse researcherNeU TpBle.tCoOdM a. A sample can mean objects or events, whereas population refers to individuals or groups of people. b. A population has a broad set of defining characteristics, and a sample has a narrow

set of defining characteristics. c. A population is a representative segment of a defined sample. d. A sample is a representative segment of a defined population.

ANS: D

A B C D

Feedback A population refers to a well-defined set of people, animals, objects, or events.

A sample is the group of research subjects representing the population.

A sample is a representative segment of the population.

A sample is a set of elements or segments of a specified population.

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3. A nurse researcher has made a generalization on the basis of the experience of a small number

of participants. The result of this will most likely show: a. the small sample will invalidate the hypotheses. b. the researcher will be unable to eliminate his or her bias. c. the data obtained from a small number will inadequately represent the

phenomenon. d. the small number of participants will increase the threat to internal validity

influenced by history.

ANS: C

A B C D

Feedback A small sample does not necessarily invalidate hypotheses.

Researcher bias is not necessarily controlled by sample size, small or large.

A too-small sample may inadequately represent the phenomenon and threaten valid conclusions.

Small sample size does not necessarily increase historical threats to validity.

PTS: 1 DIF: REF: Pages 225-226

Cognitive Level: Understanding (Comprehension)

4. Which statement is most accurate regarding inclusion and exclusion criteria? a. These criteria are not needed when the population being studied is composed of

events. b. These criteria serve to ensure that the characteristics of the sample and the

population are congruent. c. Inclusion criteria are used to define the independent variables, and exclusion

criteria are used to define dependent variables. d. Inclusion criteria are used to define the dependent variables, and exclusion criteria

are used to define independent variables.

ANS: B

A B C D

NURSINGTB.COM

Feedback Inclusion and exclusion criteria are always needed in some form.

Inclusion and exclusion criteria are designed to keep the population and sample characteristics congruent.

Inclusion and exclusion criteria refer to sample subjects rather than to independent or dependent variables.

Inclusion and exclusion criteria refer to sample subjects rather than independent or dependent variables.

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5. What can a nurse researcher use to restrict the study population to homogeneous groups of

subjects? a. Sampling b. Self-selection c. Eligibility criteria d. Defining study limitations ANS: C

Feedback

A B C D

Sampling does not mandate restricting the population to a homogeneous group of subjects.

Self-selection would not restrict subjects to a homogeneous group.

Eligibility criteria restrict or control the homogeneity of subjects in relation to the population.

Specifying study limitations would not restrict subjects to homogeneity.

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6. A nurse researcher should be concerned about establishing clear eligibility criteria for

inclusion in a study sample because such criteria: a. increase the homogeneity of the sample. b. decrease the homogeneity of the sample. c. increase the size of the sample. d. decrease the size of the sample.

ANS: A

A B C D

Feedback Clear eligibility criteria are designed to increase the homogeneity of the sample.

Clear eligibility would not hinder homogeneity but support it.

Eligibility criteria do not directly increase or decrease sample size.

Eligibility criteria do not directly increase or decrease sample size.

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NURSINGTB.COM

7. A nurse researcher should attempt to clearly specify exclusion criteria for a study sample

because such criteria will: a. limit the time needed to complete the study. b. reduce the effect of extraneous variables on the accurate evaluation of the outcome variable. c. eliminate the outside influences and inferences regarding the effectiveness of a behavioral intervention. d. ensure that an adequate sample size is accrued to meet assumptions for accurate statistical analysis.

ANS: B

A B C D

Feedback Exclusion criteria do not directly affect how long a study takes.

Exclusion criteria are designed to control sample characteristics and thereby reduce the potential effect of extraneous variables on the outcome variable.

Exclusion criteria delimit the sample but do not fully act as controls for the intervention.

Sample size is not determined by exclusion criteria.

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8. The nurse researcher knows that a sample is representative of a population when: a. the sample is homogeneous. b. all units of a population are included. c. the most readily accessible persons are used as subjects. d. the characteristics of the sample closely approximate those of the population.

ANS: D

A B C D

Feedback A homogeneous sample is not the ultimate criterion for evaluating a sample.

Population elements or unit inclusion is important but not the ultimate criterion.

Ready subject accessibility does not constitute the most important evaluative criteria.

The foremost criterion in evaluating a sample is its representativeness.

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9. How can a nurse researcher tell the difference between an accessible population and a target

population? a. The accessible population meets the inclusion criteria, and the target population meets the exclusion criteria. b. The target population meets the inclusion criteria, and the accessible population meets the exclusion criteria. c. The accessible population represents the entire set of cases the researcher wishes to study, and the target populaNtiU onRS reI prN esGeT ntB s. thC atOpMart of the accessible population that could feasibly be included in the study. d. The target population represents the entire set of cases the researcher wishes to study, and the accessible population represents that part of the target population that could feasibly be included in the study.

ANS: D

A B C D

Feedback Inclusion and exclusion criteria refer to subject characteristics, not components of the population.

Inclusion and exclusion criteria refer to desirable and undesirable subject characteristics.

The target population is the entire set of cases to be studied; the accessible population is the part of the population that can be studied.

The target population is the entire set of cases the researcher wants to study; the accessible population meets population criteria and is available for study.

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DIF:

Cognitive Level: Understanding (Comprehension)

10. A nurse researcher would hesitate to use nonprobability sampling because: a. it will result in reduced or limited generalizability. b. informed consent must be obtained.

c. it will require large, unmanageable sample sizes. d. sample sizes are too small for most methods of statistical analysis.

ANS: A

A B C D

Feedback Non-probability sampling reduces or limits generalizability.

Informed consent is used for all studies despite choice of sample used.

Non-probability sampling does not mandate large unmanageable sample sizes.

Non-probability sampling does not mandate a small sample size.

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11. Which type of sampling is most at risk for sample bias? a. Quota b. Random c. Purposive d. Convenience ANS: D

A B C D

Feedback Quota sampling, if done appropriately, will not create sample bias.

Random sampling should act to counteract sample bias.

Purposive sampling would selectively include research subjects and avoid sampling bias.

NURSINGTB.COM Convenience sampling is most at risk for sample bias.

PTS: 1 DIF: REF: Pages 217-218

Cognitive Level: Analyzing (Analysis)

12. The primary characteristic of a probability sample is considered to be: a. self-selection of subjects. b. random selection of the sample. c. subjects handpicked by the researcher. d. representation of proportional segments of the population.

ANS: B

A B C D

Feedback Self-selection of subjects would be antithetical to probability sampling.

The primary characteristic of a probability sample is random selection.

Subjects being handpicked by a researcher represent a purposive sample, which is not a form of probability sampling.

Proportional segment representation can be found in quota sampling, which is a form of non-probability sampling.

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13. A nurse researcher opts to use a stratified sample in a research study because: a. the sample population is divided into subsets that are homogeneous for a particular

trait or feature. b. the sample population is divided into subsets for random assignment into an

intervention or a usual-care group. c. the sample population is randomly assigned to a specific subgroup that will vary

from the others on the basis of type of treatment. d. the sample population is randomly assigned to a specific subgroup that will vary

from the others on the basis of treatment duration.

ANS: A

A B C D

Feedback The major characteristic of a stratified sample is that selected subjects represent population subgroups that are homogeneous.

A stratified sample would have representation in both the treatment and control groups.

In a stratified sample, both treatment and control groups have representative groups.

Stratified samples are not devised on the basis of length of treatment but on proportions of subjects in the population.

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DIF:

Cognitive Level: Understanding (Comprehension)

14. The researcher used word of mouth to accrue a sample of participants. This is known as: a. referral.

NURSINGTB.COM b. networking. c. recruitment. d. quasi-probability.

ANS: B

A B C D

Feedback Referral is a generic term and is not associated specifically with word-of-mouth technique.

Networking is a sampling strategy using word-of-mouth via social networks.

Recruitment is the term used to describe the methods used to obtain research subjects.

Quasi-probability is a term that is unassociated with word-of-mouth sample approaches.

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15. The nurse researcher can most accurately determine sample size by considering what? a. The stamina of the researcher in data collection b. The importance of the independent variable c. The age of the potential subjects d. The design of the study

ANS: D

A B C D

Feedback Researcher stamina should have no impact on sample size selection.

Importance of the independent variable does not mean anything unless it is measured as effect size.

Subjects’ age should not affect the size of a sample.

A major factor determining sample size is the type of design used.

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DIF:

Cognitive Level: Understanding (Comprehension)

16. A nurse researcher can most accurately use the technique of power analysis: a. to estimate sample size. b. to establish sampling strata. c. to assign subjects randomly. d. to analyze sample representativeness.

ANS: A

A B C D

Feedback Power analysis is a statistical procedure used to estimate needed sample size.

Sampling strata would be determined by knowledge of population strata.

A table of random numbers (or a computer program) can be used to assign subjects randomly.

Sample representativenessNiU sR noSt I deNteGrT mB in.edCO byMpower analysis.

PTS: 1 DIF: REF: Pages 225-226

Cognitive Level: Analyzing (Analysis)

17. A nurse researcher should be particularly concerned about having a small sample size

because: a. there is increased risk of obtaining a non-representative sample. b. there is increased risk of a study subject interacting with another study subject. c. there is increased potential for loss of confidentiality. d. there is increased regression toward the mean.

ANS: A

A B C D

Feedback Small sample sizes tend to increase the risk of a sample being non-representative.

Study subject interaction can occur, whatever the sample size.

Confidentiality loss can affect large or small samples.

Regression toward the mean is not generated by sample size.

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DIF:

Cognitive Level: Understanding (Comprehension)

18. A research consumer should evaluate sample size in a research report:

a. b. c. d.

by asking how many assistants were involved in data collection. by asking how representative the sample is relative to the target population. by asking how great the outcome difference is between or among study groups. by asking how many previous studies the researcher has conducted on similar topics.

ANS: B

A B C D

Feedback The number of data collectors is not of critical importance for research report evaluation.

A major factor to be evaluated about sample size is how representative of the population the sample is.

Outcome differences would have greater impact on later research but not on the current study.

Researcher expertise should not determine sample size.

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Cognitive Level: Analyzing (Analysis)

19. Which statement regarding sample size is most accurate? a. Studies with smaller sample sizes have more accurate results. b. Studies with smaller sample sizes are more likely to be representative of the target

population. c. Studies with larger sample sizes have more accurate results. d. Studies with larger sample sizes are more likely to be representative of the target population.

NURSINGTB.COM ANS: D

A B C D

Feedback Smaller sample sizes may be associated with less accurate results.

Smaller sample sizes are more likely to be unrepresentative of the population.

Sample size does not guarantee accuracy of the results.

In general, studies with larger sample sizes are more representative of the population.

PTS: 1 REF: Page 225

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20. A study’s sampling strategy is most likely to be discussed in which section of the research

report? a. Conclusion b. Results c. Literature review d. Abstract ANS: B Feedback A

The conclusion of the research report does not usually contain information about

B

C

D

the sampling strategy that was utilized since it will tend to include a summary of information about the study.

A discussion of the study’s sampling strategy may be briefly mentioned in the methods section of a research report. A more lengthy discussion including statistical information will most likely be included in the results section of the report.

The literature review will discuss a synopsis of various studies that were found to be pertaining to the study but do not include information regarding the sampling strategy.

The abstract is a brief summary of the study overall and will not contain information regarding the sampling strategy utilized.

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Cognitive Level: Applying (Application)

MULTIPLE RESPONSE 1. Which of the following are types of nonprobability of sampling? (Select all that apply.) a. Purposive b. Quota c. Stratified random d. Multistage (cluster) e. Convenience ANS: A, B, E

NURSINGTB.COM

Feedback Correct

Incorrect

Purposive sampling is a non-probability type.

Quota sampling is a non-probability type.

Convenience sampling is a non-probability type.

Stratified random is probability sampling.

Cluster sampling is probability sampling.

PTS: 1 REF: Page 227

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2. The nurse researcher is deciding on a sampling strategy for the research study. Which types of

strategies would be considered to be probability sampling strategies? (Select all that apply.) a. Convenience b. Quota c. Simple random d. Cluster e. Purposive f. Stratified random ANS: C, D, F Feedback Correct

This is a probability sampling strategy.

This is a probability sampling strategy.

Incorrect

This is a probability sampling strategy.

This is a non-probability sampling strategy.

This is a non-probability sampling strategy.

This is a non-probability sampling strategy.

PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 217, Table 12.1 3. The nurse researcher is attempting to develop a purposive sampling strategy as part of a

research study. What criteria will be used to determine whether the strategy is purposive?

(Select all that apply.) a. Validation of scale with a known-group technique b. Focus of study population relates to specific diagnosis c. Focus of study population relates to broad, general topic d. Effective posttesting of instruments e. Collection of exploratory data f. Collection of descriptive data ANS: A, B, E, F Feedback Correct

Incorrect

This would be a criterion used to determine whether the sampling strategy is purposive.

This would be a criterion used to determine whether the sampling strategy is purposive.

This would be a criterion used to determine whether the sampling strategy is purposive.

This would be a criterion used to determine whether the sampling strategy is purposive.

The study population should relate to a specific diagnosis, not to a broad topic.

The instrument should be pretested, not posttested.

PTS: 1 DIF: REF: Pages 219-220

Cognitive Level: Applying (Application)

Chapter 13: Legal and Ethical Issues LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. The nurse researcher is planning a research study that will use human subjects and their

choice to participate in a specific treatment. The ethical principle guiding the research study that describes the nurse researcher’s obligation to benefit others is: a. justice. b. beneficence. c. confidentiality. d. respect for persons.

ANS: B

A B C D

Feedback Justice refers to fair treatment.

Beneficence refers to benefitting others.

Confidentiality refers to anonymity and privacy.

Respect for persons refers to the right to self-determination.

PTS: 1 DIF: REF: Page 235, Box 13.1

Cognitive Level: Remembering (Knowledge)

gUaRreSsI eaN rcGhTstBu. dyCtOhM at will use human subjects and their 2. The nurse researcher is planninN choice to participate in a specific treatment. The ethical principle that describes a prospective subject’s freedom to choose whether or not to participate in the research study is: a. justice. b. beneficence. c. confidentiality. d. respect for persons.

ANS: D

A B C D

Feedback Justice refers to fair treatment.

Beneficence refers to benefitting others.

Confidentiality refers to anonymity and privacy.

Respect for persons refers to the right to self-determination.

PTS: 1 DIF: REF: Page 235, Box 13.1

Cognitive Level: Remembering (Knowledge)

3. A person gives consent to participate in a study, is assigned to an intervention group, and is

expected to remain in the study for 1 year. What ethical principle is violated if after 6 months the subjects in the treatment group have more problems than the control subjects, and the nurse researcher does not allow the members of the treatment group to stop treatment? a. Justice

b. Beneficence c. Confidentiality d. Respect for persons ANS: A

A

B C D

Feedback Justice is an ethical principle that preserves a participant’s right to fair treatment.

Participants should be able to withdraw without recrimination from the researcher. They can choose to withdraw from a study at any time.

Beneficence refers to benefitting others.

Confidentiality refers to privacy.

Respect for persons refers to self-determination.

PTS: 1 DIF: REF: Page 235, Box 13.1

Cognitive Level: Analyzing (Analysis)

4. What is the ethical principle that is violated if doctors inject aged and senile patients with their

cancer cells to study their rejection responses? a. Justice b. Beneficence c. Confidentiality d. Respect for persons ANS: D

NURSINGTB.COM A B C D

Justice refers to fair treatment.

Beneficence refers to benefitting others.

Confidentiality refers to maintaining privacy.

Participants have a right to decide whether they receive a treatment or not.

Injecting senile patients with a medication without their expressed consent violates the ethical principle of respect for persons.

PTS: 1 REF: Page 235

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5. A patient newly diagnosed with breast cancer is asked to participate in a clinical trial for a

new chemotherapy agent. This patient’s freedom to participate or not participate in the study exercises protection of which of her human rights? a. Right to fair treatment b. Right to self-determination c. Right to privacy and dignity d. Right to anonymity and confidentiality ANS: B

A

Feedback Right to fair treatment protects a participant from coercion or undue influence as it relates to decisions related to participation in studies.

B C D

Freedom to participate or not participate is the right to self-determination.

Refers to a participant’s right to privacy.

Refers to a participant’s right to privacy.

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6. The issue of personal privacy may be more difficult for nurse researchers to protect in

qualitative studies than it is in quantitative studies because: a. participants may be related to each other. b. the researcher meets face to face with most participants. c. participants are not asked to sign an informed consent statement. d. verbatim quotations from participants may reveal personal information.

ANS: D

A B C D

Feedback Participants are usually not related to each other.

Meeting face to face with participants occurs in qualitative and quantitative research and is not an issue of personal privacy unique to qualitative research.

Participants do provide informed consent for qualitative studies.

Verbatim quotes regarding personal situations could inadvertently reveal a participant’s identity. Qualitative researchers will not use a participant’s real name in a study report in an attempt to maintain a participant’s anonymity.

PTS: 1 REF: Page 238

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Cognitive Level: Understanding (Comprehension)

7. All the following statements appear in a study’s informed consent form. Which statement

violates the Code of Federal Regulations? a. “I understand that I may feel discomfort during the study when blood is drawn.” b. “I understand that the researcher is not responsible for negligence-caused injury.” c. “I understand that I will not be compensated for participating in this study.” d. “I understand that participating in the study will not immediately benefit me.”

ANS: B

A B C D

Feedback Consent should inform a participant of potential discomfort.

Consent does not release researchers from negligence.

Issues of compensation should be addressed.

Consent should include issues related to the presence of or lack of benefits for participants.

PTS: 1 REF: Page 239

DIF:

Cognitive Level: Analyzing (Analysis)

8. What is the basic human right that is violated when a nurse researcher allows an unauthorized

person access to study data containing information about subject identity and responses? a. Justice

b. Beneficence c. Confidentiality d. Respect for persons ANS: C

A B C D

Feedback Justice refers to fair treatment.

Beneficence refers to benefitting others.

Participants should be assured of anonymity and confidentiality. The ethical principle of confidentiality is being violated.

Respect for persons refers to self-determination.

PTS: 1 REF: Page 239

DIF:

Cognitive Level: Analyzing (Analysis)

9. Which statement regarding informed consent is most accurate? a. Informed consent needs to be sought only if the risks outweigh the benefits. b. Informed consent is required if there are physical risks but not if there are

psychological risks. c. Researchers must obtain voluntary participation of subjects after informing them

of possible risks and benefits. d. A researcher is not obligated to seek informed consent if the details of the study

could upset the subject and potentially affect the study outcome.

ANS: C

A B C D

NURSINGTB.COM Feedback Informed consent should be obtained regardless of the risk-benefit ratio.

Informed consent should be obtained whether risks are physical or psychological.

Informed consent is required to inform participants of risks and benefits.

Informed consent is especially important if participation in the study can result in the participant’s experiencing emotional distress.

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10. What is the next step after an informed consent form is completed and signed? a. It is turned over to the agency’s institutional review board (IRB) for safekeeping. b. It is sent to the National Institutes of Health Office of Research Integrity. c. It is filed in a locked filing cabinet, separate from data generated by the study. d. It is copied, with one given to the participant and the other held by the researcher.

ANS: D

A B

Feedback The IRB does not hold records of informed consent.

The National Institutes of Health (NIH) does not hold informed consent documents.

C D

All materials from a study should be secured in the same location.

The participant and researcher should both receive a copy of the informed consent document.

PTS: 1 REF: Page 239

DIF:

Cognitive Level: Analyzing (Analysis)

11. Which is considered an essential element of the informed consent form for a research study? a. The witnessing signature of an authorized party b. The listing of members of the agency’s IRB c. Explanation of whom to contact regarding any area of the study d. List of subject’s assignment to intervention group or control group ANS: C

A B C D

Feedback A witnessing signature is not required.

Members of the IRB do not need to be listed on the consent form.

Consent forms must include identification of investigators.

Consent forms do not indicate in what group a participant will be placed.

PTS: 1 DIF: REF: Pages 238-239

Cognitive Level: Understanding (Comprehension)

12. A staff nurse overhears a health care professional use coercion to make a patient agree to

participate in a research study. What should the staff nurse do? a. Confront the researcher witN hUcoRnSceIrN nsG. TB.COM b. Document suspicions in the patient’s medical record. c. Contact the hospital’s institutional review board. d. Secretly tape-record the researcher’s interaction with a potential subject.

ANS: C

A B C D

Feedback Confronting the researcher is not appropriate.

Documenting in the medical record is not appropriate.

Concerns regarding unethical conduct by a researcher should be directed to the IRB. Tape-recording the researcher is not appropriate.

PTS: 1 DIF: REF: Pages 240-241

Cognitive Level: Applying (Application)

13. What is the basic human right that exists when the subject’s identity cannot be linked, even by

the researcher, with his or her individual responses? a. Right to self-determination b. Right to anonymity and confidentiality c. Right to fair treatment d. Right to protection from discomfort and harm ANS: B

A B C D

Feedback This does not describe the right to self-determination.

The right to anonymity and confidentiality exists when the subject’s identity cannot be linked, even by the researcher, with his or her individual responses.

This does not describe the right to fair treatment.

This does not describe the right to protection from discomfort and harm.

PTS: 1 DIF: REF: Pages 235-236

Cognitive Level: Understanding (Comprehension)

14. What basic human right is considered to be equitable selection of subjects and their treatment

during the research study? a. Right to self-determination b. Right to anonymity and confidentiality c. Right to fair treatment d. Right to protection from discomfort and harm ANS: C

A B C D

Feedback This does not describe the right to self-determination.

This does not describe the right to anonymity and confidentiality.

The right to fair treatment is being honored when there is equitable selection of subjects and their treatment during the research study.

This does not describe the right to protection from discomfort and harm.

PTS: 1 REF: Page 237

DIF:

Cognitive Level: Understanding (Comprehension)

15. What basic human right exists when subjects have the right to withdraw from a study without

penalty? a. Right to self-determination b. Right to anonymity and confidentiality c. Right to fair treatment d. Right to protection from discomfort and harm ANS: A

A B C D

Feedback The right to self-determination exists when subjects have the right to withdraw from a study without penalty.

This does not describe the right to anonymity and confidentiality.

This does not describe right to fair treatment.

This does not describe the right to protection from discomfort and harm.

PTS: 1 REF: Page 236 MULTIPLE RESPONSE

DIF:

Cognitive Level: Remembering (Knowledge)

1. Which statements are accurate regarding the assent process for pediatric research? (Select all

that apply.) a. A parental signature is required for a child to participate in a study. b. The study protocol is reviewed with the parent and not the child. c. The child should be able to express a preference for participation. d. A child older than age 16 does not require a parent’s signature for consent. e. The child should understand the purpose of the study.

ANS: A, C, E Feedback Correct

Incorrect

A parental signature is required as a part of the assent process.

The child should be able express a preference for participation.

The child should understand the purpose of the study.

The research protocol should be reviewed with both the parent and the child.

Children require a parent’s signature for participation until they reach age 18.

PTS: 1 REF: Page 242

DIF:

Cognitive Level: Remembering (Knowledge)

2. The role of an IRB includes: (Select all that apply.) a. assisting researchers in maintaining rigor during the data analysis phase of a study. b. ensuring that human subjects are protected from undue risks. c. providing approval for studies to be conducted at an institution.

NURSINGTB.CO d. interviewing subjects for the informed consent process. e. ensuring that HIPAA privacy rules are maintained in a study.

ANS: B, C, E Feedback Correct

Incorrect

The IRB functions to protect human subjects.

The IRB approves studies to be conducted at institutions.

The IRB ensures that potential studies will maintain the privacy of participants.

The IRB does not assist with data analysis.

IRB members do not interview for informed consent of participants in studies.

PTS: 1 DIF: REF: Pages 240-241

Cognitive Level: Understanding (Comprehension)

3. An adult participant receives an informed consent form to participate in a study on breast

cancer in women younger than the age of 35. The study’s informed consent process should include: (Select all that apply.) a. the participants meeting the IRB members who approved the study. b. the participants being informed of risks associated with the study. c. the participants being informed of the study protocol. d. the participants being given the right to decline participation at any time.

e. the participants being assured that her confidentiality will be maintained.

ANS: B, C, D, E Feedback Correct

Incorrect

The participant must be notified of potential risks.

The participant must be informed of the study protocol.

The participant must be made aware that she can decline participation in the study at any time without penalty to her.

The participant should be assured that her personal information will be kept confidential.

The participant does not meet IRB members.

PTS: 1 DIF: REF: Pages 238-239

Cognitive Level: Understanding (Comprehension)

4. The five human rights that are outlined in ANA guidelines include: (Select all that apply.) a. right to self-determination. b. right to privacy and dignity. c. right to legal consultation. d. right to anonymity and confidentiality. e. right to fair treatment. f. right to protection from discomfort and harm. g. right to comprehensive medical care.

ANS: A, B, D, E, F

NURSINGTB.COM

Feedback Correct

Incorrect

This is one of the five human rights that are outlined in ANA guidelines.

This is one of the five human rights that are outlined in ANA guidelines.

This is one of the five human rights that are outlined in ANA guidelines.

This is one of the five human rights that are outlined in ANA guidelines.

This is one of the five human rights that are outlined in ANA guidelines.

This is not one of the five human rights that are outlined in ANA guidelines.

This is not one of the five human rights that are outlined in ANA guidelines.

PTS: 1 REF: Page 235

DIF:

Cognitive Level: Remembering (Knowledge)

5. What are ethical principles that are illustrated by obtaining IRB approval? (Select all that

apply.) a. Respect b. Beneficence c. Trust d. Justice e. Anonymity f. Confidentiality ANS: A, B, D

Feedback Correct

Incorrect

IRB approval illustrates the principle of respect.

IRB approval illustrates the principle of beneficence.

IRB approval illustrates the principle of justice.

IRB approval does not illustrate the principle of trust.

IRB approval does not illustrate the principle of anonymity.

IRB approval does not illustrate the principle of confidentiality.

PTS: 1 REF: Page 235

DIF:

Cognitive Level: Remembering (Knowledge)

6. What factors might influence whether it is ethical to require an older adult to participate in a

research study? (Select all that apply.) a. The relevance of the research to issues important to older adults b. The ethnic background of the potential participant c. The age of the potential participant d. The cognitive capacity of the potential participant e. The degree of risk associated with the study ANS: A, D, E Feedback Correct

Incorrect

The study should require elderly participants only if it is relevant to do so.

Elderly individuals should not be used because they are a convenient sample.

Alterations in cognitive capacity can influence whether an elderly person can properly consenNt.URSINGTB.COM A complex study might be too difficult for an elderly person to understand if they have even mild cognitive impairment.

The ethnic background should not be an ethical concern.

The age of the participant should not be an ethical concern.

PTS: 1 REF: Page 243

DIF:

Cognitive Level: Applying (Application)

Chapter 14: Data-Collection Methods LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. What should the nurse researcher expect to be the difference between data collection for

patient care and data collection for the purposes of research? a. For patient care, data are obtained from the patient and medical record; for research, data are obtained only from the patient. b. Data collection for research may include direct patient quotations; in patient care, recording of direct quotations is avoided. c. During research data collection, there is no direct interaction between the nurse and the patient. d. Data collection for research purposes must be objective and systematic.

ANS: D

A B C D

Feedback In research, data may be collected from patients, medical records, and many other sources.

Quotations may be used in either research or patient care.

Research data collection may involve direct nurse contact, depending on design.

The major difference between data collection for patient care and research purposes is that data collection for research purposes must be free from the researchers’ personal biasN esU , bReS liI efN s,GvT alB ue.sC , oOrMattitudes and collected in a uniform, consistent, or standard way from each subject by everyone who is involved in the data-collection process.

PTS: 1 REF: Page 247

DIF:

Cognitive Level: Understanding (Comprehension)

2. The nurse researcher is attempting to answer specific questions about families’ perceptions of

caring for elderly parents with dementia. What would be the most appropriate method of data collection for this study? a. Field notes b. Structured interview c. Unstructured interview d. Physiological instrumentation ANS: B

A B C

Feedback Field notes are comments made by researchers and may not target critical areas of focus.

A structured interview would allow the researcher to ask specific questions about families’ perceptions and attitudes.

Unstructured interviews may not permit coverage of critical topics to be addressed.

D

Physiological instrumentation would not be useful in collecting data about families’ perceptions and feelings.

PTS: 1 REF: Page 250

DIF:

Cognitive Level: Creating (Evaluation)

3. Which data-collection method would be most appropriate in studying bullying behavior in

elementary school–aged girls? a. An unstructured interview b. Asking parents about their children’s experience with bullying c. Responses of the children on a paper-and-pencil bullying scale d. Concealment of the researcher without intervention in children’s behavior ANS: D

A B C D

Feedback Children may be unable to answer unstructured questions and stay focused on the topic of interest.

Parents’ opinions would not give the best data for children’s views on bullying.

Children may not give accurate responses to such a scale.

This method is often used in developmental research and allows for observational studies.

PTS: 1 REF: Page 250

DIF:

Cognitive Level: Creating (Evaluation)

4. What is the nurse researcher’s N prU imRaSryIcNoG ncTeB rn.iC nO daMta collection for research? a. Flexibility in data collection b. Consistency in data collection c. Accurate interpretation of data collected d. Averaging of numerical scores to reduce the effect of outliers ANS: B

A B C D

Feedback Flexibility does not necessarily support integrity in data collection.

Consistency is the most critical issue in the data-collection phase.

Interpretation of data occurs in the data analysis phase.

Arithmetic activities and statistical approaches are part of the data analysis phase.

PTS: 1 REF: Page 259

DIF:

Cognitive Level: Understanding (Comprehension)

5. The training of data collectors to adhere strictly to a standard protocol for a research project

will affect the ultimate outcome of the study by doing what? a. Reducing risks to human subjects b. Reducing cost of data collection c. Increasing consistency in data collection d. Increasing risk of introducing researcher bias into the study

ANS: C

A B C D

Feedback Reducing risks to human subjects is best controlled by institutional review board clearance and informed consent.

Data collector training may actually increase costs in a research study.

Training of data collectors increases consistency in data collection.

Data collector training does not increase risk of researcher bias.

PTS: 1 REF: Page 252

DIF:

Cognitive Level: Understanding (Comprehension)

6. Two data collectors scored pressure ulcers similarly using the Braden Scale for pressure ulcer

assessment. This finding indicates what? a. Interrater reliability between the two data collectors was high. b. Interrater reliability between the two data collectors was low. c. The data-collection method was inappropriate for the investigation. d. Interrater reliability cannot be established without the two data collectors examining each pressure ulcer together at the same time.

ANS: A

A B C D

Feedback Interrater reliability is the consistency of observations between two or more observers.

Agreement of 54 of 56 scores would indicate a high level of interrater reliability.

The data-collection methoN dUwRaS s aIpN prGoT prBia.teCfO orMpressure ulcer risk assessment.

The risk assessments did not have to be done by both evaluators at the same time.

PTS: 1 REF: Page 252

DIF:

Cognitive Level: Understanding (Comprehension)

7. A nurse researcher would choose physiological data-collection methods for which reason? a. Cost and subject acceptance b. Reduced researcher time c. Data collection of patient body weights d. No need for interrater reliability ANS: C

A B C D

Feedback Physiological data-collection instruments can be very costly.

Physiological measurement methods do not necessarily reduce researcher time.

Data collected in this case are physiological.

Physiological measurement methods often use interrated approaches.

PTS: 1 REF: Page 256

DIF:

Cognitive Level: Understanding (Comprehension)

8. What is an example of a physiological measurement? a. Definition of a type A behavior pattern b. Description of self-care behavior abilities in patients with dementia c. Ranges of values on two consecutive arterial blood gas analyses d. Adjusted scores on the State-Trait Anxiety Scale ANS: C

A B C D

Feedback Definition of a human behavior pattern is a theoretical abstraction.

Description of behaviors is observation of activities and is not physiological.

Arterial blood gas readings are examples of a physiological measure.

The State-Trait Anxiety Scale is a paper-pencil survey and is not physiological.

PTS: 1 DIF: REF: Pages 257-258

Cognitive Level: Analyzing (Analysis)

9. During a research project, the researcher notes that the subject completes each assigned task

with a much higher level of performance than is normally exhibited. How should a nurse researcher most accurately describe this change in the subject’s behavior? a. Reactivity b. Instability c. Therapeutic d. Interventionist ANS: A

A B C D

NURSINGTB.COM Feedback Reactivity is behavior change that occurs as a result of being observed.

Instability does not describe this situation adequately.

Therapeutic refers to an intervention and might not be related to reactivity.

Interventionist is not a term used to describe change in behavior that results from awareness of being observed.

PTS: 1 REF: Page 251

DIF:

Cognitive Level: Remembering (Knowledge)

10. The nurse researcher’s use of a focus group interview with audio recording of group

interactions would be considered to be an observational role of what? a. Concealment with intervention b. Concealment without intervention c. No concealment with intervention d. No concealment without intervention ANS: D

A B

Feedback Concealment with intervention involves a hidden treatment without subject awareness.

Concealment without intervention means subjects are unaware of observation

C D

and no action or treatment is invoked.

No concealment with intervention would mean subject awareness of observation and a response provoked by the researcher.

A focus group approach uses no concealment, and no intervention is inherent in the method.

PTS: 1 REF: Page 251

DIF:

Cognitive Level: Analyzing (Analysis)

11. The nurse researcher informs subjects that he or she would like to include them in a research

study and that they can refuse to participate through what? a. Informed consent b. Concealment with intervention c. Unauthorized research d. Concealment without intervention ANS: A

A B C D

Feedback Informed consent is the process of asking subjects to participate in a research study.

Concealment means that research subjects are unaware that they are being observed by a researcher.

Unauthorized research would not have been approved by an IRB. Scientific misconduct is unethical or illegal activities committed by the researcher(s) in a research study.

NURSINGTB.COM PTS: 1 REF: Page 251

DIF:

Cognitive Level: Remembering (Knowledge)

12. Which observational role would be most appropriate if the nurse researcher wants to identify

maternal response behaviors to cries of infants with colic? a. Concealment with intervention b. Concealment without intervention c. No concealment with intervention d. No concealment without intervention ANS: B

A B C D

Feedback Concealment with intervention would not allow natural observations; the mother would be prompted to a response.

Concealment without intervention would promote valid observations of maternal response behaviors to infants’ cries.

The mother would be aware of the observation and prompted to act, affecting validity of the observations.

No concealment without intervention could affect the validity of observations owing to maternal awareness of being watched.

PTS: 1

DIF:

Cognitive Level: Creating (Evaluation)

REF: Page 251 13. Which data-collection method is most vulnerable to researcher bias? a. Questionnaires b. Available data c. Observation methods d. Physiological measurement ANS: C

A B C D

Feedback Questionnaires, because they are prestructured, are less susceptible to researcher bias.

Available data do not constitute a data-collection method.

Researcher bias can most affect observational methods because the researcher is the observer.

Physiological measurement is objective and less susceptible to researcher bias.

PTS: 1 REF: Page 252

DIF:

Cognitive Level: Understanding (Comprehension)

14. What advantage is shared by both interview and questionnaire data-collection methods? a. Both seek to understand the attitudes, beliefs, and feelings of participants. b. Both are analyzed by statistical methods selected by the researcher. c. Both require extensive training of the researcher coordinating the study. d. Both are paper-and-pencil tests implemented by the researcher.

ANS: A

A B C D

NURSINGTB.COM

Feedback Interviews and questionnaires are both good for understanding the attitudes, beliefs, and feelings of participants.

Interviews are not usually analyzed using statistics.

Interviews and questionnaires do not necessarily require extensive researcher training.

Interviews are not usually paper-and-pencil tests.

PTS: 1 DIF: REF: Pages 252-253

Cognitive Level: Understanding (Comprehension)

15. A nurse researcher would select the interview method of data collection for which reason? a. It is of value only in qualitative studies. b. It allows subjects to provide more detailed answers. c. Consistency, rather than objectivity, is of primary importance. d. Objectivity, rather than consistency, is of primary importance.

ANS: B

A B

Feedback Interviews can be and often are used in quantitative studies.

The interview method allows subjects to provide more in-depth answers.

C D

Interviews do not sacrifice consistency for objectivity; interviews are by nature subjective.

Interviews are by nature subjective because subjects report data directly.

PTS: 1 REF: Page 253

DIF:

Cognitive Level: Understanding (Comprehension)

16. Use of records or data-available methods of data collection would be most appropriate: a. When research subjects are considered to be illiterate b. When participants are not known to be reliable historians c. When the goal of research is to analyze trends and change over time d. When the researcher suspects the subject may alter responses to please the

researcher ANS: C

A B C D

Feedback Subject literacy level does not mandate use of records.

Unreliable historians do not mandate use of records because their previous records may also be problematic.

Records and other data-available methods of data collection are good for analyzing trends and change over time.

Subject acquiescence or social desirability can be controlled by questioning techniques rather than use of records.

PTS: 1 REF: Page 257

DIF:

Cognitive Level: Understanding (Comprehension)

17. Which data-collection method can be assessed by asking, “Is there clear indication that the

subjects understood the task and the questions?” a. Questionnaires b. Interviews c. Physiological measurement d. Records and databases ANS: B

A B C D

Feedback This question does not assess questionnaires as a data-collection method.

This question assesses interviews as a data-collection method.

This question does not assess physiological measurement as a data-collection method.

This question does not assess records and databases as a data-collection method.

PTS: 1 DIF: REF: Pages 252-253

Cognitive Level: Understanding (Comprehension)

18. Which data-collection method can be assessed by asking, “Are the data examined in such a

way as to provide new information?” a. Questionnaires

b. Interviews c. Physiological measurement d. Records and databases ANS: D

A B C D

Feedback This question does not assess questionnaires as a data-collection method.

This question does not assess interviews as a data-collection method.

This question does not assess physiological measurement as a data-collection method.

This question assesses records and databases as a data-collection method.

PTS: 1 REF: Page 257

DIF:

Cognitive Level: Understanding (Comprehension)

19. Which data-collection method can be assessed by asking, “Is there evidence that subjects were

able to answer the questions?” a. Questionnaires b. Interviews c. Physiological measurement d. Records and databases ANS: A

A B C D

Feedback This question assesses questionnaires as a data-collection method.

This question does not assess interviews as a data-collection method.

This question does not assess physiological measurement as a data-collection method.

This question does not assess records and databases as a data-collection method.

PTS: 1 DIF: REF: Pages 253-255

Cognitive Level: Understanding (Comprehension)

20. Which data-collection method can be assessed by asking, “Are the majority of the items

appropriately close-ended or open-ended?” a. Questionnaires b. Interviews c. Physiological measurement d. Records and databases ANS: A

A B C D

Feedback This question assesses questionnaires as a data-collection method.

This question does not assess interviews as a data-collection method.

This question does not assess physiological measurement as a data-collection method.

This question does not assess records and databases as a data-collection method.

PTS: 1 DIF: REF: Pages 253-254

Cognitive Level: Understanding (Comprehension)

21. Which data-collection method can be assessed by asking, “Is there a provision for evaluating

the accuracy of the instrument?” a. Questionnaires b. Interviews c. Physiological measurement d. Records and databases ANS: C

A B C D

Feedback This question does not assess questionnaires as a data-collection method.

This question does not assess interviews as a data-collection method.

This question assesses physiological measurement as a data-collection method.

This question does not assess records and databases as a data-collection method.

PTS: 1 DIF: REF: Pages 256-257

Cognitive Level: Understanding (Comprehension)

MULTIPLE RESPONSE 1. A nurse researcher is designing a study on objective analysis of vital sign monitoring before,

during, and after trauma care in the emergency department. To analyze trends in this process, which types of measurements cNoU ulR dS thIeNnG urT seBc.oC nsOidMer incorporating? (Select all that apply.) a. Available data (records of vital signs) b. Paper-and-pencil scales c. Questionnaires d. Physiological instruments readouts e. Interviews ANS: A, D Feedback Correct Incorrect

Vital sign records would be evidence of physiological measurements.

Physiological instrumentation would provide objective readings.

Paper-and-pencil scales are not objective data.

Questionnaires are not objective data.

Interviews are not objective data.

PTS: 1 DIF: REF: Pages 256-257

Cognitive Level: Analyzing (Analysis)

2. A nurse researcher is working with students experiencing test anxiety. The nurse has the

students take a test while she watches through a two-way mirror. What does this approach incorporate? (Select all that apply.) a. Observation b. Interviewing

c. Reactivity d. Structured interviewing e. Concealment ANS: A, E Feedback Correct Incorrect

The nurse is incorporating the process of observation for data collection.

A two-way mirror involves the use of concealment.

This process does not involve interviewing.

Reactivity is a change in subjects’ behavior because of being observed, which is not the case in this study.

Structured interviewing was not used in this scenario.

PTS: 1 REF: Page 250

DIF:

Cognitive Level: Applying (Application)

3. What are some advantages of using physiological data-collection methods? (Select all that

apply.) a. Objectivity b. Precision c. Flexibility d. Inexpensive e. Sensitivity ANS: A, B, E

NURSINGTB.COM

Feedback Correct

Incorrect

This is considered an advantage of the physiological data-collection method.

This is considered an advantage of the physiological data-collection method.

This is considered an advantage of the physiological data-collection method.

Physiological data-collection methods are not known to be flexible.

Physiological data-collection methods may actually be quite expensive.

PTS: 1 REF: Page 256

DIF:

Cognitive Level: Understanding (Comprehension)

4. What are the steps involved in instrument development? (Select all that apply.) a. Clarify the target population b. Define concept to be measured c. Develop items d. Estimate reliability and validity e. Statistically analyze individual items f. Develop implications from the item analysis ANS: A, B, C, D Feedback

Correct

Incorrect

This is the second step in instrument development.

This is the first step in instrument development.

This is the third step in instrument development.

This is the final step in instrument development.

This is not considered a step in instrument development.

This is not considered a step in instrument development.

PTS: 1 REF: Page 258

DIF:

Cognitive Level: Remembering (Knowledge)

5. A nurse researcher is designing a study examining the construct of anxiety. The researcher

could operationalize anxiety through what? (Select all that apply.) a. Vital signs readouts b. Observation c. Sweat-level measurements d. Interview e. Paper-and-pencil scale ANS: A, B, C, D, E Feedback Correct

Incorrect

Changes in vital signs can indicate increased anxiety.

Observation could be used to identify specific behaviors often associated with anxiety.

Anxiety is associated with changes in sweat production.

Interviews of subjects could elicit subjective descriptions of anxiety.

Paper-and-pencil scN alU esRoSrI inNstGruTmBe.nC tsOarMe available to address anxiety.

PTS: 1 REF: Page 259

DIF:

Cognitive Level: Applying (Application)

Chapter 15: Reliability and Validity LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. Nurse researchers critiquing research reports should be concerned with the assessment of the

validity and reliability of study instruments: a. to determine the utility of the instruments for triangulation. b. to assess the relationships between the hypotheses and the research questions. c. to determine whether the concepts and variables were measured adequately. d. to assess whether the concept under study is being treated as a dependent or an independent variable.

ANS: C

A

B C D

Feedback There are several types of triangulation; the instrument chosen might assist a study to become triangulated, but the reliability and validity of it must be determined before triangulation.

This response fits the connection between hypotheses and research questions but not instrument reliability and validity.

An indicator of a study’s excellence is the establishment of the reliability and validity of the instruments used to measure variables.

Instrument reliability and validity issues are separate issues from whether variables are independent N orUdReS peInN deGnT tB va.riC abOleMs.

PTS: 1 REF: Page 263

DIF:

Cognitive Level: Understanding (Comprehension)

2. An ear temperature probe that consistently reports body temperature at a degree lower than the

patient’s actual temperature has what type of reliability or validity problem? a. Reduced reliability, systematic error b. Reduced validity, random error c. Increased validity, systematic error d. Increased validity, random error ANS: A

A B C D

Feedback The instrument is systematically measuring temperature inaccurately.

This response does not refer to random error.

The validity of the instrument is not increased.

The validity of the instrument is not increased.

PTS: 1 REF: Page 264

DIF:

Cognitive Level: Understanding (Comprehension)

3. A researcher who is developing a new instrument to measure pain has been informed that the

instrument has face validity. The researcher’s next step should be to: a. use the instrument in a parent study. b. use the instrument in a pilot study. c. assess the reliability of the instrument. d. assess the content validity of the instrument.

ANS: D

A B C D

Feedback The findings would be in question if this were the next step.

Another step should be taken before testing is done.

Reliability testing is not the next step; establishing greater validity should occur first.

The next step is content validity established through literature and expert judges.

PTS: 1 DIF: REF: Pages 264-265

Cognitive Level: Remembering (Knowledge)

4. Which type of validity is most difficult to establish? a. Content validity b. Construct validity c. Predictive validity d. Concurrent validity ANS: B

A B C D

NURSINGTB.COM Feedback Face and expert validity are relatively easy to establish.

Construct validity includes many types of validity; it is complex and tends to take much more time to establish than other types of validity.

Predictive validity is relatively easy to establish.

Concurrent validity is relatively easy to establish.

PTS: 1 REF: Page 266

DIF:

Cognitive Level: Understanding (Comprehension)

5. When the nurse researcher demonstrates that an instrument is highly reliable, which type of

error is reduced? a. Random error b. Variance error c. Persistent error d. Systematic error ANS: D

A B

Feedback Random error is connected with validity.

Variance and error are connected as a research term, error variance, not the reverse; it is defined as variability in test scores.

C D

Persistent error is not a research term.

Systematic error is connected with reliability.

PTS: 1 DIF: REF: Pages 263-264

Cognitive Level: Remembering (Knowledge)

6. The reliability coefficient of a new instrument is established at 0.86. The nurse researcher

should interpret this finding as: a. high error variance; high reliability. b. high error variance; low reliability. c. low error variance; high reliability. d. low error variance; low reliability.

ANS: C

A B C D

Feedback When the error variance is low, the reliability coefficient will be closer to 1; a reliability level of 0.70 or higher is considered acceptable.

When the error variance is low, the reliability coefficient will be closer to 1; a reliability level of 0.70 or higher is considered acceptable.

When the error variance is low, the reliability coefficient will be closer to 1; a reliability level of 0.70 or higher is considered acceptable.

When the error variance is low, the reliability coefficient will be closer to 1; a reliability level of 0.70 or higher is considered acceptable.

PTS: 1 REF: Page 270

DIF:

Cognitive Level: Understanding (Comprehension)

NURSINGTB.COM

7. A new instrument has been determined to be highly valid. The nurse researcher should

interpret this finding to mean: a. it is sensitive but not specific. b. its use results in minimal random errors. c. it accurately measures level of mentation. d. determination of interrater reliability is unnecessary.

ANS: C

A B C D

Feedback This answer does not reflect validity, but rather it reflects characteristics of screening tests.

Validity does not guarantee minimal random errors.

Validity of an instrument is associated with its accuracy.

Interrater reliability is not an example of validity.

PTS: 1 REF: Page 264

DIF:

Cognitive Level: Remembering (Knowledge)

8. Which type of validity is demonstrated when a nurse researcher submits items of an

instrument to a panel of experts to evaluate item clarity? a. Content validity

b. Construct validity c. Concurrent validity d. Criterion-related validity ANS: A

A B C D

Feedback A panel of experts judges instrument validity through the content type of validity.

Construct validity validates the theory underlying the measurement and testing of hypothesized relationships.

Concurrent validity refers to the degree of correlation of two measures of the same concept administered at the same time.

Criterion-related validity incorporates two forms: concurrent and predictive.

PTS: 1 REF: Page 265

DIF:

Cognitive Level: Understanding (Comprehension)

9. Which type of validity is demonstrated by administering a test in which all items relate to

wound care, and then evaluating student performance in caring for patients with wounds in the clinical setting? a. Face validity b. Content validity c. Construct validity d. Criterion-related validity ANS: D

A B C D

NURSINGTB.COM

Feedback This does not illustrate face validity, or the instrument appears to be measuring the construct.

This does not illustrate content validity, representing the universe of content or domain of a given construct.

Construct validity is characterized by the test measuring theoretical construct or trait.

This validity type connects the subject’s performance with his or her actual behavior.

PTS: 1 REF: Page 266

DIF:

Cognitive Level: Understanding (Comprehension)

10. Concurrent validity indicates: a. the degree of correlation between the measure of the concept and some future

measure of the same concept. b. the degree of correlation of two measures of the same concept administered at the

same time. c. the extent to which a test measures a theoretical construct or trait. d. the representativeness of the items to measure a specific concept.

ANS: B

A B C D

Feedback Concurrent validity is established when two measures of the same construct are administered at the same time, not a future measure.

This response fits the definition of concurrent validity.

This answer fits the description of construct validity.

This response fits the description of content validity.

PTS: 1 REF: Page 267

DIF:

Cognitive Level: Understanding (Comprehension)

11. What type of validity is demonstrated by examining the extent to which a passing grade in a

nursing course is correlated with passing the registered nurse licensure examination? a. Content validity b. Construct validity c. Predictive validity d. Concurrent validity ANS: C

A B C D

Feedback Content validity refers to the representativeness of items to measure a specific concept.

Construct validity refers to the extent to which a test measures a theoretical construct or trait.

This criterion-related validity example is predictive and connects past with future performance.

The example in the stem dNoU esRnSoI t fNitGcT onBc. urCreOnM t validity.

PTS: 1 REF: Page 267

DIF:

Cognitive Level: Analyzing (Analysis)

12. During development of an instrument to measure self-esteem, the nurse researcher

administered the instrument to individuals who were substance abusers and to individuals who were not substance abusers and anticipated a significant difference in scores. This method of establishing construct validity is categorized as what? a. Factor analysis b. Convergent validity c. Discriminant validity d. Contrasted-groups approach ANS: D

A B C D

Feedback The example in the stem does not provide an example of construct validity using factor analysis.

The example does not illustrate convergent validity.

The example does not illustrate discriminant validity.

Two groups of subjects who are suspected to score extremely high or low in the characteristic being measured complete the instrument and differences in scores are examined; the groups should differ and construct validity will be supported.

PTS: 1 REF: Page 268

DIF:

Cognitive Level: Understanding (Comprehension)

13. A nurse researcher assesses the degree to which individual items on a scale cluster together

around multiple dimensions using what? a. Factor analysis b. Split-half reliability c. Cronbach’s alpha coefficient d. Kuder-Richardson coefficient ANS: A

A

B C D

Feedback The extent to which a set of items measures the same underlying construct or dimension of a construct and clusters together around one or more dimensions describes factor analytic construct validity.

This reliability is not associated with factor analysis and construct validity.

This reliability is not associated with factor analysis and construct validity.

This reliability is not associated with factor analysis and construct validity.

PTS: 1 DIF: REF: Pages 268-269

Cognitive Level: Remembering (Knowledge)

14. A nurse researcher describes an instrument that is administered repeatedly and obtains the

same results as demonstrating: a. validity.

NURSINGTB.COM b. reliability. c. consistency. d. predictability.

ANS: B

A B C D

Feedback The stem indicates reliability, not validity.

This answer indicates consistency and stability of an instrument.

Consistency is a characteristic of reliability.

Predictability is a characteristic of reliability.

PTS: 1 REF: Page 270

DIF:

Cognitive Level: Remembering (Knowledge)

15. A nurse researcher describes an instrument that produces the same result when it is

administered to the same subjects under similar conditions on two or more occasions as possessing: a. homogeneity. b. equivalence. c. stability. d. validity.

ANS: C

A

B C D

Feedback The instrument is administered to the same subjects under similar conditions on two or more occasions. Correlations are strong. Test-retest reliability establishes stability of the instrument.

Parallel forms is a reliability example.

The same results are obtained on repeated administration of the instrument.

This stem is a reliability example, not a validity example.

PTS: 1 DIF: REF: Pages 270-271

Cognitive Level: Understanding (Comprehension)

16. What property is established when the results of two separately administered tests that

measure the same domain or concept are highly correlated? a. Validity b. Stability c. Equivalence d. Homogeneity ANS: A

A B C D

Feedback Convergent validity example: two or more instruments that theoretically measure the same construct and are administered to the same subjects.

The example in the stem matches validity, not reliability.

The example in the stem matches validity, not reliability.

NaUtcRhSesIvNaG The example in the stem m lidTitBy. , nCoO tM reliability.

PTS: 1 REF: Page 268

DIF:

Cognitive Level: Understanding (Comprehension)

17. A nurse researcher administered a test anxiety questionnaire to a group of nursing students

before they attended a test anxiety workshop and then administered a different questionnaire to the same nurses immediately following the workshop. This is indicative of which type of reliability? a. Split-half b. Test-retest c. Parallel form d. Alternate form ANS: C

A B C D

Feedback Split-half refers to internal consistency and involves dividing a scale into two halves and making a comparison.

This response fits a quantitative study only partially and is incomplete for a quantitative, quasi-experimental study.

Parallel form means that the same individuals are tested within a specific interval but the subjects are given a different form of the test on the second testing.

This response fits with quantitative tests.

PTS: 1 REF: Page 272

DIF:

Cognitive Level: Understanding (Comprehension)

18. A nurse researcher should be concerned about an instrument’s degree of internal consistency

because it means: a. the instrument is appropriate to use to measure a single concept. b. the instrument has low measurement error and high error variance. c. more refinement of the instrument is needed before it can be applied. d. the instrument is valid, but the reliability has yet to be determined.

ANS: A

A B C D

Feedback Internal consistency or homogeneity reliability indicates that the items within the scale measure the same concept.

This is an inaccurate statement.

A high degree of internal consistency indicates that the instrument is refined; however, additional testing is always warranted.

There is no indication that the instrument is valid; the reliability coefficient is very acceptable.

PTS: 1 DIF: REF: Pages 272-273

Cognitive Level: Applying (Application)

19. A nurse researcher determines an instrument’s homogeneity using which type of reliability? a. Split-half reliability b. Test-retest reliability c. Interrater reliability d. Alternate form reliability ANS: A

A B C D

Feedback Instrument homogeneity is established with split-half reliability.

Test-retest reliability establishes instrument stability.

Interrater reliability is not a homogeneity measure.

Alternate form or parallel form reliability is not a test of homogeneity.

PTS: 1 REF: Page 274

DIF:

Cognitive Level: Applying (Application)

20. A nurse researcher would want to use a Kuder-Richardson (KR-20) coefficient to establish the

internal consistency of an instrument: a. when questions are open-ended. b. when multiple choice tests are analyzed. c. when the instrument uses a Likert-type response scale. d. when the instrument is designed to measure more than one concept.

ANS: B

A B C D

Feedback Open-ended questions elicit textual data that are content analyzed (qualitative analysis).

The KR-20 coefficient provides estimates of homogeneity used for instruments that have a dichotomous response format.

Cronbach’s alpha coefficient provides estimates of homogeneity when instruments are scaled with ordinal responses.

The KR-20 coefficient does not apply to this answer.

PTS: 1 REF: Page 274

DIF:

Cognitive Level: Understanding (Comprehension)

21. A nurse researcher would want to use a Cronbach’s alpha coefficient to establish the internal

consistency of an instrument: a. when questions are open-ended. b. when questions/statements demand a yes or no response. c. when the instrument uses a Likert-type response scale. d. when the instrument is designed to measure more than one concept.

ANS: C

A B C D

Feedback Open-ended questions elicit textual data that are content analyzed (qualitative analysis).

KR-20 provides estimates of homogeneity used for instruments that have a dichotomous response format.

Cronbach’s alpha coefficiN enUt R prSoI viN deGsTeB st. imCaO teM s of homogeneity when instruments are scaled with ordinal responses.

Cronbach’s alpha coefficient does not apply to this answer.

PTS: 1 DIF: REF: Pages 273-274

Cognitive Level: Remembering (Knowledge)

22. Which type of reliability exists when consistency of observation, measured by a correlation

coefficient, is noted between two or more research assistants who record their observations of an event at the same time? a. Internal consistency b. Parallel forms c. Test-retest d. Interrater ANS: D

A B C D

Feedback The example illustrates a test of homogeneity.

The example does not include two instruments measuring the same construct.

The example does not include a time interval between administration of the instrument.

The consistency of observations between two raters making an observation illustrates interrater reliability.

PTS: 1 DIF: REF: Pages 274-275

Cognitive Level: Understanding (Comprehension)

23. A group of researchers developing an instrument performed a test-retest on the instrument

with an interval of 5 days. This testing resulted in a correlation coefficient of 0.38. The nurse researcher interprets this as indicating: a. instrument is stable; high reliability. b. instrument is stable; low reliability. c. instrument is unstable; high reliability. d. instrument is unstable; low reliability.

ANS: D

A B C D

Feedback The low correlation coefficient reveals an unstable instrument and low reliability.

The low correlation coefficient reveals an unstable instrument and low reliability.

The low correlation coefficient reveals an unstable instrument and low reliability.

The low correlation coefficient reveals an unstable instrument and low reliability.

PTS: 1 DIF: Cognitive Level: Analyzing (Analysis) REF: Pages 270-272

NURSINGTB.COM 24.2 Testing of a new instrument demonstrates that it has a high degree of internal consistency. To 4 the nurse researcher this indicates: . a. the instrument is appropriate to use to measure a single concept. b. the instrument has low measurement error and high error variance. c. more refinement of the instrument is necessary before it can be applied. d. the instrument is valid, but the reliability has yet to be determined.

ANS: A

A B C D

Feedback Internal consistency or homogeneity reliability indicates that the items within the scale measure the same concept.

This is an inaccurate statement.

A high degree of internal consistency indicates that the instrument is refined; however, additional testing is always warranted.

There is no indication that the instrument is valid; the reliability coefficient is very acceptable.

PTS: 1 REF: Page 272

DIF: Cognitive Level: Understanding (Comprehension)

25. In testing an instrument consisting of 25 items for homogeneity using the “item-to-total”

correlation, 8 items were found to have a low correlation to the total. The nurse researcher interprets this information to mean that the researcher should: a. use the instrument without changes. b. use the instrument only with a multitrait-multimethod approach. c. retain the 8 items with low correlation and delete the other 17 items. d. delete the 8 items with low correlation and retain the other 17 items.

ANS: D

A B C D

Feedback The instrument should be modified. Items should be deleted.

The multitrait-multimethod approach is appropriate for ongoing instrument development and validity.

The reverse of this answer should be performed: 17 items should be retained and 8 items should be eliminated.

Eight items should be deleted and 17 items should be retained.

PTS: 1 DIF: REF: Pages 272-273

Cognitive Level: Analyzing (Analysis)

26. The nurse researcher notes that the initial test for reliability of an instrument has been

conducted on a sample that has different characteristics from those of the current study sample. The researcher should: a. conduct a pilot study on the current sample to determine whether reliability is maintained. b. use the instrument with theNcU urR reSnI t sNam plB e. beCcO auMse reliability holds across GT samples. c. use the Kuder-Richardson formula to recalculate the reliability coefficient. d. discard or reject the instrument.

ANS: B

A B C D

Feedback The pilot sample was most likely done before this time.

A reliable instrument can be used on more than one occasion to measure a set of behaviors that ordinarily remains relatively constant.

Kuder-Richardson could be calculated on the current sample, but this answer is incorrect.

The instrument should not be discarded.

PTS: 1 REF: Page 270

DIF:

Cognitive Level: Applying (Application)

27. A newly developed instrument is found to have a Cronbach’s alpha of 0.82. The nurse

researcher interprets this to mean: a. the instrument has no internal consistency. b. the instrument has a low degree of internal consistency. c. the instrument has a moderate degree of internal consistency. d. the instrument has a relatively high degree of internal consistency.

ANS: D

A B C D

Feedback This is not an accurate interpretation of the example.

The example evidences a high degree of internal consistency.

The example evidences a high degree of internal consistency.

Alphas above 0.70 provide very good or relatively high evidence for supporting the internal consistency of the instrument.

PTS: 1 REF: Page 273

DIF:

Cognitive Level: Applying (Application)

28. The nurse researcher notes that test-retest correlations were r = 0.79 when given over 4-week

intervals. This is interpreted to indicate: a. equivalence. b. discriminability. c. reliability. d. homogeneity.

ANS: C

A B C D

Feedback This response is one type of reliability.

This response refers to a type of validity.

The example of test-retest correlations fits reliability.

Test-retest procedures estaNbU liR shSsI taN biGliT tyBo.f C inO stM ruments, not homogeneity.

PTS: 1 REF: Page 272

DIF:

Cognitive Level: Analyzing (Analysis)

MULTIPLE RESPONSE 1. When validity of an instrument is determined, the nurse researcher assesses: (Select all that

apply.) a. stability. b. variance. c. accuracy. d. precision.

ANS: C, D Feedback Correct Incorrect

Accuracy refers to instrument validity.

Precision refers to instrument reliability.

Stability refers to instrument reliability.

Variance refers to error.

PTS: 1 REF: Page 270

DIF:

Cognitive Level: Applying (Application)

2. How should the nurse researcher describe variability in test scores attributed to error rather

than to actual differences in behavior? (Select all that apply.) a. Random error b. Variance error c. Persistent error d. Systematic error ANS: A, D Feedback Correct

Incorrect

Random error is attributable to transient subject states, study context, or administration of the instrument.

Bias in subject behavior and incorrect instrument calibrations are causes of systematic error.

Variance and error are connected as a research term, error variance, which is defined as variability in test scores.

Persistent error is not a research term.

PTS: 1 DIF: REF: Pages 263-264

Cognitive Level: Understanding (Comprehension)

3. Which measures used to test reliability are specific for homogeneity? (Select all that apply.) a. Test-retest reliability b. Item-to-total correlation c. Parallel or alternate form d. Split-half reliability e. Kuder-Richardson coefficient NURSINGTB.COM f. Cronbach’s alpha g. Interrater reliability ANS: B, D, E, F Feedback Correct

Incorrect

This measure is specific for homogeneity.

This measure is specific for homogeneity.

This measure is specific for homogeneity.

This measure is specific for homogeneity.

This is a measure specific for stability.

This is a measure specific for stability.

This measure is specific for equivalence.

PTS: 1 DIF: REF: Pages 272-274

Cognitive Level: Remembering (Knowledge)

4. Which measures used to test reliability are specific for equivalence? (Select all that apply.) a. Test-retest reliability b. Item-to-total correlation c. Parallel or alternate form d. Split-half reliability e. Kuder-Richardson coefficient f. Cronbach’s alpha

g. Interrater reliability ANS: C, G Feedback Correct Incorrect

This measure can be used for both equivalence and stability.

This measure is specific for equivalence.

This measure is specific for stability.

This measure is specific for homogeneity.

This measure is specific for homogeneity.

This measure is specific for homogeneity.

This measure is specific for homogeneity.

PTS: 1 DIF: REF: Pages 272, 274

Cognitive Level: Remembering (Knowledge)

NURSINGTB.COM

Chapter 16: Data Analysis: Descriptive and Inferential Statistics LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. The nurse researcher is interested in estimating how reliably data can be used to generalize the

findings of a study. In order for this to occur, the researcher should use: a. inferential statistics. b. descriptive statistics. c. nonparametric statistics. d. mathematical statistics.

ANS: A

A B C D

Feedback Inferential statistics are used by researchers to make predictions and generalize findings on the basis of data.

Descriptive statistics are used to describe and summarize data by reducing data to manageable proportions by summarizing them.

Nonparametric statistics are a type of inferential statistics.

The term mathematical statistics is a circular answer.

PTS: 1 REF: Page 282

DIF:

Cognitive Level: Remembering (Knowledge)

NURSINGTB.COM 2. The nurse researcher is interested in describing and summarizing the characteristics of the

sample used in the research study. In order for this to occur, the researcher should use: a. inferential statistics. b. descriptive statistics. c. nonparametric statistics. d. mathematical statistics.

ANS: B

A B C D

Feedback Inferential statistics are used by researchers to make predictions and generalize findings on the basis of data.

Descriptive statistics are used to describe and summarize data by reducing data to manageable proportions by summarizing them.

Nonparametric statistics are a type of inferential statistics.

The term mathematical statistics is a circular answer.

PTS: 1 REF: Page 282

DIF:

Cognitive Level: Remembering (Knowledge)

3. A nurse researcher would opt to use measures of central tendency: a. when there is a need to describe how reliably the findings can be generalized. b. when there is a need to describe how much dispersion is in the sample.

c. when there is a need to describe the accuracy of predictions made. d. when there is a need to describe the average member of the sample.

ANS: D

A B C D

Feedback This answer describes a function of inferential statistics.

This answer describes measures of variability.

This answer is incorrect.

Measures of central tendency yield a single number that describes the middle of the group and summarizes the members of a sample.

PTS: 1 REF: Page 282

DIF:

Cognitive Level: Understanding (Comprehension)

4. The nurse researcher is interested in describing the assignment of numbers to objects or

events. This is best achieved: a. through use of prediction. b. through use of dispersion. c. through use of variability. d. through use of measurement.

ANS: D

A B C D

Feedback This answer does not fit the definition provided.

This answer represents a m suSreIoNfGvT arB ia. biCliO tyMdescription.

NeUaR This answer represents a measure of dispersion (variability) description.

This answer fits the definition provided.

PTS: 1 DIF: REF: Pages 282, 284

Cognitive Level: Understanding (Comprehension)

5. A nurse researcher determines the assignment of a number to an object for measurement by

verifying what? a. The objects vary within a narrow range to meet category requirements. b. All objects assigned a specific measurement number are similar to all other objects assigned the same number. c. The objects assigned to one specific number are positively related to the dependent variable of the study. d. The objects assigned to one specific number are positively related to the independent variable of the study.

ANS: B

A B

Feedback A narrow range is not necessary to meet category requirements; the range may be large.

The assignment of a number or a value to a category that represents the category must be consistently applied to similar objects assigned the same number-value

C D

label.

The numbers assigned to objects are consistently applied; this relates to independent and dependent variables.

The numbers assigned to objects are consistently applied; this relates to independent and dependent variables.

PTS: 1 DIF: REF: Pages 272-274

Cognitive Level: Understanding (Comprehension)

6. The nurse researcher is interested in having the greatest flexibility possible in choosing

statistical procedures. The level of measurement used to achieve this is: a. nominal. b. ordinal. c. interval. d. ratio.

ANS: D

A B C D

Feedback Nominal-level data allow the least amount of mathematical manipulation.

Ordinal-level data are limited in the amount of mathematical manipulation possible.

Interval-level data allow for a great amount of data manipulation.

Ratio measurement is the highest level of measurement; all mathematical procedures can be performed on data from ratio scales.

PTS: 1 REF: Page 285

DIF:

CogN niU tivReSLI evNelG :T UB nd. erC stO anMding (Comprehension)

7. The nurse researcher is interested in using nominal-level data. The object or event that could

be used if nominal-level data are of primary interest is: a. test scores. b. education level. c. marital status. d. weight.

ANS: C

A B C D

Feedback Test scores are best represented by interval-level data.

Education level is best represented by ordinal data: increasing rankings of education level.

Marital status is most often represented by nominal-level data.

Weight is represented by interval or ratio-level data.

PTS: 1 REF: Page 284

DIF:

Cognitive Level: Understanding (Comprehension)

8. The nurse researcher is using a research study that involved categories of patient weights. The

level of measurement that would be most appropriate in this study is:

a. b. c. d.

nominal. ordinal. interval. ratio.

ANS: A

A B C D

Feedback The data are represented by nominal-level data, categories, or classifications.

The data are represented by nominal-level data, categories, or classifications.

The data are represented by nominal-level data, categories, or classifications.

The data are represented by nominal-level data, categories, or classifications.

PTS: 1 REF: Page 284

DIF:

Cognitive Level: Applying (Application)

9. The nurse researcher opts to use interval-level data. The researcher’s primary concern will be: a. categories must be mutually exclusive. b. intervals between data categories must be equal. c. the rank of zero (0) represents the absence of the measured variable. d. variance between assigned categories is qualitative rather than quantitative.

ANS: B

A B C D

Feedback This response is true for all levels of data: nominal, ordinal, interval, and ratio.

This is the defining characNteUriRstS icIoNf G inTteBrv.aC lm easurement.

OM The zero does not represent the total absence of a variable in interval-level data.

This response does not describe interval-level data.

PTS: 1 DIF: REF: Pages 284-285

Cognitive Level: Understanding (Comprehension)

10. The nurse researcher opts to use ratio-level data. The researcher’s primary concern will be: a. categories must be mutually exclusive. b. intervals between data categories must be equal. c. the rank of zero (0) represents the absence of the measured variable. d. variance between assigned categories is qualitative rather than quantitative.

ANS: C

A B C D

Feedback This response is true for all levels of data: nominal, ordinal, interval, and ratio.

This is true for intervals between numbers for interval- and ratio-level data.

This is characteristic of ratio measurement.

This response does not describe interval-level data.

PTS: 1 REF: Page 285

DIF:

Cognitive Level: Understanding (Comprehension)

11. The nurse researcher is using a nursing degree as a variable in a research study. The level of

measurement most appropriate in this case is: a. nominal. b. ordinal. c. interval. d. ratio.

ANS: A

A B C D

Feedback This variable (type of nursing degree) is scaled using categorical data, nominal level. The type fits only one characteristic.

This variable (type of nursing degree) is scaled using categorical data, nominal level. The type fits only one characteristic.

This variable (type of nursing degree) is scaled using categorical data, nominal level. The type fits only one characteristic.

This variable (type of nursing degree) is scaled using categorical data, nominal level. The type fits only one characteristic.

PTS: 1 DIF: REF: Pages 284-285

Cognitive Level: Applying (Application)

12. The nurse researcher is using respiratory rate as a variable in a research study. The level of

measurement most appropriate in this case is: a. nominal. b. ordinal. c. interval.

NURSINGTB.COM d. ratio.

ANS: D

A B C D

Feedback Rate is represented by a number representing frequency per minute.

Rate is represented by a number representing frequency per minute.

Rate is represented by a number representing frequency per minute.

Respiratory rate can have an absolute zero—absence of respirations.

PTS: 1 REF: Page 285

DIF:

Cognitive Level: Applying (Application)

13. The nurse researcher is using the percentage of nurses holding various nursing degrees as a

variable in a research study. Which type of statistics is most appropriate in this case? a. Inferential statistics b. Descriptive statistics c. Non-parametric statistics d. Mathematical statistics ANS: B

Feedback

A B C D

Percentage represents descriptive statistics.

Percentage represents descriptive statistics.

Non-parametric statistics are used when testing hypotheses on data generated at nominal and ordinal units.

This is a circular answer and does not apply.

PTS: 1 REF: Page 285

DIF:

Cognitive Level: Understanding (Comprehension)

14. The nurse researcher opts to group frequency data using large interval widths in a research

study. Which problem may be encountered by using this type of interval widths? a. Overlap can occur. b. Patterns can be obscured. c. Means cannot be determined. d. Some data may not fit into any category.

ANS: B

A B C D

Feedback Overlap is eliminated by defining the size of the group or interval width so that no score falls into two groups.

Very large interval widths lead to loss of data information and may obscure patterns in the data.

Frequency intervals do not generate means.

Data or a score generated on a variable will fit into one frequency interval defined by the investigator.

NURSINGTB.COM

PTS: 1 REF: Page 301

DIF:

Cognitive Level: Understanding (Comprehension)

15. Which term represents the most frequent score in a frequency distribution? a. Mean b. Mode c. Median d. Percentile ANS: B

A B C D

Feedback The mean as an average represents interval- and ratio-level data.

The category with the highest frequency is the mode and is used often with nominal-level data.

The median is the middle score or the score when 50% of the scores are above it and 50% of the scores are below it.

Percentile represents the percentage of cases a given score exceeds.

PTS: 1 REF: Page 287

DIF:

Cognitive Level: Understanding (Comprehension)

16. The nurse researcher’s data contain extremes of high and low scores. The measure of central

tendency that should be used in order to be least affected by extremes of high and low scores is: a. mean. b. mode. c. median. d. percentile.

ANS: A

A

B C D

Feedback The mean is affected by every score and the least affected by chance. The larger the sample size was, the less affected the mean will be by a single score. The mean is the most stable, least affected by extremes, and most useful for other calculations.

The mode is unstable and can fluctuate widely from sample to sample from the same population.

The median is not sensitive to extremes in high and low scores; it is less stable than the mean.

Percentile is not a measure of central tendency; the median is the 50th percentile.

PTS: 1 REF: Page 287

DIF:

Cognitive Level: Remembering (Knowledge)

17. When is it most appropriate for the nurse researcher to report the mean, mode, and median of

a variable in a research study? a. When the distribution is unN evUeR n.SINGTB.COM b. When the distribution is wide. c. When the distribution is narrow. d. When the distribution is symmetrical.

ANS: D

A B C D

Feedback This is an inaccurate statement.

This is an inaccurate statement.

This is an inaccurate statement.

If the distribution of a variable of a sample is symmetrical and unimodal, the mean, mode, and median should be reported.

PTS: 1 REF: Page 287

DIF:

Cognitive Level: Understanding (Comprehension)

18. The nurse researcher opts to use a measure of variability. Which measure of variability does

the researcher recognize as being most unstable? a. Mean b. Median c. Range d. Semiquartile range ANS: C

A B C D

Feedback Mean is a measure of central tendency.

Median is a measure of central tendency.

The range is very likely to be changed by a single extreme score.

The semiquartile range is more stable than the range; it is less likely to be changed by a single extreme score.

PTS: 1 REF: Page 289

DIF:

Cognitive Level: Remembering (Knowledge)

19. The nurse researcher finds that the data include a score reported to be in the 75th percentile.

This indicates: a. the score is at the median. b. the score has exceeded the mode. c. the score is exceeded by only 25% of the cases. d. the score represents the average of all scores measured at this time.

ANS: C

A B C D

Feedback You cannot conclude this on the basis of the data provided.

You cannot conclude this on the basis of the data provided.

The score of 75% is exceeded by only 25% of the cases.

This is not a logical answer.

PTS: 1 REF: Page 289

DIF:

CogN niU tivReSLI evNelG :T AB pp. lyC inO gM (Application)

20. In a study of nurses’ willingness to care for patients with a contagious disease, it was found

that the greater the nurses’ spirituality, the greater the willingness to provide care. This finding is indicative of: a. no correlation. b. perfect correlation. c. positive correlation. d. negative correlation.

ANS: C

A B C D

Feedback The example suggests a correlation, not the absence of a correlation.

There is no indication in the example of a 1.0 correlation coefficient.

Both variables are correlated in the same (+, +) direction.

The variables are not correlated in opposite (+, −) directions.

PTS: 1 REF: Page 298

DIF:

Cognitive Level: Applying (Application)

21. The alpha level that is interpreted by the nurse researcher as a highly statistically significant

result is:

a. p = 0.20. b. p = 0.02. c. p = 0.002. d. p = 0.0002.

ANS: D

A B C D

Feedback This result is above the conventional 0.05 and is not statistically significant.

Although this result is statistically significant, it is not highly statistically significant.

This is a highly statistically significant result, but not the highest.

This is the most highly statistically significant result.

PTS: 1 DIF: REF: Pages 293-294

Cognitive Level: Applying (Application)

22. When should a nurse researcher opt to use factor analysis? a. To control statistically for a variable and measure differences among group means b. To take a large number of variables and group them into a smaller number of

factors c. To test the relationship between two variables measured at interval- or ratio-level

data d. To measure the relationship between one outcome or dependent variable and

several dependent variables ANS: B

A B C D

NURSINGTB.COM

Feedback This answer defines analysis of covariance.

This is a definition of factor analysis.

This defines a correlation coefficient.

This answer defines multiple regression.

PTS: 1 REF: Page 299

DIF:

Cognitive Level: Applying (Application)

MULTIPLE RESPONSE 1. Which characteristic is an essential criterion for categorizing an object, event, or fact as

nominal-level data? (Select all that apply.) a. The degree of the characteristic must be positively related to the number assigned. b. Rank orders must be calculated for meaningful interpretation. c. Categories must be mutually exclusive. d. Category ranges cannot overlap.

ANS: C, D Feedback Correct

This is the definition of nominal-level data; categories are mutually

Incorrect

exclusive.

Category ranges must not overlap; each score fits into only one category.

This answer does not fit categorizing an object, event, or fact as nominal level.

Rank orders apply to ordinal-level data, not to nominal-level data.

PTS: 1 DIF: REF: Pages 284-285

Cognitive Level: Understanding (Comprehension)

2. Which statements regarding measures of central tendency are accurate? (Select all that apply.) a. This classification of levels of measurement is scientifically inaccurate. b. Having the mean, mode, and median exactly the same indicates the measures have

been correctly applied. c. They have great flexibility with regard to the amount of mathematical

manipulation possible. d. They vary from sample to sample, even when the same trait or characteristic is

measured.

ANS: C, D Feedback Correct

Incorrect

Various inferential statistical tests employ mean, median, or mode in their calculations.

Measures of central tendency vary from sample to sample, even when the same trait is measured.

The classification of levels of measurement is well accepted by the scientific communitN y.URSINGTB.COM This is an inaccurate statement.

PTS: 1 DIF: REF: Pages 285-287

Cognitive Level: Applying (Application)

3. Which data measurement scales typically use nonparametric tests of significance? (Select all

that apply.) a. Nominal b. Ordinal c. Interval d. Ratio ANS: A, B Feedback Correct

Incorrect

Non-parametric tests of significance are used when data are measured on a nominal or ordinal scale.

Non-parametric tests of significance are used when data are measured on a nominal or ordinal scale.

Parametric statistics are used when data are scaled at the interval- or ratiolevel scale.

Parametric statistics are used when data are scaled at the interval- or ratiolevel scale.

PTS: 1 DIF: REF: Pages 294-295

Cognitive Level: Remembering (Knowledge)

4. Which measures of central tendency allow for rank ordering with equal intervals? (Select all

that apply.) a. Mode b. Range c. Median d. Mean e. Semiquartile range f. Percentile g. SD ANS: A, C, D Feedback Correct

Incorrect

The mode will allow for rank ordering with equal intervals.

The mode will allow for rank ordering with equal intervals.

The mode will allow for rank ordering with equal intervals.

This is an ordinal measure of variability.

This is an ordinal measure of variability.

This is an ordinal measure of variability.

This is an ordinal measure of variability.

PTS: 1 REF: Page 287

DIF:

Cognitive Level: Remembering (Knowledge)

GT 5. Which measures of central tendNeU ncRySaI lloNw foBr . reC laOtiM ve rankings? (Select all that apply.) a. Mode b. Range c. Median d. Mean e. Semiquartile range f. Percentile g. SD ANS: A, C Feedback Correct Incorrect

The mode will allow for relative rankings.

The median will allow for relative rankings.

This is an ordinal measure of variability.

The mean will not allow for relative rankings.

This is an ordinal measure of variability.

This is an ordinal measure of variability.

This is an ordinal measure of variability.

PTS: 1 REF: Page 287

DIF:

Cognitive Level: Remembering (Knowledge)

Chapter 17: Understanding Research Findings LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. The results section of a research report includes what? a. Instruments b. Data c. Design d. Theory ANS: B

A B C D

Feedback Instruments are referred to in the methods section.

The results section of a research report is considered the data-bound section of the report.

Design fits into the methods section.

Theory is frequently referred to in the literature review section.

PTS: 1 REF: Page 306

DIF:

Cognitive Level: Understanding (Comprehension)

2. What should be the nurse researcher’s response to a study that’s results are not supported

statistically or are only partiallyNsUuR ppSoIrtN edG?TB.COM a. Dismiss the study as being irrelevant. b. Review the study’s processes. c. Consider the study to be proven. d. Recognize that findings are not accurate.

ANS: B

A B C D

Feedback The study is important; information from unsupported studies can often be useful.

The study is worth reviewing; information from unsupported studies can often be useful.

Statistical study results do not prove hypotheses; hypotheses that are not supported by statistical tests provide useful information.

This answer does not define the usefulness of a study.

PTS: 1 REF: Page 308

DIF:

Cognitive Level: Understanding (Comprehension)

3. Which section of the report allows a nurse researcher to review critical summary numbers for

each test? a. Results b. Discussion

c. Literature review d. Methods ANS: A

A B C D

Feedback The results section will allow the nurse researcher to review critical summary numbers for each test.

The discussion section will not allow the nurse researcher to review critical summary numbers for each test.

The literature review will not allow the nurse researcher to review critical summary numbers for each test.

The methods section will not allow the nurse researcher to review critical summary numbers for each test.

PTS: 1 REF: Page 309

DIF:

Cognitive Level: Remembering (Knowledge)

4. Which section of the report allows a nurse researcher to review reduction of data in the form

of tables and figures? a. Results b. Discussion c. Literature review d. Methods ANS: A

A B C D

NURSINGTB.COM Feedback The results section will allow the nurse researcher to review reduction of data in the form of tables and figures.

The discussion section will not allow the nurse researcher to review reduction of data in the form of tables and figures.

The literature review will not allow the nurse researcher to review reduction of data in the form of tables and figures.

The methods section will not allow the nurse researcher to review reduction of data in the form of tables and figures.

PTS: 1 REF: Page 309

DIF:

Cognitive Level: Remembering (Knowledge)

5. Which section of the report allows a nurse researcher to report unforeseen events that occurred

during the course of the study? a. Results b. Discussion c. Literature review d. Methods ANS: A

Feedback

A B C D

The results section will allow the nurse researcher to report untoward events that occurred during the course of the study.

The discussion section will not allow the nurse researcher to report untoward events that occurred during the course of the study.

The literature review will not allow the nurse researcher to report untoward events that occurred during the course of the study.

The methods section will not allow the nurse researcher to report untoward events that occurred during the course of the study.

PTS: 1 REF: Page 309

DIF:

Cognitive Level: Remembering (Knowledge)

6. Which section of the report allows a nurse researcher to review all data, including data that are

not significant? a. Results b. Discussion c. Literature review d. Methods ANS: A

A B C D

Feedback The results section will allow the nurse researcher to review all data, even data that are not significant.

The discussion section will not allow the nurse researcher to review all data, even data that are not significant.

The literature review will N noUtRaS lloIwNtGhT eB nu.rsCeOreMsearcher to review all data, even data that are not significant.

The methods section will not allow the nurse researcher to review all data, even data that are not significant.

PTS: 1 REF: Page 309

DIF: Cognitive Level: Remembering (Knowledge)

7. Which section of the report allows the nurse researcher to address limitations or weaknesses

of the study? a. Results b. Discussion c. Literature review d. Methods ANS: B

A B C D

Feedback The results section does not include addressing limitations or weaknesses.

Limitations or weaknesses of the study are addressed in the discussion section.

The literature review does not include addressing limitations or weaknesses.

The methods section does not include addressing limitations or weaknesses.

PTS: 1

DIF:

Cognitive Level: Remembering (Knowledge)

REF: Page 311 8. Which section of the report will allow the nurse researcher to determine what contribution the

study makes to nursing? a. Results b. Discussion c. Recommendations d. Methods ANS: C

A B C D

Feedback The results section does not allow the nurse researcher to answer the question “What contribution to nursing does this study make?”

The discussion section does not allow the nurse researcher to answer the question “What contribution to nursing does this study make?”

The recommendations section allows the nurse researcher to answer the question “What contribution to nursing does this study make?”

The methods section does not allow the nurse researcher to answer the question “What contribution to nursing does this study make?”

PTS: 1 REF: Page 313

DIF:

Cognitive Level: Applying (Application)

9. Which section of the report will allow the nurse researcher to determine the strength, quality,

and consistency of the evidence provided by the findings? a. Results b. Discussion c. Recommendations d. Methods ANS: C

A

B

C

D

Feedback The results section does not allow the nurse researcher to answer the question “What are the strength, quality, and consistency of the evidence provided by the findings?”

The discussion section does not allow the nurse researcher to answer the question “What are the strength, quality, and consistency of the evidence provided by the findings?”

The recommendations section allows the nurse researcher to answer the question “What are the strength, quality, and consistency of the evidence provided by the findings?”

The methods section does not allow the nurse researcher to answer the question “What are the strength, quality, and consistency of the evidence provided by the findings?”

PTS: 1 DIF: REF: Pages 312-313

Cognitive Level: Applying (Application)

10. Which section of the report allows the researcher to determine if evidence provided in the

findings validates current practice or supports the need for change? a. Results b. Discussion c. Recommendations d. Methods ANS: C

A

B

C

D

Feedback The results section does not allow the nurse researcher to answer the question “Does the evidence provided in the findings validate current practice or support the need for change in practice?”

The discussion section does not allow the nurse researcher to answer the question “Does the evidence provided in the findings validate current practice or support the need for change in practice?”

The recommendations section allows the nurse researcher to answer the question “Does the evidence provided in the findings validate current practice or support the need for change in practice?”

The methods section does not allow the nurse researcher to answer the question “Does the evidence provided in the findings validate current practice or support the need for change in practice?”

PTS: 1 DIF: REF: Pages 312-313

Cognitive Level: Applying (Application)

gaUtoRrS s sIhN ouGlT dB de.mCoO nsMtrate what?

11. When reporting results, investiN a. Subjectivity b. Appropriateness c. Objectivity d. Inference ANS: C

A B C D

Feedback Researchers must present results with objectivity.

This is a non-specific answer.

Researchers must present results with objectivity.

Inference is used when interpreting inferential statistical results.

PTS: 1 REF: Page 308

DIF:

Cognitive Level: Remembering (Knowledge)

12. Which section of the report allows the nurse researcher to determine if bias arose during the

study? a. Results b. Discussion c. Literature review d. Methods ANS: B

A B C D

Feedback The results section does not allow the nurse researcher to determine whether any bias arose during the conduct of the study.

The discussion section allows the nurse researcher to determine whether any bias arose during the conduct of the study.

The literature review does not allow the nurse researcher to determine whether any bias arose during the conduct of the study.

The methods section does not allow the nurse researcher to determine whether any bias arose during the conduct of the study.

PTS: 1 REF: Page 311

DIF:

Cognitive Level: Understanding (Comprehension)

13. How should researchers and reviewers accept statistical significance? a. With the belief that statistically significant results are the final word b. With the cautious regard for how results might apply to practice c. With the view that careful appraisal is necessary to apply results to theory d. With the idea that additional testing is not necessary ANS: B

A B C D

Feedback Even if results are statistically significant, reviewers should not believe they are the final word.

Caution or prudence is always warranted when reviewing the results of studies.

This response does not maNkU eR seSnI seN . GTB.COM Many quantitative studies require additional statistical testing.

PTS: 1 REF: Page 311

DIF:

Cognitive Level: Analyzing (Analysis)

14. Which section of the report allows the nurse researcher to address support of the theoretical

framework? a. Results b. Discussion c. Literature review d. Methods ANS: B

A B C D

Feedback The results section does not include addressing support of the theoretical framework.

Support of the theoretical framework is addressed in the discussion section.

The literature review does not include addressing support of the theoretical framework.

The methods section does not include addressing support of the theoretical framework.

PTS: 1 DIF: REF: Pages 310-311

Cognitive Level: Remembering (Knowledge)

15. When researchers write the discussion section of a study, which section of the report is used to

evaluate the findings? a. Method b. Introduction c. Theoretical framework d. Data analysis ANS: C

A B C D

Feedback Investigators return to the theoretical framework to assess whether the findings support, extend, or counter it.

Investigators return to the theoretical framework to assess whether the findings support, extend, or counter it.

Investigators return to the theoretical framework to assess whether the findings support, extend, or counter it.

Investigators return to the theoretical framework, not the data analysis section, to determine the fit of the findings with previously described theory.

PTS: 1 REF: Page 312

DIF:

Cognitive Level: Understanding (Comprehension)

16. Which section of the report allows the nurse researcher to determine if data collection was

consistent? a. Results b. Discussion c. Literature review d. Methods

NURSINGTB.COM

ANS: B

A B C D

Feedback The results section does not allow the nurse researcher to determine whether data collection was consistent and exhibited fidelity.

The discussion section allows the nurse researcher to determine whether data collection was consistent and exhibited fidelity.

The literature review does not allow the nurse researcher to determine whether data collection was consistent and exhibited fidelity.

The methods section does not allow the nurse researcher to determine whether data collection was consistent and exhibited fidelity.

PTS: 1 REF: Page 312

DIF:

Cognitive Level: Understanding (Comprehension)

17. A researcher makes generalizations beyond the population being studied. The nurse researcher

recognizes this as: a. accurate.

b. appropriate. c. inappropriate. d. supportable.

ANS: C

A B C

D

Feedback One should not generalize beyond the population on which a study is based.

One should not generalize beyond the population on which a study is based.

Generalizations that draw conclusions and make inferences within a particular situation at a particular time are appropriate but not beyond the population on which the study is based.

Generalizations that draw conclusions and make inferences beyond the population on which a study is based are not acceptable when considering sample and population statistics and inference.

PTS: 1 REF: Page 312

DIF:

Cognitive Level: Remembering (Knowledge)

18. The nurse researcher questions the strength, quality, and consistency of the evidence provided

by the findings. This is described in which part of the discussion section? a. Inferences b. Summary c. Limitations d. Recommendations ANS: D

A B C D

NURSINGTB.COM

Feedback Inferences are made when interpreting statistical test results.

Summary statements are made in another part of the discussion section.

Limitations are addressed by examining the weaknesses of a study and are often attributable to instruments, analysis, and sampling.

These questions help with the identification of the recommendations part of the discussion section.

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DIF:

Cognitive Level: Remembering (Knowledge)

19. In which section of the report will the nurse researcher address applicability to practice and

future research? a. Results b. Discussion c. Literature review d. Methods ANS: B

A

Feedback The results section does not include addressing applicability to practice and

B C D

future research.

Applicability to practice and future research is addressed in the discussion section.

The literature review does not include addressing applicability to practice and future research.

The methods section does not include addressing applicability to practice and future research.

PTS: 1 REF: Page 311

DIF:

Cognitive Level: Understanding (Comprehension)

20. The section of the report in which the nurse researcher determines if the theoretical thinking

used was correct is called: a. results. b. discussion. c. literature review. d. methods.

ANS: B

A B C D

Feedback The results section will not allow the nurse researcher to determine whether theoretical thinking was correct.

The discussion section allows the nurse researcher to determine whether theoretical thinking was correct.

The literature review will not allow the nurse researcher to determine whether theoretical thinking was cN orU reRctS. INGTB.COM The methods section will not allow the nurse researcher to determine whether theoretical thinking was correct.

PTS: 1 REF: Page 312

DIF:

Cognitive Level: Understanding (Comprehension)

21. The nurse researcher can determine if the sampling size was adequate in which section of the

report? a. Results b. Discussion c. Literature review d. Methods ANS: B

A B C D

Feedback The results section will not allow the nurse researcher to determine whether sampling size was adequate.

The discussion section allows the nurse researcher to determine whether sampling size was adequate.

The literature review will not allow the nurse researcher to determine whether sampling size was adequate.

The methods section will not allow the nurse researcher to determine whether

sampling size was adequate.

PTS: 1 REF: Page 312

DIF:

Cognitive Level: Understanding (Comprehension)

22. When discussing the results, what facilitates presentation of large amounts of data? a. Subjective presentation b. Inferential statistics c. Tables and figures d. Descriptive statistics ANS: C

A B C D

Feedback A subjective presentation does not facilitate the presentation of large amounts of data.

Inferential statistics are important, but they do not necessarily facilitate the presentation of large amounts of data.

The use of tables and figures facilitates the presentation of large amounts of data.

Descriptive statistics are important, but they do not necessarily facilitate the presentation of large amounts of data.

PTS: 1 REF: Page 309

DIF:

Cognitive Level: Remembering (Knowledge)

23. A problem with the study’s validity would be classified as: a. unsupported data. b. poor interpretation of results. c. limitation. d. lack of objectivity.

ANS: C

A B C D

Feedback A problem with validity would not necessarily be synonymous with unsupported data.

A problem with validity would not necessarily be synonymous with poor interpretation of results.

A problem with the study’s validity would be considered to be a limitation.

A problem with validity would not necessarily be synonymous with lack of objectivity.

PTS: 1 REF: Page 311

DIF:

Cognitive Level: Understanding (Comprehension)

24. In which section of the report does the nurse researcher address supported and unsupported

data? a. Results b. Discussion c. Literature review

d. Methods ANS: B

A B C D

Feedback The results section does not include addressing supported and unsupported data.

Supported and unsupported data are addressed in the discussion section.

The literature review does not include addressing supported and unsupported data.

The methods section does not include addressing supported and unsupported data.

PTS: 1 REF: Page 311

DIF:

Cognitive Level: Understanding (Comprehension)

25. Which section of the report allows the nurse researcher to determine if instruments were

reliable and valid? a. Results b. Discussion c. Literature review d. Methods ANS: B

A B C D

Feedback The results section will not allow the nurse researcher to determine whether instruments were reliable and valid.

The discussion section allows the nurse researcher to determine whether instruments were reliable and valid.

The literature review will not allow the nurse researcher to determine whether instruments were reliable and valid.

The methods section will not allow the nurse researcher to determine whether instruments were reliable and valid.

PTS: 1 DIF: REF: Pages 311-312

Cognitive Level: Understanding (Comprehension)

26. Which section of the report allows the nurse researcher to discuss the analysis choices? a. Results b. Discussion c. Literature review d. Methods ANS: B

A B

Feedback The results section will not allow the nurse researcher to discuss the analysis choices.

The discussion section allows the nurse researcher to discuss the analysis choices.

C D

The literature review will not allow the nurse researcher to discuss the analysis choices.

The methods section will not allow the nurse researcher to discuss the analysis choices.

PTS: 1 REF: Page 312

DIF:

Cognitive Level: Understanding (Comprehension)

27. Which section of the report allows a nurse researcher to interpret the evidence provided? a. Results b. Discussion c. Literature review d. Methods ANS: A

A B C D

Feedback The results section will allow the nurse researcher to interpret the evidence provided.

The discussion section will not allow the nurse researcher to interpret the evidence provided.

The literature review will not allow the nurse researcher to interpret evidence provided.

The methods section will not allow the nurse researcher to interpret evidence provided.

PTS: 1 REF: Page 306

DIF:

CogN niU tivReSLI evNelG :T UB nd. erC stO anMding (Comprehension)

28. Which section of the report allows a nurse researcher to review the descriptive and inferential

statistics for each hypothesis or research question? a. Results b. Discussion c. Literature review d. Methods ANS: A

A B C D

Feedback The results section will allow the nurse researcher to review the descriptive and inferential statistics for each hypothesis or research question.

The discussion section will not allow the nurse researcher to review the descriptive and inferential statistics for each hypothesis or research question.

The literature review will not allow the nurse researcher to review the descriptive and inferential statistics for each hypothesis or research question.

The methods section will not allow the nurse researcher to review the descriptive and inferential statistics for each hypothesis or research question.

PTS: 1 REF: Page 306

DIF:

Cognitive Level: Understanding (Comprehension)

MULTIPLE RESPONSE 1. The findings of a study include: (Select all that apply.) a. methods. b. conclusions. c. interpretations. d. theories.

ANS: B, C, D Feedback Correct

Incorrect

Conclusions describe findings.

Interpretations describe findings.

Theories are referred to when findings are interpreted, typically in the discussion section of a study.

Methods describe one major section of a study.

PTS: 1 REF: Page 306

DIF:

Cognitive Level: Remembering (Knowledge)

2. When presenting results, it is essential that investigators avoid: (Select all that apply.) a. opinion. b. bias. c. reactionary statements. d. data.

ANS: A, B, C

NURSINGTB.COM

Feedback Correct

Incorrect

Opinion should always be avoided; factual reporting is essential.

Bias in reporting is never consistent with research.

Reactionary statements are narrow minded and inconsistent with objective research.

Data are always presented in the results of studies.

PTS: 1 DIF: REF: Pages 308-309

Cognitive Level: Remembering (Knowledge)

3. Tables and figures assist in presenting the findings of studies by: (Select all that apply.) a. supplementing the text. b. repeating the text. c. representing the results. d. reproducing the results.

ANS: A, C Feedback Correct Incorrect

Tables and figures supplement the text.

Tables and figures represent the results.

Tables and figures avoid repeating the text.

Tables and figures do not reproduce or duplicate the results.

PTS: 1 REF: Page 309

DIF:

Cognitive Level: Understanding (Comprehension)

4. Limitations of a study may be attributed to: (Select all that apply.) a. instruments. b. sampling methods. c. analysis. d. literature review.

ANS: A, B, C Feedback Correct

Incorrect

Instrument issues with reliability and validity may limit study findings.

Sampling methods, such as a convenience sample, may limit study findings.

Analysis techniques, such as inappropriate statistical tests, may limit study findings.

Limitations of a study are not specified in the literature review and are not often attributed to the literature review.

PTS: 1 DIF: REF: Pages 308, 311

Cognitive Level: Understanding (Comprehension)

5. Characteristics of an effective table include: (Select all that apply.) a. it supplements and economizes the text. b. it repeats text frequently foN r aUdR deSdIeN mGpT haBs. is.COM c. it has precise titles and headings. d. it does not repeat the text. e. there is creativity in the presentation of data.

ANS: A, C, D Feedback Correct

Incorrect

Supplementing and economizing the text are considered characteristics of a good table.

Precise titles and headings are considered characteristics of a good table.

A good table should not repeat the text.

Repeating the text is not considered a characteristic of a good table.

Although creativity is important, a creative presentation does not necessarily make a good table.

PTS: 1 REF: Page 314

DIF:

Cognitive Level: Understanding (Comprehension)

Chapter 18: Appraising Quantitative Research LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. The critique of a quantitative research report should include: a. applying the findings in clinical practice. b. summarizing the major steps of the research process. c. constructively evaluating a study for its strengths and weaknesses. d. determining whether the phenomenon studied by participants can be recognized as

their own.

ANS: C

A B C D

Feedback Applying findings in clinical practice is performed after critiquing a study’s strengths.

Summarizing the steps of the research process is not equivalent to constructive evaluation.

Research critique is constructive evaluation of a study’s strengths and limitations.

Research critique is performed by an objective reviewer, not by participants.

PTS: 1 REF: Page 319

DIF:

Cognitive Level: Understanding (Comprehension)

NURSINGTB.COM

2. Which statement most accurately evaluates a quantitative research study report’s scientific

merit? a. The sample size was appropriate for the statistical tests used. b. The study had one independent variable and two dependent variables. c. Data described in narrative form within the text could have been more concise in a table. d. The discussion was excessive in length.

ANS: A

A B C D

Feedback Describing appropriate use of sample size for pertinent statistical tests is an example of scientific merit.

Explaining the number of variables is not an example of scientific critique.

The critique of narrative display is an example of stylistic comment.

The comment about length of discussion is an example of stylistic critique.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Understanding (Comprehension)

3. Both the problem statement and the purpose of a quantitative research study report should

address:

a. b. c. d.

generalizability. sampling procedure. implications for future research. relationship between the variables.

ANS: D

A B C D

Feedback Generalizability would be addressed by research design and sampling procedures.

The sampling procedure is usually described in the methods section.

Implications for future research are developed after study findings are obtained.

The problem statement and the purpose both specify relationships between study variables.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Understanding (Comprehension)

4. Where in a report of a quantitative research study would a nurse researcher expect the gaps or

conflicts about the phenomenon studied to be identified? a. Analysis of data b. Research design c. Problem statement d. Review of the literature ANS: D

A B C D

NURSINGTB.COM Feedback The data analysis section describes how obtained data were organized and analyzed.

The research design section explains the design chosen by the researcher and how it will be used.

The problem statement specifies the focus of the study and the significance of the problem.

A literature review describes what is known, as well as what is not known about a phenomenon being studied.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Remembering (Knowledge)

5. A study abstract includes the following statement: “There was a negative relationship between

infants with difficult behavioral styles and maternal involvement.” The most accurate interpretation of the statement is: a. the more difficult the infant was, the more involved the mother was. b. the more difficult the infant was, the less involved the mother was. c. the less difficult the infant was, the less involved the mother was. d. there was no relationship between infant behavior and maternal involvement.

ANS: B

Feedback

A B C D

This is a positive variable relationship and does not match the abstract statement.

The statement involves an inverse relationship; more infant difficulty, less maternal involvement.

This is a positive variable relationship and does not match the abstract statement.

This is a statement of no relationship between variables and does not match the abstract statement.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Analyzing (Analysis)

6. A comparison study investigating the levels of depression in blind and sighted adolescents

does not use a hypothesis. Does the lack of a hypothesis in this study represent a weakness?

Why or why not? a. Not a weakness; study is descriptive b. Not a weakness; study is quasi-experimental c. Is a weakness; study is descriptive d. Is a weakness; study is quasi-experimental ANS: A

A B C D

Feedback The title suggests a descriptive study, and a hypothesis is not necessary.

The study title is descriptive comparative and is not quasi-experimental.

A hypothesis is not necessary for a descriptive study.

The study is nonexperimental, so a hypothesis is not necessary.

PTS: 1 REF: Page 318

DIF:

CogN niU tivReSLI evNelG :T AB na. lyC ziO ngM(Analysis)

7. Why would a study involving continuous handrail support, oxygen uptake, and heart rate in

women during submaximal step treadmill exercise be quasi-experimental in design rather than experimental? a. The sample size was small. b. Randomization was not used in sample selection. c. The dependent variables were not manipulated. d. The independent variables were not manipulated.

ANS: B

A B C D

Feedback The size of the sample does not primarily affect the nature of the study design.

The major difference between experimental and quasi-experimental designs is lack of randomization in sampling selection.

Dependent variables or outcome variables are not manipulated.

Independent variables (or the treatment) must be manipulated to conduct an experiment or quasi-experiment.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Analyzing (Analysis)

8. What would make a study researching the levels of depression occurring in blind and sighted

adolescents nonexperimental rather than experimental in design? a. The sample size was small. b. The two samples were not equal in size. c. The dependent variable was not manipulated. d. The independent variable was not manipulated.

ANS: D

A B C D

Feedback Sample size does not designate study design.

Size of sample groups does not designate study design.

Dependent variables are the outcome variables and are not manipulated in experimental research.

Non-experimental designs are by nature characterized by non-manipulation of the independent variable.

PTS: 1 DIF: REF: Pages 318-319

Cognitive Level: Analyzing (Analysis)

9. How could the sample selection procedures used in a research study investigating the levels of

depression occurring in blind and sighted adolescents make the sample of blind adolescents more homogeneous? a. Eliminate subjects taking prescription medications. b. Narrow the age range of subjects to those between 13 and 18 years. c. Have the same person administer the questionnaire to all subjects. d. Avoid telling the subjects tN heUnRaS tuI reNoGf T thB e. stC udOyM. ANS: A

A B C D

Feedback Because many potential subjects take prescription medications, elimination of subjects taking prescription medications would make the sample homogeneous.

Narrowing the age range of subjects in an adolescent study would not necessarily increase homogeneity.

Having the same data collector would not alter the nature of the sample.

Not sharing the nature of the study with subjects would not alter sample characteristics.

PTS: 1 DIF: REF: Pages 318-319

Cognitive Level: Applying (Application)

10. This statement was included in a study’s abstract: “This research was an exploratory

descriptive investigation of the pregnancy experiences of a multiethnic group of pregnant adolescents.” This is indicative of: a. the study’s aims. b. the study’s design. c. the study’s significance. d. the study’s implications.

ANS: B

A B C D

Feedback Aims of the research are not explained in the statement.

The statement describes the design of the study.

The statement does not allude to the significance of the study.

Implications of the study findings are not explained in the statement.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Analyzing (Analysis)

11. This statement was included in a study’s abstract: “By formalizing parenting education in the

immediate postpartum period, midwives may have the opportunity to reduce the prevalence of postnatal depression”? This is indicative of: a. the study’s results. b. the study’s analysis. c. the study’s implications. d. the study’s recommendations.

ANS: C

A B C D

Feedback The statement does not explain the explicit results of the study.

The statement does not describe data analysis issues.

The statement describes the implications of parenting education for use by midwives.

The statement does not specify recommendations for future activities.

NURSINGTB.COM PTS: 1 REF: Page 318

DIF:

Cognitive Level: Analyzing (Analysis)

12. Which change in the sample selection procedure of a study involving continuous handrail

support, oxygen uptake, and heart rate in women during submaximal step treadmill exercise would have the greatest impact on increasing the generalizability of the results? a. Increasing the sample size b. Including subjects who smoke in the study c. Having a true control group rather than having subjects serve as their own controls d. Expanding the sample population to include equal numbers of women who were moderately fit and highly fit ANS: D

A B C D

Feedback Increasing sample size does not necessarily increase the generalizability of results.

Smoking may or may not alter women’s fitness level and does not necessarily affect generalizability.

Having a control group does not increase generalizability like increasing heterogeneity of the sample.

Including various types of women according to fitness level would increase the generalizability of the results.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Applying (Application)

13. This statement was included in a research report: “A positive correlation was found between

the variables of self-reported sleep adequacy and performance on the driving simulator (r = 0.21), although the correlation did not reach statistical significance.” A research consumer should evaluate this to mean: a. no relationship exists between the two variables. b. the hypothesis was supported by the data presented. c. the hypothesis was not supported by the data presented. d. the relationship between the variables is too weak to have practical application.

ANS: D

A B C D

Feedback Because there is a correlation, a relationship has to exist between variables.

No hypothesis is expressed, so no judgment can be made regarding the statement.

No hypothesis is expressed, so no judgment can be made regarding the statement.

The statement explains that the relationships among the variables are too weak for practical application.

PTS: 1 REF: Page 318

DIF: Cognitive Level: Applying (Application)

NURSINGTB.COM

14.1 A study includes this statement: “The fact that the inventory [instrument] was administered 4 verbally introduced a potential bias of social desirability.” This is indicative of: . a. implications for practice. b. limitations of the study. c. generalizability of the study. d. recommendations for future research.

ANS: B

A B C D

Feedback The statement does not specify any implications for practice.

Administering the questionnaire verbally and risking bias of social desirability is an example of a study limitation.

Generalizability of study results would be most affected by sample characteristics, not by the method of data collection.

No recommendations for future research are explained in this statement.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Analyzing (Analysis)

15. In evaluating quantitative research, a researcher can expect to review the report’s segments in

which order?

A. Methods

B. Introduction C. Literature review D. Discussion E. Results a. A, B, C, D, E b. B, A, C, D, E c. E, C, D, B, A d. B, C, A, E, D ANS: D

A B C D

Feedback This is not the correct order.

This is not the correct order.

This is not the correct order.

This is the correct order of a research report’s segments.

PTS: 1 DIF: REF: Pages 318-319

Cognitive Level: Remembering (Knowledge)

16. Which critical appraisal question would evaluate the research question and hypothesis of a

research report? a. Is there a synthesis summary that presents the overall strengths and weaknesses and arrives at a logical conclusion that generates hypotheses or research questions? b. What are the sources of bias, and are they dealt with appropriately? c. How have the purpose, aims, or goals of the study been substantiated? d. To what population may thN eU finRdSinIgN sG beTgBe. neCraOliMzed? What are the limitations in generalizability?

ANS: C

A B C D

Feedback This question would evaluate the review of the literature.

This question would evaluate internal and external validity.

This question would evaluate the research question and hypothesis.

This question would evaluate sampling.

PTS: 1 DIF: REF: Pages 319-320

Cognitive Level: Analyzing (Analysis)

17. Which critical appraisal question would evaluate the review of the literature of a research

report? a. Is there a synthesis summary that presents the overall strengths and weaknesses and arrives at a logical conclusion that generates hypotheses or research questions? b. What are the sources of bias, and are they dealt with appropriately? c. How have the purpose, aims, or goals of the study been substantiated? d. To what population may the findings be generalized? What are the limitations in generalizability?

ANS: A

A B C D

Feedback This question would evaluate the review of the literature.

This question would evaluate internal and external validity.

This question would evaluate the research question and hypothesis.

This question would evaluate sampling.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Analyzing (Analysis)

18. Which critical appraisal question would evaluate the sampling of a research report? a. Is there a synthesis summary that presents the overall strengths and weaknesses

and arrives at a logical conclusion that generates hypotheses or research questions? b. What are the sources of bias, and are they dealt with appropriately? c. How have the purpose, aims, or goals of the study been substantiated? d. To what population may the findings be generalized? What are the limitations in

generalizability?

ANS: D

A B C D

Feedback This question would evaluate the review of the literature.

This question would evaluate internal and external validity.

This question would evaluate the research question and hypothesis.

This question would evaluate sampling.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Analyzing (Analysis)

NURSINGTB.COM

19. The critical appraisal question that would most accurately evaluate the research question and

hypothesis of a research report is: a. Is there a synthesis summary that presents the overall strengths and weaknesses and arrives at a logical conclusion that generates hypotheses or research questions? b. What are the sources of bias, and are they dealt with appropriately? c. How have the purpose, aims, or goals of the study been substantiated? d. To what population may the findings be generalized? What are the limitations in generalizability?

ANS: C

A B C D

Feedback This question would evaluate the review of the literature.

This question would evaluate internal and external validity.

This question would evaluate the research question and hypothesis.

This question would evaluate sampling.

PTS: 1 DIF: REF: Pages 318-319

Cognitive Level: Analyzing (Analysis)

20. The critical appraisal question that would most accurately evaluate the applicability to nursing

practice of a research report is:

a. Would it be possible to replicate this study in another clinical setting? b. Are the results of each hypothesis or research question presented and presented

objectively? c. Did testing of the hypothesis(es) or research question(s) clearly support or not

support each hypothesis or research question? d. Was there an observation guide?

ANS: A

A B C D

Feedback This question would evaluate the applicability to nursing practice.

This question would evaluate conclusions, implications, and recommendations.

This question would evaluate the data analysis.

This question would evaluate data-collection methods and procedures.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Analyzing (Analysis)

21. Which critical appraisal question would evaluate the data analysis of a research report? a. Would it be possible to replicate this study in another clinical setting? b. Are the results of each hypothesis or research question presented and presented

objectively? c. Did testing of the hypothesis(es) or research question(s) clearly support or not

support each hypothesis or research question? d. Was there an observation guide?

ANS: C

A B C D

NURSINGTB.COM

Feedback This question would evaluate the applicability to nursing practice.

This question would evaluate conclusions, implications, and recommendations.

This question would evaluate the data analysis.

This question would evaluate data-collection methods and procedures.

PTS: 1 DIF: REF: Pages 318-319

Cognitive Level: Analyzing (Analysis)

22. The critical appraisal question that would most accurately evaluate the conclusions,

implications, and recommendations of a research report is: a. Would it be possible to replicate this study in another clinical setting? b. Are the results of each hypothesis or research question presented and presented objectively? c. Did testing of the hypothesis(es) or research question(s) clearly support or not support each hypothesis or research question? d. Was there an observation guide?

ANS: B

A

Feedback This question would evaluate the applicability to nursing practice.

B C D

This question would evaluate conclusions, implications, and recommendations.

This question would evaluate the data analysis.

This question would evaluate data-collection methods and procedures.

PTS: 1 DIF: REF: Pages 318-320

Cognitive Level: Analyzing (Analysis)

23. The critical appraisal question that would most accurately evaluate the data-collection

methods and procedures of a research report is: a. Would it be possible to replicate this study in another clinical setting? b. Are the results of each hypothesis or research question presented and presented objectively? c. Did testing of the hypothesis(es) or research question(s) clearly support or not support each hypothesis or research question? d. Was there an observation guide?

ANS: D

A B C D

Feedback This question would evaluate the applicability to nursing practice.

This question would evaluate conclusions, implications, and recommendations.

This question would evaluate the data analysis.

This question would evaluate data-collection methods and procedures.

PTS: 1 REF: Page 319

DIF:

Cognitive Level: Analyzing (Analysis)

24. A nurse researcher is critically appraising a research report and asks the question “What

sources of bias are possible with use of records or existing data sets?” The data-collection method(s) and procedure(s) that this question evaluates is: a. physiological measurement. b. interviews. c. available data records. d. questionnaires.

ANS: C

A B C D

Feedback This question would not evaluate physiological measurement.

This question would not evaluate interviews.

This question would evaluate available data records.

This question would not evaluate questionnaires.

PTS: 1 REF: Page 319

DIF:

Cognitive Level: Analyzing (Analysis)

25. A nurse researcher is critically appraising a research report and asks the question “Was

interrater reliability calculated?” Which data-collection methods and procedures would this question evaluate? a. Physiological measurement

b. Interviews c. Available data records d. Observation ANS: D

A B C D

Feedback This question would not evaluate physiological measurement.

This question would not evaluate interviews.

This question would not evaluate available data records.

This question would evaluate observation.

PTS: 1 REF: Page 319

DIF:

Cognitive Level: Analyzing (Analysis)

26. A nurse researcher is critically appraising a research report and asks the question “Is a

rationale given for the selection of a particular instrument or method?” Which data-collection methods and procedures would this question evaluate? a. Physiological measurement b. Interviews c. Available data records d. Observation ANS: A

A B C D

Feedback This question would evaluate physiological measurement.

This question would not evaluate interviews.

This question would not evaluate available data records.

This question would not evaluate observation.

PTS: 1 REF: Page 319

DIF:

Cognitive Level: Analyzing (Analysis)

27. A nurse researcher is critically appraising a research report and asks the question “Is the

format appropriate for use with this population?” Which data-collection methods and procedures would this question evaluate? a. Physiological measurement b. Questionnaires c. Available data records d. Observation ANS: B

A B C D

Feedback This question would not evaluate physiological measurement.

This question would evaluate questionnaires.

This question would not evaluate available data records.

This question would not evaluate observation.

PTS: 1 REF: Page 319

DIF:

Cognitive Level: Analyzing (Analysis)

28. A nurse researcher is critically appraising a research report and asks the question “What

provision is made for maintaining accuracy of the instrument and its use, if any?” Which data-collection methods and procedures would this question evaluate? a. Physiological measurement b. Questionnaires c. Available data records d. Observation ANS: A

A B C D

Feedback This question would evaluate physiological measurement.

This question would not evaluate questionnaires.

This question would not evaluate available data records.

This question would not evaluate observation.

PTS: 1 REF: Page 319

DIF:

Cognitive Level: Analyzing (Analysis)

MULTIPLE RESPONSE 1. A nursing student is critiquing a research study on the effects of test anxiety reduction and a

review course on National Council Licensure Examination-Registered Nurse (NCLEX-RN) success rates of graduate nurseN s. UTR heSsItuNdG enTtBn. otC esOsMeveral threats to internal validity. These threats affect the accuracy of which variables? (Select all that apply.) a. NCLEX success rates b. Test anxiety reduction c. Graduate nurses d. Review course e. Type of nursing program ANS: B, D Feedback Correct

Incorrect

Test anxiety, an independent variable, is affected by internal validity threats.

Review course, an independent variable, would be affected by internal validity threats.

NCLEX success is the dependent variable.

Graduate nurse is a description of the sample and is not affected by threats to internal validity.

Type of nursing program is not a designated variable.

PTS: 1 REF: Page 318

DIF:

Cognitive Level: Applying (Application)

2. Evaluating a research report for issues of scientific merit includes which factors? (Select all

that apply.) a. Quality of data collection b. Appropriateness of statistical analysis c. Comprehensiveness of literature review d. Design match to research question e. Presentation of typeface in article ANS: A, B, C, D Feedback Correct

Incorrect

Scientific merit includes quality of data collection.

Scientific merit includes appropriate statistical analysis.

Scientific merit also includes quality of literature review.

Scientific merit also includes critiquing quality of research design.

Selected typeface and presentation are stylistic issues.

PTS: 1 DIF: REF: Pages 318-320

Cognitive Level: Remembering (Knowledge)

NURSINGTB.COM

Chapter 19: Strategies and Tools for Developing an Evidence-Based Practice LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. What order would be most appropriate for these statements involving development of a

focused clinical question, progressing from lowest level to highest level?

A. What is the population of interest?

B. To what will this intervention be compared?

C. What is the intervention of interest?

D. How will the intervention make things better or worse? a. A, B, C, D b. D, C, B, A c. D, B, C, A d. A, C, B, D ANS: D

A B C D

Feedback This is not the correct order.

This is not the correct order.

This is not the correct order.

This is the correct order for developing a focused clinical question.

PTS: 1 REF: Page 365

DIF:

CogN niU tivReSLI evNelG :T UB nd. erC stO anMding (Comprehension)

2. What type of study would be most appropriate if the nurse researcher is seeking to answer a

question about the effectiveness of a particular treatment? a. Descriptive b. Correlational c. Exploratory d. Quasi-experimental e. Qualitative ANS: D

A B C D E

Feedback Descriptive studies describe a phenomenon and do not test treatments.

Correlational studies examine relationships, not causation.

Exploratory studies do not analyze treatment efficacy.

Quasi-experimental studies do allow testing of a treatment.

Qualitative studies are not experimental.

PTS: 1 DIF: REF: Pages 365-366

Cognitive Level: Understanding (Comprehension)

3. What type of study would be most appropriate if a nurse researcher wants to answer a

question about a patient’s likely course in a disease trajectory? a. Experimental b. Longitudinal c. Cross-sectional d. Methodological e. Quasi-experimental ANS: B

A B C D E

Feedback Experimental design would not examine disease progress over time.

Longitudinal design is recommended for studying outcomes in a particular disease.

Cross-sectional study looks at data in one point of time.

Methodological design is used for the instrument developed.

Quasi-experimental design is recommended to test effects of interventions, not disease trajectory.

PTS: 1 REF: Page 376

DIF: Cognitive Level: Applying (Application)

4. Skills needed to consult the literature and answer a clinical question are known as: a. informatics. b. database searching. c. information literacy. d. evidence-based practice (EB NPU)R. ANS: C

A B C D

Feedback Informatics is the use of computers in data management.

Database searching is one component of information literacy.

Information literacy refers to the skills needed to consult the literature and answer a clinical question.

Information literacy is a major component of EBP.

PTS: 1 REF: Page 366

DIF:

Cognitive Level: Remembering (Knowledge)

5. What type of study would be most appropriate if a nurse researcher wants to determine if

historical exposure to a specific water source is associated with later development of inflammatory bowel disease? a. Ex post facto design b. Experimental design c. Qualitative design d. Therapeutic design ANS: A

A B C D

Feedback Ex post facto design is used when the researcher wants to determine whether one thing is related to or causes another thing.

Experimental design tests efficacy of an intervention.

Qualitative design would not be able to assess relationships or causation.

Therapeutic design is not a designated design; therapy category is testing efficacy.

PTS: 1 REF: Page 366

DIF:

Cognitive Level: Applying (Application)

6. In reviewing product materials, which reported precision confidence interval (CI) would make

the nurse researcher interested in purchasing the product? a. CI of 2 to 100 mm b. CI of 15 to 75 mm c. CI of 25 to 75 mm d. CI of 2 to 5 mm ANS: D

A B C D

Feedback CI at this range would not be precise.

CI at this range would not be precise.

CI at this range would not be precise.

The most precise CI is the smallest range.

PTS: 1 DIF: REF: Pages 369-370

CogN niU tivReSLI evNelG :T AB pp. lyC inO gM (Application)

7. What term is used for the ability of a test or technique to detect a disease when present? a. Specificity b. Confidence interval c. Survival curve d. Sensitivity ANS: D

A B C D

Feedback Specificity is the measure of how well a test or technique rules out disease when it is absent.

Confidence interval is a measure of precision of study results.

Survival curve is a graph showing the probability of a patient’s surviving in a given state for a specified time.

Sensitivity is the measure of how well a test or technique detects disease when it is present.

PTS: 1 REF: Page 373

DIF:

Cognitive Level: Remembering (Knowledge)

8. Which type of research findings is considered the strongest available evidence?

a. b. c. d.

Meta-analysis Descriptive Case study Narrative

ANS: A

A B C D

Feedback Meta-analysis findings provide the strongest evidence available to clinicians.

Descriptive findings are low-level evidence because descriptive studies are done when little is known about a subject.

Case study describes findings most commonly from one person, often an unusual case.

Narrative findings are used in qualitative studies and are not considered as strong evidence as meta-analysis.

PTS: 1 DIF: REF: Pages 377-378

Cognitive Level: Applying (Application)

9. Which database is most likely to yield the highest level evidence for a nurse researcher? a. Psychological abstracts b. Google.com c. Cumulative Index to Nursing and Allied Health Literature (CINAHL) d. Cochrane Review ANS: D

A B C D

NURSINGTB.COM Feedback Psychological abstracts will not necessarily target the topical area or have systematic reviews.

Google is a search engine on the Internet and would not contain systematic research reviews.

CINAHL may have studies on this topic but not necessarily meta-analyses or systematic reviews.

The Cochrane Review database provides systematic reviews that are primarily meta-analyses of interventions for health-related disorders.

PTS: 1 REF: Page 379

DIF:

Cognitive Level: Applying (Application)

10. Which term is used to describe the reduction of risk because of an experimental treatment? a. Relative risk reduction b. Number needed to treat c. Control event rate d. Absolute risk reduction ANS: D

A

Feedback Relative risk ratio is the risk of the event after the experimental treatment as a

B C D

percentage of the original risk.

Number needed to treat is the estimated number of treatment patients needed vs standard treatment for one patient to benefit.

Control event rate is the proportion of patients in whom an event is observed in the control group.

Absolute risk reduction is the description of risk in absolute terms because it is the difference between risk observed in those who did and did not experience the event.

PTS: 1 REF: Page 380

DIF:

Cognitive Level: Remembering (Knowledge)

11. To assess the efficacy of a specific intervention, which type of clinical category should the

student investigate in appraising study results? a. Therapy b. Sensitivity and specificity c. Prognosis d. Harm ANS: A

A B C D

Feedback Therapy category articles attempt to determine whether a difference exists between two or more treatments.

In sensitivity and specificity studies, investigators assess the ability of screening tools and techniques to detect a disease.

In prognosis category articNleUsR , rSesIeN arG chTeB rs.tC ryOtoMdetermine the outcome of a particular disease or condition.

Harm category articles assess whether an individual has been harmed by exposure to a particular event.

PTS: 1 REF: Page 365

DIF:

Cognitive Level: Understanding (Comprehension)

12. The statistic a nurse researcher should choose to use in a meta-analysis is: a. survival curve. b. odds ratio. c. measure of central tendency. d. measure of dispersion.

ANS: B

A B C D

Feedback Survival curve is a graph showing the probability that a patient survives in a given state for a specified time.

Odds ratio is the statistic of choice for meta-analysis.

Measure of central tendency refers to several statistics (e.g., mean), not reserved to meta-analysis.

Measure of dispersion refers to several statistics (e.g., standard deviation), not reserved to meta-analysis.

PTS: 1 REF: Page 378

DIF:

Cognitive Level: Applying (Application)

13. A nurse researcher critiquing a research study notes that a confidence interval (CI) is too large

for a new therapy to be clinically meaningful. What likely contributed to this statistical outcome? a. Strong power level b. Quantitative experimental design c. Statistical analysis d. Too small a sample ANS: D

A B C D

Feedback Strong power level would contribute to a small CI. Quantitative experimental design would not hamper CI outcomes.

Statistical analysis is the process of calculating a CI. As the number of subjects in a study increases, the CI narrows.

PTS: 1 DIF: REF: Pages 369-370

Cognitive Level: Analyzing (Analysis)

14. In an experiment, when a value is obtained that shows no difference between the treatment

and control group, the value is considered: a. causal. b. sensitivity. c. null. d. positively predictive.

ANS: C

A B C D

Feedback Causal refers to a relationship between treatment and outcome that makes a difference.

Sensitivity refers to the ability of a test or screen to identify a disease.

Null refers to a value indicating no difference between the treatment and control group.

Positively predictive indicates a relationship between two variables in which one predicts the other.

PTS: 1 REF: Page 370

DIF:

Cognitive Level: Remembering (Knowledge)

15. What is the significance of a diagnostic test with a large positive likelihood ratio? a. It provides only limited predictive value for disease. b. It provides a high degree of certainty that the patient has the suspected disorder. c. It mandates other supportive diagnostic tests. d. It provides little assistance in clinical decision making.

ANS: B

A B C D

Feedback A large positive likelihood ratio has strong predictive value.

A test with a large positive likelihood ratio provides a high degree of certainty that the patient has the suspected disorder.

A large positive likelihood ratio in a test is likely to decrease the need for other backup tests.

A large positive likelihood ratio test is helpful in clinical decision making because it provides a high degree of certainty.

PTS: 1 REF: Page 375

DIF:

Cognitive Level: Understanding (Comprehension)

16. A nurse researcher reviewing an experimental study notices that one group received the “gold

standard” treatment. This should be most accurately interpreted as: a. experimental treatment. b. no treatment. c. nonconventional treatment. d. current standard of treatment.

ANS: D

A B C D

Feedback Experimental treatment is the new or nonstandard treatment.

Any experimental study must have a treatment involved.

Nonconventional or new treatment is the experimental treatment.

Gold standard refers to thN eU cuRrrSeI ntNaG ccTeB pt. edCsOtaMndard of treatment.

PTS: 1 REF: Page 366

DIF:

Cognitive Level: Understanding (Comprehension)

17. Applying study results to individual patients or to a specific patient population and

communicating findings to patients in a meaningful way is the hallmark of: a. scientific perspectives. b. clinical practice. c. meta-analysis. d. EBP. ANS: D

A B C D

Feedback Science does not always address clinical or applied issues.

Clinical practice is not always applicable to patient issues.

Meta-analysis is a statistical method that may or may not be patient focused.

EBP is characterized by these processes.

PTS: 1 REF: Page 380

DIF:

Cognitive Level: Understanding (Comprehension)

18. The vertical line in a graphic of a systematic review represents:

a. b. c. d.

an odds ratio of 1. the 95% CI. the findings from an individual study. the amount of information in an individual study.

ANS: A

A B C D

Feedback The vertical line is the line of no effect (odds ratio = 1) The 95% CI is represented by the width of the horizontal line.

The findings from each study are represented by a blob or square on the horizontal line.

The amount of information in each study may be represented by the size of the blob or square.

PTS: 1 REF: Page 379

DIF:

Cognitive Level: Remembering (Knowledge)

19. How should the nurse researcher most accurately interpret an odds ratio greater than 1.0? a. This means there is no difference in the odds of an event occurring between the

experimental and control groups. b. The event is less likely in the treatment group than the control group. c. The event is more likely to occur in the treatment group than the control group. d. Percent increase in risk of the event that is added after considering the percent of

risk that would occur anyway.

ANS: C

A B C D

NURSINGTB.COM

Feedback This defines an odds ratio that is equal to 1.0.

This defines an odds ratio that is less than 1.0.

An odds ratio greater than 1.0 means the event is more likely to occur in the treatment group than in the control group.

This would refer to relative risk increase.

PTS: 1 REF: Page 376

DIF:

Cognitive Level: Analyzing (Analysis)

20. How should the nurse researcher most accurately interpret an odds ratio less than 1.0? a. This means there is no difference in the odds of an event occurring between the

experimental and control groups. b. The event is less likely in the treatment group than in the control group. c. The event is more likely to occur in the treatment group than in the control group. d. Percent increase in risk of the event that is added after considering the percent of risk that would occur anyway.

ANS: B

A

Feedback This defines an odds ratio that is equal to 1.0.

B C D

This defines an odds ratio that is less than 1.0.

An odds ratio greater than 1.0 means that the event is more likely to occur in the treatment group than the control group.

This would refer to relative risk increase.

PTS: 1 REF: Page 376

DIF:

Cognitive Level: Analyzing (Analysis)

21. How should the nurse researcher most accurately interpret an odds ratio equal to 1.0? a. This means there is no difference in the odds of an event occurring between the

experimental and control groups. b. The event is less likely in the treatment group than in the control group. c. The event is more likely to occur in the treatment group than in the control group. d. Percent increase in risk of the event that is added after considering the percent of

risk that would occur anyway.

ANS: A

A B C D

Feedback This defines an odds ratio that is equal to 1.0.

This defines an odds ratio that is less than 1.0.

An odds ratio greater than 1.0 means that the event is more likely to occur in the treatment group than the control group.

This would refer to relative risk increase.

PTS: 1 REF: Page 376

DIF:

Cognitive Level: Analyzing (Analysis)

22. How should the nurse researcher most accurately interpret a relative risk that is greater than

1.0? a. There is no difference between the experimental and control group outcomes. b. The risk of the event is reduced in experimental event rate (EER) compared with control event rate (CER). c. The risk of an event is greater in EER compared with CER. d. It is the difference in risk of outcome between patients who have had the event and those who have not.

ANS: C

A B C D

Feedback This describes the state of a relative risk that is equal to 1.0.

This describes the state of a relative risk that is less than 1.0.

This describes the state of a relative risk that is greater than 1.0.

This describes absolute risk reduction.

PTS: 1 REF: Page 369

DIF:

Cognitive Level: Analyzing (Analysis)

23. How should the nurse researcher most accurately interpret a relative risk that is less than 1.0? a. There is no difference between the experimental and control group outcomes.

b. The risk of the event is reduced in EER compared with CER. c. The risk of an event is greater in EER compared with CER. d. Difference in risk of outcome between patients who have had the event and those

who have not.

ANS: B

A B C D

Feedback This describes the state of a relative risk that is equal to 1.0.

This describes the state of a relative risk that is less than 1.0.

This describes the state of a relative risk that is greater than 1.0.

This describes absolute risk reduction.

PTS: 1 REF: Page 369

DIF:

Cognitive Level: Analyzing (Analysis)

24. How should the nurse researcher most accurately interpret a relative risk that is equal to 1.0? a. There is no difference between the experimental and control group outcomes. b. The risk of the event is reduced in EER compared with CER. c. The risk of an event is greater in EER compared with CER. d. Difference in risk of outcome between patients who have had the event and those

who have not.

ANS: A

A B C D

Feedback This describes the state of a relative risk that is equal to 1.0.

NURSINGTB.COM This describes the state of a relative risk that is less than 1.0.

This describes the state of a relative risk that is greater than 1.0.

This describes absolute risk reduction.

PTS: 1 REF: Page 369

DIF:

Cognitive Level: Analyzing (Analysis)

25. Absolute risk reduction is most accurately calculated as: a. EER + CER. b. EER – CER/CER. c. EER – CER. d. EER/CER. ANS: C

A B C D

Feedback This is not an accurate method of calculating absolute risk reduction.

This is the method of calculating relative risk reduction.

This is the method of calculating absolute risk reduction.

This is not an accurate method of calculating absolute risk reduction.

PTS: 1 REF: Page 369

DIF:

Cognitive Level: Remembering (Knowledge)

26. Relative risk reduction is most accurately calculated as: a. EER + CER. b. EER – CER/CER. c. EER – CER. d. EER/CER. ANS: B

A B C D

Feedback This is not an accurate method of calculating absolute risk reduction.

This is the method of calculating relative risk reduction.

This is the method of calculating absolute risk reduction.

This is not an accurate method of calculating absolute risk reduction.

PTS: 1 REF: Page 369

DIF:

Cognitive Level: Remembering (Knowledge)

MULTIPLE RESPONSE 1. Which questions determine a researcher’s selection of a relevant, credible article? (Select all

that apply.) a. Who or what paid for the research? b. Is the setting of the study similar to my study? c. Is the sample of the study similar to mine? d. Was the article peer reviewed?

ANS: A, B, C, D Feedback Correct

An important question is whether the study was sponsored by an organization, which could possibly influence the results.

An important question is the relationship of sample and setting to the proposed study.

An important question is the relationship of sample and setting to the proposed study.

Articles published in a peer-reviewed journal undergo an extensive review and editing process.

Incorrect

PTS: 1 REF: Page 367

DIF:

Cognitive Level: Understanding (Comprehension)

2. Therapy-type articles are associated with outcome variables that are categorized as: (Select all

that apply.) a. continuous. b. isolated. c. rich text. d. dichotomous.

ANS: A, D

Feedback Correct

Incorrect

Outcome variables may be continuous (with degree of change in response to therapy).

Outcome variables may also be dichotomous (proportion of those who experience or do not experience an event in response to therapy).

Isolated is not a term commonly used to describe outcome variables.

Rich text is a term used to describe data in a qualitative study.

PTS: 1 REF: Page 368

DIF:

Cognitive Level: Understanding (Comprehension)

3. A nurse researcher is seeking studies whose outcomes are described with a measure of

precision about the studies’ results. The statistical descriptions the researcher will seek include: (Select all that apply.) a. the t test. b. correlation. c. standard deviation. d. CI. e. mean.

ANS: C, D Feedback Correct

Standard deviation describes how scores vary on average and are a component of assessing precision.

Confidence interval is a range of values, accompanying measures of central tendency and association, giving a measure of precision about findings.

Incorrect

The t test examines differences between mean scores in two groups and does not address precision.

Correlation describes strength of relationships but not precision.

Mean is the average of scores in a sample and does not address precision or uncertainty of findings.

PTS: 1 DIF: REF: Pages 368-369

Cognitive Level: Applying (Application)

4. Types of EBP clinical categories include: (Select all that apply.) a. therapy. b. diagnosis. c. prognosis. d. harm. e. hazard.

ANS: A, B, C, D Feedback Correct

Therapy is one of the four EBP clinical categories.

Diagnosis is one of the four EBP clinical categories.

Prognosis is one of the four EBP clinical categories.

Harm is one of the four EBP clinical categories.

Incorrect

Hazard is not an EBP clinical category.

PTS: 1 DIF: REF: Pages 365-366

Cognitive Level: Remembering (Knowledge)

5. Which information regarding a new algorithm for pressure support surface selection should be

interpreted as favorable for adoption of the algorithm? (Select all that apply.) a. It is solely clinically focused. b. It was recently published. c. It is endorsed by two prominent wound care organizations. d. It is based on two systematic reviews from Cochrane Library.

ANS: C, D Feedback Correct

Incorrect

Endorsement by two nationally prominent organizations would add to credibility.

Credibility of the algorithm is enhanced because it is based on systematic analyses.

A sole clinical focus does not ensure credibility.

Recent publication does not ensure credibility.

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6. A nurse is investigating the literature on a clinical topic and is particularly interested in studies

that are experimental. What other terms may the nurse encounter in a literature search? (Select all that apply.) a. Randomized controlled trials b. Intervention studies c. Individual studies d. Prognostic studies ANS: A, B, C Feedback Correct

Incorrect

Randomized controlled trials is one form of experimental design.

Intervention studies is a synonym for experimental design.

Individual studies is a synonym for experimental design.

Prognostic studies are essentially correlational in nature, not experimental.

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Cognitive Level: Understanding (Comprehension)

7. From top to bottom, what are the study designs associated with the strongest level of evidence

base? (Select all that apply.) a. Randomized controlled trial b. Quasi-experimental c. Correlational d. Descriptive study e. Phenomenal

ANS: A, B, C, D Feedback Correct

Incorrect

A randomized controlled trial is the highest level of evidence.

Quasi-experimental design is the second highest level.

Correlational design is the third highest level of evidence.

Descriptive design is the lowest level of evidence base.

A phenomenal study design will not have a strong level of evidence base.

PTS: 1 DIF: REF: Pages 369-370

Cognitive Level: Remembering (Knowledge)

Chapter 20: Developing an Evidence-Based Practice LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. A nurse researcher can use research findings to go beyond dissemination of evidence-based

guidelines and promote adoption of evidence-based practice (EBP) guidelines through: a. dissemination activities. b. translating research into practice. c. research utilization. d. critiquing findings.

ANS: B

A B

C D

Feedback Dissemination activities include publications, conferences, consultations, and training programs.

Through translating research into practice (TRIP) is a multifaceted, systemic process of promoting adoption of EBP in delivery of health care services that goes beyond dissemination of evidence-based guidelines.

Research utilization is the process of using research findings to improve patient care.

Research critique involves analyzing the strengths and weaknesses of studies.

PTS: 1 DIF: REF: Pages 383-384

CogN niU tivReSLI evNelG :T UB nd. erC stO anMding (Comprehension)

2. What should a nurse researcher use to guide the analysis of data collected from subjects who

meet study inclusion and exclusion criteria for the purpose of answering specific research questions that test specified hypotheses? a. Dissemination of research b. Meta-synthesis of research c. Utilization of research d. Conduct of research ANS: D

A B C D

Feedback Dissemination activities include publications, conferences, consultations, and training programs.

Meta-synthesis is the process of integrating or comparing findings from qualitative studies.

Research utilization is the process of using research findings to improve patient care.

Analyzing data collected from subjects who meet study inclusion and exclusion criteria for the purpose of answering specific research questions that test specified hypotheses describes research conduct.

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3. The nurse researcher who is involved in conduct of research should plan to accomplish: a. active interchange with active care practitioners. b. dissemination of findings via research reports. c. determining applicability of findings for practice. d. use of randomized controlled trials.

ANS: B

A B C D

Feedback This is characteristic of TRIP. This is part of the process of the conduct of research.

This is characteristic of research utilization.

This is characteristic of EBP.

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4. A nurse researcher should view EBP as: a. the integration of best research evidence with clinical expertise and patient values. b. the promotion of the publication of research findings among practicing nurses. c. the process of using research findings to improve patient care. d. the collection of data from subjects using measurement devices.

ANS: A A B C D

Feedback This is a definition of EBP. This refers to one aspect of research dissemination.

This answer defines research utilization.

This answer describes procedures for data collection.

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5. What should the nurse researcher plan to include in a research study that is focused on EBP? a. Interaction with direct care practitioners b. Dissemination of findings via professional journals c. Determining applicability of findings for practice d. Use of randomized controlled trials ANS: D

A B C D

Feedback This is characteristic of TRIP. This is part of the process of the conduct of research.

This is characteristic of research utilization.

This is characteristic of EBP.

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6. To determine the guiding steps involved in actualizing EBP, the researcher should expect to

study the Iowa Model of Evidence-Based Practice to Promote Quality Care in conjunction with: a. Evidence-Based Medicine Reviews. b. Cochrane Database of Systematic Reviews. c. Rogers’ Diffusion of Innovation Model. d. The Agency for Healthcare Research and Quality (AHRQ)’s National Guideline Clearinghouse.

ANS: C

A B C D

Feedback Evidence-Based Medicine Reviews is an electronic database.

Cochrane Database of Systematic Reviews is an electronic database.

The Diffusion of Innovation Model is a dynamic, interactive, and nonlinear process.

The AHRQ’s National Guideline Clearinghouse has abstracts of EBP guidelines available on a Web site.

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7. A nurse researcher is selecting a topic for an EBP project. Which type of topic would be most

appropriate if the researcher is N inU teRreSstIedNG inTdB ev.eC loOpM ing an idea from a problem-focused trigger? a. Treatment of heart failure b. Increased incidence of deep venous thrombosis in trauma patients c. Prevention of nosocomial pressure ulcers d. Community-acquired pneumonia ANS: B

A B C D

Feedback This would be a knowledge-focused trigger.

This would be a problem-focused trigger.

This would be a knowledge-focused trigger.

This would be a knowledge-focused trigger.

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8. A nurse researcher is selecting a topic for an EBP project. Which type of topic would be most

appropriate if the researcher is interested in developing an idea from a knowledge-focused trigger? a. One identified through the benchmarking of data b. One identified through risk surveillance c. One identified through financial data

d. One identified through staff reading research ANS: D

A B C D

Feedback This would be a problem-focused trigger.

This would be a problem-focused trigger.

This would be a problem-focused trigger.

This would be a knowledge-focused trigger.

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9. The EBP team is attempting to formulate an EBP question. When defining the question, the

team should focus on: a. objectives to be accomplished. b. interventions or exposures. c. implementations to be accomplished. d. evaluation of the problem.

ANS: B

A B C D

Feedback This is not part of the process of defining an EBP question.

This is an important part of the process of defining an EBP question.

This is not part of the process of defining an EBP question.

This is not part of the procNeU ssRoS fI deNfiGnT inB g. anCE OBMP question.

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10. Which approach is useful to evaluate an EBP standard after providers have written it? a. Nursing staff meeting b. Focus group c. Patient safety committee d. Quality improvement committee ANS: B

A B C D

Feedback This answer does not include all stakeholders.

This answer could include all stakeholders.

This answer may not be the best fit and may exclude various stakeholders.

This answer may not be the best fit and may exclude various stakeholders.

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11. How is PICO [Patient/population/problem; Intervention/treatment;

Comparison/intervention/treatment; Outcome(s)] used in EBP? a. It is used to formulate the practice question.

b. It is used in evidence retrieval. c. It is used to grade the evidence. d. It is used to critique practice guidelines.

ANS: A

A B C D

Feedback PICO is used to formulate the practice question in EBP. PICO is not used in evidence retrieval.

PICO is not used in grading evidence.

PICO is not used in critiquing practice guidelines.

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12. The nurse researcher is reading theoretical and clinical articles to have a broad view of the

topic and related concepts before reviewing existing EBP guidelines. The nurse researcher begins the process by: a. reading evidence-based guidelines and evidence reports. b. reading clinical articles to understand the state of the practice. c. reading theory articles to understand theoretical perspectives in critiquing studies. d. reading systematic review articles to understand the state of the science.

ANS: B

A B C D

Feedback This is the fourth step involved in reading the articles.

This is the first step involved in reading the articles.

This is the second step involved in reading the articles.

This is the third step involved in reading the articles.

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Cognitive Level: Applying (Application)

13. The nurse researcher is reading theoretical and clinical articles to have a broad view of the

topic and related concepts before reviewing existing EBP guidelines. The nurse researcher concludes the process by: a. reading evidence-based guidelines and evidence reports. b. reading systematic review articles and synthesis reports. c. reading theory articles to understand theoretical perspectives in critiquing studies. d. reading research articles including meta-analyses.

ANS: D

A B C D

Feedback This is the fourth step involved in reading the articles.

This is the third step involved in reading the articles.

This is the second step involved in reading the articles.

This is the final step involved in reading the articles.

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14. Which question will assist a nurse researcher in identifying key stakeholders? a. When will system changes be necessary? b. How will uncooperative stakeholders be handled? c. What is the step-by-step process of decision making in implementing EBP? d. Who can influence the decision to proceed with implementation of an EBP? ANS: D

A B C D

Feedback This is not a question that will be considered in identifying key stakeholders.

This is not a question that will be considered in identifying key stakeholders.

This is not a question that will be considered in identifying key stakeholders.

This is one of the questions that will be considered in identifying key stakeholders.

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15. Which is an electronic database for clinical problems and evidence-based research? a. Health and Psychosocial Instruments File b. Cochrane c. National Clearinghouse d. Cumulative Index to Nursing and Allied Health Index

NURSINGTB.COM

ANS: B

A B C D

Feedback This is an instrument database.

This is a clinical database.

This is a nonspecific answer.

This is a database for nursing and allied health literature and provides a variety of professional, research, and relevant literature citations.

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16. The nurse researcher is synthesizing the findings from research critiques and is creating a

summary table. Essential information to include is: a. stakeholders involved. b. objectives of the study. c. type of research design. d. evaluation of study findings’ usefulness.

ANS: C

A B

Feedback This is not considered essential information to include in a summary table.

This is not considered essential information to include in a summary table.

C D

This is considered essential information to include in a summary table.

This is not considered essential information to include in a summary table.

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MULTIPLE RESPONSE 1. For an EBP project to succeed in improving practice, the team should include: (Select all that

apply.) a. physician. b. stakeholder. c. interdisciplinary team. d. psychologist.

ANS: B, C Feedback Correct

Incorrect

Stakeholder involvement is necessary for the success of an EBP project.

Interdisciplinary team involvement is necessary for the success of an EBP project.

The involvement of only one discipline does not guarantee the success of an EBP project.

The involvement of only one discipline does not guarantee the success of an EBP project.

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CogN niU tivReSLI evNelG :T UB nd. erC stO anMding (Comprehension)

2. Sources of relevant research and related literature that are needed for evidence retrieval

include: (Select all that apply.) a. hospital policies. b. meta-analyses. c. integrative literature review. d. anecdotal reports.

ANS: B, C Feedback Correct

Incorrect

Meta-analyses of several studies are used as a part of evidence retrieval for EBP initiatives.

An integrative literature review may be used as a part of evidence retrieval for EBP initiatives.

Clinical procedures have not necessarily been developed at this point with an EBP approach.

Anecdotal reports of interventions used to support changes in clinical practice are inappropriate for evidence retrieval.

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3. When considering the decision to change practice, criteria to be considered include: (Select all

that apply.) a. a significant number of studies and EBP guidelines. b. the risk-benefit ratio for the patient. c. a thorough review of the literature. d. feasibility for a practice application. e. preference of stakeholders.

ANS: A, B, C, D Feedback Correct

Incorrect

A significant number of studies and EBP guidelines should be considered in a decision to change nursing practice.

The potential benefit and risk of harm must always be considered in a decision to change nursing practice.

A literature review is necessary before a decision to change nursing practice is made.

The feasibility for a practice application must be considered in a decision to change nursing practice.

This is not a criterion that would be considered in the decision to change practice.

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4. The nurse researcher recognizes an opinion leader from the local peer group because this

NURSINGTB.COM

person has which characteristics? (Select all that apply.) a. Is considered by associates as technically competent. b. Is viewed as a respected source of influence. c. Has a narrow but clearly defined sphere of influence. d. Is trusted to evaluate new information in the context of group norms. e. Is a full and dedicated member of the local group.

ANS: A, B, D, E Feedback Correct

Incorrect

This is a characteristic recommended for an opinion leader from the local peer group.

This is a characteristic recommended for an opinion leader from the local peer group.

This is a characteristic recommended for an opinion leader from the local peer group.

This is a characteristic recommended for an opinion leader from the local peer group.

This is not a characteristic recommended for an opinion leader from the local peer group.

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5. Components of a receptive context for EBP include: (Select all that apply.) a. strong leadership. b. clear strategic vision. c. effective data-capture systems. d. organizational skills. e. good managerial relations. f. visionary staff in key positions. g. ability to prioritize. h. climate conducive to experimentation and risk taking.

ANS: A, B, C, E, F, H Feedback Correct

Incorrect

This is considered one of the components of a receptive context for EBP. This is considered one of the components of a receptive context for EBP. This is considered one of the components of a receptive context for EBP. This is considered one of the components of a receptive context for EBP. This is considered one of the components of a receptive context for EBP. This is considered one of the components of a receptive context for EBP. This is not considered one of the components of a receptive context for EBP. This is not considered one of the components of a receptive context for EBP.

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NURSINGTB.COM ORDERING 1. Put the following Steps of Evaluation for Evidence-Based Projects in order from first to last.

design data-collection forms collect data at specified intervals train data collectors use data to assist staff in modifying or integrating the evidence-based practice change provide feedback of analyzed data to staff determine methods and frequency of data collection provide “on-site” feedback to staff regarding the progress in achieving the practice change assess interrater reliability of data collectors establish content validity of data-collection forms identify process and outcome variables of interest determine baseline and follow-up sample sizes ANS:

4, 8, 6, 11, 10, 2, 9, 7, 5, 1, 3 Steps of Evaluation for Evidence-Based Projects 1. Identify process and outcome variables of interest.

2. Determine methods and frequency of data collection.

3. Determine baseline and follow-up sample sizes.

4. Design data-collection forms.

5. Establish content validity of data-collection forms.

6. Train data collectors.

7. Assess interrater reliability of data collectors.

8. Collect data at specified intervals.

9. Provide “on-site” feedback to staff regarding the progress in achieving the practice change.

10. Provide feedback of analyzed data to staff.

11. Use data to assist staff in modifying or integrating the evidence-based practice change.

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NURSINGTB.COM

Chapter 21: Quality Improvement LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. What is the initial phase in application of quality improvement (QI) steps to a clinical

performance problem? a. Analysis b. Assessment c. Test and implement the improvement plan d. Develop a plan for improvement ANS: B

A B C D

Feedback Analysis is the second step in application of the quality improvement steps to a clinical performance problem.

The initial step in applying the quality improvement steps to a clinical performance problem is assessment.

Testing and implementation of the improvement plan is the final step in application of the quality improvement steps to a clinical performance problem.

Development of a plan for improvement is the third step in application of the quality improvement steps to a clinical performance problem.

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2. What is the name of the initiative of organizations that buy health care and are working to

improve the safety, quality, and affordability of health care for Americans? a. Physician Quality Reporting Initiative b. Home Health Compare c. The Leapfrog Group d. Hospital Consumer Assessment of Healthcare Providers and Systems ANS: C

A

B

C

D

Feedback Physician Quality Reporting Initiative is a program administered by the CMS that collects performance data at the physician/provider clinical level in the ambulatory and primary care sectors.

Home Health Compare has information about the quality of care provided by Medicare-certified home health agencies that meet federal health and safety requirements throughout the nation.

The Leapfrog Group is an initiative of organizations that buy health care who are working to improve the safety, quality, and affordability of health care for Americans.

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was developed by the Agency for Healthcare Research and Quality

and is a standardized survey and data-collection method for measuring patients’ perspectives on hospital care.

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3. What is a standardized survey and data-collection method for measuring patients’ perspectives

on hospital care? a. Physician Quality Reporting Initiative b. Home Health Compare c. The Leapfrog Group d. Hospital Consumer Assessment of Healthcare Providers and Systems ANS: D

A

B

C

D

Feedback Physician Quality Reporting Initiative is a program administered by the CMS that collects performance data at the physician/provider clinical level in the ambulatory and primary care sectors.

Home Health Compare has information about the quality of care provided by Medicare-certified home health agencies that meet federal health and safety requirements throughout the nation.

The Leapfrog Group is an initiative of organizations that buy health care who are working to improve the safety, quality, and affordability of health care for Americans.

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) was developedNU byRtS heIA NgGeTnB cy.fC orOH Mealthcare Research and Quality and is a standardized survey and data-collection method for measuring patients’ perspectives on hospital care.

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MULTIPLE RESPONSE 1. What should the nurse researcher do in order to effectively influence improvements in the

work setting and ensure that all patients consistently receive excellent care? (Select all that apply.) a. Align national, organizational, and unit level goals for QI. b. Recognize external drivers of quality. c. Develop skills to apply QI models and tools. d. Review previous attainment of predetermined standards.

ANS: A, B, C Feedback Correct

To effectively influence improvements in the work setting and ensure that all patients consistently receive excellent care, it is important to align national, organizational, and unit level goals for QI; recognize external drivers of quality such as accreditation, payment, and performance

Incorrect

measurement; and develop skills to apply QI models and tools.

Reviewing attainment of predetermined standards applies to the process of accreditation.

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2. The nurse researcher who is participating in quality improvement recognizes that external

drivers of it include: (Select all that apply.) a. accreditation. b. financial incentives. c. performance measurement. d. public reporting.

ANS: A, B, C, D Feedback Correct

External drivers of quality assurance include accreditation, financial incentives, performance measurement, and public reporting.

Incorrect

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MATCHING

Match the Principle of QualityNIm ovIeN mG enTt B w. ithCO itsMKey Benefits.

UpRrS a. Customer focus/patient focus b. Leadership c. Involvement of people d. Process approach e. System approach to management f. Continual improvement g. Factual approach to decision making h. Mutually beneficial supplier relationships 1. People understand and are motivated toward the organization’s goals and objectives.

2. Motivated, committed, and involved people within the organization 3. Increased revenue and market share obtained through flexible and fast responses to market

opportunities Miscommunication between organization levels is minimized.

Increased ability to create value for both parties Increased effectiveness in the organization’s resources to enhance patient satisfaction People are eager to participate in and contribute to continual improvement.

Improved confidence among key stakeholders as to the organization’s consistency, effectiveness, and efficiency 9. Improved patient loyalty leading to repeat business 10. Increased ability to review, challenge, and change opinions and decisions 11. Alignment of improvement activities at all levels to an organization’s strategic intent 4.

5.

6.

7.

8.

Innovation and creativity further the organization’s objectives Activities are evaluated, aligned, and implemented in a unified way Flexibility to react quickly to opportunities People are accountable for own performance.

Performance advantage through improved organizational capabilities Focused and prioritized improvement opportunities Increased ability to demonstrate past decisions’ effectiveness through reference to factual records 19. Integration and alignment of processes that will best achieve desired results 20. Lower costs and shorter cycle times through effective use of resources 12.

13.

14.

15.

16.

17.

18.

1. ANS: B REF: Page 416 2. ANS: C REF: Page 416 3. ANS: A REF: Page 416 4. ANS: B REF: Page 416 5. ANS: H REF: Page 416 6. ANS: A REF: Page 416 7. ANS: C REF: Page 416 8. ANS: E REF: Page 416 9. ANS: A REF: Page 416 10. ANS: G REF: Page 416 11. ANS: F REF: Page 416 12. ANS: C REF: Page 416 13. ANS: B REF: Page 416 14. ANS: F REF: Page 416 15. ANS: C REF: Page 416 16. ANS: F REF: Page 416 17. ANS: D REF: Page 416 18. ANS: G REF: Page 416 19. ANS: E REF: Page 416 20. ANS: D

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