Test Bank for Burns & Groves The Practice of Nursing Research 9th Edition by Jennifer Gray & Grove

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TEST BANK

2023

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COMPLETE Elaborated Test Bank For Burns and Grove's The Practice of Nursing Research-Appraisal, Synthesis, and Generation of Evidence

9th Edition Jennifer R. Gray Susan K. Grove 2023

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Burns and Grove's The Practice of Nursing ResearchAppraisal, Synthesis, and Generation of Evidence 9th Edition by Jennifer R. Gray & Susan K. Grove.

ISBN-10 0323673171 ISBN-13 978-0323673174

Test bank for Burns and Grove's The Practice of Nursing Research-Appraisal, Synthesis, and Generation of Evidence 9th Edition by Jennifer R. Gray & Susan K. Grove

ISBN-10 0323673171 ISBN-13 978-0323673174

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TABLE OF CONTENTS Unit One: Introduction to Nursing Research 1. Discovering the World of Nursing Research 2. Evolution of Research in Building Evidence-Based Nursing Practice 3. Introduction to Quantitative Research 4. Introduction to Qualitative Research

Unit Two: The Research Process 5. Research Problem and Purpose 6. Objectives, Questions, Variables, and Hypotheses 7. Review of Relevant Literature 8. Frameworks 9. Ethics in Research 10. Quantitative Methodology: Noninterventional Designs and Methods 11. Quantitative Methodology: Interventional Designs and Methods 12. Qualitative Research Methods 13. Outcomes Research 14. Mixed Methods Research NEW! 15. Sampling 16. Measurement Concepts 17. Measurement Methods Used in Developing Evidence-Based Practice

Unit Three: Putting It All Together for Evidence-Based Health Care 18. Critical Appraisal of Nursing Studies 19. Evidence Synthesis and Strategies for Implementing Evidence-Based Practice

Unit Four: Analyzing Data, Determining Outcomes, and Disseminating Research

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20. Collecting and Managing Data 21. Introduction to Statistical Analysis 22. Using Statistics to Describe Variables 23. Using Statistics to Examine Relationships 24. Using Statistics to Predict 25 Using Statistics to Determine Differences 26. Interpreting Research Outcomes 27. Disseminating Research Findings

Unit Five: Proposing and Seeking Funding for Research 28. Writing Research Proposals 29. Seeking Funding for Research

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Gray Burns and Grove’s The Practice of Nursing Research (9e)

Chapter 1: Discovering the World of Nursing Research Test Bank MULTIPLE CHOICE 1. Nurses with a bachelor’s degree in nursing can participate in the implementation

of evidencebased protocols in practice. This means that the BSN nurse a.

Developsevidence− based guidelines b. Designs research studies, on which protocols may be based c. Evaluates and revises evidence−based protocols d. Contributes practice wisdom when applying protocols in patient settings e. Mentors PhD researchers in the clinical setting during protocol development ANS: D Nurses with a BSN degree have knowledge of the research process and skills in reading andcritically appraising studies. They assist with the implementation of evidence−based guidelines, protocols, algorithms, and policies in practice. This implies that nurses provide their point of view, from the clinician’s vantage, when new protocols are being put into practice, and continue to provide feedback, regarding the positive and negative aspects of those protocols.

DIF: Cognitive Level: Analysis

REF: Page 4

2. Research is designed to test the idea of providing companion dogs to elders in a major

hospital, in order to determine the effect upon the elders’ level of orientation. (The dogs’level of orientation will not be a focus of the research.) This type of study can do which ofthe following? a. Control b. Describe c. Explain d. Predict ANS: A Control is the ability to manipulate the situation to produce the desired outcome.

Description involves identifying and understanding the nature of nursing phenomena and, sometimes, the relationships among them. Explanation clarifies the relationships among phenomena and identifies the reasons why certain events occur. The ability to estimate theprobability of a specific outcome in a given situation in nursing practice is known as prediction. The researcher’s focus is on predicting what is likely.

DIF: Cognitive Level: Application

REF: Page 13

Gray Burns and Grove’s The Practice of Nursing Research (9e)

2

Gray Burns and Grove’s The Practice of Nursing Research (9e) 3. A researcher wants to find out whether children with autism who are hospitalized on a

pediatric ward will require more hours of nursing care than average children when the parents or caregivers are not present. What type of research outcome does this provide? a.

Control b. Description c. Explantation d. Prediction ANS: D Control is the ability to manipulate the situation to produce the desired outcome.

Description involves identifying and understanding the nature of nursing phenomena and, sometimes, the relationships among them. Explanation clarifies the relationships among phenomena and identifies the reasons why certain events occur. The ability to estimate the probability of a specific outcome in a given situation in nursing practice is known as prediction. The researcher’s focus is on predicting what is likely.

DIF: Cognitive Level: Application

REF: Page 16

4. A researcher who desires to determine the cause−and−effect relationship between

requiring that all children under the age of 8 will ride in special care harnesses and the subsequent rate of children’s spinal cord injury will consequently utilize which form of nursing research? a.

Descriptive research b. Outcomes research c. Qualitative research d. Quantitative research ANS: D Quantitative research, the most frequently used method, is a formal, objective, systematic methodology to describe variables, test relationships, and examine cause−and−effect interactions. Quantitative research includes experimental research, which is the method for testing cause−and−effect relationships between and among specific variables. Qualitative research methods are used for explaining meanings and describing experiences in context.

Descriptive research involves identifying and understanding the nature of phenomena and, sometimes, the relationships among them. Outcomes research examines the end result of care in huge populations, most often retrospectively, using a database.

DIF: Cognitive Level: Application

REF: Page 3

Gray Burns and Grove’s The Practice of Nursing Research (9e)

6. Which best describes evidence-based-practice (EBP)? a.A combination of best research evidence, clinical expertise, and the needs and values of patients. b. A determination of the factors necessary to control patient responses to care. c. The development of population care guidelines applicable to all patients. d. The utilization of quantitative and qualitative studies to enhance patient outcomes.

ANS: A Feedback AEvidence-based practice evolves from the integration of the best research evidence with clinical expertise and patient needs and values.

BStudies that attempt to find determinants of patient outcomes are generally experimental or quasi-experimental. They may be used to guide EBP but do not completely define it.

CEBP is a combination of guidelines and specific patient needs and values.

DQuantitative and qualitative studies applied to the evaluation of patient outcomes are part of EBP but do not completely define EBP. PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 3 1. The nurse is collecting data about the sleep patterns of breastfed babies as part of a larger research study. Which research method will the nurse use when collecting data for this study? a.Control b.Description c.Explanation d.Prediction ANS: B Feedback AControl can be described as the ability to write a prescription to produce the desired outcome.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

B Description involves identifying and understanding the nature of nursing phenomena and the relationships among these phenomena.

C Explanation clarifies the relationships among phenomena and identifies why certain events occur.

D Through prediction, the probability of a specific outcome can be estimated in a given situation.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 6 2. The nurse is participating in a study and is collecting data identifying the number of obese adults whose parents were also obese or overweight. Which research method is being used in this study? a.Control b.Description c.Explanation d.Prediction ANS: D Feedback AControl indicates the ability to use a prescribed intervention to produce a desired outcome.

BDescription involves identifying and understanding the nature of nursing phenomena and the relationships among these phenomena.

CExplanation clarifies the relationships among phenomena and identifies why certain events occur.

DThrough prediction the probability of a specific outcome can be estimated in a given situation.

By knowing the percentage of parents of obese adults who were obese, the probability of predicting this may be calculated.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 7-8 3. The nurse reviews a study in which adherence to an asthma action plan is compared among groups of adolescents who received different asthma education. Which research method does this represent? a.Control b.Description c.Explanation

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Prediction ANS: C Feedback A Control indicates the ability to use a prescribed intervention to produce a desired outcome.

B Description involves identifying and understanding the nature of nursing phenomena and the relationships among these phenomena.

C Explanation clarifies the relationships among phenomena and identifies why certain events occur.

D Through prediction, the probability of a specific outcome can be estimated in a given situation.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 7 4. A nurse manager is interested in learning which attitudes among staff nurses may indicate relative risk of needle-stick injuries. To study this, the nurse manager will employ which method of study? a.Control b.Description c.Explanation d.Prediction ANS: D Feedback AControl indicates the ability to use a prescribed intervention to produce a desired outcome.

BExplanation clarifies the relationships among phenomena and identifies why certain events occur.

CDescription involves identifying and understanding the nature of nursing phenomena and the relationships among these phenomena.

DThrough prediction, the probability of a specific outcome can be estimated in a given situation.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 7-8 5. Which is the most important result of Florence Nightingales data collection and statistical analysis during the Crimean War?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.Bringing awareness of the rigors of war to the general public. b.Developing a process for statistical analysis and nursing documentation. c.Identifying and defining the role of nurses in modern health care. d.Using clinical research to evaluate the importance of sanitation, clean drinking water, and adequate nutrition.

ANS: D Feedback AThis was not the most important result BThis was not the most important result CThis was not the most important result DNightingales research enabled her to instigate attitudinal, organizational, and social changes, including the militarys approach to the care of the sick and societys sense of responsibility for testing public water, improving sanitation, and preventing starvation to decrease morbidity and mortality rates.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)REF: MCS: 11 6. The nurse participates in data collection in a study in which two different pain management protocols are used with randomly assigned patients to measure differences in postoperative recovery time. Which method of study is this? a.Control b.Correlation c.Description d.Explanation ANS: A Feedback AControl indicates the ability to use a prescribed intervention to produce a desired outcome.

BCorrelation examines the relationships between different phenomena.

CDescription involves identifying and understanding the nature of nursing phenomena and the relationships among these phenomena.

DExplanation clarifies the relationships among phenomena and identifies why certain events occur.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 8

Gray Burns and Grove’s The Practice of Nursing Research (9e)

7. The development of nursing theories and conceptual models in the late 1960s and 1970s served to: a.determine the effectiveness of nursing interventions. b.establish the concept of evidence-based practice. c.provide funding for nursing research. d.provide direction for nursing research.

ANS: D Feedback AOutcome studies are used to determine the effectiveness of nursing interventions.

BThe concept of EBP was developed in the 1970s and promoted by the ANCC Magnet Designation program.

CThe NINR seeks to provide funding for nursing research.

DThe theories developed in the 1960s and 1970s helped to direct future nursing research.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 11-12 8. Under Ada Sue Hinshaw, the National Institute of Nursing Research (NINR) began to change its focus to: a.funding nursing rather than medical research. b.evaluating outcomes rather than process studies. c.increasing the status and funding for nursing research. d.supporting the dissemination of nursing research.

ANS: C Feedback AThe change in focus from medical to nursing research came about with the first nursing programs. Specialty nursing organizations today and some nursing researchers still conduct medical research for specific studies.

BOutcomes research emerged in the 1980s and 1990s to document the effectiveness of health care services.

CUnder Ada Sue Hinshaw, the national Center for Nursing Research (NCNR) changed its name to the NINR to increase the status and funding of nursing research.

DThe NCNRs purpose was to support the dissemination of nursing research.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: pp. 12-13 9. An emphasis of the American Nurses Credentialing Center (ANCC) Magnet Hospital Designation Program for Excellence in Nursing is: a.research and development of clinical practice guidelines. b.putting qualitative research into practice in clinical settings. c.using standard nursing care plans based on outcomes research. d.utilizing evidence-based practice in nursing.

ANS: D Feedback AClinical practice guidelines are a more recent phenomenon, using evidence-based research, expert opinion, and patient needs and values to standardize care.

BQualitative research was introduced in the late 1970s to gain insight into the phenomena related to nursing.

COutcomes research was important in the 1980s to 1990s to document the effectiveness of health care services.

DANCC implemented the Magnet Hospital Designation Program for Excellence in Nursing Service in 1990 that emphasized EBP for nursing.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp. 12-13 10. In a position statement in 2006, the American Association of Colleges of Nursing (AACN) identified a need to: a.acquire clinical knowledge and expertise. b.focus on evidence-based practice. c.fund academic nursing research. d.prepare a workforce of nurse scientists.

ANS: D Feedback ABasic nursing education focuses on clinical knowledge and expertise.

BEvidence-based practice is a focus of ANCC and the Magnet Designation Program for Excellence in Nursing Service.

CThe NINR focuses on funding for nursing research.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DThe AACN identified the importance of creating a research culture, providing high-quality educational programs to prepare a workforce of nurse scientists, develop a sound research structure, and obtain funding for nursing research.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 14 11. The lead agency designated to improve health care quality is: a. Agency for Healthcare Research and Quality (AHRQ). b. American Nurses Credentialing Center (ANCC). c. Quality and Safety Education for Nurses (QSEN). d. National Institute for Nursing Research (NINR).

ANS: A Feedback AAHRQ is a scientific partner with the public and private sectors to improve the quality and safety of patient care.

BANCC provides credentialing for advanced practice nurses and for Magnet Designation for Excellence in Nursing Service CQSEN is focused on developing the requisite skills, knowledge, and attitude statements for the competencies for prelicensure and graduate education.

DThe National Institute of Nursing Research, originally the National Center for Nursing Research, is a federally funded arm of the National Institutes of Health, providing nursing with federal support for nursing research priorities.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp. 12-13 12. To help fulfill the mission of the National Institute for Nursing Researchto promote and improve the health of individuals, families, communities, and populationsa study may be conducted which: a.assesses the effectiveness of strategies for weight management in patients with type 2 diabetes. b.compares the attitudes of nurses toward clients with type 1 and type 2 diabetes. c.generates up-to-date nursing diagnoses reflecting the needs of clients with type 2 diabetes. d.reviews hospital nurses adherence to glucose-monitoring guidelines for patients with type 2 diabetes.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: A Feedback AA study that assesses the effectiveness of interventions helps to improve the health of patient populations by identifying appropriate strategies.

BA comparison of attitudes is a descriptive study that does not improve outcomes.

CA study to generate nursing diagnoses does not directly affect patient outcomes.

DA study reviewing adherence to guidelines seeks to provide data for quality assurance.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 14-15 13. Which best describes the Quality and Safety Education for Nurses (QSEN) competency for evidence-based practice (EBP)? a. Adhering to published guidelines to provide care for a specific population.

b.Empowering clients to choose among effective disease management strategies. c. Relying on expert knowledge to guide care plan development for an individual patient. d. Using evidence gained solely from experimental studies to guide care.

ANS: B Feedback AStrict adherence to guidelines does not take the patient/family preferences into account.

BThe QSEN competency for EBP is defined as integrating the best evidence with clinical expertise and patient/family preferences.

CEBP does not rely solely on expert knowledge or experimental studies.

DAlthough experimental studies provide the highest level of study data, EBP does not rely soley on experiemental studies..

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 15 14. Through knowledge gained from her phenomenological qualitative study identifying levels of experience of professional nurses, Patricia Benner would identify which nurse as an expert? a.A hospice nurse who values the unique wishes of each patient when providing palliative care. b. A medical-surgical nurse who organizes care for a group of patients to ensure timely administration of medications.

Gray Burns and Grove’s The Practice of Nursing Research (9e) c. A neonatal intensive care nurse who is skilled in inserting peripherally inserted central

catheters. d. A pediatric nurse who notes subtle changes and intervenes to prevent respiratory failure.

ANS: D Feedback AThe proficient nurse views the patient as a whole and recognizes that each patient responds differently to illness and health.

BThe competent nurse is able to achieve goals and plans and to take conscious actions to organize and provide efficient care.

CThe NIC nurse is also an example of a competent nurse who is skilled in a procedure.

DThe expert nurse has an extensive background of experience and is able to identify and accurately intervene skillfully in a situation. The pediatric nurse in this case recognizes subtle changes and is able to act to prevent serious circumstances.

Chapter 2. Evolution of Research in Building Evidence-Based Nursing Practice MULTIPLE CHOICE 1. In which way did Florence Nightingale contribute to evidence-based practice? a. She conducted research on outcomes and the power of nursing for change. b. She was the first woman elected to the Royal Statistical Society. c. She gathered data that changed the care of hospitalized soldiers. d. She calculated mortality rates under varying conditions.

ANS: C Nightingale gathered data on soldier morbidity and mortality rates and the factors influencing them and presented her results in tables and pie charts, a sophisticated type of data presentation for the period. Nightingales research enabled her to instigate attitudinal, organizational, and social changes. She changed the attitudes of the military and society toward the care of the sick.

The military began to view the sick as having the right to adequate food, suitable quarters, and appropriate medical treatment, which greatly reduced the mortality rate.

DIF: Cognitive Level: Application REF: MCS: 17

Gray Burns and Grove’s The Practice of Nursing Research (9e)

2. If a nurse manager wants to study how well last years policies governing implementation of a bundle of interventions to prevent cross-contamination of MRSA have been working in her units, which of the following strategies would she use? a. Outcomes research b. Intervention research c. Ethnographic research d. Experimental research ANS: A Outcomes research emerged as an important methodology for documenting the effectiveness of health care services in the 1980s and 1990s. This type of research evolved from the quality assessment and quality assurance functions that originated with the professional standards review organizations (PSROs) in 1972. During the 1980s, William Roper, the director of the Health Care Finance Administration (HCFA), promoted outcomes research for determining the quality and cost-effectiveness of patient care. Intervention research investigates the effectiveness of a nursing intervention in achieving the desired outcome or outcomes in a natural setting.

Through the use of ethnographic research, different cultures are described, compared, and contrasted to add to our understanding of the impact of culture on human behavior and health.

Experimental studies have three main characteristics: (1) a controlled manipulation of at least one treatment variable (independent variable), (2) administration of the treatment to some of the subjects in the study (experimental group) and not to others (control group), and (3) random selection of subjects or random assignment of subjects to groups, or both. Experimental studies usually are conducted in highly controlled settings, such as laboratories or research units in clinical agencies.

DIF: Cognitive Level: Analysis REF: MCS: 22 3. A researcher publishes a paper describing how faith, pain, adherence to therapy, and meditation interact during the rehabilitation process. The description of the process is based on many interviews the researcher conducted with persons during and following rehabilitation experiences. The methodology is a. Ethnography

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. Phenomenology c. Historical research d. Grounded theory ANS: D Grounded theory methodology emphasizes observation and the development of practice-based intuitive relationships among variables. Throughout the study, the researcher formulates, tests, and redevelops propositions until a theory evolves. The theory developed is grounded, or has its roots in, the data from which it was derived.

DIF: Cognitive Level: Synthesis REF: MCS: 27 4. A panel of researchers conducts several studies, all drawn from an existent hospital and clinic database. The studies focus on quality and effectiveness within that system. The specific studies address mortality rates in elders within a year after hip fracture, functional outcomes six months after admission to a neurosurgical ICU after traumatic brain injury, rate of nurse injuries in an emergency department, and number of patient falls on various floors of the hospital. What type of research is this? a. Experimental research b. Outcomes research c. Ethnographic research d. Grounded theory research ANS: B The spiraling cost of health care has generated many questions about the quality and effectiveness of health care services and the patient outcomes. Consumers want to know what services they are buying, and whether these services will improve their health. Health care policy makers want to know whether the care is cost-effective and of high quality. These concerns have promoted the development of outcomes research, which examines the results of care and measures the changes in health status of patients. It can also examine costs related to care delivery within a hospital system.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Comprehension REF: MCS: 27 5. A researcher designs a study. It depends on questionnaires for data, it has a clear purpose statement, it provides its results as a narrative without statistical analysis, and it makes general suggestions for practice. What type of research is this? a. Qualitative research b. Outcomes research c. Intervention research d. Quantitative research ANS: D Quantitative research is a formal, objective, systematic process in which numerical data are used to obtain information about the world. Qualitative research is also systematic, but it is a holistic, interactive, and subjective approach to describe life experiences and identify their meaning. Both types of research have a purpose statement and can use a survey instrument; however, neither depends on surveys for data. Both can contain suggestions for practice. Qualitative research results are presented as a narrative, without statistical analysis. Outcomes research examines the results of care and measures the changes in health status of patients. Intervention research investigates the effectiveness of a nursing intervention in achieving the desired outcome or outcomes in a natural setting.

DIF: Cognitive Level: Application REF: MCS: 23 6. A newly employed nurse administrator wants to know more about the employees on the units the administrator supervises. The manager accesses the managerial database and gathers data about all of the current employees on the unit, including work shift, number of years employed, age, gender, educational preparation, certifications, work history, and professional accomplishments. What type of research is this? a. Descriptive research b. Correlational research c. Quasi-experimental research

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Experimental research ANS: A The quantitative research methods are classified into four categories: (1) descriptive, which defines the magnitude of a concept and its characteristics, (2) correlational, which determines association between or among variables, (3) quasi-experimental, which tests an intervention and lacks control in at least one of three areas, and (4) experimental, which tests an intervention and includes both a control group and random assignment. This is a research study, even though it depends upon existent data, collected by another manager. Its purpose is to describe the employees.

DIF: Cognitive Level: Analysis REF: MCS: 26 7. A human resources employee performs research focusing on the professional lifespan within the institution of nurses, and trying to discover whether their choice of work area is connected with the number of years they work in the institution. What type of research is this? a. Descriptive research b. Correlational research c. Quasi-experimental research d. Experimental research ANS: B The quantitative research methods are classified into four categories: (1) descriptive, which defines the magnitude of a concept and its characteristics, (2) correlational, which determines association between or among variables, (3) quasi-experimental, which tests an intervention and lacks control in at least one of three areas, and (4) experimental, which tests an intervention and includes both a control group and random assignment. This study investigates the connection or association between work area and length of time worked.

DIF: Cognitive Level: Analysis REF: MCS: 26

Gray Burns and Grove’s The Practice of Nursing Research (9e)

8. In an attempt to assess whether selection of a same-gender psychiatrist leads to better mental health outcomes, clients newly referred for mental health services are told they may choose their mental health physicians. Later, measures of mental health are performed. What type of research is this? a. Descriptive research b. Correlational research c. Quasi-experimental research d. Experimental research ANS: C The quantitative research methods are classified into four categories: (1) descriptive, which defines the magnitude of a concept and its characteristics, (2) correlational, which determines association between or among variables, (3) quasi-experimental, which tests an intervention and lacks control in at least one of three areas, and (4) experimental, which tests an intervention and includes both a control group and random assignment. This research study is designed to test an intervention but does not include random assignment.

DIF: Cognitive Level: Analysis REF: MCS: 26 9. In a rehabilitation unit, patients are randomly assigned to high fiber diets versus ordinary fiber diets, in order to measure the effect on constipation. What type of research is this? a. Descriptive research b. Correlational research c. Quasi-experimental research d. Experimental research ANS: D The quantitative research methods are classified into four categories: (1) descriptive, which defines the magnitude of a concept and its characteristics, (2) correlational, which determines association between or among variables, (3) quasi-experimental, which tests an intervention and

Gray Burns and Grove’s The Practice of Nursing Research (9e)

lacks either a control group or random assignment, and (4) experimental, which tests an intervention and includes both a control group and random assignment. This research study tests an intervention and includes both a control group and random assignment.

DIF: Cognitive Level: Analysis REF: MCS: 26 10. A researcher uses interviews with two or three open-ended questions to study women in the staging phase of breast cancer treatment, in order to understand their experiences and the meanings they attribute to those experiences. What type of research is this? a. Phenomenologic research b. Grounded theory research c. Ethnographic research d. Historicism ANS: A Phenomenologic research examines the lived experiences of participants and the meanings those experiences hold for them, drawing its results only from the participants views. Grounded theory research defines under-researched concepts and explains them within a social framework, building on both observation and the perceptions of the persons who are familiar with the concepts, and sometimes generating theory; it emphasizes interaction, observation, and development of relationships among concepts. Ethnography defines shared characteristics of members of a culture or participants who share in a common characteristic, and explains commonalities, often within a cultural framework, using observation, interview, and other data collection strategies; through the use of ethnographic research, different cultures are described, compared, and contrasted to add to our understanding of the impact of culture on the human experience. Historicism tells the story of past events, reconstructing these from other historical references, interviews, artifacts, art, and other sources that reflect the time of interest.

DIF: Cognitive Level: Analysis REF: MCS: 27 11. A researcher uses interviews with eight open-ended questions to study women in a new staging phase of breast cancer treatment, which includes serial biopsies and necessitates weekly

Gray Burns and Grove’s The Practice of Nursing Research (9e)

closed biopsy, in order to understand more about social factors that impinge upon their experience. What type of research is this? a. Phenomenologic research b. Grounded theory research c. Ethnographic research d. Historicism ANS: B Grounded theory research defines under-researched concepts and explains them within a social framework, building on both observation and the perceptions of the persons who are familiar with the concepts, and sometimes generating theory; it emphasizes interaction, observation, and development of relationships among concepts. Phenomenologic research examines the lived experiences of participants and the meanings those experiences hold for them, drawing its results only from the participants views. Ethnography defines shared characteristics of members of a culture or participants who share in a common characteristic, and explains commonalities, often within a cultural framework, using observation, interview, and other data collection strategies; through the use of ethnographic research, different cultures are described, compared, and contrasted to add to our understanding of the impact of culture on the human experience.

Historicism tells the story of past events, reconstructing these from other historical references, interviews, artifacts, art, and other sources that reflect the time of interest.

DIF: Cognitive Level: Analysis REF: MCS: 27 12. A researcher conducts many interviews, over a one-year period, with women in the treatment phase of breast cancer, all of whom are attending a breast cancer support group, in order to understand what happens in the support group, how the members are affected by membership, and how the members contribute to the group. The researcher herself is also in treatment for breast cancer and is a member of the group. What type of research is this? a. Phenomenologic research b. Grounded theory research c. Ethnographic research

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Historicism ANS: C Ethnography defines shared characteristics of members of a culture or participants who share in a common characteristic, and explains commonalities, often within a cultural framework, using observation, interview, and other data collection strategies; through the use of ethnographic research, different cultures are described, compared, and contrasted to add to our understanding of the impact of culture on the human experience. Phenomenologic research examines the lived experiences of participants and the meanings those experiences hold for them, drawing its results only from the participants views. Grounded theory research defines under-researched concepts and explains them within a social framework, building on both observation and the perceptions of the persons who are familiar with the concepts, and sometimes generating theory; it emphasizes interaction, observation, and development of relationships among concepts.

Historicism tells the story of past events, reconstructing these from other historical references, interviews, artifacts, art, and other sources that reflect the time of interest.

DIF: Cognitive Level: Analysis REF: MCS: 27 13. A researcher reviews the twenty years that a breast cancer clinic has been in operation in a small Midwestern city. The researcher interviews many of the women who have been treated in the clinic during this period and reviews the records of the clinic, along with its survival rates and the emergence of several of its innovative support programs for women and their families.

The researcher ultimately writes a story of the clinic over those twenty years. What type of research is this? a. Phenomenologic research b. Grounded theory research c. Ethnographic research d. Historicism ANS: D

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Phenomenologic research examines the lived experiences of participants and the meanings those experiences hold for them, drawing its results only from the participants views. Grounded theory research defines under-researched concepts and explains them within a social framework, building on both observation and the perceptions of the persons who are familiar with the concepts, and sometimes generating theory; it emphasizes interaction, observation, and development of relationships among concepts. Ethnography defines shared characteristics of members of a culture or participants who share in a common characteristic, and explains commonalities, often within a cultural framework, using observation, interview, and other data collection strategies; through the use of ethnographic research, different cultures are described, compared, and contrasted to add to our understanding of the impact of culture on the human experience. Historicism tells the story of past events, reconstructing these from other historical references, interviews, artifacts, art, and other sources that reflect the time of interest.

DIF: Cognitive Level: Analysis REF: MCS: 27 MULTIPLE RESPONSE 1. Florence Nightingale researched mortality and morbidity rates in soldiers during the Crimean War and investigated various factors that influenced both, presenting her results as pie charts and graphs. Consequently, it is known that she conducted which types of research? (Select all that apply.) a. Phenomenologic research b. Causational research c. Descriptive research d. Correlational research e. Ethnographic research ANS: C, D Nightingale is noted for her data collection and statistical analyses during the Crimean War. She gathered data on soldier morbidity and mortality rates and the factors influencing them and presented her results in tables and pie charts, a sophisticated type of data presentation for the

Gray Burns and Grove’s The Practice of Nursing Research (9e)

period. There is no evidence that she designed causational (experimental or quasi-experimental) research or any type of qualitative research.

DIF: Cognitive Level: Analysis REF: MCS: 17 2. Which of the following statements about quantitative research is accurate? (Select all that apply.) a. The results of quantitative research should be generalized back to the population from which the sample was drawn. b. Quantitative research is always easy and straightforward to read and understand. c. Quantitative research addresses quantities, connections, and causes. d. Quantitative research predominates in the nursing research literature. e. Quantitative research is always experimental. f. Quantitative research provides answers to What? and Who? questions.

ANS: A, C, D, F The quantitative approach to scientific inquiry emerged from a branch of philosophy called logical positivism, which operates on strict rules of logic, truth, laws, axioms, and predictions.

Quantitative research requires the use of structured interviews, questionnaires, or observations, scales, or physiological measures that generate numerical data. Statistical analyses are conducted to reduce and organize data, describe variables, examine relationships, and determine differences among groups. Control, instruments, and statistical analyses are used to ensure that the research findings accurately reflect reality so that the study findings can be generalized. Generalization involves the application of trends or general tendencies (which are identified by studying a sample) to the population from which the research sample was drawn. Researchers must be cautious in making generalizations, because a sound generalization requires the support of many studies with a variety of samples.

DIF: Cognitive Level: Analysis REF: MCS: 24 3. Which of the following statements about qualitative research is accurate? (Select all that apply.)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. Qualitative research deals exclusively with humans. b. Qualitative researchs principal purpose is to inform the reader. c. Qualitative research yields data that are not numbers-based, such as audiotapes, videotapes, and field notes. d. Qualitative research is not systematic. e. Qualitative research does not contain or imply a research question. f. Qualitative research is ill-defined and vague. g. Qualitative research has no practical use.

ANS: B, C Qualitative researchers use observations, interviews, and focus groups to gather data. The interactions are guided but not controlled in the way that quantitative data collection is controlled. For example, the researcher may ask subjects to share their experiences of powerlessness in the health care system. Qualitative researchers would begin interpreting the subjective data during data collection, recognizing that their interpretation is influenced by their own perceptions and beliefs. Qualitative data take the form of words and are analyzed according to the qualitative approach that is being used. The intent of the analysis is to organize the data into a meaningful, individualized interpretation, framework, or theory that describes the phenomenon studied. The findings from a qualitative study are unique to that study, and it is not the researchers intent to generalize the findings to a larger population. Qualitative researchers are encouraged to question generalizations and to interpret meaning based on individual study participants perceptions and realities.

DIF: Cognitive Level: Analysis REF: MCS: 25 4. Which is true of quantitative research? (Select all that apply.) a. It addresses human responses by measuring or counting them. b. It presents information by clustering it or counting it. c. It yields a data set that can be analyzed by statistics. d. It operates systematically. e. It states or implies a research question.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

f. It operates in a concrete realm. g. It can always be generalized.

ANS: A, B, C, D, E, F The quantitative approach to scientific inquiry emerged from a branch of philosophy called logical positivism, which operates on strict rules of logic, truth, laws, axioms, and predictions.

Quantitative research requires the use of structured interviews, questionnaires, or observations, scales, or physiological measures that generate numerical data. Statistical analyses are conducted to reduce and organize data, describe variables, examine relationships, and determine differences among groups. Control, instruments, and statistical analyses are used to ensure that the research findings accurately reflect reality so that the study findings can be generalized. Generalization involves the application of trends or general tendencies (which are identified by studying a sample) to the population from which the research sample was drawn. Researchers must be cautious in making generalizations, because a sound generalization requires the support of many studies with a variety of samples.

DIF: Cognitive Level: Analysis REF: MCS: 24 5. Ethnographic research might focus upon which of the following topics? (Select all that apply.) a. Bacterial cultures b. Cultural beliefs of the ancient Romans c. How children in Alaska play during the winter d. Twenty-year abstinence members of Alcoholics Anonymous e. The mentoring process in a labor-delivery unit f. Conversational Spanish ANS: C, D, E Ethnographic research was developed by anthropologists to investigate cultures through an indepth study of the members of the culture. The culture may be an actual culture, a loosely connected group of people who share a common characteristic, or a work or recreational group.

The ethnographic research process is the systematic collection, description, and analysis of data

Gray Burns and Grove’s The Practice of Nursing Research (9e)

to develop a description of cultural behavior. The researcher (ethnographer) actually lives in or becomes a part of the cultural setting to gather the data.

DIF: Cognitive Level: Analysis REF: MCS: 24 6. A researcher is operating from the point of view of logical positivism. Which of the following research methods would the logical positivist use? (Select all that apply.) a. Grounded theory research b. Correlational research c. Historical research d. Quasi-experimental research e. Quantitative descriptive research f. Exploratory descriptive qualitative research ANS: B, D, E The quantitative approach to scientific inquiry emerged from a branch of philosophy called logical positivism, which operates on strict rules of logic, truth, laws, axioms, and predictions.

The quantitative research methods are classified into four categories: (1) descriptive, (2) correlational, (3) quasi-experimental, and (4) experimental. The qualitative research methods included in this textbook are (1) phenomenological research, (2) grounded theory research, (3) ethnographic research, (4) exploratory-descriptive qualitative research, and (5) historical research.

DIF: Cognitive Level: Analysis REF: MCS: 27 7. Which of the follow potential studies would fall within the Agency for Healthcare Research and Qualitys future research goals? (Select all that apply.) a. Performing a synthesis of research evidence regarding skin-to-skin contact of mothers and newborns b. Enacting a quantitative research project measuring bacterial count on nurses uniforms at the beginning and the end of 12-hour work shifts

Gray Burns and Grove’s The Practice of Nursing Research (9e)

c. Performing a qualitative research project to explain sources of student nurses stress d. Enacting a public education Internet commercial encouraging smokers to read the statistics regarding sequelae of cigarette smoking e. Trialing clean-and-sober support groups that are based in community shopping centers ANS: A, D, E The Agency for Healthcare Research and Quality partners with public and private sectors to improve the quality and safety of patient care by promoting the use of the best research evidence available in practice. Its three future goals are focused on the following: Safety and quality: Reduce the risk of harm by promoting delivery of the best possible health care; Effectiveness: Improve healthcare outcomes by encouraging the use of evidence to make informed healthcare decisions; and Efficiency: Transform research into practice to facilitate wider access to effective healthcare services and reduce unnecessary costs.

DIF: Cognitive Level: Analysis REF: MCS: 22 8. Early nursing research by Nightingale focused on improving patient outcomes. What were the principal topics for the next wave of nursing research, in the first half of the 20th century?

(Select all that apply.) a. Evidence-based practice b. Primary nursings advantages in hospitals c. Nursing education, as opposed to nurse training d. The nursing process and nursing diagnosis e. Staffing, patient assignments, and type of care ANS: C, E From 1900 to 1950, research activities in nursing were limited, but a few studies advanced nursing education. Based on recommendations of the Goldmark Report, more schools of nursing were established in university settings. A research trend that started in the 1940s and continued in the 1950s focused on the organization and delivery of nursing services. Studies were

Gray Burns and Grove’s The Practice of Nursing Research (9e)

conducted on the numbers and kinds of nursing personnel, staffing patterns, patient classification systems, patient and nurse satisfaction, and unit arrangement. Types of care such as comprehensive care, home care, and progressive patient care were evaluated. In the 1970s, the nursing process became the focus of many studies, with the investigations of assessment techniques, nursing diagnoses classification, goal-setting methods, and specific nursing interventions. Primary nursing care, which involves the delivery of patient care predominantly by registered nurses (RNs), was the trend for the 1970s. The vision for nursing research in the twenty-first century includes conducting quality studies using a variety of methodologies, synthesizing the study findings into the best research evidence, and using this research evidence to guide practice. The focus on EBP has become stronger over the last decade.

DIF: Cognitive Level: Synthesis REF: MCS: 19 9. Which of the following is true of the Cochrane Center and Cochrane Collaboration, begun in the 1970s by Professor Archie Cochrane? (Select all that apply.) a. It was originally called the Walter Reed Army Institute of Research. b. It developed the original masters degrees in nursing practice. c. It serves as a repository for evidence-based practice guidelines. d. It was the first association to publish a nursing research journal. e. It is the online library resource for research literature reviews.

ANS: C, E Cochrane advocated the provision of health care based on research to improve the quality of care and patient outcomes. To facilitate the use of research evidence in practice, the Cochrane Center was established in 1992 and the Cochrane Collaboration in 1993. The Cochrane Collaboration and Library house numerous resources to promote EBP, such as systematic reviews of research and evidence-based guidelines for practice.

DIF: Cognitive Level: Evaluation REF: MCS: 20 10. How does quantitative research contribute to evidence-based practice? (Select all that apply.)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. It provides facts that nurses can add to their knowledge base. This makes practice more objective and quantifiable. b. It provides scientific support for policies already in place. More evidence makes an existent policy more defensible. c. It provides evidence opposing policies already in place. Evidence in opposition to policies may result in new policies. d. It allows the nurse to understand the personal experience of illness and the meaning the client attaches to it. This engenders compassion. e. It contributes evidence that will make nursing practice almost completely evidence-based, eliminating different styles of nursing practice.

ANS: B, C Quantitative research is a formal, objective, systematic process in which numerical data are used to obtain information about the world. This research method is used to describe variables, examine relationships among variables, and determine cause-and-effect interactions between variables. The qualitative research method of phenomenology allows understanding of the lived experience and the meaning it engenders. The aim of phenomenology is to explore an experience as it is lived by the study participants and interpreted by the researcher. Evidence-based practice is the conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of quality, cost-effective health care. It provides the basis for policy decisions and for voluntary change in individual nursing practice. Nursing style is a matter of personal choice.

DIF: Cognitive Level: Analysis REF: MCS: 23 11. What does appropriate generalization require? (Select all that apply.) a. Any type of sample, whether or not it is representative b. Application of findings to the population from which the sample was drawn c. More than one research study using the same research questions and variables d. Statistically significant findings e. Non-significant findings that are supported by several related studies ANS: B, C, D

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Generalization involves the application of trends or general tendencies (which are identified by studying a sample) to the population from which the research sample was drawn. Researchers must be cautious in making generalizations, because a sound generalization requires the support of many studies with a variety of samples.

DIF: Cognitive Level: Analysis REF: MCS: 23 12. What best characterizes the contribution of qualitative nursing research to evidence-based practice? (Select all that apply.) a. It presents collective common evidence of health care clients experiences, which may provide inspirations for individual practice. b. It provides stories of how health care clients feel. This lets nurses know what people in similar circumstances can be expected to experience. c. It provides evidence that determines how nurses should interact with various cultures. This mandates action. d. It generates and tests theory. e. It reveals participants experiences and individual viewpoints, feelings, and interpretations. These can provide guidelines for client-centered care.

ANS: A, E Qualitative research is a systematic, interactive, subjective approach used to describe life experiences from the research participants point of view. This type of research is conducted to explore, describe, and promote understanding of human experiences, events, and cultures over time. It is holistic and describes the human in context.

Chapter 3. Introduction to Quantitative Research MULTIPLE CHOICE 1. A researcher conducts a study which outlines the daily habits of women who are overweight.

This study represents what type of research? a.Correlational b.Descriptive

Gray Burns and Grove’s The Practice of Nursing Research (9e)

c.Experimental d.Quasi-experimental ANS: B Feedback ACorrelational research investigates the relationship between or among variables.

BDescriptive research is the exploration of phenomena in real-life situations.

CExperimental research is an objective, systematic, highly controlled investigation for the purpose of predicting and controlling phenomena.

DThe purpose of quasi-experimental research is to examine causal relationships or determine the effect of one variable on another. Thus, these studies involve implementing a treatment or intervention and examining the effects of this intervention using selected methods of measurement.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 32-33 2. The researcher wants to learn whether there is a relationship between parental education and emergency room use among children who have asthma. Which type of research study will this researcher use? a.Basic b.Correlational c.Historical d.Phenomenological ANS: B Feedback ABasic research is scientific investigation that involves the pursuit of knowledge for knowledges sake.

BCorrelational research investigates the relationship between or among variables.

CHistorical research is a type of qualitative research.

DPhenomenological research is a type of qualitative research.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 32-33

Gray Burns and Grove’s The Practice of Nursing Research (9e)

3. The nurse evaluates a research study that examines the relationship between computer and television screen time and obesity. A correlational analysis reveals a correlation of +0.95. What can the nurse conclude about the relationship between these two variables? a. An increase in screen time causes obesity. b. An increase in obesity leads to increased screen time. c. Screen time and obesity vary in opposite directions. d. Screen time and obesity vary together.

ANS: D Feedback AVariables that vary in opposite directions will have a negative correlation.

BDescriptive research is the exploration of phenomena in real-life situations.

CCorrelational studies do not indicate cause, so an increase in screen time or an increase in obesity does not cause or lead to an increase in the other.

DA positive correlation between variables indicates that the variables vary together.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 33-34 4. In which type of research does the researcher seek to examine causal relationships among variables without being able to manipulate the variables? a.Descriptive b.Correlational c.Experimental d.Quasi-experimental ANS: D Feedback ADescriptive research is the exploration of phenomena in real-life situations.

BCorrelational research investigates the relationship between or among variables but does not attribute cause.

CExperimental design is considered the most powerful quantitative design because of the rigorous control of variables.

DQuasi-experimental studies have less control than experimental studies, but they do exhibit some degree of control.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: MCS: 34 5. The nurse participates in data collection for a clinical drug trial in which subjects are randomly assigned to either a treatment or a placebo group to measure the effects of the drug on a specific outcome. This is which type of study? a.Correlational b.Descriptive c.Experimental d.Quasi-experimental ANS: C Feedback ACorrelational research investigates the relationship between or among variables but does not attribute cause.

BDescriptive research is the exploration of phenomena in real-life situations.

CExperimental design involves control of variables and random assignment of subjects so that effects of variables on specific outcomes can be measured.

DQuasi-experimental studies have less control than experimental studies, but they do exhibit some degree of control.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 34 6. A researcher studies the effect of asthma action plans on frequency of emergency department visits for asthma-related symptoms. The study would be described as: a.applied research. b.basic research. c.descriptive research. d.phenomenological research.

ANS: A Feedback AApplied research involves research that is directly applicable to clinical practice.

BBasic research is scientific investigation that involves the pursuit of knowledge for knowledges sake.

CDescriptive research is the exploration of phenomena in real-life situations.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DPhenomenological research would not investigate this type of research question.

Phenomenological research asks what is the lived experience of the person in this situation?

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 35 7. Basic research seeks to: a.directly influence clinical practice. b.generate knowledge for knowledges sake. c.predict or control outcomes of variables. d.validate or test theoretical frameworks.

ANS: B Feedback AApplied research is used to solve problems, make decisions, or predict or control outcomes in real-life practice situations.

BBasic research is more likely to be found in a laboratory setting and generates knowledge for knowledges sake. It may be used as the foundation for other research.

CExperimental research is conducted in order to be able to predict or control outcomes DGrounded theory research is used to validate theoretical frameworks.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 35-36 8. When developing a study, a researcher establishes rules for measurement of independent and dependent variables in order to minimize the possibility of error. This is an example of: a.control. b.manipulation. c.precision. d.rigor.

ANS: A Feedback AControl involves the imposing of rules by the researcher to decrease the possibility of error and thus increase the probability that the studys findings are an accurate reflection of reality.

BManipulation is when the researcher makes changes in the treatment received by the subjects.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

CPrecision encompasses accuracy, detail, and order and is evident in the concise statement of the research purpose.

DRigor is the discipline, attention to detail, and precision necessary when striving for excellence in research.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 36-37 9. In which type of research study does the researcher have the most control? a.Correlational b.Descriptive c.Experimental d.Quasi-experimental ANS: C Feedback ACorrelational research investigates the relationship between or among variables but does not attribute cause.

BDescriptive research is the exploration of phenomena in real-life situations.

CExperimental design involves control of variables and random assignment of subjects so that effects of variables on specific outcomes can be measured.

DQuasi-experimental studies have less control than experimental studies, but they do exhibit some degree of control.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF:MCS: 34| pp. 36-37 10. A researcher designs a study to evaluate stress and anxiety associated with breastfeeding in which data collection takes place in the homes of mothers with premature newborns after discharge home from the NIC. This would be an example of which type of research setting? a. Highly controlled, field b. Highly controlled, laboratory

c.Natural, field d.Partially controlled, laboratory ANS: C

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback AThere are three common settings for conducting research: natural, partially controlled, and highly controlled. A highly-controlled setting would involve experimental control of an independent variable, which this study does not do.

BThis is a field study, with data collection occurring in patients homes and not in a laboratory.

CThe setting describes where the research and data collection occur. A natural setting, or field setting, is an uncontrolled, real-life situation or environment, such as the home. In a natural setting, there is relatively little control over the setting and the variables associated with the setting.

DThere are three common settings for conducting research: natural, partially controlled, and highly controlled. A natural setting, or field setting, is an uncontrolled, real-life situation or environment. This is a field study, with data collection occurring in patients homes and not in a laboratory PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 36-37 11. When conducting a research study using a convenience sample of all first grade students from two classrooms in a nearby school, the nurse researcher may increase the sample control by: a.assigning one classroom to the experimental group and the other classroom to the control group. b.exposing all subjects to the treatment variable and then comparing the outcome data to pretreatment data. c.randomly assigning students from both classrooms to either the experimental group or the control group. d.using all of these subjects as treatment subjects and comparing outcomes to a group of subjects from a similar study.

ANS: C Feedback AAssigning one classroom to one group and the other classroom to the other group is less effective than random sampling.

BPre- and post-treatment comparison may be used when random assignment is not possible.

CRandomly assigning subjects to either a treatment group or a control group improves sample control and decreases bias. Even when convenience sampling is used, subjects may be randomly assigned to groups.

DComparing a treatment group to a group in another study does not control the treatment variables because of variations between two studies.

PTS:1DIF:Cognitive level: Analyzing (Analysis)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: MCS: 37 12. A nurse is assisting with data collection for a study measuring the effects of a sleep aid medication on oxygen saturations. Subjects will sleep in a darkened room in a sleep lab while participating. Which type of research setting is this? a. Field b. Highly controlled

c.Natural d.Partially controlled ANS: B Feedback AField settings are uncontrolled, real-life situations or environments.

BA highly controlled setting is one in which the influence of extraneous variables is greatly reduced. Examples of such a setting would include laboratories, research or experimental centers, and test units in hospitals.

CNatural settings are uncontrolled, real-life situations or environments.

DPartially controlled settings are environments that the researcher has manipulated or modified in some way.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 38 13. A nurse researcher explains the relationships between research processes and the nursing process to a group of graduate-level nursing students. Which statement by a nursing student indicates the need for further teaching? a. Nursing research leads to evidence-based nursing practice guidelines. b. Nursing research has a broader focus than the nursing process. c. The nursing process helps to identify potential nursing research problems. d. The nursing process requires rigorous application of research methods.

ANS: D Feedback ANursing research may be used to develop evidence-based nursing practice guidelines.

BNursing research has a broader focus than the nursing process and is generally population based rather than individual based.

CThe nursing process can help to identify nursing research problems.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DThe nursing process may be based on research, but does not require the rigorous application of research methods.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 38 14. Research subjects in a study of body image after mastectomy will complete a questionnaire about body image after surgery. Which assumption would the researcher likely make when conducting this study? a. All mastectomy patients are likely to be negatively affected by the surgery. b. Body image and appearance are important to survivors of breast cancer. c. Subjects will be able to describe a personal awareness of body image. d. Subjects will complete every item on the questionnaire.

ANS: C Feedback AThe researcher does not indicate that negative effects of mastectomy are an assumption of the study. The results of the study may indicate whether this is true or not.

BThe researcher does not indicate that the importance of body image an appearance is an assumption of the study. The results of the study may indicate whether this is true or not.

CAssumptions are statements taken for granted or considered true, even though they have not been scientifically tested. The researcher will assume that subjects have an awareness of this concept.

DThe researcher does not indicate that this is an assumption of the study. It is undoubtedly hoped for to get complete data.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 42-43 15. Statements that will be scientifically tested as part of a research study are called: a.assumptions. b.hypotheses. c.limitations. d.variables.

ANS: B

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback AAssumptions are statements that are taken for granted or considered true, even though they have not been scientifically tested.

BHypotheses are the researchers best guess as to the outcome of the study.

CLimitations are factors in the study that cannot be controlled or manipulated, but might have an influence on the outcome.

DVariables are the factors influencing the hypotheses that the researcher wants to investigate.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp. 42-44 16. A study that analyzes the effect of exercise on diabetes control among Native-American children with type II diabetes would most credibly be generalizable to which population? a. African-Americans with type II diabetes

b.Native-American children with type I diabetes c. Children with type II diabetes d. All people with type II diabetes ANS: B Feedback A The population that the sample represents does not include all African-Americans with type II diabetes.

B Generalization is the extension of the implications of the research findings from the sample to a larger population. The population represented in the study is Native-American children, so the results of this study may be generalized to this population.

C The population that the sample represents does not include all children with type II diabetes.

D The population that the sample represents does not include all patients with type II diabetes.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 46 17. To evaluate data collection methodology prior to conducting a large-scale study, a researcher might carry out a smaller-scale study. This smaller-scale study is known as a/an: a.abstract. b.exploratory design. c.pilot study. d.proposal.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: C Feedback AThe abstract is a synopsis of the study found at the beginning of a research report.

BExploratory design is used when the total situation is unclear.

CA pilot study is frequently defined as a smaller version of a proposed study conducted to refine the methodology.

DA proposal is a formal request to conduct a study; it can be submitted to obtain funds or get feedback on the studys methodology.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 45 18. The nurse researcher is developing a study to examine the effects of asthma education on missed school days among grade school children. When defining the research problem in the research proposal, the nurse will discuss: a.the proposed methodologies for data collection. b.statistics about the number of school days missed by children with asthma. c.the costs and types of various medications to treat asthma symptoms. d.the need for future studies to examine asthma care for this population.

ANS: B Feedback A The discussion about proposed methodologies is part of the study design.

B When describing the research problem, the researcher identifies an area of concern for a particular population.

C The costs and types of medications would be included in background information, but this discussion does not identify the research problem.

D The discussion about the need for further studies is part of the discussion and summary.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 41 19. Which portion of a research report would the nurse initially read to get an overview of the study? a. Abstract

b.Conclusion

Gray Burns and Grove’s The Practice of Nursing Research (9e)

c.Framework d.Methodology ANS: A Feedback AThe research report usually begins with an abstract: a clear, concise summary of a study, including the research problem and purpose, methodology, and conclusions. The reader can gain an understanding of the study by reading the abstract.

BConclusions are presented at the end of the report and describe the findings based on the data collection and data analysis.

CThe framework is present later in the study report and tells about the foundation of the study.

DThe methodology is in the middle part of the report and describes the study methods, tools, data collection, and analysis.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 51 20. The section of a research report that describes the purpose of a research study will include: a.what relationships among key variables will be examined. b.which various theories provide context for the research problem. c.what is currently understood about the research problem. d.why the research is necessary to help close a gap in knowledge.

ANS: A Feedback AThe research purpose is a statement generated from the research problem identifying the specific focus of goal of the study.

BThe theoretical framework identifies how theories provide context for the research question.

CThe literature review identifies what is currently known about the research problem.

DThe research problem is a statement about why the research is necessary to close gaps in knowledge.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 41 21. A researcher conducts a review of relevant literature prior to developing a research study in order to:

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.avoid duplication of research ideas. b.determine which theoretical framework is best adapted to the research problem. c.determine which type of study would be most cost-effective. d.identify what is known and unknown about a particular problem.

ANS: D Feedback AThe literature review identifies what is known and may describe past studies, but is not necessarily performed to avoid duplication of research ideas since many studies are replicated in order to confirm results.

BThe literature review does not evaluate the theoretical framework.

CThe literature review does not determine cost-effectiveness of a study.

DThe literature review is conducted in order to identify what is already known about a research problem and to document why a research study needs to be conducted.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 41-42 22. In a qualitative study to describe stages of grief, the researcher asks parents who have lost a child to cancer to describe their experiences with grief at specific time intervals after their childrens deaths. Which assumption will the researcher make? a. Study subjects have knowledge about theoretical concepts about grief. b. Study subjects understand the concept of grief. c. Subjects will be able to articulate their feelings coherently. d. Subjects will be available for data collection at specific time intervals.

ANS: B Feedback ASubjects who know what grief is do not necessarily have an understanding of theoretical concepts about grief.

BA researcher may make an assumption that study subjects will understand the concept of grief.

CAlthough it is desired that subjects will be able to articulate their feelings or be available at specific intervals, there is no assumption that they will be able to do so.

DSubjects may not always be available at specific intervals.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 42-43

Gray Burns and Grove’s The Practice of Nursing Research (9e)

23. How is theory tested in quantitative research? a.Assumptions about the theoretical framework are evaluated. b.Concepts become more clearly defined as they are tested. c.Relationships among concepts are tested. d.The entire theory is proven or disproven.

ANS: C Feedback AAssumptions are statements that are taken for granted and are not tested in research.

BConcepts are defined prior to initiating research.

CIn quantitative research, relational statements between two or more concepts are tested, not the entire theory.

DQuantitative studies do not prove or disprove an entire theory, just relationships among key concepts.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 42-43 24. An operational definition of a variable or concept ensures that the variable or concept will be: a.given theoretical meaning. b.linked to other variables or concepts. c.measured or manipulated. d.understood in context of a theoretical framework.

ANS: C Feedback AA conceptual definition of a concept gives that concept theoretical meaning.

BThe research question links concepts and variables to other concepts and variables.

CAn operational definition of a concept allows the concept to be measured or manipulated.

DThe operational definition does not necessarily give meaning to a concept in the context of a theoretical framework.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 44 25. In a research proposal, when describing a research design, the researcher would include:

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.discussion of a theoretical framework. b.evaluation of the researchers expertise. c.methods for measurement of variables. d.purpose of the study.

ANS: C Feedback A The theoretical framework is discussed in the theory section.

B The evaluation of the researchers expertise is part of the discussion.

C In the research design, the researcher will describe how variables are measured along with sampling procedures and plans for data collection and analysis.

D The purpose of the study is discussed in the introduction and purpose section.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 45 26. Prior to initiating a large-scale research study, the researcher conducts a small-scale study using similar subjects, methods, instruments, measurements, and analysis. This is done in order to: a.define the conceptual framework of the study. b.determine the quality of the study components. c.link study variables to one another. d.provide a study design.

ANS: B Feedback A The pilot is not performed to define the conceptual framework of the study.

B A pilot study is performed on a smaller scale in order to determine the quality of the study components before the study is conducted on a larger scale.

C The pilot does not necessarily link study variables to one another and is not the purpose of performing a pilot study.

D The pilot study tests components of the study design, which has already been determined.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 45 27. The methodology portion of the research report is used to:

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.describe the study design. b.discuss the implications of the study. c.provide a theoretical framework for the study. d.summarize the purpose, methods, and results.

ANS: A Feedback A In the methodology section, the researcher describes the study design including sampling methods, measurement of variables, data collection, and data analysis.

B The implications of the study are explored in the discussion section.

C The theoretical framework is discussed in the introduction.

D The summary is discussed in the conclusion.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 45 28. When the researcher describes the population of a study, the research consumer understands that this represents: a.all members of the population at large. b.all people who meet inclusion criteria for the study. c.members of the study group and the control group. d.subjects selected for the study based on sampling techniques.

ANS: B Feedback A Nmobterasllomf ethe population at large meet inclusion criteria and those who do not are not considered part of the population being studied.

B The population is all people who meet inclusion criteria for the study whether they are sampled and included or not.

C Members of the study and control group are the sample of the population selected for participation in the study.

D Subjects selected for the study are a representative sample of the population. PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 46 29. When a researcher describes an instrument as being valid this indicates that the instrument:

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.accurately measures a variable. b.consistently measures variables across studies. c.has been described as high quality by other researchers. d.has been routinely used in other, similar studies.

ANS: A Feedback AWhen an instrument is valid, it is considered to be accurate.

BReliability of an instrument means that it is consistent across studies.

CQuality of the instrument is not defined by validity measures.

DFrequency of use of the instrument is not defined by validity measures.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 46-47 30. When noting the limitations of a research study, the nurse might make which observation? a. Abstract concepts were defined using concrete, consistent terms. b. Findings could not be generalized to a population not included in the study. c. The researcher included a discussion of the links between the studys variables. d. The subjects were randomly assigned to control and experimental groups.

ANS: B Feedback AThe definition of concepts does not address the limitations of a study.

BLimitations are restrictions in a study methodology or framework that may decrease the credibility and generalizability of the findings.

CThe theoretical framework contains a discussion about the links between study variables.

DRandom assignment to control or experimental groups increases the likelihood that the studys findings may be generalized to a larger population.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 47-48 31. The purpose of a study abstract is to: a.describe the reason for conducting the study. b.outline the theoretical framework that defines the study. c.summarize a study concisely and capture the readers attention.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. summarize previous research about the studys topic.

ANS: C Feedback A The research purpose describes the reason for conducting the study.

B The theoretical framework clarifies links among variables.

C An abstract is a clear, concise summary of a study which, researchers hope, will capture the readers attention.

D The literature review summarizes previous research.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 51 32. In a study about concussion recovery in high school football players, which statement would be part of the introduction? a. The Functional Independence Measure was used to measure postconcussion symptoms. b. The purpose of this study was to determine average length of recovery time after a first

concussion. c. The results of this study showed an average recovery time of 6 weeks among football players. d. The study included a convenience sample of high school football players in a five-county area.

ANS: B Feedback A The methods section contains descriptions of the tools used as well as the sampling methods.

B The introduction section contains a statement about the study purpose.

C The conclusion section includes statements about the results of the tests performed.

D The methods section contains descriptions of the tools used as well as the sampling methods. PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 52 33. If a nurse wishes to critically appraise a studys sampling criteria and measurement tools, the nurse will read which part of the study report? a.Abstract b.Introduction c.Methods

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Results ANS: C Feedback A The abstract contains a concise description of the entire study.

B The introduction section contains a statement about the study purpose.

C The methods section contains descriptions of the tools used as well as the sampling methods.

D The results section includes statements about the results of the tests performed. PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 53 34. To learn whether there is a statistically significant difference between the control group and the experimental group in a study, the nurse would review which section of the research report? a.Introduction b.Methods c.Purpose d.Results ANS: D Feedback AThe introduction section contains a statement about the study purpose.

BThe methods section contains descriptions of the tools used as well as the sampling methods.

CThe purpose section contains a discussion of the reason for conducting the study.

DThe results section includes statements about the results of the tests performed and includes statements about the statistical significance of the differences among the variables.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 53 35. To help determine the relevance of a study to practice, it is recommended that the reviewer read which two sections of the study initially? a.Abstract, discussion b.Conclusions, references c.Literature review, purpose d.Methods, results

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: A Feedback AScanning the abstract or introduction and then the discussion will give an overview of the studys findings.

BThe conclusions and references may be read partly or in full after skimming the abstract and discussion.

CThe literature review and purpose may be read partly or in full after skimming the abstract and discussion.

DThe methods and results may be read partly or in full after skimming the abstract and discussion.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 54-55 36. The author of a research report describes the research problem in order to: a.conceptualize the research project. b.guide the development of the study methods. c.determine the goals and focus of the study. d.identify gaps in knowledge.

ANS: D Feedback AThe theoretical framework serves to conceptualize the research project.

BThe methodology section outlines the development of study methods.

CThe research purpose identifies the goals and focus of the study.

DThe research problem statement identifies gaps in current knowledge about the subject.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 52-53 MULTIPLE RESPONSE 1. Which of the following are true statements about quantitative research? (Choose all that apply.) a. Correlational research involves the use of statistics to determine relationships among variables.

b.Experimental research is the only type of quantitative research that is valid.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

c.Quasi-experimental research is a useful option when controlled conditions are not possible. d.Statistical tests are employed with quantitative research studies.

ANS: A, C, D Feedback Correct Correlational research involves statistical analysis of variables using correlational statistics.

Quasi-experimental research is a useful option when controlled conditions are not possible.

Statistical tests are employed with quantitative research studies.

Incorrect Experiments are only one form of quantitative research.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 33 2. What study design involves no intervention on the part of the researcher? (Choose all that apply.) a.Correlational b.Descriptive c.Experimental d.Quasi-experimental ANS: A, B Feedback Correct A correlational study does not involve interventions by the researcher.

A descriptive study does not involve interventions by the researcher.

IncorrectAn experimental study involves a highly controlled intervention.

A quasi-experimental study involves a controlled intervention.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 36-37

Gray Burns and Grove’s The Practice of Nursing Research (9e)

3. The nurse researcher submits a proposal for an initial study to evaluate the effects of regular moderate exercise on asthma control scores in adolescents with asthma. To achieve increased control in the initial study, the researcher will do which of the following? (Select all that apply.) a. Ask subjects to keep track of time spent exercising in a journal. b. Have subjects exercise on treadmills in the clinic three times weekly. c. Choose subjects classified as having moderate intermittent asthma symptoms. d. Limit participants to adolescent males who have asthma.

ANS: B, C, D Feedback Correct To control variables, the researcher should have subjects participate in the action in as controlled a setting as possible.

Having participants exercise in the clinic allows for better control and evaluation of the degree of exercise.

Limiting subjects to those who have similar symptoms will help limit extraneous variables that might be attributed to differences in asthma severity or any differences attributed to gender.

IncorrectAsking subjects to record unsupervised exercise limits the degree of control of this variable.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 37 4. The nurse participates in data collection in a study comparing the effect of two antilipidemia medications on total cholesterol in patients with hyperlipidemia. Which are extraneous variables to consider in such a study? (Select all that apply.) a. Differences between the antilipidemia medications.

b.Family history of hyperlipidemia. c.Individual patients weights. d.Other serum lipid values.

ANS: B, C, D Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Correct One variable that can affect the study outcome is family history of hyperlipidemia in study participants.

Patients who are obese may have different outcomes related to this variable than the reactions of those who are not obese.

Other serum lipid values, such as high-density lipoproteins or low-density lipoproteins, can affect total cholesterol.

IncorrectThe differences between the two medications are controlled in this study and are not extraneous variables.

Chapter 4. Introduction to Qualitative Research MULTIPLE CHOICE 1. What role does qualitative research play in evidence-based practice (EBP)? a. Because it does not involve random-controlled trials (RCTs), it does not contribute directly to

EBP. b. It offers a systematic approach for yielding insights into human experience and behavior. c. It provides a way to measure and evaluate quality outcomes that affect patient care. d. It provides the basis for most EBP guidelines and patient care protocols.

ANS: B Feedback A Many insights gained through qualitative studies are used to develop theories on which RCTs may be based.

B Qualitative research offers a systematic approach for collecting data about and evaluating human perception and experience that cannot be achieved through experimental research.

C Qualitative research is not concerned solely with outcomes research, which looks at the effects of nursing interventions on patient care outcomes.

D RCTs are the basis for most EBP guidelines and protocols PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 67 2. A researcher identifies a socioeconomic group of people to study. After developing a rapport with key members of the group, getting information about group members from the key members, and spending time working among group members, the researcher develops theories about the group based on this experience. Which type of qualitative research does this represent?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.Ethnographic b.Grounded theory c.Historical d.Phenomenological ANS: A Feedback AEthnographic research was developed by anthropologists as a mechanism for studying cultures and involves immersion in the group in order to make observations and get information.

BGrounded theory research is an inductive technique that emerged from the discipline of sociology. Ethnographic research was developed by anthropologists as a mechanism for studying cultures.

CHistorical research examines events of the past. Ethnographic research was developed by anthropologists as a mechanism for studying cultures.

DPhenomenological research describes experiences as they are lived. Ethnographic research was developed by anthropologists as a mechanism for studying cultures.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 74-75 3. What is true about phenomena in qualitative research? a. Human behavior is generally the result of the direct influence of independent variables.

b.Knowledge gained by qualitative research is concrete and derived from statistical data. c. Multiple realities are possible based on meanings created by individuals and groups. d. Time and context have very little influence on individual or group perspectives.

ANS: C Feedback AHuman behavior is complex and not just the result of the influence of independent variables.

BKnowledge gained in qualitative research is less concrete than that gained through quantitative research.

CThe understanding of phenomena in qualitative research is not the same as in quantitative research. In qualitative research, multiple realities, based on individual and group meanings, may be derived from research data.

DPhenomena in qualitative research are considered unique to the individual and in the time and the context that they occur.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 67

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4. A researcher conducts a qualitative study and learns that individuals have a variety of reactions to an event. What can the researcher conclude from this finding? a. The findings are interesting, but are not useful for theory development. b. The reactions described in this study may be generalized to a larger population. c. The study has little significance since there is no well-defined single outcome. d. The variety of reactions is expected since perception varies with individuals.

ANS: D Feedback AFindings in qualitative studies are often used to guide initial theory development whose constructs are later tested through experimental studies.

BReactions in qualitative studies do not have statistical significance and cannot be generalized to a larger population.

CEven without a well-defined outcome, the results do have significance and contribute to the larger body of scientific knowledge.

DBecause meaning is subjective, there can be multiple realities in qualitative research, which seeks to learn how individuals and groups respond to experiences.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 67 5. A researcher develops a study to examine various phenomena that contribute to theory development. This is an example of which type of research? a.Ethnographic research b.Grounded theory research c.Historical research d.Phenomenological research ANS: B Feedback AEthnographers observe and document interactions within a culture.

BGrounded theory develops theory directly from the research data.

CHistorical research examines events of the past.

DPhenomenological research attempts to capture the lived experience of study participants.

PTS:1DIF:Cognitive level: Applying (Application)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: MCS: 67| MCS: 70 6. A researcher conducts a study to examine the feelings of cancer patients at various points during their disease, including at diagnosis, when beginning chemotherapy, and during remission. Which type of study will the researcher use for this study? a.Ethnographic b.Grounded Theory c.Historical d.Phenomenological ANS: D Feedback A Ethnographers observe and document interactions within a culture.

B Grounded theory develops theory directly from the research data.

C Historical research examines events of the past.

D Phenomenological research attempts to capture the lived experience of study participants.

PTS:1DIF:Cognitive level: Applying (Application) REF:MCS: 67| pp. 69-70 7. What is true about scientific rigor in qualitative nursing research? a.Studies are rigorous only when results are quantifiable. b.Study findings are considered trustworthy when rigor is applied. c.Scientific rigor is not applicable with qualitative studies. d.Scientific rigor is only used with random-controlled trials.

ANS: B Feedback A Rigor can be applied to qualitative research.

B Rigor is valued because the findings of rigorous studies are seen as being more credible and of greater worth.

C Rigor can be applied to both qualitative and quantitative research.

D Rigor is used with qualitative research.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 68

Gray Burns and Grove’s The Practice of Nursing Research (9e)

8. When designing a study, which has the greatest influence as a researcher decides which type of qualitative study design to use? a.Funding and resources b.Literature review c.Population d.Research question ANS: D Feedback AFunding and resources influence the size of the population and the types of measures that may be employed.

BThe literature review and the population do not influence the study design directly.

CThe literature review and the population do not influence the study design directly.

DDeciding which qualitative approach to use depends on the research question and the purpose of the study.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 68 9. A researcher wishes to learn about the experiences that women have when breastfeeding their infants in the workplace. Which type of study design will the researcher employ? a.Ethnographic b.Exploratory-descriptive c.Grounded theory d.Historical ANS: B Feedback AEthnographers observe and document interactions within a culture.

BExploratory-descriptive studies are used when researchers are exploring a new topic or describing a situation.

CGrounded theory develops theory directly from the research data.

DHistorical research examines events of the past.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 76-77

Gray Burns and Grove’s The Practice of Nursing Research (9e)

10. A researcher who bases phenomenological research on Husserls philosophy will: a.incorporate personal biases into conclusions and discussion of the research. b.interpret subjects experiences according to the researchers own biases. c.place personal biases aside when considering and reporting research findings. d.use personal biases to look for hidden meanings in research data.

ANS: C Feedback AThis is not an accurate statement.

BThis is not an accurate statement.

CAccording to Husserl, to capture the lived experience of study participants, the researcher must set aside personal biases to describe the phenomena in a nave way.

Heidegger describes ways that personal biases are incorporated into qualitative research.

DThis is not an accurate statement.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 69-70 11. What is a key element of hermeneutics in research? a.Analysis of documents and interviews to identify themes and subthemes in data b.Bracketing of the researchers own perceptions for the duration of the study c.Description of phenomena without interpretation by the researcher d.Focusing solely on phenomena themselves without consideration of biases ANS: A Feedback AHermeneutics is a type of interpretive phenomenological research method that involves textual analysis and identification of themes and subthemes present in interviews and published documents in light of the studys research questions.

BHusserl suggested that the researcher must bracket personal biases in order to examine the research data. Husserl differs from Heidigger in this regard.Heidigger argued that it is impossible to set aside beliefs and biases.

CHeidiggers approach is interpretive and is part of hermeneutics.

DHeidigger believed that researchers cannot set aside their biases.

PTS:1DIF:Cognitive level: Analyzing (Analysis)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: pp. 69-70 12. When performing an external criticism of the documents used in historical research, the reviewer must determine whether the documents are: a.genuine or fraudulent. b.interesting or dull. c.well known or obscure. d.written by authors who are still living.

ANS: A Feedback AExternal criticism determines the validity of source material.

BWhether or not the document is interesting has little to do with the importance of the document.

CAs long as the document is genuine and of interest to the study, whether it is well known or not is irrelevant.

DAlthough it might be useful to know whether or not the writers of the document are living, this does not relate to external criticism.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 78-79 13. What is true about grounded theory research? a. It is a method used to quantify theoretical constructs in theory development. b. It is used to further research in areas where much concrete data is already known. c. Study designs use a theoretical basis to develop the research questions. d. Theory is developed from the data collected during the research.

ANS: D Feedback AExperimental studies are used to quantify theoretical constructs to test theories.

BGrounded theory research is preliminary and is often used when little is known about a subject.

CTheory is developed from the research findings of grounded theory research.

DGrounded theory develops theory directly from the research data.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: MCS: 70 14. A researcher wishes to understand how inner-city Somali immigrants adapt health care practices into their experiences with the U.S. health care system. Which type of study approach will the researcher use? a.Descriptive-qualitative b.Ethnographic c.Grounded theory d.Phenomenological ANS: B Feedback AExploratory-descriptive studies are used when researchers are exploring a new topic or describing a situation.

BEthnographic research involves observation and documentation of interactions within a culture.

CGrounded theory develops theory directly from the research data.

DPhenomenological research attempts to capture the lived experience of study participants.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 70-71 15. Which is an example of an etic approach in an ethnographic study? a.A longitudinal study examining individual immigrants attitudes about health care b.A study about African tribal women and their feelings about HIV prevention c.A study comparing various ethnic groups folk health practices d.A study of differences between BSN- and AND-prepared nurses attitudes about health care ANS: C Feedback AA study of immigrants attitudes about health care is a phenomenological study.

BA study examining a particular cultural group is an ethnographic study.

CThe etic approach involves studying behavior from outside the culture and examining similarities and differences across cultures.

DA study of attitudes about health care is a phenomenological study.

PTS:1DIF:Cognitive level: Applying (Application)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: MCS: 74 16. Which qualitative study will call for an exploratory-descriptive study approach? a. An evaluation of clinical outcomes of standard nursing interventions b. An examination of the effects of a treatment on various ethnic groups c. A review of data in order to evaluate theoretical constructs d. A study on a topic about which little is known or understood

ANS: D Feedback AOutcomes research is concerned with clinical outcomes of standard interventions.

BComparing the effects of a treatment on two groups of subjects is a quasi-experimental design.

CTheory testing uses data to evaluate theoretical constructs.

DExploratory-descriptive studies are used when researchers are exploring a new topic or describing a situation.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 77-78 17. A researcher utilizes an emic approach in a research study in order to: a.gather data about lived experiences of individuals. b.trying to understand behaviors from within a culture. c.examine individual human behavior according to personal biases. d.use techniques such as bracketing and intuiting.

ANS: B Feedback APhenomenological research attempts to capture the lived experience of study participants. The emic approach involves studying behaviors from within a culture.

BThe emic approach involves studying behaviors from within a culture.

CThe etic perspective studies behaviors from outside the culture and examines similarities and differences across cultures. (The emic approach involves studying behaviors from within a culture.) The ethnographic approach looks at groups, not individual behaviors.

DBracketing and intuiting are techniques used rather than the focus of a study. The emic approach involves studying behaviors from within a culture.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: MCS: 74 18. The goal of grounded theory research is to: a.develop theories and hypotheses based on research findings. b.establish an ethnographic perspective on subjects. c.provide validity checks for constructs. d.test theoretical constructs and hypotheses.

ANS: A Feedback A Theory developed from grounded theory research is grounded in the data from which it was derived.

B An ethnographic perception of research is part of an ethnographic perspective.

C Validity checks for constructs are not the concern of grounded theory research.

D Theory testing uses data to evaluate theoretical constructs.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 74 19. A researcher wishes to examine the experiences and feelings of siblings of children who have cancer in order to gain information about this population. Which type of qualitative study method will the researcher use? a.Ethnographic b.Exploratory-descriptive c.Grounded theory d.Historical ANS: B Feedback AEthnographic research involves observation and documentation of interactions within a culture.

BExploratory-descriptive studies are used when researchers are exploring a new topic or describing a situation.

CGrounded theory develops theory directly from the research data.

DHistorical research uses historical documents to describe events.

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Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: pp. 77-78 20. When conducting historical research about the experiences of women refugees from the Sudan, the researcher interviews women who served as nurses among this population. These nurses represent: a.control group subjects. b.experimental group subjects. c.primary data sources. d.secondary data sources.

ANS: D Feedback AControl and experimental group subjects are used in experimental, quantitative, and not in qualitative studies.

BControl and experimental group subjects are used in experimental, quantitative, and not in qualitative studies.

CPrimary data sources are those gathered directly from the study subjects and can either be from direct interviews or from diaries or other documents written by the subjects.

DA secondary data source can be a person who lived at the same time or who had contact with the subjects of the study. Nurses who cared for Sudanese woman immigrants would be secondary sources for this population.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 78-79 21. When conducting research about the experiences of early advanced practice nurses, the researcher may consult which possible secondary source? a.A textbook history of early advanced practice nurses b.Currently practicing advanced practice nurses c.Former patients of early advanced practice nurses d.The scope of practice guidelines for advanced practice nursing ANS: C Feedback AA textbook history may itself use primary and secondary data sources.

BCurrently practicing APRNs rely on primary and secondary sources for their information, but are not themselves sources of historical information.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

CA secondary data source can be a person who lived at the same time or who had contact with the subjects of the study.

DThe scope of practice guidelines may use historical information, but it is not a historical document.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 78-79 22. What are subjects in qualitative research studies usually called? a.Experimental subjects b.Participants c.Primary sources d.Secondary sources ANS: B Feedback AExperimental subjects are subjects who are part of experimental studies.

BSubjects in qualitative studies are referred to as participants because the researcher and the participants cooperatively carry out the study.

CPrimary sources are subjects in historical studies who actually lived the experiences being described.

DSecondary sources are people who knew or worked closely with primary sources in historical research.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp. 81-82 23. How are subjects selected for qualitative research studies? a. As volunteers through advertising for subjects b. Based on knowledge or experience c. By random sampling methods d. Through convenience sampling

ANS: B Feedback ASubjects tend to be recruited and do not necessarily volunteer.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

BSubjects in qualitative research studies are selected based on their knowledge or experience or for their views related to the study.

CRandom sampling techniques are not generally used in qualitative research.

DConvenience samples are used when random sampling techniques are not possible and generally in qualitative research. Subjects in qualitative research are selected based on knowledge or experience.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 82 24. What is the researcher-participant relationship in qualitative research? a. Attaching personal meanings of the researcher to subjects responses

b.Controlling subjects responses by stating the aims of the study c. Creating empathetic and honest relationships with study subjects d. Keeping a distance to avoid skewing research findings ANS: C Feedback AIt is necessary for the researcher to be open to the perceptions of the participants.

BThe researcher tries to avoid controlling the subjects responses.

CIn qualitative research, the researcher creates a respectful relationship with each participant that includes being honest and open about the studys purpose and methods.

DThe researcher does not maintain a detached distance as with quantitative studies, but must become closely involved in the subjects experience in order to interpret it.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 82 25. What type of data collection method is most common in qualitative research? a.Distribution and review of questionnaires from subjects b.Interviews with and observation of subjects c.Participation and immersion in the lives of subjects d.Review of historical documents and literature about subjects ANS: B Feedback AQuestionnaires are used occasionally, but are often used in quantitative research as well.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

BBecause the data in most qualitative studies are the participants thoughts, ideas, and perceptions, data collection is most often done by interviewing and observing participants.

CEthnographic research is a less common type of qualitative research and involves participation and immersion in the lives of subjects.

DHistorical research is a type of qualitative research that involves review of historical documents and literature.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 83 26. During a qualitative research study, a researcher asks subjects a fixed set of questions to which the participants respond freely. This is an example of a(n): a.open-ended interview. b.semi-structured interview. c.structured interview. d.unstructured interview.

ANS: B Feedback AAn open-ended interview is unstructured and, while the researcher defines the focus of the interview, there may be no fixed sequence of questions.

BA semi-structured interview involves a fixed set of questions with no fixed responses.

CA structured interview involves a fixed set of questions with a fixed set of answers.

DAn unstructured interview may not have fixed questions or answers.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 83-84 27. What may characterize questions asked by the researcher during an exploratory-descriptive study? a.A focus on participants biographical information b.Using structured individual questions c.One main question with follow-up questions d.Open-ended questions with probes to follow up ANS: B

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback AEthnographic researchers will focus on biographical data.

BIn an exploratory-descriptive study, the researcher may ask more structured questions to achieve the purpose of the study.

CInterviews in a phenomenology study may have one main question with follow-up questions used as needed to elicit the participants perspective on the phenomenon.

DPhenomenological research interviews begin with open-ended questions followed up with more probing questions to elicit participants perspectives.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 83-84 28. A researcher investigates how nurses in a rural hospital regard the importance of asthma education using an ethnographic approach. Why was this approach appropriate? a. To find out what it was like for nurses to provide this education b. To explore the theoretical basis of asthma education c. To improve understanding of how these nurses define asthma education d. To look at the history of asthma education to shed light on current practice

ANS: C Feedback A A study to learn what it is like to do something would be best learned through an exploratory study.

B Grounded theory research explores the theoretical basis for interventions.

C The ethnographic approach looks at phenomena within a certain culture, in this case the hospital, and seeks to describe how that culture deals with the subject of interest.

D Historical research studies the history of an intervention.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 74 29. When appraising a study in which data was collected by interview, the reviewer will assess for: a.a dequate length of time for each interview.

b.evidence that prompts were not used to encourage responses. c.use of clinical setting for conducting interviews. d.utilization of payment for participation of subjects.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: A Feedback A An important aspect of reviewing interview methods is to assess the length of time the researcher allowed for each interview to determine whether subjects had adequate time to respond.

B Prompts may be used in interviews.

C It is better if interviews are conducted in a natural, and not a clinical setting.

D Subjects will ideally be volunteers, recruited for their knowledge and experience. PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 83 30. A researcher may choose to use a focus group instead of one-to-one interviews in order to: a.encourage free expression of views of the participants. b.increase conformity and consistency of participants responses. c.reduce the time needed to collect data. d.allow more time for lengthy and complete responses.

ANS: A Feedback A One of the assumptions underlying the use of focus groups is that group dynamics can help people to express and clarify their views in ways that are less likely to occur in a one-to-one setting.

B The goal of a focus group is not to increase conformity, but this may sometimes occur if participants go along with the group.

C This type of data collection often takes more time that with one-on-one interviews.

D Focus groups often do not allow for lengthy responses by individuals. PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 85 31. When gathering data for a study using observational methods, it is important for the data collector to: a.b e observant of all that is done and said and unsaid.

b.direct subjects by setting the stage through structured questions. c.record those actions and words that are related to the focus of the study. d.participate directly with subjects in order to better understand them.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: A Feedback A During observational experiences, the researcher should be observant and attempt to record what is said as well as unsaid and to record all that is done.

B The observer should not try to direct the actions of the participants.

C Unexpected events occurring during routine activities may be significant and are carefully noted.

D Ethnographic research involves immersion and participation.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 86 32. To maximize collection of pertinent information when conducting an observational study, the researcher records field notes: a.after the observation has concluded. b.during or immediately after the observation. c.prior to beginning the observation. d.when writing the research discussion.

ANS: B Feedback A This is not an accurate statement.

B In studies that use observation, notes taken during or shortly after observations (field notes) are best recorded while the information is easily recalled. It may be necessary to avoid taking notes during the observation so that the recorder does not miss observing something important.

C This is not an accurate statement.

D This is not an accurate statement.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 86 33. Which is true about data analysis in a qualitative study? a. It has very little structure. b. It is unnecessary in qualitative studies. c. It requires less time than with quantitative analysis. d. It should be consistent with the philosophical method of the study.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: D Feedback AData analysis is as rigorous as with quantitative studies.

BData analysis is as rigorous as with quantitative studies and as important.

CData analysis may take more time in qualitative studies because dwelling with the data requires considerable reading and reflection of the data.

DData analysis in qualitative studies should be consistent with the philosophical method of the study.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 89 34. A researcher classifies words and phrases that occur in data collected in a qualitative study.

This process is called: a.c oding the data.

b.describing the data. c.dwelling with the data. d.interpreting the data.

ANS: A Feedback ACoding the data is the process of reading the data, breaking text down into subparts, and labeling that part of the text.

BDescribing the data requires less analysis of the data than coding.

CDwelling with the data involves spending time mulling over the data to read and reflect on its meaning.

DDuring interpretation, the researcher places the findings in a larger context and may link different themes or factors in the findings to each other.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 89 35. Which type of research uses a less formal method of reporting data? a.Ethnographic b.Grounded theory c.Historical d.Phenomenological

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: C Feedback AReports of ethnographic research follow the traditional style. Historical research reports do not follow the traditional formalized style that is characteristic of much research.

BReports of grounded theory research follow the traditional style. Historical research reports do not follow the traditional formalized style that is characteristic of much research.

CHistorical research reports do not follow the traditional formalized style that is characteristic of much research.

DReports of phenomenological research follow the traditional style. Historical research reports do not follow the traditional formalized style that is characteristic of much research.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 78 36. A researcher describes phrases and terms discovered in a qualitative study and describes and links these with various themes. This is an example of: a.coding the data. b.describing the data. c.dwelling with the data. d.interpreting the data.

ANS: D Feedback ACoding the data is the process of reading the data, breaking text down into subparts, and labeling that part of the text.

BDescribing the data involves stating the findings in meaningful terms.

CDwelling with the data involves spending time mulling over the data to read and reflect on its meaning.

DIn qualitative research, data interpretation involves placing things discovered into categories that are linked with themes in order to identify meaning.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 89 37. While reviewing transcripts of interviews conducted for a qualitative study, the researcher appraises the data for congruence with the philosophical perspective of the study. This is an example of:

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.perspective. b.reliability. c.rigor. d.validity.

ANS: C Feedback A The perspective identifies the initial intent of the study.

B Reliability is used to evaluate measurement methods in quantitative research.

C Rigor in qualitative research requires critically appraising the study for congruence with the philosophical perspective.

D Validity is used to evaluate measurement methods in quantitative research.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 90 38. What is the purpose of qualitative research? a. To allow researchers to interject their own values into studies b. To describe data that cannot be measured or quantified c. To describe experiences and insight from the subjects perspective d. To establish causal relationships among subjective data

ANS: C Feedback A Qualitative research often involves the interaction of the researchers and the subjects perspectives and values, but that is not the purpose.

B Measureable data may be included in qualitative research.

C Qualitative research seeks to study the experiences of subjects and to gain insights from their perspective and not that of the researcher.

D Qualitative research seeks to identify meaning and context and not cause and effect.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 90 39. How are findings from qualitative studies used to add to the body of nursing knowledge? a.Findings are useful only for describing study subjects. b. Findings may be generalized to a wide variety of population groups.

Gray Burns and Grove’s The Practice of Nursing Research (9e) c. Findings provide a broad overview from which meaning is derived. d. Findings reveal meanings that can be used to develop theory.

ANS: D Feedback AAlthough they describe the particular situation, they have relevance in theory development.

BFindings are particular to the situation being observed and do not provide a broad overview.

CFindings are particular to the situation being observed and do not provide a broad overview.

DThe findings from a qualitative study lead to an understanding of a phenomenon in a particular situation and are not generalized, but provide an initial picture or theory.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 67 40. A researcher uses film footage to collect data in which type of research? a.Ethnographic b.Grounded theory c.Historical d.Phenomenological ANS: C Feedback AEthnographers observe and document interactions within a culture. Historians may observe film, videotapes, photographs, or artistic representations of historical events.

BGrounded theory develops theory directly from the research data. Historians may observe film, videotapes, photographs, or artistic representations of historical events.

CHistorians may observe film, videotapes, photographs, or artistic representations of historical events.

DPhenomenological research attempts to capture the lived experience of study participants.

Historians may observe film, videotapes, photographs, or artistic representations of historical events.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 67|MCS: 78 41. Which is true about rigor in qualitative research? a. Data should be interpreted according to the initial expectations of the researcher.

Gray Burns and Grove’s The Practice of Nursing Research (9e) b. Findings of the study should be generalizable to a larger population. c. Studies are evaluated based on design detail and thoroughness of evaluation. d. There is no method for judging rigor in qualitative research.

ANS: C Feedback A The meaning of the data should be interpreted with an open mind, even if the meaning is not what was initially anticipated.

B The findings of a qualitative study cannot be generalized but may be applied in other contexts or with other subjects.

C Rigor in qualitative studies is assessed based on the degree of detail in study design, the care taken in data collection, and the thoroughness of data analysis.

D Rigor is valued in all research as a means to ensure the credibility and worth of studies.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 68 42. Which is true about phenomenological research? a. It is a method that views the person and the environment as integrated. b. It seeks to quantify human behavior and experience. c. It disregards the meaning of lived experiences. d. It is a single approach that uses quantitative research methods.

ANS: A Feedback APhenomenological research views the person as integrated with the environment.

BPhenomenological research does not seek to quantify human behavior and experience CPhenomenological research seeks to find and interpret the meaning of lived experiences.

DThere are several philosophical approaches to phenomenological research.

Chapter 5. Research Problem and Purpose MULTIPLE CHOICE 1. A researcher has conducted 9 clinical studies, some quantitative and others qualitative, all of which focus on depressions relationship to perceived abandonment. Depressions relationship to perceived abandonment is an example of which of the following?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. Research problem b. Research topic c. Research purpose d. Problem statement ANS: B Research topics are concepts, phenomena of interest, or broad problem areas that researchers can focus on to enhance evidence-based nursing. A research problem is an area of concern where there is a gap in the knowledge base needed for nursing practice. Research topics contain numerous potential research problems, and each problem provides the basis for developing many research purposes. The problem statement identifies the specific gap in the knowledge needed for practice. A nursing situation often includes a variety of research topics or concepts.

DIF: Cognitive Level: Application REF: MCS: 73 2. Why is replicating a research study essential for knowledge development? a. Each time a study is replicated, its probability of error decreases. b. Reproducing a study decreases theoretical knowledge, increasing real knowledge. c. Replication helps confirm that the initial results were not reached in error. d. Replication studies represent the majority of published nursing literature.

ANS: C Replication involves reproducing or repeating a study to determine if similar findings will be obtained. Replication is essential for knowledge development because it (1) establishes the credibility of the findings, (2) extends the generalizability of the findings over a range of instances and contexts, (3) reduces the number of type I and type II errors, (4) corrects the limitations in studies methodologies, (5) supports theory development, and (6) lessens the acceptance of erroneous results. Some researchers replicate studies because they agree with the findings and wonder if the findings will hold up in different settings with different subjects over time. Others want to challenge the findings or interpretations of prior investigators. However, the number of nursing studies replicated continues to be limited.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Synthesis REF: MCS: 77 3. A nurse researcher working in a subacute orthopedic hospital floor. She notes that her elders with knee replacements sleep as many as 16 hours a day, waking only for physical therapy and meals, but she also notices that those with many visitors sleep fewer hours and seem to experience more pain. She wonders whether sleep in elders after knee replacement prevents pain, or whether elders select the coping strategy of sleeping more, in response to pain, and begins to attempt to identify the relationship between the two. A literature search reveals only three descriptive studies on this topic, one quantitative and two qualitative. What is the relationship between elders hours of sleep following knee replacement and its relationship with report of pain? a. The research aim b. The research purpose c. The research problem d. The research topic ANS: C Research topics are concepts, phenomena of interest, or broad problem areas that researchers can focus on to enhance evidence-based nursing. A research problem is an area of concern where there is a gap in the knowledge base needed for nursing practice. Research topics contain numerous potential research problems, and each problem provides the basis for developing many research purposes.

DIF: Cognitive Level: Synthesis REF: MCS: 73 4. A masters student who works in cardiothoracic ICU reads a 20-year-old nursing research study; the findings document use of much larger per-kilogram amounts of opioids and anxiolytics postoperatively in adults with open-heart surgery, as opposed to children with openheart surgery. The student strongly suspects that modern hospitals medicate children and adults more or less the same, on a per-kilogram basis. She decides to replicate the original research in her hospital. What type of replication is this?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. Exact replication b. Concurrent replication c. Systematic replication d. Approximate replication ANS: D Replication involves reproducing or repeating a study to determine whether similar findings will be obtained. Four different types of replication are important in generating sound scientific knowledge for nursing: (1) exact, (2) approximate, (3) concurrent, and (4) systematic extension.

An exact, or identical, replication involves duplicating the initial researchers study to confirm the original findings. All conditions of the original study must be maintained. An approximate, or operational, replication involves repeating the original study under similar conditions, following the methods as closely as possible. A concurrent, or internal, replication involves the collection of data for the original study and its simultaneous replication to provide a check of the reliability of the original study. A systematic extension or constructive replication is done under distinctly new conditions.

DIF: Cognitive Level: Application REF: MCS: 77 5. A research study contains the question, Can the application of twice-daily cortisone in the period from 6 to 10 weeks postoperatively produce significantly increased range of motion in 50to 60-year-old rotator-cuff repair patients at the six-month mark? The study is

research.

a. Ethnographic b. Historical c. Experimental d. Basic ANS: C Experimental studies are conducted in highly controlled settings and under highly controlled conditions to determine the effect of one or more independent variables on one or more dependent variables. An experimental research question takes the form of, Does provision of

Gray Burns and Grove’s The Practice of Nursing Research (9e)

increased A have an effect on B? where the study variables are A and B, the relationship is a change in A and its effect on B, and the question ends with a question mark.

DIF: Cognitive Level: Synthesis REF: MCS: 87 6. A knowledge gap is identified by a nurse researcher. Which of the following may NOT necessarily represent a knowledge gap? a. A literature search that shows that no quantitative research, but only qualitative research, exists in the area. b. The National Institutes of Health (NIH) identify the area as one of research priority. c. The phenomenon of interest is a new disease, just identified in Phoenix, Arizona. d. There is one study examining a new intervention, but the research has not yet been replicated.

ANS: A The lack of quantitative research may mean only that the phenomenon or idea of the research is not suited for quantitative research, since some concepts are suitable only for qualitative enquiry.

By questioning and reviewing the literature, researchers begin to recognize a specific area of concern and the knowledge gap that surrounds it. The knowledge gap, or what is not known about this clinical problem, determines the complexity and number of studies needed to generate essential knowledge for nursing practice. Since 1975, expert researchers, specialty groups, professional organizations, and funding agencies have identified nursing research priorities.

DIF: Cognitive Level: Application REF: MCS: 87 7. Which of the following represents a concise, clear statement of the specific goal or aim of a research study? a. The research problem was identified as the general area of ignorance surrounding the causation and diagnosis of meningococcal meningitis, especially among soldiers in uniform, and this constituted a significant gap in the literature.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. The purpose of the project, then, was to define changes in the variable of hypertension across time, with the four most prevalent treatment modalities prescribed by primary care physicians in the greater Chicago area. c. The phenomenon of depression experienced by the primary schoolchild was focused upon in this study. It is an under-researched topic, especially since recent research has identified correlational links with childhood obesity, especially Hispanic and African-American populations. d. Despite the fact that studying the disease, especially from standpoints of prevention and early detection, is costly and time-consuming, it represents a clear priority, since treatment itself is remarkably costly and the afflicted are not likely to experience even short remissions without early intervention.

ANS: B The research purpose is a concise, clear statement of the specific goal or aim of the study that is generated from the research problem. A research problem is an area of concern where there is a gap in the knowledge base needed for nursing practice. Research topics are concepts, phenomena of interest, or broad problem areas that researchers can focus on to enhance evidence-based nursing. One source of research problems is research priorities identified by funding agencies and specialty groups.

DIF: Cognitive Level: Comprehension REF: MCS: 74 8. What is the relationship between a research topic and a research problem? a. The purpose is the most general statement; the research topic is the most specific to the research itself. b. Research topics contain numerous potential research problems, and each problem provides the basis for developing many purposes. c. The research topic and the research problem are identical. d. The research topic specifies setting and population, but the problem does not.

ANS: A Research topics are concepts, phenomena of interest, or broad problem areas that researchers can focus on to enhance evidence-based nursing. Research topics contain numerous potential research problems, and each problem provides the basis for developing many purposes. Thus, the

Gray Burns and Grove’s The Practice of Nursing Research (9e)

identification of a relevant research topic and a challenging, significant problem can facilitate the development of numerous study purposes to direct a lifetime program of research.

DIF: Cognitive Level: Analysis REF: MCS: 73 9. Which of the following is the practicing nurses most important source of researchable problems? a. The nurses own clinical practice b. Review of the literature c. Nursing theories d. Administrative mandates to conduct clinical research on every hospital unit ANS: A The practice of nursing must be based on knowledge or evidence generated through research.

Thus, clinical practice is an extremely important source for research problems. Problems can evolve from clinical observations. A review of patient records, treatment plans, and procedure manuals might reveal concerns or raise questions about practice that could be the basis for research problems.

DIF: Cognitive Level: Analysis REF: MCS: 75 MULTIPLE RESPONSE 1. Which of the following are considered evidence-generating? (Select all that apply.) a. Replication of previous research b. Identification of research topics, followed by basic research c. Applied research studies that examine clinical response to interventions d. Reviews of the literature e. Qualitative research examining responses to diagnosis ANS: A, B, C, E

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Research topics are concepts, phenomena of interest, or broad problem areas that researchers can focus on to enhance evidence-based nursing. However, the lack of replication studies severely limits the generation of sound research findings needed for evidence-based practice in nursing.

Basic, or pure, research is a scientific investigation that involves the pursuit of knowledge for knowledges sake, or for the pleasure of learning and finding truth. The purpose of basic research is to generate and refine theory and build constructs; thus, the findings are frequently not directly useful in practice. Replication of previously conducted research is essential for knowledge development. By questioning and reviewing the literature, researchers begin to recognize a specific area of concern and the knowledge gap that surrounds it; however, review of the literature does not generate knowledgeit reviews previous knowledge. Questions focusing on investigating new techniques to improve existing skills, patient responses to techniques, or ways to educate patients and families to perform techniques. . . could add to knowledge needed for evidence-based practice.

DIF: Cognitive Level: Analysis REF: MCS: 73 2. Reasons to conduct an exact replication include which of the following? (Select all that apply.) a. A different sample is used in the replication, because subjects seldom elect to undergo the same surgical procedure twice. b. The same site is again used, in order to decrease variation. c. Sample size was adequate, the design was strong, and measurements were robust. d. Validation of the truthfulness of the original subjects responses is desired. e. A similar population is used, in order to verify the findings.

ANS: B, C, D Four different types of replication are important in generating sound scientific knowledge for nursing: (1) exact, (2) approximate, (3) concurrent, and (4) systematic extension. An exact (or identical) replication involves duplicating the initial researchers study to confirm the original findings. All conditions of the original study must be maintained. Exact replications might be thought of as ideal to confirm original study findings, but these are frequently not attainable. In addition, one would not want to replicate the errors in an original study, such as small sample size, weak design, or poor-quality measurement methods.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Analysis REF: MCS: 77 3. The American Association of Critical Care Nurses (AACN) funds various research projects that focus on its research priorities. A masters student wants to initiate research to study the relative accuracy of new computer-assisted assessment device that painlessly measures blood glucose values through a probe just distal to the insertion hub of a central line, in patients on insulin drips with hourly Accu-Chek readings. Does this pertain to any of the organizations research priorities, listed here? (Select all that apply.) a. Technology use to achieve patient assessment, management, or outcomes b. Prevention and management of complications c. Processes and systems that foster the optimal contribution of critical care nurses d. Creation of a healing, humane environment e. Development of processes and systems that foster the optimal contribution of critical care nurses ANS: A, D The American Association of Critical Care Nurses (AACN) determined initial research priorities for this specialty in the early 1980s and revised these priorities based on patients needs and the changes in health care. The current AACN (2011) research priorities are identified on this organizations website as (1) effective and appropriate use of technology to achieve optimal patient assessment, management, or outcomes; (2) creation of a healing, humane environment; (3) processes and systems that foster the optimal contribution of critical care nurses; (4) effective approaches to symptom management; and (5) prevention and management of complications.

This research study uses technology. Also, it saves the patient from interruptions in sleep, as the nurse flushes a line and draws blood hourly, or performs hourly Accu-Cheks, if the line will not draw.

DIF: Cognitive Level: Synthesis REF: MCS: 79 4. The purpose of the research will be, most likely, to document how admirable charitable efforts

by The Children of the Land were terminated by the well-meaning Los Angeles Police Force.

What is incorrect about this wording? (Select all that apply.)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. A police organization cannot be named in a research purpose. b. A purpose should specify methodology. c. The terms admirable and well-meaning are both subjective. d. The purpose must identify the goal of the study, not the most likely goal. e. The purpose should be stated as was or is but not will be.

ANS: C, D, E The purpose is generated from the problem, identifies the goal or goals of the study, and directs the development of the study. In the research process, the purpose is usually stated after the problem, because the problem identifies the gap in knowledge in a selected area and the purpose clarifies the knowledge to be generated by the study. The research purpose must be stated objectively, that is, in a way that does not reflect particular biases or values of the researcher.

Investigators who do not recognize their values might include their biases in the research. This can lead them to generate the answers they want or believe to be true and might add inaccurate information to a disciplines body of knowledge.

DIF: Cognitive Level: Evaluation REF: MCS: 83 5. Children in publicly funded school breakfast programs often have learning delays. These are not readily attributable to single causes. Research on learning delays has revealed that family literacy, measured by parental reading level and comprehension scores, is the most powerful predictor of delay in the primary grades. On the other hand, repeated exposure to eyes-on reading, in the company of a trusted non-parent adult, has been shown to over-ride family literacy as a predictor. No research, however, has studied institution of a reading-andbreakfast program, delivered five days a week before school, intended to over-ride the variable of family literacy. Given this problem statement, which of these purposes would be appropriate for the study? (Select all that apply.) a. The purpose of the study was to determine whether providing volunteer readers during school breakfasts for all kindergarten and first-grade children would result in fewer than anticipated learning delays. b. The purpose of the study was to determine the lived experience of children with learning delays, against the context of school and home, and to examine the childrens peer relationships.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

c. The purpose of the study was to determine whether a buddy system of one sixthgrader, and one kindergartner or first-grader, who ate breakfast together and then read together for 20 minutes, was effective in decreasing the anticipated number learning delays. d. The purpose of the study was to experimentally determine what causes learning delays, by introducing various strategies already in place in community primary schools and measuring their effect, using basic research. e. The purpose of the study was to measure the effectiveness of using school computers, allowing children to visually scan a story concurrently read by a school teacher over the cafeteria microphone during school breakfast time, in decreasing the incidence and severity of learning delays.

ANS: A, C, E The problem statement identifies the specific gap in the knowledge needed for practice. Each problem may generate many research purposes. The research purpose is a clear, concise statement of the specific goal or aim of the study that is generated from the research problem.

The purpose usually indicates the type of study to be conducted and often includes the variables, population, and setting for the study.

DIF: Cognitive Level: Synthesis REF: MCS: 73 6. In determining a studys feasibility, which of the following statements are true, regarding the time needed for study completion? (Select all that apply.) a. Some data collection must be performed over an extended period of time, such as measurements of the depth and extent of scar tissue over 18 months. b. Sufficient subjects meeting the study criteria may be difficult to access, requiring data collection that extends for months or even years. c. The inflationary spiral makes all research funding inadequate. d. Computerized records make data analysis much less time-consuming. e. Obtaining Institutional Review Board (IRB. approval may be time-consuming, especially if the research uses more than one hospital or agency.

ANS: A, B, E

Gray Burns and Grove’s The Practice of Nursing Research (9e)

One can approximate the time needed to complete a study by assessing the following factors: (1) type and number of subjects needed, (2) number and complexity of the variables to be studied, (3) methods for measuring the variables (are instruments available to measure the variables, or must they be developed?), (4) methods for collecting data, and (5) the data analysis process.

Another factor that can increase the time needed for a study is obtaining institutional review board (IRB) approval, especially if more than one clinical agency is used for data collection in a study. Not all research funding is inadequate. Computerized records may be easier or may be more difficult for data retrieval; however, data analysis is not affected by the existence of computerized data.

DIF: Cognitive Level: Application REF: MCS: 84 7. How do seasoned nurse researchers, years away from clinical practice, select meaningful research questions? (Select all that apply.) a. They continue to conduct research in the same general areas in which they have previously conducted research, with one project leading into the next. b. They cannot do so, because they are not working bedside nurses. c. They establish working relationships with clinical nurses, sharing authorship of research publications. d. They collaborate with novice researchers who are closer to the clinical world. e. They use research methods that allow data collection through only observation.

ANS: A, C, D Interactions with researchers and peers offer valuable opportunities for generating research problems. Experienced researchers serve as mentors and help novice researchers to identify research topics and formulate problems. This type of relationship could also be developed between an expert researcher and a nurse clinician. Since nursing research is critical to be designated as a Magnet facility, hospitals and healthcare systems employ nurse researchers for the purpose of guiding studies conducted by staff nurses. Building an evidence-based practice for nursing requires collaboration between nurse researchers and clinicians, as well as collaboration with researchers from other health-related disciplines. During data collection, study variables are

Gray Burns and Grove’s The Practice of Nursing Research (9e)

measured through a variety of techniques, such as observation, interview, questionnaires, scales, and physiological measurement methods.

DIF: Cognitive Level: Synthesis REF: MCS: 76 8. A masters student does not know how to choose a research problem. She has been off work for the past two years. What sources can she use in order to identify a researchable nursing problem?

Her work area used to be trauma nursing, but she does not wish to perform research in this area.

By using which of the following sources can she identify a nursing research problem? (Select all that apply.) a. Talking with nurse friends about questions that have arisen in their work areas b. Talking with other masters students about ideas for study c. Reading professional research journals d. Depending on her instructors to provide a research problem for her e. National Institutes for Nursing Research priorities ANS: A, B, C, E The major sources for nursing research problems include nursing practice; researcher and peer interactions; literature review; theories; and research priorities identified by individuals, specialty groups, professional organizations, and funding agencies.

DIF: Cognitive Level: Application REF: MCS: 75 9. What is the relationship among the research problem, the research purpose, and the research question? (Select all that apply.) a. The purpose is but one of many purposes that can be generated from one particular problem statement. b. The problem statement is more focused and specific than is the purpose. c. The research purpose and the research question should address the same facet of the research problem. d. The problem, purpose, and question are all focused upon a specific gap in the knowledge base.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

e. Research can be conducted without a research question, but not without a research purpose.

ANS: A, C, D A research problem is an area of concern where there is a gap in the knowledge based needed for nursing practice. A research problem includes significance, background, and a problem statement. The problem statement identifies the specific gap in the knowledge needed for practice. The research purpose is a clear, concise statement of the specific goal or aim of the study that is generated from the research problem, so the purpose is usually identified after the research purpose is identified. Consequently, more than one purpose can emanate from a given problem statement. Based on the research purpose, specific research objectives, questions, or hypotheses are developed to direct the study.

DIF: Cognitive Level: Analysis REF: MCS: 73 10. A researcher gains support of the medical staff, the nursing staff, and the nurse manager of a cardiothoracic ICU within a prestigious private hospital, aligned with a teaching institution. A research proposal, concerning ambulation patterns after bypass surgery, is approved by the Human Subjects Committee. Federal funding is obtained. Just before data collection is to begin, the hospital is sold to a large university with a medical school, the nurse manager is replaced with a manger from another hospital in the corporation, and there is a 30% staff turnover. Choose the factors that are real concerns and could impact feasibility. (Select all that apply.) a. Most of the newly hired nurses are BSNs and newly graduated. b. The new manager grudgingly allows the research to proceed but makes it clear that she will not support subsequent research until the unit is more stable. c. Fewer patients come to this hospital now for bypass surgery, going instead to its sister hospital across town. d. Two of the research assistants, who were already trained, take jobs elsewhere. e. Staff nurses dislike the new manager and miss the old one.

ANS: B, C, D

Gray Burns and Grove’s The Practice of Nursing Research (9e)

The feasibility of a study is determined by examining the time and money commitment; the researchers expertise; availability of subjects, facility, and equipment; cooperation of others; and the studys ethical considerations. A study might appear feasible but, without the cooperation of others, it is not. However, most nursing studies involve human subjects and are conducted in hospitals, clinics, schools, offices, or homes. Having the cooperation of people in the research setting, the subjects, and the research assistants involved in data collection is essential. People are frequently willing to cooperate with a study if they view the problem and purpose as significant or if they are personally interested.

DIF: Cognitive Level: Analysis REF: MCS: 84 11. A masters student decides to conduct a pilot study in order to help with which of the following? (Select all that apply.) a. Assess working nurses responses to having a researcher collect data in the middle of their unit. b. Re-evaluate the actual expenditure of the researchers time for each subject consented and studied. c. Allow potential subjects to sample research participation before they fully commit. d. Apply for Human Subjects permission to perform the actual study. e. Determine whether the research side has enough research subjects who are interested in participating in the research.

ANS: A A pilot study is commonly defined as a smaller version of a proposed study conducted to refine the methodology. It is developed much like the proposed study, using similar subjects, the same setting, the same treatment, and the same data collection and analysis techniques. As the research problem and purpose increase in clarity and conciseness, the researcher has greater direction in determining the feasibility of a study. The feasibility of a study is determined by examining the time and money commitment; the researchers expertise; availability of subjects, facility, and equipment; cooperation of others; and the studys ethical considerations. The purpose selected for investigation must be ethical, and Human Subjects permission must be obtained before even a pilot study is conducted. A pilot study is not used to allow potential subjects to sample

Gray Burns and Grove’s The Practice of Nursing Research (9e)

participation before they commit: Human Subjects permission must be obtained before study participation.

Chapter 6. Objectives, Questions, Variables, and Hypotheses MULTIPLE CHOICE 1. Which of the following is the research objective? a. To answer the research question b. To determine the strength of the statistical relationship among the variables c. To determine whether homeless children seem to have longer length of hospital stay, poorer verbal skills, and more fear of separation from their parents than do other children d. To measure length of stay, verbal skills, and fear of separation from parents in homeless children admitted to the hospital ANS: C Research objectives are clear, concise, declarative statements that are expressed in the present tense. For clarity, an objective usually focuses on one or two variables (or concepts) and indicates whether the variables are to be identified or described. Objectives can also identify relationships or associations among variables, determine differences between groups or compare groups on selected variables, and predict a dependent variable based on selected independent variables.

DIF: Cognitive Level: Application REF: MCS: 138 2. What is the research question? a. Length of hospital stay, verbal skills, and fear of separation from parents have no relationship to childrens homelessness. b. Does childrens homelessness affect length of hospital stay, verbal skills, and fear of separation from parents? c. Was homelessness related to length of hospital stay, verbal skills, and fear of separation from parents in this study?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Is homelessness in children related to length of hospital stay, verbal skills, and fear of separation from parents?

ANS: D A research question is a concise, interrogative statement that is worded in the present tense and includes one or more variables (or concepts). The research questions focus on (1) the description of the variable(s), (2) a determination of differences between two or more groups regarding selected variables, (3) an examination of relationships among variables (relational), and (4) the use of independent variables to predict a dependent variable. In this case (3), the examination of relationships among variables, would be the focus of the research question, since cause is not a focus of study.

DIF: Cognitive Level: Application REF: MCS: 140 3. What is the research hypothesis? a. Longer length of hospital stay, worse verbal skills, and fear of separation from parents are caused by childrens homelessness. b. Homelessness in children is related to length of hospital stay, verbal skills, and fear of separation from parents. c. There is no relationship between childrens homelessness and length of hospital stay, verbal skills, and fear of separation from parents. d. If a child is homeless, that child is likely to have poor verbal skills, more difficulty separating from parents, and a longer hospital stay.

ANS: B A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. The hypothesis translates the problem and purpose into a clear explanation or prediction of the expected results or outcomes of the study. A hypothesis (1) specifies the variables the researcher will manipulate or measure, (2) identifies the population the researcher will examine, (3) indicates the type of research, and (4) directs the conduct of the study. Hypotheses are described using the terms in the following four categories: (1) associative versus causal, (2) simple versus complex, (3) directional versus nondirectional, and (4) null versus research.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Application REF: MCS: 142 4. A researcher identifies three variables and formulates a hypothesis that links them. That hypothesis is testable. What does it mean that the hypothesis is testable? a. All the variables in the hypothesis are measurable. b. The hypothesis must be replaced by a research question. c. The value of the hypothesis is low. d. The hypothesis is causational.

ANS: A Hypotheses identify different types of relationships and numbers of variables. A well-formulated hypothesis clearly identifies the relationship between the variables. A hypothesiss value is ultimately derived from whether it can be tested in the real world. A testable hypothesis is one that contains variables that can be measured or manipulated in the world.

DIF: Cognitive Level: Synthesis REF: MCS: 144 5. A stimulus or activity that is measured to examine the effect created by the independent variable best describes a(n)

variable.

a. Independent b. Demographic c. Extraneous d. Dependent ANS: D In quantitative research, the independent variable (intervention, treatment, or experimental variable) is manipulated or varied by the researcher to cause an effect on the dependent variable.

The dependent variable (response or outcome variable) is measured to examine the effect created by the independent variable. An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. A dependent variable is

Gray Burns and Grove’s The Practice of Nursing Research (9e)

the response behavior or outcome that the researcher wants to predict or explain. Extraneous variables exist in all studies and can affect the measurement of study variables and the relationships among them. Extraneous variables are of primary concern in quantitative studies, because they can obscure ones understanding of the relational or causal dynamics within the studies. Demographic variables are attributes of the subjects that are measured during the study and used to describe the sample.

DIF: Cognitive Level: Comprehension REF: MCS: 145 6. The intervention that the researcher manipulates is the

variable.

a. Independent b. Demographic c. Extraneous d. Dependent ANS: A In quantitative research, the independent variable (intervention, treatment, or experimental variable) is manipulated or varied by the researcher to cause an effect on the dependent variable.

The dependent variable(response or outcome variable) is measured to examine the effect created by the independent variable. An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. A dependent variable is the response behavior or outcome that the researcher wants to predict or explain. Extraneous variables exist in all studies and can affect the measurement of study variables and the relationships among them. Extraneous variables are of primary concern in quantitative studies, because they can obscure ones understanding of the relational or causal dynamics within the studies. The extraneous variables that are not recognized until the study is in process or are recognized before the study is initiated but cannot be controlled are referred to as confounding variables. Demographic variables are attributes of the subjects that are measured during the study and used to describe the sample.

DIF: Cognitive Level: Comprehension REF: MCS: 145 7. It is important for the researcher to identify extraneous variables so that

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. All of the extraneous variables can be manipulated by the researcher. b. The findings can be explained as clearly and truthfully as possible. c. The research results are not critiqued unfairly. d. The extraneous variables have no influence on the dependent variable.

ANS: B Extraneous variables exist in all studies and can affect the measurement of study variables and the relationships among them. Extraneous variables are of primary concern in quantitative studies, because they can obscure ones understanding of the relational or causal dynamics within the studies. Extraneous variables are classified as (1) recognized or unrecognized and (2) controlled or uncontrolled. The extraneous variables that are not recognized until the study is in process or are recognized before the study is initiated but cannot be controlled are referred to as confounding variables. Sometimes these variables can be measured during the study and controlled statistically during analysis. In other cases, it is not possible to measure a confounding variable, and the variable thus hinders the interpretation of findings. Such extraneous variables must be identified as limitations or areas of study weakness in the discussion section of a research report.

DIF: Cognitive Level: Analysis REF: MCS: 152 8. Simple descriptive statistics may be used to depict the sample characteristics, reflecting demographic variable values, in which kind of research? a. Quantitative research only b. Qualitative research only c. Both quantitative and qualitative research d. Only when data has been extracted from an electronic database ANS: C Demographic variables are attributes of the subjects that are measured during the study and used to describe the sample. Demographic variables are presented as the sample characteristics, using

Gray Burns and Grove’s The Practice of Nursing Research (9e)

simple descriptive statistics such as frequency and percentage, in both quantitative and qualitative research.

DIF: Cognitive Level: Application REF: MCS: 154 9. In the following hypothesis, what is the independent variable?

Patients with recurrent bowel obstruction due to Crohns disease who are assigned to be treated in an emergency room complain less frequently of pain and require less pain medication than those patients admitted, in the usual fashion, and treated on a medical floor. a. Bowel obstruction due to Crohns disease b. Place treated c. Number of complaints of pain d. Number of doses of pain medication ANS: B An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. The independent variable is also called an intervention, treatment, or experimental variable. In this example, place treated (emergency room versus medical floor) is the independent variable.

DIF: Cognitive Level: Application REF: MCS: 145 10. In the following purpose statement, what kind of variable is number of days absent from class?

The purpose of this study was to examine the effects of a generous weekly allowance and twiceweekly text messages from parents on number of days absent from class, in freshman college students. a. Demographic variable b. Independent variable c. Extraneous variable

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Dependent variable ANS: D A dependent variable is the response behavior, or outcome that the researcher wants to predict or explain. In this example, number of days absent from class is the dependent variable. An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. The independent variable is also called an intervention, treatment, or experimental variable. Demographic variables are attributes of the subjects that are measured during the study and used to describe the sample. Extraneous variables exist in all studies and can affect the measurement of study variables and the relationships among them.

DIF: Cognitive Level: Application REF: MCS: 145 11. The following statement is an example of which of the following?

There is no measurable difference in incidence of incarceration for adolescent children whose mothers work outside the home in comparison with those whose mothers do not work outside the home. a. Null hypothesis b. Confounding variable c. Research objective d. Research question ANS: A A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. The null hypothesis, also referred to as a statistical hypothesis, is used for statistical testing and interpretation of statistical outcomes. The null hypothesis can be simple or complex and associative or causal. The null hypothesis states that there is no relationship between two or more variables. Extraneousvariables exist in all studies and can affect the measurement of study variables and the relationships among them. The extraneous variables that are not recognized until the study is in process, or that are recognized

Gray Burns and Grove’s The Practice of Nursing Research (9e)

before the study is initiated but cannot be controlled, are referred to as confounding variables.

Research objectives are clear, concise, declarative statements that are expressed in the present tense, focus on one or two variables (or concepts), and indicate whether the variables are to be identified or described. A research question is a concise, interrogative statement that is worded in the present tense and includes one or more variables (or concepts).

DIF: Cognitive Level: Application REF: MCS: 142 12. In the following hypothesis, what is the dependent variable?

There is no measurable difference in incidence of acne in 15-year-olds who are placed on a chocolate-free diet. a. Fifteen-year-olds b. No chocolate in the diet c. Chocolate in the diet d. Acne ANS: D A dependent variable is the response behavior or outcome that the researcher wants to predict or explain. An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. In this example, acne is the dependent variable and removal of chocolate from the diet is the independent variable.

DIF: Cognitive Level: Application REF: MCS: 151 13. What is the relationship between a conceptual definition and an operational definition? a. The conceptual definition provides information; the operational definition provides none. b. The conceptual definition is concrete, and the operational definition is abstract. c. They are the same, in most instances. d. The operational definition allows the researcher to create a measurable variable from a concept; the conceptual definition does not.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: D Operationalizing a variable or a concept involves developing conceptual and operational definitions. A conceptual definition provides the theoretical meaning of a concept or variable.

The conceptual definition provides a basis for formulating an operational definition. An operational definition is derived from a set of procedures and progressive acts that a researcher performs either to manipulate an independent variable or to measure the existence or degree of existence of the dependent variable.

DIF: Cognitive Level: Synthesis REF: MCS: 155 14. In the following research question, what is the independent variable?

Can diabetics on oral antiglycemic medications achieve better control of blood sugar, as measured by Hgb A1C, if they are taught to meditate and do this on a daily basis? a. Oral antiglycemic medications b. Hgb A1C c. Meditation d. Blood sugar ANS: C An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. The independent variable is also called an intervention, treatment, or experimental variable. In this example, nausea and vomiting are dependent variables and guided imagery and relaxation techniques are independent variables.

DIF: Cognitive Level: Application REF: MCS: 145 MULTIPLE RESPONSE 1. Which of the following are the research variables in this study? (Select all that apply.) a. Patient age

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. Verbal skills c. Homelessness d. Parental presence e. Fear of separation from parents f. Whether or not a child is homeless g. Length of hospital stay ANS: B, E, G Research variables or concepts are the qualities, properties, or characteristics that are measured in qualitative studies and selected quantitative studies. Concrete concepts, such as temperature, weight, and blood pressure, are referred to as variables in a study; abstract concepts, such as creativity, empathy, and social support, are sometimes referred to as research concepts.

DIF: Cognitive Level: Application REF: MCS: 151 2. Which of the following could be a dependent variable in an experimental study? (Select all that apply.) a. Medication A b. The number of times the gerbil rings the bell c. Quality of life d. The number of times the subject is instructed in how to use the experimental equipment e. Vomiting ANS: B, C, E A dependent variable is the response behavior, or outcome that the researcher wants to predict or explain. An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable.

DIF: Cognitive Level: Synthesis REF: MCS: 151

Gray Burns and Grove’s The Practice of Nursing Research (9e)

3. Which of the following could be an independent variable in an experimental study? (Select all that apply.) a. Quality of life b. The percentage of moisture in the inspired air the subject breathes c. The researchers preference for quantitative versus qualitative methodologies d. Wearing a hat with a large brim e. Seizure activity during the experiment ANS: B, D An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. The independent variable is also called an intervention, treatment, or experimental variable. A dependent variable is the response behavior, or outcome that the researcher wants to predict or explain.

DIF: Cognitive Level: Analysis REF: MCS: 151 4. Which of the following are operational definitions? (Select all that apply.) a. Length of smoking cessation is the subjects statement of how long it has been since the subject last smoked tobacco. b. Pain is whatever the patient says it is, whenever the patient says it is (Margo McCaffrey). c. Imagination is the ability to see what will be, not what is. d. Startle is the distance the research subject moves when a puppet tarantula is dropped into his field of view, in front of a computer screen. e. Nausea is the number the subject provides, on a 0- to 10-point numerical scale, in response to being asked how nauseated the subject is.

ANS: A, D, E An operational definition is derived from a set of procedures and progressive acts that a researcher performs either to manipulate an independent variable or to measure the existence or degree of existence of the dependent variable.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Application REF: MCS: 155 5. Which of the following could be a research question? (Select all that apply.) a. What does postoperative vomiting feel like, to research subjects? b. How is hypnosis related to smoking cessation? c. In an English course, how do grading, praise, practice, submitting papers for publication, and writing skills interact? d. What are the differences between clients with pre-op orientation and those without, in terms of procedural anxiety? e. How does the researcher define loneliness?

ANS: A, B, C, D Research questions meet the following criteria: (1) the identification and/or description of the variable(s), (2) a determination of differences between two or more groups regarding selected variables, (3) an examination of relationships among variables (relational), and (4) the use of independent variables to predict a dependent variable.

DIF: Cognitive Level: Application REF: MCS: 140 6. Martha wants to know what happens when she fries bacon in a frying pan, versus microwaving it: does the bacon end up moister and more flavorful when fried, or when microwaved? What are the dependent variables? (Select all that apply.) a. Frying bacon b. Microwaving bacon c. Consistent cooking temperature d. Variable cooking temperature e. Moistness of bacon f. Kitchen burns g. Flavor of bacon ANS: E, G

Gray Burns and Grove’s The Practice of Nursing Research (9e)

A dependent variable is the response behavior, or outcome that the researcher wants to predict or explain. An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. In this example, whether the bacon ends up moister and more flavorful is the dependent variable and method of cooking is the independent variable.

DIF: Cognitive Level: Application REF: MCS: 145 7. Ralph is an experimental psychologist. He studies rat behavior. He runs rats through a maze, under different scent conditions. At the end of the maze is cheese. Sometimes the maze is lit, and sometimes it is dark. During each run, the rates are subjected to different scents (cat pheromone, the smell of cheddar cheese, tiger pheromone, the smell of rat feces) at crucial decision-points in the maze. Ralph measures the time it takes the rats to finish the maze. Which of the following could be considered independent variables in this study? (Select all that apply.) a. The rats b. Light versus dark c. Ralph d. The amount of time the rats take to finish the maze e. The scents f. The cheese at the end of the maze g. Rat behavior ANS: B, E An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. The independent variable is also called an intervention, treatment, or experimental variable. In this example, how long in seconds it takes the rats to run through the maze is the dependent variables and different scents are independent variables; light versus dark are the two experimental conditions, and these could also affect the outcome, so they could also be considered independent variables.

DIF: Cognitive Level: Application REF: MCS: 145

Gray Burns and Grove’s The Practice of Nursing Research (9e)

8. What type of hypothesis is the following? (Select all that apply.)

Increased intake of dietary fiber in elders and increased fluid intake are associated with fewer episodes of diverticulitis? a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: B, D, F A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship (associative or causal) between two variables. A complex hypothesis predicts the relationship (associative or causal) among three or more variables. The relationships identified in hypotheses are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142 9. What type of hypothesis is the following? (Select all that apply.)

Taking lessons to learn how to play bridge, and weekly practice in playing bridge, have an effect on beginning bridge players win-loss ratio. a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: B, C, E A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship (associative or causal) between two variables. A complex hypothesis predicts the relationship (associative or causal) among three or more variables. The relationships identified in hypotheses are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142 10. What type of hypothesis is the following? (Select all that apply.)

Having ones house and yard professionally sprayed yearly by an extermination service has an effect on infestations of common garden ants. a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: A, C, E A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship

Gray Burns and Grove’s The Practice of Nursing Research (9e)

(associative or causal) between two variables. A complex hypothesis predicts the relationship (associative or causal) among three or more variables. The relationships identified in hypotheses are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142 11. What type of hypothesis is the following? (Select all that apply.)

Providing early written feedback to undergraduate nursing students in the clinical setting increases the incidence of desired behaviors of safe medication administration, work efficiency, accurate charting, and competent time management. a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: A, C, F A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship (associative or causal) between two variables. A complex hypothesis predicts the relationship (associative or causal) among three or more variables. The relationships identified in hypotheses are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Analysis REF: MCS: 142 12. What type of hypothesis is the following? (Select all that apply.)

Number of hours spent daily playing video games is negatively related to student achievement in high school history class. a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: A, D, F A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship (associative or causal) between two variables. A complex hypothesis predicts the relationship (associative or causal) among three or more variables. The relationships identified in hypotheses are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142 13. What type of hypothesis is the following? (Select all that apply.)

The number of children in the home is associated with noise level in that home, and with parental stress. a. Simple hypothesis

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: B, D, E A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship (associative or causal) between two variables. A complex hypothesis predicts the relationship (associative or causal) among three or more variables. The relationships identified in hypotheses are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142 14. What type of hypothesis is the following? (Select all that apply.)

The number of minutes a 16-year-old girl spends applying her makeup in the morning is related to her perceived personal attractiveness. a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: A, D, E

Gray Burns and Grove’s The Practice of Nursing Research (9e)

A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship (associative or causal) between two variables. A complex hypothesis predicts the relationship (associative or causal) among three or more variables. The relationships identified in hypotheses are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

DIF: Cognitive Level: Analysis REF: MCS: 142 15. What type of hypothesis is the following? (Select all that apply.)

Decreasing the time allotted for weekly in-class pop quizzes increases student anxiety and decreases student grades. a. Simple hypothesis b. Complex hypothesis c. Causal hypothesis d. Associative hypothesis e. Nondirectional hypothesis f. Directional hypothesis ANS: B, C, F A hypothesis is a formal statement of the expected relationship or relationships between two or more variables in a specified population. A simple hypothesis predicts the relationship (associative or causal) between two variables. A complex hypothesis predicts the relationship (associative or causal) among three or more variables. The relationships identified in hypotheses are associative or causal. An associative relationship identifies variables that occur or exist together in the real world. Causal relationships identify a cause-and-effect interaction between two or more variables. A nondirectional hypothesis states that a relationship exists but does not

Gray Burns and Grove’s The Practice of Nursing Research (9e)

predict the nature of the relationship. A directional hypothesis states the nature or direction of the relationship between two or more variables.

ANS: B Feedback AUnlike variables in a quantitative study, they usually are not easily measured.

BIn many qualitative studies, the focus of the study is to define or describe the concept.

CThey are developed as the study unfolds and do not have to be clearly described in order to proceed with the study.

DThey are developed as the study unfolds and do not have to be clearly described in order to proceed with the study.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 156 34. Which type of variable is used in a summary of sample characteristics? a.Demographic variables b.Dependent variables c.Independent variables d.Research variables ANS: A Feedback A Demographic variables are attributes of subjects that are collected to describe the sample.

B Dependent variables are variables that change as a result of manipulation of the independent variable.

C Independent variables are variables that are manipulated to observe effects on dependent variables.

D Research variables are variables used in qualitative studies.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 157

Gray Burns and Grove’s The Practice of Nursing Research (9e)

35. Which is true about a statement of the research purpose? a. It describes the background for the subject of the research study. b. It includes a discussion of the significance of the study. c. It includes the research problem statement. d. It provides a concise description of the studys focus.

ANS: D Feedback A The review of the literature provides background for the subject of a research study.

B The studys significance is a part of the overall purpose of the study.

C The research problem statement is a separate statement and includes a discussion of the studys significance.

D The research purpose is a concise, clear statement of the specific goal of focus of the study.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 158 36. An examination of the researchers plan for using measurement tools to examine relationships among variables helps determine the: a.research hypothesis. b.research objectives. c.study feasibility. d.study purpose.

ANS: A Feedback A The research hypothesis is determined through the research question and is a statement about the relationship among the research variables.

B The research objectives are identified in the research purpose.

C The study feasibility is determined by the researchers expertise, the available funding, measurement tools and sample population availability, and ethical considerations.

D The study purpose is a statement identifying what will be measured in a particular study.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 158

Gray Burns and Grove’s The Practice of Nursing Research (9e)

37. Which is true about a research hypothesis? a. It defines the various research variables and describes how they will be measured. b. It explains the relationship of the research purpose to theory development. c. It includes the research problem, purpose, and research questions. d. It links the research problem statement to the study design and data analysis.

ANS: D Feedback AThe problem statement can link the research purpose to theory development.

BThe introduction contains the research problem, purpose, and research questions.

CThe research purpose links the problem statement to the study design and data analysis.

DThe research hypothesis is the formal statement of the expected relationship between two or more variables in a specified population.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 158 38. In a research proposal, a statement about expected relationships among variables is the: a.conceptual definition. b.operational definition. c.research hypothesis. d.research problem.

ANS: C Feedback A The conceptual definition is derived from the theoretical definition of a related concept and provides theoretical meaning for a variable.

B An operational definition is derived from a set of procedures or progressive acts that a researcher performs to receive sensory impressions that indicate the existence or degree of existence of a variable.

C The research hypothesis is the formal statement of the expected relationship between two or more variables in a specified population.

D The research problem identifies gaps in knowledge. PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 158

Gray Burns and Grove’s The Practice of Nursing Research (9e)

39. Which type of variable is manipulated by the researcher? a.Demographic b.Dependent c.Independent d.Research ANS: C Feedback A Demographic variables are attributes of members of a sample population.

B The dependent variable is the outcome variable and is the variable researchers wish to predict based on manipulation of the independent variable.

C The independent, or experimental variable, is manipulated by the researcher in order to observe possible effects on the dependent variable.

D A research variable is used in qualitative studies.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 158 40. In a study of adolescent children using a group of high school football players and juniorhigh school cyclists, researchers compared the length of recovery from concussion between those wearing brand X helmets and those wearing brand Y helmets. In this study high school football players represent which type of variable? a.Demographic b.Dependent c.Independent d.Research ANS: A Feedback ADemographic variables are attributes of members of a sample population.

BThe dependent variable is the outcome variable and is the variable researchers wish to predict based on manipulation of the independent variable.

CThe independent, or experimental variable, is manipulated by the researcher in order to observe possible effects on the dependent variable.

DA research variable is used in qualitative studies.

Chapter 7. Review of Relevant Literature

Gray Burns and Grove’s The Practice of Nursing Research (9e)

MULTIPLE CHOICE 1. One reason for conducting a review of the literature other than for purposes of developing a research study is to: a.determine the expertise of researchers in the field of study. b.identify current theoretical frameworks. c.implement evidence-based practice guidelines. d.work in a Magnet-certified hospital setting.

ANS: C Feedback AEvaluation of the expertise of researchers and identification of theoretical frameworks are part of literature reviews but are not the reason for conducting them.

BEvaluation of the expertise of researchers and identification of theoretical frameworks are part of literature reviews but are not the reason for conducting them.

CAlthough a literature reviews are commonly associated with development of research studies, they are also conducted when developing projects to establish evidence-based-practice (EBP).

DNurses in Magnet hospitals often participate in EBP projects and will conduct literature reviews for these, but not solely to be able to work in these institutions.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 163 2. What is the purpose of a limited research review? a. To allow the reader to become familiar with the research problem b. To develop an initial pilot study prior to a more in-depth study c. To direct the planning and execution of a study d. To identify studies published after a study is performed

ANS: D Feedback AA full literature review allows the reader to become familiar with the research problem and is performed prior to a pilot or a full study.

BThe full literature review directs the planning and execution of the study.

CThe full literature review directs the planning and execution of the study.

DA limited research review is often conducted after an initial literature review in order to describe any studies performed after the study has been performed. The results of both the original literature review and the limited literature review are included in the report.

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PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 163 3. A reviewer reading a proposal for a qualitative research study notes that the author has not included a literature review. The reviewer understands that a literature review may have been omitted in this case because: a. it is not necessary to conduct a literature review for qualitative research. b. qualitative research is conducted to study areas where there is no previous knowledge.

c.some researchers feel that previous studies may bias data collection in qualitative studies. d.the researcher was not adequately prepared to conduct this research study.

ANS: C Feedback AA literature review can be helpful in qualitative research and should be performed if possible.

BThis is true of some but not all qualitative methods (for example grounded theory); however, it is not true of all qualitative designs.

CMany times literature reviews are omitted from qualitative research to avoid causing expectations that might bias findings, data collection, and data analysis.

DAt times, there is little or no previous research on the topic, but not always.

Omission of a literature review in qualitative research does not indicate that the researcher is ill-prepared.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 164 4. Which type of study is least likely to include a review of the literature prior to initiating the study? a.Grounded theory b.Phenomenological c.Qualitative d.Quantitative ANS: B Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

AGrounded theory researchers may have a limited review of relevant studies in order to make the researcher aware of what studies have been conducted and that a research problem exists.

BPhenomenological researchers are most likely to delay literature review until after a study is completed in order to avoid bias.

CQualitative and quantitative research will involve literature reviews, although these may be less substantial in qualitative studies.

DQualitative and quantitative research will involve literature reviews, although these may be less substantial in qualitative studies.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 164 5. What is the main purpose of a literature review in grounded theory research? a. To explain, extend, and support the framework used for the study b. To identify gaps in current knowledge about the research topic c. To place research findings in context of what is already known. d. To support the need to study the selected research topic

ANS: A Feedback AIn grounded theory research, the researcher uses the literature review primarily to explain, support, and extend the framework used in the study, and not to direct data collection or study methods. It is usually completed at the end of the analysis rather than before the proposal development BThe literature review in quantitative studies is designed to identify gaps in knowledge.

CPhenomenological literature reviews are conducted to place research findings in the context of what is already known.

DBecause the literature review for grounded theory research is generally conducted at the end of the analysis, it is not used to support the need for studying the topic, but to summarize what is known.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 164 6. Why might Wikipedia be a questionable reference for a study citation? a. It does not contain factual information. b. It does not provide ideas for other resources. c. It is an online resource.. d. It is an open, editable format.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: D Feedback AWikipedia may contain factual information, but this is not reliable.

BWikipedia may provide ideas for other resources.

CWikipedia is an online resource, but that fact does not exclude it from being used.

DWikipedia is an open, editable format; the information may not always be accurate because it is not peer reviewed and scientifically based.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 166 7. Which source of information is rarely cited in academic publications? a.Conference proceedings b.Dissertation or thesis c.Encyclopedia d.Textbooks ANS: C Feedback A Conference proceedings, dissertations or theses, and textbooks may all be cited.

B Conference proceedings, dissertations or theses, and textbooks may all be cited.

C Encyclopedias tend to provide background information and some information leading to other resources, but generally not scholarly or primary source information.

D Conference proceedings, dissertations or theses, and textbooks may all be cited.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 166 8. When determining the reliability of a website resource in a literature review, it is important to determine: a.accessibility of the website information. b.costs of retrieving website information. c.sponsorship of website information. d.whether website information is also published conventionally.

ANS: C

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback AAccessibility, cost, and conventional publication of website information are not determinants of reliability of website information.

BAccessibility, cost, and conventional publication of website information are not determinants of reliability of website information.

CNot all websites are valid and appropriate for citation in a literature review. Those that are sponsored by companies that sell certain products under study may not be appropriate resources because their information may be biased.

DAccessibility, cost, and conventional publication of website information are not determinants of reliability of website information.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 166 9. A review of empirical literature will yield information obtained from: a.concept analyses. b.descriptions of models and frameworks. c.research studies. d.theories.

ANS: C Feedback A Theoretical literature includes concept analyses, models, theories, and conceptual frameworks.

B Theoretical literature includes concept analyses, models, theories, and conceptual frameworks.

C Empirical literature refers to knowledge derived from research and is based on data from research.

D Theoretical literature includes concept analyses, models, theories, and conceptual frameworks.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 166 10. What is an important limitation of secondary sources in literature reviews? a.The authors do not have high levels of expertise. b. They are usually not peer-reviewed sources. c. They do not contain unique or original information. d. They may contain misinterpreted information.

ANS: D

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback AAuthors of secondary sources have similar levels of expertise as those of primary sources.

BSecondary sources may contain original information as authors synthesize and analyze findings from primary sources.

CSecondary sources are usually peer reviewed.

DA secondary source summarizes or quotes content from primary sources. Because authors of secondary sources paraphrase the works of researchers and theorists and interpret what the primary author wrote, this information may be misinterpreted.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 166 11. When reviewing articles in a peer-reviewed publication, the reader is assured that the articles are: a.landmark studies. b.primary sources. c.seminal studies. d.trustworthy sources.

ANS: D Feedback ALandmark studies, primary sources, and seminal studies are included in peer-reviewed literature, but may also appear in literature that is not peer reviewed.

BLandmark studies, primary sources, and seminal studies are included in peer-reviewed literature, but may also appear in literature that is not peer reviewed.

CLandmark studies, primary sources, and seminal studies are included in peer-reviewed literature, but may also appear in literature that is not peer reviewed.

DResearch reports detailing study events, including results and analysis of findings included in refereed professional journals, are considered one of the most credible types of evidence and are typically considered one of the most useful sources for researchers as they conduct a literature review for a current study. Articles found in refereed journals have been evaluated in an anonymous process by unbiased reviewers and received favorable review, not only for the integrity of the research itself, but because the topic of interest has been deemed significant to the profession.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 166 12. For a study to be considered current, it should be published within the last:

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.year. b.2 years. c.5 years. d.10 years.

ANS: C Feedback A This is not a correct statement.

B This is not a correct statement.

C Current sources are those published within 5 years before publication of the manuscript.

D This is not a correct statement.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 166 13. Some studies cited in a literature review may be decades old. The researcher may decide to use studies from this far back because these studies: a.are groundbreaking or landmark studies. b.are particularly well-written studies. c.are peer-reviewed, relevant studies. d.are still considered current studies.

ANS: A Feedback AStudies that are groundbreaking or landmark studies are those that were significant to the development of knowledge on the topic being reviewed. In this case, it is appropriate to cite these studies, even if they are very old.

BWell-written, peer reviewed studies that are not current are generally not used in a literature review.

CWell-written, peer reviewed studies that are not current are generally not used in a literature review.

DStudies that are decades old, however well-written and relevant, are not current studies, but are used for historical or seminal context.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 166

Gray Burns and Grove’s The Practice of Nursing Research (9e)

14. A researcher conducts a study using dependent and independent variables used in a previous study but uses a different population of subjects. What type of study is this? a.Landmark b.Pilot c.Replication d.Seminal ANS: C Feedback AA landmark study is one that generates knowledge that influences a discipline and sometimes society as a whole. Landmark studies are often replicated.

BA pilot study is a study using a small sample size to develop the study methods and tools and is later replicated on a larger scale.

CA replication study is a reproduction or repetition of a study that a researcher conducts to determine whether the findings of the original study can be consistently found in different settings with different subjects.

DA seminal study is the first study on a particular topic that signals a new way of thinking about the topic. These studies are often replicated.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 166 15. A nurse appraising a research article should perform which action in order to critically evaluate the literature review? a. Locate and review sources and abstracts listed in the research article b. Note the number of data-based and theoretical sources cited in the reference list c. Perform a meta-analysis or meta-synthesis on the cited references d. Search the literature to determine whether other relevant sources exist

ANS: B Feedback ALocating and reviewing all abstracts would be too time consuming and may not be possible.

BBecause it would be very time consuming to search the literature and determine whether the listed sources are relevant, the reviewer should review the reference list and determine the focus of the sources, the number of data-based and theoretical sources cited, and where and when the sources were published.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

CMeta-analysis and meta-synthesis are not done when critically appraising a literature review.

These techniques are used to perform an in-depth analysis of studies already cited in the literature.

DIt is not necessary at this point to search the literature to determine other relevant sources.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 168-169 16. When appraising a literature review, one aspect of determining the breadth of the review is: a.whether the review provides direction for the proposed study. b.the number and percentages of sources from the past 5 to 10 years. c.whether landmark or seminal studies have been used. d.the disciplines of the study authors and journals cited in the review.

ANS: D Feedback AAn assessment of whether the literature review provides direction for the study does not specifically evaluate the breadth of the literature review.

BThe currency of the literature review is evaluated by noting the number of sources more than 5 to 10 years old as well as whether landmark or seminal studies are cited.

CThe currency of the literature review is evaluated by noting the number of sources more than 5 to 10 years old as well as whether landmark or seminal studies are cited.

DWhen assessing the breadth of a literature review, the reviewer should identify the disciplines of the authors cited and the journals in which they published their studies.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 168-169 17. An initial step when preparing to conduct a literature review is to: a.choose the types of sources to use. b.clarify the purpose of the review. c.determine how many articles to review. d.select electronic data bases and keywords.

ANS: B Feedback AThe types of sources and the number of articles to review depend on the purpose of the review.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

BBecause the approach will vary according to the purpose of the review, the first step in conducting a literature review is to identify the purpose of the review.

COnce the purpose of the review is established and the author has an idea about the type and number of sources, the electronic databases and keywords are selected.

DOnce the purpose of the review is established and the author has an idea about the type and number of sources, the electronic databases and keywords are selected.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 176 18. When conducting a literature review for a thesis or dissertation and deciding how far back in the available literature to search, what will the student do? a. Ask the instructor to specify necessary publication years for articles cited. b. Base the decision on the number of articles necessary for the assigned task. c. Locate any seminal or landmark studies on the topic of research. d. Look for sources no older than 10 years prior.

ANS: C Feedback AThe breadth and currency of the literature review should be based on the topic and the purpose of the research and not on an assigned number or a particular number of years.

BThe breadth and currency of the literature review should be based on the topic and the purpose of the research and not on an assigned number or a particular number of years.

CWhen beginning a thesis or dissertation, the graduate student should look for seminal or landmark studies as a place to begin a literature review.

DThe breadth and currency of the literature review should be based on the topic and the purpose of the research and not on an assigned number or a particular number of years.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 176 19. When developing evidence-based-practice guidelines, if a researcher wishes to identify studies that evaluate a specific intervention in quantitative research, the literature review should include: a.grounded theory research. b.only current research from the last 5 years. c.replication studies and meta-analyses.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. seminal and landmark studies about the topic.

ANS: C Feedback A Grounded theory research is performed to test theory.

B While current research is desired, researchers may review older studies, particularly if they are seminal or landmark studies, although these are not necessary for this type of literature review.

C To synthesize evidence related to a practice problem and to evaluate a specific intervention in quantitative research, replication studies, meta-analyses, and meta-syntheses are used.

D While current research is desired, researchers may review older studies, particularly if they are seminal or landmark studies, although these are not necessary for this type of literature review.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 176 20. In the following APA-formatted reference, what is indicated by the italicized words?

Maxwell, S. E., & Delaney, H. D. (2004). Designing experiments and analyzing data: A model comparison perspective (2nd ed.). Mahway, NJ: Lawrence Erlbaum Associates. a. Abstract information b. Article title c. Book title

d.Publishing company ANS: C Feedback A The abstract information is not included in a reference citation.

B An article title is italicized if the citation is from a journal.

C When citing a book, the title is italicized.

D The publishing company information is listed last. PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 184 21. A step just prior to beginning a literature search using an electronic database is to: a. decide how many articles are needed.

Gray Burns and Grove’s The Practice of Nursing Research (9e) b. determine the type of study.

c.identify keywords for the search. d.perform a Google search.

ANS: C Feedback AThe number of articles needed for a literature review depends on the content of the articles and will not be known ahead of time.

BThe study type is not typically determined just prior to an electronic search.

CTo narrow the number of articles in a search and refine the search to more relevant articles, identifying keywords is necessary.

DA Google search may or may not be helpful for leading a researcher to other articles, but it is not a scientific database.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 176 22. When conducting a literature search, which electronic product would a nurse researcher use to track and store reference information? a. Cumulative Index of Nursing and Health Literature (CINAHL) b. EndNotes or Ref Works c. Google Scholar d. Science Direct

ANS: B Feedback A CINAHL is an electronic database used to search literature.

B EndNotes is reference management software that helps to track and store information on all search fields and allows the researcher to file this information with comments about each reference.

C Google Scholar is an electronic search engine.

D Science Direct is an electronic search engine.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 178

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23. After a literature search has yielded a list of articles, an efficient way to identify relevant studies during a literature search is to review: a.an electronic database search history. b.only experimental studies. c.reference lists in other studies. d.study abstracts.

ANS: D Feedback AThe electronic database search history lists only articles searched for but does not yield information about whether or not they are relevant.

BExperimental studies are not always relevant to a particular study, and other types of studies may be relevant.

CReference lists in other studies may give information about other articles to review, but do not give information about the content of these articles.

DThe abstract provides pertinent information about the article in a condensed, easy to peruse format so that the researcher can determine whether the article is pertinent to the topic.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 179 24. Once relevant studies have been identified, the researchers next step is to: a.determine the expertise of each studys authors. b.obtain full-text copies of each of these articles. c.review the study design and methodology of each article. d.write the literature review based on abstract information.

ANS: B Feedback ADuring the literature review, the researcher will examine the authors expertise and will review the study design and methodology.

BAlthough the abstract information helps to determine a studys relevance, it is essential to read the full-text article to conduct a literature review. Once relevant studies are found, the researcher must obtain either electronic or print full-text articles.

CDuring the literature review, the researcher will examine the authors expertise and will review the study design and methodology.

DThe literature review cannot be written based on abstract information only.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 179-180 25. When initially reading the relevant literature for comprehension, the researcher will: a.critically appraise the studies. b.highlight the main points of the studies. c.make decisions about paraphrasing quotes. d.review the abstract only.

ANS: B Feedback ACritical appraisal involves making value judgments about the validity or credibility of the study content.

BComprehending a source begins by reading and focusing on understanding the main points of the article and can be achieved by highlighting the main points of the article.

CDeciding what to paraphrase occurs later, just before writing the review.

DReviewing the abstract helps the researcher determine which articles are relevant but does not help with comprehension.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 180-181 26. A researcher performs a critical appraisal of a group of studies measuring the effects of a home care education program on confidence levels of caregivers of elderly family members. The critical appraisal will include: a.determining the theoretical frameworks used for defining confidence. b.identifying sampling and inclusion criteria used in the studies. c.making value judgments about the credibility and validity of concepts. d.recording quotations relevant to the concept of confidence.

ANS: C Feedback AWhile identifying theoretical frameworks, identifying sampling techniques and inclusion criteria, and recording pertinent quotations are important, they are not part of the critical appraisal of studies.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

BWhile identifying theoretical frameworks, identifying sampling techniques and inclusion criteria, and recording pertinent quotations are important, they are not part of the critical appraisal of studies.

CTo critically appraise an article, relevant content is identified and value judgments are made about the validity and credibility of key concepts.

DWhile identifying theoretical frameworks, identifying sampling techniques and inclusion criteria, and recording pertinent quotations are important, they are not part of the critical appraisal of studies.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 180-181 27. To analyze a body of literature in a literature review the reviewer will: a.describe the findings of each study in the literature review. b.list the studies and itemize the findings of each one. c.make value judgments about the credibility of each study. d.synthesize and summarize findings from various studies.

ANS: D Feedback AIt is not enough to merely describe the findings or to list the information in each one.

BIt is not enough to merely describe the findings or to list the information in each one.

CMaking value judgments is part of the appraisal process.

DAnalysis requires synthesis and summarization of findings of the studies listed and an ability to manipulate the information by the reviewer.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 180-181 28. Which is most important in a critical appraisal of a body of literature? a. Counting the available resources to determine whether more information is necessary.

b.Examining the quality and content of the resources to determine the credibility and validity of each. c.Reviewing the reference lists in each study to find other relevant studies and landmark studies. d.Searching the literature thoroughly using appropriate keywords to ensure that all relevant literature is included.

ANS: B

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback AThe literature search is important and must be thorough, but the critical appraisal depends on an evaluation of the quality and not the quantity of the available resources.

BCritiquing the literature review of a published study involves examining the quality of the content and sources presented. This is more important than achieving an accurate count of available resources.

CReviewing the reference lists may be useful for determining whether other relevant studies exist, but it is not the most important aspect of a critical appraisal, which is an evaluation of the quality of studies available.

DSearching the literature thoroughly using appropriate keywords to ensure that all relevant literature is included. may be useful for determining whether other relevant studies exist, but it is not the most important aspect of a critical appraisal, which is an evaluation of the quality of studies available PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 180-181 29. In a literature review, the author identifies themes present in articles under review and describes connections among these themes. This is an example of: a.analysis. b.appraisal. c.synthesis. d.theorizing.

ANS: C Feedback AAnalysis requires manipulation of what is found, literally making it the authors own.

BAppraisal involves identifying relevant content and determining the credibility or validity of the information.

CSynthesis of sources involves thinking deeply about what has been found and identifying the main themes of the information.

DTheorizing is part of developing the research question.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 180-182 30. A researcher reviews several articles about coping skills among parents of children with chronic illness and notes that half of the studies involved single-parent families. The researcher

Gray Burns and Grove’s The Practice of Nursing Research (9e)

decides to examine whether coping skills differ in single-parent versus dual-parent households.

The researcher is engaging in: a.analyzing. b.appraising. c.evaluating. d.synthesizing.

ANS: D Feedback AAnalysis requires manipulation of what is found, literally making it the authors own.

BAppraisal involves identifying relevant content and determining the credibility or validity of the information.

CEvaluation involves reviewing the literature content and determining its relevance to the topic.

DSynthesis of sources involves thinking deeply about what has been found and identifying the main themes of the information. In this case, the reviewer has discovered a variable that may affect the outcome of the studies.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 182-183 31. When developing the outline for a literature review, the researchers first step is to: a.describe the focus or purpose of the review in the discussion section. b.include a statement about what is known in the literature. c.make notes about which sources to site in each section. d.use a standardized format to outline subsections in the discussion section.

ANS: C Feedback AThe introduction section includes the focus or purpose of the literature review.

BThe conclusion contains the statement about what is known in the literature.

CAn initial outline is the first step in writing the literature review and begins with determining the major sections for the paper and identifying the sources that will be used in each one.

DThe discussion section format will vary based on the topic.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 183-184

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32. The concluding sentence of each paragraph in a literature review: a.describes relevant studies that support the theme of the paragraph. b.identifies the main themes of the paragraph. c.provides evidence to support the topic of the paragraph. d.transitions to the ideas expressed in the following paragraph.

ANS: D Feedback AThe opening sentence identifies the main themes of the paragraph.

BThe sentences between the opening sentence and the concluding sentence describe relevant studies and provide evidence to support the paragraph topic.

CThe sentences between the opening sentence and the concluding sentence describe relevant studies and provide evidence to support the paragraph topic.

DThe concluding sentence in a paragraph in the literature review should transition to the ideas expressed in the following paragraph.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 183-184 33. When citing sources in a literature review, it is best if the author: a.paraphrases other authors ideas. b.points out any defects in other authors work. c.synthesizes the work of a group of authors. d.uses direct quotations as much as possible.

ANS: A Feedback AWhen citing the work of other authors, the author of a literature review should paraphrase their words whenever possibleclearly, and in the reviewers own words.

BIt is important, in an analysis of the literature, to identify defects in other authors works, but this should be done with respect and without being highly critical.

CSynthesis of others work is an important part of the literature review as well and involves paraphrasing and analysis.

DDirect quotations should be avoided unless the author states something in a unique way.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 183-184

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34. An author uses an electronic source in portable document format (PDF). Which is true about citing this source in a literature review? a. It is necessary to provide the URL used to retrieve the article electronically. b. It is not treated differently than a print version of the article. c. The original print article must be located. d. TheMCS: numbers will not be available for citation.

ANS: B Feedback A Pe rUovRiLdifnogr tshuch an article is not helpful in this case.

B When retrieving a PDF document, the source is cited as if a copy of the print version of the article had been used.

C It is not necessary to locate the original print article when a PDF article is used.

D A PDF article is the same as a print article and will haveMCS: numbers for citation.

Chapter 8. Frameworks MULTIPLE CHOICE 1. Which is true about a study framework? a.It guides nurses in clinical practice. b. It explains a portion of a theory. c. It is one of the major ideas of a theory. d. It is the underlying methodology used in research.

ANS: B Feedback AThe knowledge gained from testing theories is used to guide nursing practice.

BA study framework is a brief explanation of a theory or those portions of a theory that are to be tested in a study.

CConcepts are the major ideas contained in a theory.

DThe framework is not the methodology, which consists of sampling techniques, tools, and measures used to gather and analyze data.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 190

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2. Which statement is true about theory and qualitative studies? a. Qualitative studies rely on conceptual frameworks and not on theory.

b.Qualitative studies are not based on theory. c. Qualitative studies may be used to create theory. d. Qualitative studies use theory in the same way as quantitative studies.

ANS: C Feedback AQualitative studies do not rely on conceptual frameworks.

BQualitative studies may be based on theory.

CQualitative studies may be based on a theory or may be designed to create a theory.

DQuantitative studies are designed to test the components of a theory, while qualitative studies may merely be based on or seek to create a theory.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 190 3. A researcher is studying how anxiety affects coping with chronic disease and theorizes that measures to reduce anxiety will improve subjects ability to cope with day-to-day demands of self-care. In this example, anxiety and coping are: a.assumptions. b.concepts. c.philosophies. d.theories.

ANS: B Feedback AAssumptions are statements in a philosophy or theory that are taken for granted or considered to be true.

BConcepts are terms that abstractly describe and name an object, idea, experience, or phenomenon and are defined in specific ways to present the ideas relevant to a theory.

CPhilosophies are rational intellectual explorations of truths or principles and describe viewpoints on what reality is and which ethical ideas should guide practice.

DTheories are sets of concepts that present a view of a phenomenon.

PTS:1DIF:Cognitive level: Applying (Application)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: pp. 190-191 4. When reviewing various theoretical frameworks, the nurse researcher identifies several viewpoints about how nurses should engage with terminally ill patients. These viewpoints represent: a.abstract ideas. b.assumptions. c.concrete ideas. d.philosophies.

ANS: D Feedback AAn abstract idea focuses on a general view of a phenomenon.

BAssumptions are statements in a philosophy or theory that are taken for granted or considered to be true.

CA concrete idea focuses on a particular instance.

DA philosophy is an idea that explores truths or principles and describes which ethical ideas should guide practice.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 190-191 5. A nurse researcher develops a study to assist patients with type 2 diabetes mellitus to lose weight by altering eating patterns. The researcher states, Patients with type 2 diabetes mellitus desire to control weight to gain better glycemic control. This statement is a(n): a.assumption. b.concept. c.philosophy. d.theory.

ANS: A Feedback AAssumptions are statements in a philosophy or theory that are taken for granted or considered to be true.

BConcepts are terms that abstractly describe and name an object, idea, experience, or phenomenon and are defined in specific ways to present the ideas relevant to a theory.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

CPhilosophies are rational intellectual explorations of truths or principles and describe viewpoints on what reality is and which ethical ideas should guide practice.

DTheories are sets of concepts that present a view of a phenomenon.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 190-191 6. A nurse researcher will measure the effects of infant and parent bonding on infant weight gain in the first 6 months of life. The nurse will evaluate the number of times each day that the parent holds the infant. This measure is an example of a(n): a.abstract idea. b.concept. c.concrete idea. d.phenomenon.

ANS: C Feedback AAn abstract idea is a general view of a phenomenon, such as parent/infant bonding.

BA concept is a term that abstractly describes a phenomenon.

CConcrete ideas refer to realities or actual instances, focusing on the particular and not the general.

DA phenomenon is the appearance or aspect of reality as it is experienced.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 191-192 7. The nurse researcher plans to evaluate self-care and its effects on disease prevention. The nurse identifies various health promotion activitiessuch as proper diet, exercise, and hours of sleep per nightas components of self-care. In this example, self-care is a: a.concept. b.construct. c.theory. d.variable.

ANS: A Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

AA concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all.

BA construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

CTheories are sets of concepts that present a view of a phenomenon.

DA variable is more specific than a concept and is variable and measurable.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 191-192 8. The nurse researcher plans to evaluate self-care and its effects on disease prevention. The nurse identifies various health promotion activitiessuch as proper diet, exercise, and hours of sleep per nightas components of self-care. In this example, health promotion is a: a.concept. b.construct. c.theory. d.variable.

ANS: B Feedback AA concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all.

BA construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

CTheories are sets of concepts that present a view of a phenomenon.

DA variable is more specific than a concept and is variable and measurable.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 191-192 9. The nurse researcher plans to evaluate self-care and its effects on disease prevention. The nurse identifies various health promotion activitiessuch as proper diet, exercise, and hours of sleep per nightas components of self-care. In this example, hours of sleep is a: a.concept. b.construct. c.theory. d.variable.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: D Feedback AA construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

BA concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all.

CTheories are sets of concepts that present a view of a phenomenon.

DA variable is more specific than a concept and is variable and measurable.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 191-193 10. The nurse researcher plans to evaluate self-care and its effects on disease prevention. The nurse identifies various health promotion activitiessuch as proper diet, exercise, and hours of sleep per nightas components of self-care. In this example, effects of self-care on disease prevention is a: a.concept. b.construct. c.theory. d.variable.

ANS: C Feedback AA concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all.

BA construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

CTheories are sets of concepts that present a view of a phenomenon. A conceptual map includes all of the major concepts in a theory or framework.

DA variable is more specific than a concept and is variable and measurable.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 191-192 11. Which is an important characteristic of a variable? a.It is broad and encompasses several ideas.

Gray Burns and Grove’s The Practice of Nursing Research (9e) b. It is constant from one instance to another. c. It is less specific than a concept. d. It is measurable and changeable.

ANS: D Feedback A Variables are narrow in their definition.

B Variables vary from one instance to another.

C Variables are more specific than are concepts.

D A variable is more specific than a concept and is variable and measurable.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 191 12. Which is true about a conceptual definition in a research study? a.It defines how a concept can be manipulated in a study. b. It describes how a concept may be measured in a study. c. It is comprehensive and includes associative meanings. d. It is more specific than a dictionary definition.

ANS: C Feedback AThe operational definition describes how the concept may be manipulated in a study.

BThe operational definition describes how the concept may be measured in a study.

CA conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have.

DA conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 192 13. In a study about childhood obesity, the researcher discusses the concept of overweight in terms of weight for height measures, body mass index (BMI), body image, self-esteem, and social norms. When discussing body image, self-esteem, and social norms, the researcher is describing the:

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.conceptual definition. b.dependent variable. c.independent variable. d.operational definition.

ANS: A Feedback AA conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have.

BThe dependent variable is a measurable variable that is hypothesized to change as a result of manipulation or difference in the independent variable.

CThe independent variable is a measurable variable that is manipulated by the researcher to observe possible changes in the dependent variable.

DThe operational definition describes how the concept may be measured or manipulated in a study.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 192 14. In a study about childhood obesity, the researcher discusses the concept of overweight in terms of weight for height measures, body mass index (BMI), body image, self-esteem, and social norms. The researcher states that a BMI > the 95th percentile represents overweight.

This statement is a(n): a.conceptual definition. b.dependent variable. c.independent variable. d.operational definition.

ANS: D Feedback AA conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have.

BThe dependent variable is a measurable variable that is hypothesized to change as a result of manipulation or change in the independent variable.

CThe independent variable is a measurable variable that is manipulated by the researcher to observe possible changes in the dependent variable.

DThe operational definition describes how the concept may be measured or manipulated in a study.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 192 15. A researcher discusses how endorphins released during aerobic exercise cause a heightened sense of well-being in subjects. This discussion is a: a.conceptual definition. b.operational definition. c.relational statement. d.theoretical framework.

ANS: C Feedback AA conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have.

BThe operational definition describes how the concept may be measured or manipulated in a study.

CA relational statement clarifies the type of relationship that exists between concepts.

DA theoretical framework describes abstract concepts and phenomena and is used to guide nurses in clinical practice.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 193 16. When a researcher analyzes data obtained from study variables for possible significant relationships among these variables, the researcher is testing the: a.abstract ideas. b.conceptual definitions. c.relationship statements. d.study assumptions.

ANS: C Feedback AAn abstract idea focuses on a general view of a phenomenon.

BA conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have. It does not identify relationships.

CA relational statement clarifies the type of relationship that exists between concepts.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DAssumptions are statements in a philosophy or theory that are taken for granted or considered to be true.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 193 17. Which statement is true about the hypothesis in a research study? a. It clearly identifies concepts. b. It is written at a higher level of abstraction than a general proposition. c. It is not testable. d. It makes a statement about specific relationships among variables.

ANS: D Feedback AThe hypothesis does not define concepts.

BThe hypothesis is written at a lower level of abstraction than a framework or proposition.

CHypotheses are written to be tested in a study and make predictions about the relationships among variables.

DHypotheses are written to be tested in a study and make predictions about the relationships among variables.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 193 18. Which nursing theorist developed a grand nursing theory? a.Brennaman b.Orem c.Pender d.Swanson ANS: B Feedback ABrennaman developed mid-level nursing theories.

BOrems theory is a grand nursing theory.

CPender developed mid-level nursing theories.

DSwanson developed mid-level nursing theories.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 194 19. A nurse researcher discusses a theory about the stigma of chronic illness in children and describes aspects of chronic illness including aesthetic qualities, causes of the condition, and concealability of the disease as dimensions of this stigma. In this case, aesthetic qualities, causes of the condition, and concealability of the disease are: a.concepts. b.constructs. c.theories. d.variables.

ANS: B Feedback A A concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all.

B A construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

C Theories are sets of concepts that present a view of a phenomenon.

D A variable is more specific than a concept and is variable and measurable.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 194 20. The level of theory often derived from evidence-based guidelines is: a.grand theory. b.grounded theory. c.mid-range theory. d.practice theory.

ANS: D Feedback AA grand theory is an abstract nursing theory.

BGrounded theory is theory derived from the analysis of data.

CA mid-range theory is narrower in scope than a grand theory.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DA specific type of mid-range theory is a prescriptive, or practice theory. These are often derived from evidence-based guidelines and are specific to situations.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 195 21. In the introduction to a study, the researcher explains why self-esteem is expected to affect obesity. The explanation of this relationship represents which aspect of the study? a.Concept b.Construct c.Framework d.Theory ANS: C Feedback A A concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all.

B A construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

C A framework is an abstract, logical structure of meaning identifying how one variable is expected to affect another.

D Theories are sets of concepts that present a view of a phenomenon.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 198 22. Which will the researcher use to display the concepts and relationships in a theoretical framework? a.Construct b.Graph c.Model d.Theory ANS: C Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

AA construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts.

BA graph may be used in a model to depict variables.

CA model is a diagram or map that graphically displays concepts and relationships in a theory.

DTheories are sets of concepts that present a view of a phenomenon.

Chapter 9. Ethics in Research MULTIPLE CHOICE 1. The purpose of an institutional review board (IRB) in a university or clinical agency is to: a.approve funding for studies based on ethical standards. b.critically appraise ethical aspects of published studies. c.define ethical standards for the institution. d.protect the human rights of subjects in proposed studies.

ANS: D Feedback AIRBs do not approve funding for studies based on ethical standards.

BIRBs review ethical aspects of studies prior to the conduction of the study, not after they are published.

CIRBs do not define ethical standards.

DInstitutional review boards (IRBs) are organized to examine the ethical aspects of studies before they are conducted.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: pp. 94-95 2. An important initial focus of the Declaration of Helsinki, developed in 1964, was to: a.differentiate therapeutic from nontherapeutic research. b.define the concept of informed consent of research subjects. c.prevent the use of placebos during clinical drug trials. d.prohibit nontherapeutic research to protect subjects from harm.

ANS: A Feedback AThe Declaration of Helsinki was adopted in 1964 and its major focus was to differentiate between therapeutic research and nontherapeutic research.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

BThe Nuremberg code helped to define the concept of informed consent of subjects.

CThe Declaration of Helsinki did not prevent the use of placebos, but declared that researchers must provide subjects in the placebo group with access to proven diagnostic and therapeutic procedures after the study.

DThe Declaration of Helsinki did not prohibit nontherapeutic research, but developed guidelines to address issues with this type of research.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 96 3. The Tuskegee Syphilis Study violated several ethical principles in which way? a. Coercion of subjects to participate in the study in exchange for treatment b. Failing to inform subjects about the purpose and procedures in the study c. Failing to inform in the Centers for Disease Control about the results of the study d. Not informing the subjects physicians that they were in the study

ANS: B Feedback A Subjects were not coerced by the promise of treatment, which was not offered, even when the benefits were known.

B In the Tuskegee Syphilis Study, subjects were not informed about the purpose and procedures of the study; some were not even informed that they were subjects.

C The CDC was informed about the results and decided the study could continue.

D In the Jewish Chronic Disease Study, subjects physicians were not informed.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 97 4. After the Department of Health, Education, and Welfare (DHEW) regulations were published in 1973, all research using human subjects was required to: a.avoid using subjects who were ill, mentally impaired, or dying. b.obtain informed consent from all subjects prior to enrollment in a study. c.review only studies in which risk of harm to subjects is especially high. d.undergo full institutional review to examine risks and benefits to subjects.

ANS: D Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

AThe DHEW regulations do not prohibit using subjects who are ill, mentally impaired, or dying, but provided protections for such subjects.

BThe US Code of Federal Regulations requires informed consent of human subjects.

CDHEW regulations require institutional review of all human subjects, not just those with especially high risk.

DThe Department of Health, Education, and Welfare regulations were published in 1973, providing for the protection of human research subjects and requiring full institutional review of all studies involving human subjects.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 98 5. The ethical principles of respect for persons, beneficence, and justice are considered essential elements in research involving human subjects. In which document are these principles identified? a. Declaration of Helsinki b. Department of Health, Education, and Welfare regulations c. National Commission for the Protection of Human Subjects in the Belmont Report d. Nuremberg Code

ANS: C Feedback AA major focus of the Declaration of Helsinki was the differentiation of therapeutic research from nontherapeutic research.

BThe Department of Health, Education, and Welfare regulations were published in 1973 providing for the protection of human research subjects.

CThe National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was formed in the United States in 1978. This commission developed ethical research guidelines based on the ethical principles of respect for persons, beneficence, and justice and made recommendations to the U.S. Department of Health and Human Services (DHHS) in the Belmont Report.

DThe development of the Nuremberg Code in 1949 addressed the mistreatment of human subjects.

PTS: 1 DIF: Cognitive level: Knowledge REF: pp. 98-99 6. Which ethical principle protects human subjects from harm? a.Beneficence b. Ethics

Gray Burns and Grove’s The Practice of Nursing Research (9e) c. Justice d. Respect for persons

ANS: A Feedback AThe ethical principle of beneficence encourages the researcher to do good and to do no harm.

BEthics is not a specific ethical principle.

CThe principle of justice addresses the fair treatment of human subjects.

DThe principle of respect for persons indicates that human subjects should be treated as autonomous agents with rights to self-determination.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 98-99 7. When conducting research to study medical devices for human use, the nurse researcher must comply with the Department of Health and Human Services human subjects regulations as well as regulations put forth by the: a. American Nurses Association b. Code of Federal Regulations c. Food and Drug Administration d. Presidential Commission for the Study of Bioethics

ANS: C Feedback AThe ANA, CFR, and the Presidential Commission do not have specific regulations governing research of medical devices.

BThe ANA, CFR, and the Presidential Commission do not have specific regulations governing research of medical devices.

CThe FDA and the DHHS regulations govern most of the biomedical and behavioral research conducted in the United States. Drugs, medical devices, biological products, human dietary supplements, and electronic devices are all regulated by these two entities.

DThe ANA, CFR, and the Presidential Commission do not have specific regulations governing research of medical devices.

PTS:

1

DIF:

Cognitive

(Comprehension) REF: pp. 99-100

level:

Understanding

Gray Burns and Grove’s The Practice of Nursing Research (9e)

8. To safeguard the right to self-determination among research subjects, the researcher will ensure that subjects: a.a re afforded anonymity to the researcher and the reader. b.a re allowed to choose whether to be in a control or a study group.

c.may choose whether or not to participate in a study. d.receive a large monetary reward for participating in the study.

ANS: C Feedback A The right to anonymity means that subjects cannot be identified.

B Subjects are generally randomly assigned to groups.

C Self-determination refers to individuals rights to knowingly become a subject in the study or not, and to do so of their own free will.

D Subjects who are given large rewards for participation may be coerced.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS:101 9. The greatest risk to a person confined to an institution who is a research subject is: a.diminished autonomy. b.discomfort. c.lack of information. d.lack of privacy.

ANS: A Feedback APersons who are vulnerable because of legal or mental incompetence, terminal illness, or confinement to an institution have diminished autonomy.

BThey are not necessarily at higher risk for discomfort, lack of information, or lack of privacy than are other subjects.

CThey are not necessarily at higher risk for discomfort, lack of information, or lack of privacy than are other subjects.

DThey are not necessarily at higher risk for discomfort, lack of information, or lack of privacy than are other subjects.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 99-100

Gray Burns and Grove’s The Practice of Nursing Research (9e)

10. A researcher will have greater success gaining approval for a research study involving pregnant women if which provision is put into place? a. Care is taken to maintain strict confidentiality of subjects. b. Consent is given by the pregnant womens significant others. c. Subjects may experience therapeutic effects from the intervention. d. Subjects receive financial rewards for participation in the study.

ANS: C Feedback A Confidentiality and consent must be maintained in all research involving human subjects and do not influence approval for subjects with diminished capacity.

B Confidentiality and consent must be maintained in all research involving human subjects and do not influence approval for subjects with diminished capacity.

C Pregnant women are considered to have legal and/or mental diminishment of autonomy.

Research involving such subjects is generally more acceptable if the research is therapeutic.

D Financial rewards may be a form of coercion.

PTS:1DIF:Cognitive level: Applying (Application) REF:pp. 101-102 |MCS: 104 11. When a researcher indicates that assent for participation was gained in a study involving 10 year-old children, this indicates which has occurred? a. The children gave informed consent to participate in the study. b. The children have agreed to be subjects in the study. c. The parents granted approval for their children to participate. d. The parents do not need to give consent because the children gave consent.

ANS: B Feedback AAssent is not informed consent, which must be given by a childs parent or legal guardian.

BAssent is gained from children who are subjects and represents their agreement to participate.

CAssent does not represent approval by the parents.

DAssent is given in conjunction with informed consent by the parent or legal guardian and is not sufficient by itself to allow a minor to participate in a study.

PTS:1DIF:Cognitive level: Applying (Application)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: MCS: 102 12. A researcher wishes to study the effects of antiseizure medications on adult subjects who have severe cognitive impairments. Which statement is true about using these subjects in research? a. Assent must be gained from the subjects and is sufficient for participation. b. A legally authorized guardian must give informed consent. c. These adults cannot be used as subjects for this study. d. The subjects physicians must give consent for participation in the study.

ANS: B Feedback A Assent must be gained if possible, but is not sufficient for participation in a study.

B Persons with mental illness or a cognitive impairment are incapable of giving informed consent. A researcher must gain approval from a legally authorized representative or guardian along with gaining assent from the participant.

C Adults with mental impairments may be used in studies as long as their rights are protected and proper consent is obtained.

D Physicians are not legally authorized representatives.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 104 13. A researcher makes every effort to ensure that subjects may benefit from a research intervention while taking measures to minimize potential harm. This is an example of protecting a research subjects right to: a.anonymity and confidentiality. b.fair treatment. c.protection from discomfort and harm. d.self-determination.

ANS: C Feedback AComplete anonymity exists if the subjects identity cannot be linked, even by the researcher, with his or her individual responses. Confidentiality is the safe management of private information shared by a subject. The researcher must refrain from sharing that information

Gray Burns and Grove’s The Practice of Nursing Research (9e)

without the authorization of the subject. Research findings need to be reported so that a subject or group of subjects cannot be identified.

BThe right to fair treatment suggests that people should be treated fairly and should receive what they are due or owed.

CThe right to protection from discomfort and harm from a study is based on the ethical principle of beneficence, which states that one should do good and, above all, do no harm.

DSelf-determination refers to individuals rights to knowingly become a subject in the study or not and to do so of their own free will.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 100-101 14. When obtaining informed consent from study subjects, the researcher will ensure that subjects freely choose whether or not to participate and will provide subjects: a.general knowledge and overview of the study. b.information about the study methods and design. c.reports about the study results and conclusions. d.the right to choose whether to be in the control versus the study group.

ANS: A Feedback AInformed consent includes disclosure to the subject of essential study information, comprehension of this information by the subject, competence of the subject to give consent, and voluntary consent of the subject to participate in the study.

BInformation on the study design is given only as it applies to what will happen to the subject.

The correct answer is general knowledge and comprehension of the study. Informed consent includes disclosure to the subject of essential study information, comprehension of this information by the subject, competence of the subject to give consent, and voluntary consent of the subject to participate in the study.

CIt is not necessary to provide reports about the study results and conclusions as part of gaining informed consent.

DSubjects are generally randomly assigned to control versus study groups and choice of placement is not a part of informed consent.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 100-101 15. A special concern when conducting research using terminally ill cancer patients as subjects is:

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.an inability to randomly assign subjects to study groups. b.an increased risk of harm with decreased benefits. c.difficulty enlisting subjects for participation in the study. d.poor control of extraneous variables.

ANS: B Feedback ASubjects may still be randomly assigned to control versus study groups.

BParticipating in research may carry increased risks with minimal or no benefits for terminally ill subjects.

CTerminally ill patients may be more likely to be willing to participate in research.

DThere is no difference when controlling extraneous variables in studies involving terminally ill patients.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 104 16. Which subject groups may feel especially coerced to participate in research studies? a.Children b.Institutionalized patients c.Pregnant women d.Terminally ill patients ANS: B Feedback AChildren, pregnant women, and terminally ill patients are allowed to give assent or consent freely for participation in research.

BPersons confined to institutions may feel coerced to participate in research because they fear harm or because they feel that they may receive special benefits for participation.

CChildren, pregnant women, and terminally ill patients are allowed to give assent or consent freely for participation in research.

DChildren, pregnant women, and terminally ill patients are allowed to give assent or consent freely for participation in research.

PTS:1DIF:Cognitive level: Knowing (Knowledge) REF: MCS: 104

Gray Burns and Grove’s The Practice of Nursing Research (9e)

17. If a health care provider discloses information about a patient to a researcher for a study, the provider and the researcher must have a(n): a.agreement about the studys purpose. b.data use agreement. c.limited data set. d.written study proposal.

ANS: B Feedback A Agreement about the studys purpose is not necessary for sharing information.

B A data use agreement limits how data may be used and how it will be protected and must be in place for a provider to disclose data to a researcher.

C A limited data set describes the type of data that may be disclosed without an individual subjects authorization or an IRB waiver; in order to disclose this limited data set, a data use agreement must be in place.

D The written study proposal does not confer the right to disclose patient data to a researcher.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 106 18. In a study about pregnant womens use of tobacco, the researcher is able to link individual subjects identities to their responses on a questionnaire, but does not share this information with others. This is an example of: a.anonymity. b.b reach of confidentiality. c.confidentiality. d.privacy.

ANS: C Feedback AAnonymity exists when the subjects identity cannot be linked, even by the researcher, with individual responses.

BA breach of confidentiality occurs when a researcher allows an unauthorized person to gain access to the raw data of a study.

CConfidentiality is the researchers safe management of information or data shared by a subject to ensure the data are kept private.

DPrivacy is a larger concept encompassing anonymity and confidentiality.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 106-107 19. A researcher using a small sample of an easily distinguishable group of subjects wishes to use extensive quotes in the research report. This researcher risks: a.a loss of study validity. b.breaching confidentiality. c.losing objectivity. d.reduction of benefits to subjects.

ANS: B Feedback AStudy validity is related to the proper use of study tools and measurements.

BBreach of confidentiality is of special concern in qualitative studies that have few study participants and involve the reporting of long quotes.

CObjectivity is the ability of the researcher to avoid interpreting results in a biased manner.

DBenefits to subjects are not necessarily compromised in small studies using quotations.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 106-107 20. A subjects right to fair selection and treatment in a study is related to which ethical principle? a.Beneficence b.Justice c.Privacy d.Respect for persons ANS: B Feedback AThe principle of beneficence requires that subjects are protected from harm.

BThe right to fair selection and treatment of subjects is based on the ethical principle of justice, requiring people to be treated fairly and to receive what they are owed.

CThe principle of privacy requires that anonymity and confidentiality are protected.

DThe principle of respect for persons requires that human subjects should be treated as autonomous agents with rights to self-determination.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 107-108 21. Which unethical study in previous history involved withholding a treatment from subjects in order to study the effects of a disease progression on subjects? a. The Jewish Chronic Disease Hospital Study b. The Nazi Medical Experiments c. The Tuskegee Syphilis Study d. The Willowbrook Study

ANS: C Feedback AIn the Jewish Chronic Disease Hospital Study, subjects were injected with a suspension containing live cancer cells and did not know they were taking part in a study or that the injections contained these live cancer cells.

BIn the Nazi Medical Experiments, an array of atrocious unethical medical experiments were conducted on prisoners of war.

CIn the Tuskegee Syphilis Study, penicillin was deliberately withheld from the research subjects and their families, in order to study the effects of the natural progression of syphilis.

DIn the Willowbrook Study, mentally retarded children were infected with the hepatitis virus and new patients were not admitted to this institution unless their parents consented for their children to participate in this study.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 97 22. A researcher conducts a study to evaluate the frequency of intimate partner violence among females treated for sexually transmitted diseases (STDs). When collecting data, which action may be problematic when protecting subjects rights? a.Allowing subjects to decline participation in the study b.Approaching all patients who meet eligibility requirements c.Identifying subjects with numbers instead of names d.Instructing subjects to complete every item on the questionnaire ANS: D Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

AAutonomy is protected when subjects are informed that participation is voluntary.

BApproaching all subjects who meet eligibility requirements removes the possibility of bias.

CUsing numbers instead of names helps to protect privacy.

DSubjects who are told that they must complete every item on a questionnaire risk losing their right to autonomy.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 101 23. A researcher gives healthy adult subjects a handout explaining the nature of a study and then obtains written consent from those who choose to participate. Which statement is true about this process? a. Subjects have given informed consent for participation in the study. b. Subjects have not given voluntary consent for participation in the study. c. The researcher has failed to determine comprehension of the study by participants. d. The researcher has not disclosed information about the study to the participants.

ANS: C Feedback AInformed consent implies not only that the researcher has imparted information to the subjects, but also that the prospective subjects have comprehended the information. The researcher needs to discuss the information with the subjects and ask them to restate the information to assess their understanding.

B The subjects have voluntarily consented to participate.

C These subjects have been given written information, but have not stated their understanding, so informed consent has not been obtained.

D The researcher disclosed information to the subjects about the study.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 112 24. Which situation may allow waiving the need to obtain written consent for participation in a research study? a. The researcher is conducting an informal study about heart disease. b. The researcher is using questionnaires to collect data about suicide risk. c. The subjects do not want documentation linking them to the study. d. The subjects desire complete anonymity in the study.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: C Feedback A Informal studies and those using questionnaires about potentially harmful subjects do not meet the requirements for waiving of consent.

B Informal studies and those using questionnaires about potentially harmful subjects do not meet the requirements for waiving of consent.

C Subjects who do not want documentation linking them to the research who have received information and demonstrated comprehension of the information may have consent waived if they desire.

D Anonymity can be maintained even with signed consent.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 114 25. Which federal agency was established to manage investigations of misconduct in research? a.Department of Health, Education, and Welfare (DHEW) b. Department of Health and Human Services (DHHS) c.Food and Drug Administration (FDA) d.Office of Research Integrity (ORI) ANS: D Feedback AThis is not a correct statement.

BThis is not a correct statement.

CThis is not a correct statement.

DThe Office of Research Integrity was developed by the federal government in 1989 to supervise the implementation of the rules and regulations related to research misconduct and to manage any investigations of misconduct.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 122 26. A researcher makes an honest error when tabulating and analyzing research findings. According to the Office of Research Integrity, this constitutes: a.fabrication. b.falsification. c.misrepresentation.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. no misconduct.

ANS: D Feedback A Fabrication refers to making up results and recording or reporting them.

B Falsification is manipulating research materials, equipment, or processes, or changing or omitting data or results so that the research is not accurately represented.

C Misrepresentation refers to presenting data inaccurately.

D A researcher making an honest error is not guilty of misconduct.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 122 27. Which is an example of falsification in research? a. Citing work by another researcher and claiming it as ones own. b. Making up statistics about the incidence of reactions to an intervention. c. Omitting data about a subject that disproves the researchers hypothesis. d. Using data gained without the consent of the research subjects.

ANS: C Feedback A Plagiarism is citing anothers research and claiming it as ones own.

B Fabrication involves making up results and reporting them.

C Falsification is manipulating research materials, equipment, or processes, or changing or omitting data or results so that the research is not accurately represented.

D Lack of informed consent occurs when the researcher fails to gain consent from study subjects.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 122 28. A researcher combines data from another researchers study along with data from the reported study in graphs without noting the source of the data. This is an example of: a.an honest error. b.fabrication. c.falsification. d.plagiarism.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: D Feedback A An honest error would occur if the researcher was unaware that the data belonged to someone else.

B Fabrication involves making up results and reporting them.

C Falsification is manipulating research materials, equipment, or processes, or changing or omitting data or results so that the research is not accurately represented.

D Plagiarism is citing anothers research and claiming it as ones own.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 122 MULTIPLE RESPONSE 1. Which patient information requires deidentifying in order to maintain privacy? (Select all that apply) a.E-mail addresses b.Full-face photographs c. State of residence d. Medical record numbers ANS: A, B, D Feedback Correct E-mail addresses, full-face photographs, and medical record numbers may all be used to identify patients and must be de-identified in study reports to prevent linking study results to individuals.

E-mail addresses, full-face photographs, and medical record numbers may all be used to identify patients and must be de-identified in study reports to prevent linking study results to individuals.

E-mail addresses, full-face photographs, and medical record numbers may all be used to identify patients and must be de-identified in study reports to prevent linking study results to individuals.

IncorrectThe state of residence is not necessarily an identifier, but any geographic division smaller than a state is.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: MCS: 106 2. According to the HIPAA privacy rules, which are covered entities that may use and disclose a limited data set to researchers for study? (Select all that apply) a. Health plans b. Health care providers

c.Institutional Review Boards d.Researchers ANS: A, B Feedback Correct Health care providers, health plans, and health care clearinghouses are covered entities.

Health care providers, health plans, and health care clearinghouses are covered entities.

IncorrectThis is not a correct statement.

This is not a correct statement.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 106 3. Which of the following represent some degree of risk of causing discomfort or harm to subjects in a study? (Select all that apply) a. Asking parents of children in a clinic waiting room to complete a patient satisfaction

questionnaire. b. Assessing the number of males and females enrolled in nursing schools using enrollment data. c.Interviewing nursing home residents about their memories of the Great Depression. d.Using pathology reports from a hospital lab to gain data about the percentage of new patients who have anemia.

ANS: A, C, D Feedback Correct Asking parents to complete a questionnaire increases the risk of temporary discomfort associated with filling out the form. Interviewing nursing home residents increases the risk of discomfort because it may invoke bad memories. Using pathology reports does not confer benefits to the subjects and may run the risk of invasion of privacy.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Asking parents to complete a questionnaire increases the risk of temporary discomfort associated with filling out the form. Interviewing nursing home residents increases the risk of discomfort because it may invoke bad memories. Using pathology reports does not confer benefits to the subjects and may run the risk of invasion of privacy.

Asking parents to complete a questionnaire increases the risk of temporary discomfort associated with filling out the form. Interviewing nursing home residents increases the risk of discomfort because it may invoke bad memories. Using pathology reports does not confer benefits to the subjects and may run the risk of invasion of privacy.

IncorrectAssessing the numbers of males and females does not increase risk or cause discomfort.

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 108 4. A researcher wants to study whether showing a video about car safety increases the likelihood of car seat use among a group of first-time parents. When obtaining informed consent, the researcher must include: (Select all that apply) a.an assurance of anonymity. b.a statement of the research purpose. c.consent to incomplete disclosure. d.voluntary participation.

ANS: A, C, D Feedback Correct Anonymity and voluntary participation must be assured in all research involving human subjects. In this study, parents who know ahead of time that the purpose is to see whether car seat use is increased may increase their use of car seats whether or not they view the video.

Anonymity and voluntary participation must be assured in all research involving human subjects. In this study, parents who know ahead of time that the purpose is to see whether car seat use is increased may increase their use of car seats whether or not they view the video.

Anonymity and voluntary participation must be assured in all research involving human subjects. In this study, parents who know ahead of time that the purpose is to see whether car seat use is increased may increase their use of car seats whether or not they view the video.

IncorrectIn some cases, a statement of the research purpose can influence the results and a consent to incomplete disclosure may be obtained instead.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

PTS:1DIF:Cognitive level: Analyzing (Analysis) REF: MCS: 111 5. A researcher has submitted a proposal to an Institutional Review Board (IRB) to evaluate the effects of a new drug on newborn infants. In this case, members of the IRB should include: (Select all that apply) a.an ethicist. b.a hospital pharmacist. c.a neonatologist. d.a pharmaceutical representative.

ANS: A, B, C Feedback Correct When selecting an IRB, there must be at least five members of varying backgrounds to promote a complete, scholarly, and fair review of research. When vulnerable subjects such as newborns are part of a study, at least one member must have knowledge and experience in working with these subjects. A neonatologist and a hospital pharmacist would both be included in this case. All IRBs must have an ethicist, lawyer, or minister whose primary concern is nonscientific.

When selecting an IRB, there must be at least five members of varying backgrounds to promote a complete, scholarly, and fair review of research. When vulnerable subjects such as newborns are part of a study, at least one member must have knowledge and experience in working with these subjects. A neonatologist and a hospital pharmacist would both be included in this case. All IRBs must have an ethicist, lawyer, or minister whose primary concern is nonscientific.

When selecting an IRB, there must be at least five members of varying backgrounds to promote a complete, scholarly, and fair review of research. When vulnerable subjects such as newborns are part of a study, at least one member must have knowledge and experience in working with these subjects. A neonatologist and a hospital pharmacist would both be included in this case. All IRBs must have an ethicist, lawyer, or minister whose primary concern is nonscientific.

IncorrectA pharmaceutical representative would have a conflict of interest in promoting the drug.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 117

Gray Burns and Grove’s The Practice of Nursing Research (9e)

6. A nurse researcher who wishes to use animals in a research study must include which elements in an animal use protocol? (Select all that apply) a.Animal living conditions and veterinary care b.Assurances that animals will be kept alive c.Justification for the use of animals over humans d.Procedures to minimize pain and distress ANS: A, C, D Feedback Correct Elements of animal use protocols should include descriptions of animal living conditions and veterinary care, justifications for the use of animals, and procedures that will minimize pain and distress.

Researches need to identify methods of euthanasia and do not need assurances that animals will be kept alive.

IncorrectElements of animal use protocols should include descriptions of animal living conditions and veterinary care, justifications for the use of animals, and procedures that will minimize pain and distress.

Elements of animal use protocols should include descriptions of animal living conditions and veterinary care, justifications for the use of animals, and procedures that will minimize pain and distress.

Chapter 10. Quantitative Methodology: Noninterventional Designs and Methods MULTIPLE CHOICE 1. Which type of research design focuses on implementation of a treatment by the researcher? a.Correlational b.Descriptive c.Experimental d.Longitudinal ANS: C Feedback ACorrelational and descriptive designs are nonexperimental studies that focus on examining variables as they naturally occur and not on the implementation of a treatment by the researcher.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

BCorrelational and descriptive designs are nonexperimental studies that focus on examining variables as they naturally occur and not on the implementation of a treatment by the researcher.

CQuasi-experimental and experimental studies are designed to examine causality between a researcher-implemented treatment and a study outcome.

DLongitudinal design refers to data collection from the same subjects at different points in time and may or may not be used with experimental or nonexperimental studies.

PTS: 1 DIF: Cognitive level: Comprehension REF: MCS: 212 2. A researcher administers a written test to evaluate knowledge of insulin administration and glucose monitoring to a group of subjects at annual intervals over the next decade. This is an example of which type of study design? a.Correlational b.Cross-sectional c.Descriptive d.Longitudinal ANS: D Feedback A Correlational studies seek to examine relationships among variables without manipulation of a treatment by the researcher.

B Cross-sectional designs examine a group of subjects simultaneously in various stages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

C A descriptive study is used to examine variables as they occur naturally without manipulation of variables.

D Longitudinal design refers to data collection from the same subjects at different points in time.

PTS: 1 DIF: Cognitive level: Application REF: MCS: 212 3. A nurse researcher wishes to identify rates of pertussis infection in children less than one year of age and then again at 6 years of age to examine the relationship of immunization status on infection rates in this population. This is an example of which type of study design? a.Correlational, longitudinal b.Correlational, cross-sectional c.Descriptive, longitudinal d.Descriptive, cross-sectional ANS: A

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback AA correlational study design looks at predictive relationships between variables. A longitudinal study design refers to data collection from the same subjects at different points in time.

BCross-sectional designs examine a group of subjects simultaneously in various stages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

C A descriptive study is used to examine variables as they occur naturally without manipulation.

D Cross-sectional designs examine a group of subjects simultaneously in various stages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

A descriptive study is used to examine variables as they occur naturally without manipulation.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 212 4. Which statement is true about a descriptive study design? a. It is not possible to operationally define variables in this type of study. b. Sample selection and size cannot be controlled in descriptive studies. c. This type of design is used to identify problems occurring in practice.

d.Variables may be manipulated to avoid bias in this type of study.

ANS: C Feedback ADescriptive designs may involve operational definitions of variables, but variables are not manipulated in descriptive studies.

BProtection against bias in a descriptive design is achieved through conceptual and operational definition of variables, sample selection and size, valid and reliable instruments, and data collection procedures that partially control the environment.

CDescriptive designs may be used to develop theories and identify problems with current practice.

DProtection against bias in a descriptive design is achieved through conceptual and operational definition of variables, sample selection and size, valid and reliable instruments, and data collection procedures that partially control the environment.

PTS: 1 DIF: Cognitive level: Understanding REF: pp. 212-213 5. A nurse conducts a study to see whether there are differences in the number of books Latino parents and the number of books African-American parents read to their toddlers each week.

Which type of study will this researcher utilize? a. Comparative descriptive

b.Correlational c.Cross-sectional d.Longitudinal

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: A Feedback A A comparative descriptive design is used to describe variables and to examine differences in variables in two or more groups that occur naturally in a setting that may have been formed using gender, age, or socioeconomic status.

B A correlational study design looks at predictive relationships between variables.

C Cross-sectional designs examine a group of subjects simultaneously in various stages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

D Longitudinal design refers to data collection from the same subjects at different points in time.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 216 6. A researcher wishes to conduct a correlational study to determine whether there is a relationship between stress levels and relapse rates among patients who have chronic conditions. In order to determine the existence of a relationship between these two variables, the researcher will attempt to: a.manipulate the level of stress in study subjects. b.obtain a large range of possible scores. c.provide lengthy descriptions of subjects behaviors. d.randomly assign subjects to study groups.

ANS: B Feedback A Correlational studies do not involve manipulation of a variable.

B In correlational designs, a large range in the variable scores is necessary to determine the existence of a relationship.

C Providing lengthy descriptions of subjects behaviors is a necessary part of the discussion of the results, but it does not determine the existence of a relationship.

D Subjects in correlational studies are not randomly assigned to study groups.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 217 7. If a researcher wishes to describe variables and to examine many relationships in a study, which type of study design will the researcher employ? a.Correlational b.Descriptive c.Descriptive correlational d.Descriptive cross-sectional

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: C Feedback ACorrelational studies seek to examine relationships among variables without manipulation of a treatment by the researcher.

BA descriptive study is used to examine variables as they occur naturally without manipulation of variables.

CA descriptive correlational design is used to describe variables and examine relationships among these variables. Using this design facilitates the identification of many interrelationships in a situation.

DCross-sectional designs examine a group of subjects simultaneously in various stages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

PTS: 1 DIF: Cognitive level: Applying REF: pp. 218-220 8. A nurse researcher conducts a study to determine whether women who breastfeed their infants experience better sleep in the first two postpartum months. This study will employ which type of research design? a.Correlational b.Descriptive c.Descriptive correlational d.Predictive correlational ANS: D Feedback ACorrelational studies seek to examine relationships among variables without manipulation of a treatment by the researcher.

BA descriptive study is used to examine variables as they occur naturally without manipulation of variables.

CA descriptive correlational design is used to describe variables and examine relationships among these variables.

DA predictive correlational design is used to predict the value of one variable based on the values obtained for another variable or variables.

PTS: 1 DIF: Cognitive level: Comprehension REF: MCS: 220 9. A researcher theorizes a set of relationships among concepts used to describe why patients with chronic illness are often depressed. To test the accuracy of these hypothesized relationships, which type of study will be used?

Gray Burns and Grove’s The Practice of Nursing Research (9e) a. Descriptive correlational b. Grounded theory c. Model testing

d.Predictive correlational ANS: C Feedback AA descriptive correlational design is used to describe variables and examine relationships among these variables.

BGrounded theory research is designed to generate theory and to develop new concepts.

CThe model testing design requires all concepts relevant to the model be measured and the relationships among these concepts examined.

DA predictive correlational design is used to predict the value of one variable based on the values obtained for another variable or variables.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 221 10. A researcher conducts a study to examine possible contributors to glycemic control in a group of subjects who have type 2 diabetes mellitus in a local community. A convenience sample of patients includes patients from 28 to 65 years old who range in weight from normal to obese, with time since diagnosis ranging from several months to several years. To determine causality in this study, the researcher will: a.discuss outcomes in terms of the probability that education will improve glycemic control. b.increase the manipulation of the independent variable to allow greater control by the researcher. c.identify multicausal variables that may influence the outcome of glycemic control measures. d.limit the study to younger persons only to minimize the effects of extraneous variables.

ANS: C Feedback A Probability addresses relative and not absolute causality and may be used when given effects are not produced consistently.

B In this case, increasing the manipulation of the independent variable does not alter the influence of multiple causes.

C Multicausality is the presence of multiple causes for an effect. In this study, patient age, weight, and length of time of diagnosis may all influence the outcome and should be addressed as factors that may alter the results.

D Limiting the study to patients of a certain age only controls for one extraneous variable.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 223

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11. A study in which subjects are assigned by the researcher into experimental and control groups increases: a. ias.

b.control. c.manipulation d.validity.

ANS: A Feedback A Bias occurs when the attitudes or motivations of the researcher cause a deviation from a true measurement of the study variables. This may occur when researchers control assignment to study groups.

B Control is used to manage manipulation of variables and to reduce extraneous factors in the environment that might alter outcomes.

C Manipulation of independent variables is used to evaluate changes in dependent variables.

D Researcher control over assignment into groups does not increase a studys validity.

PTS: 1 DIF: Cognitive level: Understanding REF: MCS: 223 12. In a quasi-experimental study examining the effects of nonpharmacologic treatments on postoperative pain management, the researcher trains nursing staff so that all experimental group subjects receive the same types of treatments. This is an example of: a.bias. b.manipulation. c.reliability. d.validity.

ANS: B Feedback A Bias refers to interference by the researcher that influences the outcome of a study.

B Manipulation is a form of control used in quasi-experimental and experimental studies and may involve control of the intervention so that it is applied consistently.

C Reliability and validity are related to consistency and trustworthiness of measurement tools.

D Reliability and validity are related to consistency and trustworthiness of measurement tools.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 224

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13. A researcher conducts a quasi-experimental study to determine whether there is appropriate weight gain among premature infants who are fed according to cue-based protocols. The researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fed according to cue-based protocols and those fed according to standard protocols. The reviewer critiquing the study notes that not all nurses completed the cue-based feeding module. This would affect which type of validity? a. Construct validity b. External validity c. Internal validity d. Statistical conclusion validity

ANS: D Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. This can be threatened by anything interfering with consistent implementation of a variable, including inadequate training of individuals who implement the intervention.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 224-225 14. A researcher conducts a quasi-experimental study to determine whether there is improved weight gain among premature infants who are fed according to cue-based protocols. The researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fed according to cue-based protocols and those fed according to standard protocols. The reviewer notes that components of cue-based feedings are not clearly identified. This is a threat to: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: A Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 15. A researcher conducts a quasi-experimental study to determine whether there is improved weight gain among premature infants who are fed according to cue-based protocols. The researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fed according to cue-based protocols and those fed according to standard protocols. Which might be a threat to internal validity in this study? a. The concept of cue-based feeding is not well defined. b. The study sample is homogeneous. c. Some infants developed gastroenteritis. d. Not all nurses received cue-based protocol education.

ANS: C Feedback AInadequate definitions of constructs are threats to construct validity.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample. A study with a more homogenous sample is less likely to have findings that can be generalized to other populations.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. If not all nurses received cue-based education, the intervention implementation will be unreliable.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 16. A researcher conducts a quasi-experimental study to determine whether there is improved weight gain among premature infants who are fed according to cue-based protocols. The

Gray Burns and Grove’s The Practice of Nursing Research (9e)

researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fed according to cue-based protocols and those fed according to standard protocols. The reviewer notes that parents who gave consent to participate in the study were from a higher socioeconomic class than the population as a whole. This is a threat to: b. onstruct validity.

b.external validity. c.internal validity. d.s tatistical conclusion validity.

ANS: B Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 17. A researcher develops a 7-point Likert scale to evaluate feelings of well-being in patients who are undergoing chemotherapy. The researcher administers this measure to other, similar patients in other medical centers. This is done in order to: c. decrease mono-operation bias. b. improve the test-retest reliability. c. increase interrater reliability. d. strengthen the operational definition of constructs.

ANS: B Feedback AMono-operation bias occurs when only one measure is used to evaluate an outcome.

BTo improve the reliability of the measurement tool, it should be tested in various settings to determine whether it gives consistent measures each time it is used.

CInterrater reliability refers to consistent results that occur when various people administer study measures.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DEvaluating the consistency of a measurement tool does not affect the operational definition of constructs.

PTS: 1 DIF: Cognitive level: Analysis REF: pp. 225-226 18. In a research study, ambulatory clinic nurses teach children with asthma how to monitor peak expiratory flow volumes and how to use metered-dose inhalers to determine whether asthma control scores improve. The researcher discovers inconsistencies in how these measures were taught and how well the children understood the concepts. This represents a lack of: a.control of extraneous variables. b.internal validity. c.intervention fidelity. d.precision of measurement.

ANS: C Feedback ATo control for extraneous variables, the researcher would identify characteristics of subjects or settings that might influence outcomes.

BInternal validity looks at the influence of extraneous variables on study outcomes.

CConsistent implementation of the treatment is referred to as intervention fidelity. If the method of administering a research intervention varies from one person to another, the chance of identifying a true difference based on the independent variables decreases.

DPrecision of measurement refers to whether or not the tools yield the same readings or findings from one test to another.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 226 19. A researcher wishes to conduct a study of a small number of subjects on a large hospital intensive care unit. To minimize problems associated with extraneous variables in the study setting, the researcher will: a.ensure double-blind data collection methods. b.randomly assign subjects to treatment and control groups. c.test the reliability of study measures. d.t rain a small number of nurses to administer the intervention.

ANS: D Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ADouble-blind data collection, random assignment of subjects, and reliability of test measures are important to improve control and reduce bias.

BExtraneous variables in complex settings can influence scores on the dependent variable.

CDouble-blind data collection, random assignment of subjects, and reliability of test measures are important to improve control and reduce bias.

DOne way to reduce the effect of extraneous variables is to train a small number of staff to administer the intervention to improve consistency.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 20. A researcher reviews demographic characteristics of potential study subjects, such as age and gender, to determine whether these characteristics may influence the outcome of the study. This is done to help ensure: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: C Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 226 21. An important measure to decrease threats to internal validity in an experimental study is to: a.apply the intervention consistently. b. improve the precision of measurement methods. c. increase the sample size. d. randomly assign subjects to study groups.

ANS: D Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

AConsistent application of the intervention and improved precision of measurements help minimize threats to statistical conclusion validity.

BConsistent application of the intervention and improved precision of measurements help minimize threats to statistical conclusion validity.

CIncreasing sample size minimizes threats to external validity.

DAn important threat to internal validity is any concern about subject selection and assignment to groups. Randomly assigning subjects to treatment and control groups helps to minimize this threat.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 224-225 22. Which action will the researcher take to improve construct validity? a. Allow data collectors to know which subjects are assigned to which groups b. Ensure that operational definitions reflect theoretical constructs c. Make sure that the researcher is involved in data collection d. Utilize only one measurement method to measure study variables

ANS: B Feedback A Allowing data collectors to know which subjects are assigned to which groups and involving the researcher in data collection both increase the risk of bias.

B Construct validity depends on adequate definition and measurement of constructs. The conceptual definition should emerge from the concept analysis and the operational definition should clearly reflect both.

C Allowing data collectors to know which subjects are assigned to which groups and involving the researcher in data collection both increase the risk of bias.

D Using only one measurement tool increases the risk of mono-operation bias.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 23. A researcher wishes to study the effects of effective sleep hygiene on sleep quality and behavior among children diagnosed with attention deficit disorder. To minimize mono-operation bias, the researcher will: a.accurately describe conceptual and operational definitions. b.adequately discuss construct validity in the introduction. c.evaluate multiple sleep hygiene techniques. d.u tilize a double-blind data collection methodology.

ANS: C

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback A Construct validity is improved with adequate description of conceptual and operational definitions.

B Construct validity is improved with adequate description of conceptual and operational definitions.

C Mono-operation bias occurs when only one method of measurement is used to assess a construct and can be minimized with the use of multiple measures.

D Use of double-blind data collection methods helps to minimize bias.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225|MCS: 228 24. Multiple replications of an initial study conducted in different populations produce findings that do not match those in the initial study. The initial study may lack which type of validity? a. Construct validity b. External validity c. Internal validity d. Statistical conclusion validity

ANS: B Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 25. In order to increase participation among potential subjects of a larger population, the researcher will: a.limit the time and effort required to participate in the study. b.provide demographic information about those who refuse to participate. c.provide instruments that are detailed to increase the amount of data collected. d.offer potential subjects a financial incentive to participate in the study.

ANS: A Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ALimiting the investment demands on subjects helps to improve participation.

BProviding demographic information about those who do not participate is an important part of the discussion of limitations of a study but does not ensure generalization to a larger population.

CDetailed instruments may be time consuming and may limit participation to a small sample size.

DOffering financial incentives does not ensure a sample that is representative of the larger population.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 26. In order to attribute causality of a posttest measure in an experimental study, the independent variable will be: a.administered to control group subjects only. b.administered to subjects selected by the researcher. c.administered to treatment group subjects. d.defined loosely to avoid bias.

ANS: C Feedback AThe independent variable is administered to the treatment group and not the control group.

BSelection of subjects by the researcher increases the likelihood of bias.

CTo improve determinations of causality, the independent variable should be administered consistently to all subjects in the treatment group.

DThe independent variable should be precisely defined.

PTS: 1 DIF: Cognitive level: Applying REF: pp. 229-230 27. In a study to examine the effects of a newly modified anxiety-reducing nursing action on a group of subjects who have cancer, the control group will receive: a.an alternative intervention. b.no intervention. c.the newly modified intervention. d.the standard intervention.

ANS: D Feedback AAn alternative intervention would invite comparison, but if it is new, it would also be experimental.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

BOffering no intervention is often unethical.

CGiving the newly modified intervention would not create a difference between the treatment and the control groups.

DIn many nursing studies, offering no intervention (when one exists) to subjects in the control group is considered unethical. Subjects in this group generally receive the standard intervention as a comparison to those in the treatment group.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 230-232 28. In a quasi-experimental study design, the group that receives standard care is usually referred to as the: a.comparison group. b.control group. c.experimental group. d.treatment group.

ANS: A Feedback AIn a quasi-experimental study, the group that does not receive treatment is usually referred to as the comparison group.

BSubjects not receiving treatment in an experimental group are generally referred to as the control group.

CGroups that receive the intervention in either type of study are referred to as experimental or treatment groups.

DGroups that receive the intervention in either type of study are referred to as experimental or treatment groups.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 230-232 29. In a quasi-experimental study using a convenience sample of subjects from a local high school, the researcher asks potential subjects to volunteer for placement in either a low sugar diet program or a regular sugar diet program. This technique for assigning participation may compromise: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: C

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 232-233 30. Which type of study is considered strongest for testing the effectiveness of an intervention? a.Experimental b.Pretest/Posttest c.Quasi-experimental d.Randomized controlled trial ANS: D Feedback A Experimental designs involve manipulation independent variables, but without random assignment of subjects to groups, which can weaken the study by increasing the potential for bias.

B Pre-test/Post-test designs are a type of quasi-experimental study design that generally doesnt use random assignment of subjects.

C Quasi-experimental studies do not have complete control over variables and usually do not use random assignment of subjects.

D Randomized controlled trials are noted to be the strongest methodology for testing the effectiveness of a treatment due to the elements of the design that limit the potential for bias.

PTS: 1 DIF: Cognitive level: Remembering REF: MCS: 232|MCS: 237|MCS: 238|MCS: 241 31. When using Consolidated Standards for Reporting Trials (CONSORT) guidelines to critically appraise a randomized controlled trial (RCT), the nurse will make sure that the study: a. is designed to definitively test a hypothesis. b. is conducted in a laboratory to minimize setting bias.

c.uses subjects selected by the researcher for participation. d.uses a descriptive or correlational design.

ANS: A Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ARCTs should be designed to be a definitive test of the hypothesis that the intervention caused the defined dependent variables.

BRCTs should be conducted in a clinical setting and not a laboratory.

CSubjects selected by the researcher may be biased.

DDescriptive or correlational designs are not RCTs.

Chapter 11. Quantitative Methodology: Interventional Designs and Methods MULTIPLE CHOICE 1. Which type of research design focuses on implementation of a treatment by the researcher? a.Correlational b.Descriptive c.Experimental d.Longitudinal ANS: C Feedback ACorrelational and descriptive designs are nonexperimental studies that focus on examining variables as they naturally occur and not on the implementation of a treatment by the researcher.

BCorrelational and descriptive designs are nonexperimental studies that focus on examining variables as they naturally occur and not on the implementation of a treatment by the researcher.

CQuasi-experimental and experimental studies are designed to examine causality between a researcher-implemented treatment and a study outcome.

DLongitudinal design refers to data collection from the same subjects at different points in time and may or may not be used with experimental or nonexperimental studies.

PTS: 1 DIF: Cognitive level: Comprehension REF: MCS: 212 2. A researcher administers a written test to evaluate knowledge of insulin administration and glucose monitoring to a group of subjects at annual intervals over the next decade. This is an example of which type of study design? a.Correlational b.Cross-sectional c.Descriptive d.Longitudinal

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: D Feedback A Correlational studies seek to examine relationships among variables without manipulation of a treatment by the researcher.

B Cross-sectional designs examine a group of subjects simultaneously in various stages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

C A descriptive study is used to examine variables as they occur naturally without manipulation of variables.

D Longitudinal design refers to data collection from the same subjects at different points in time.

PTS: 1 DIF: Cognitive level: Application REF: MCS: 212 3. A nurse researcher wishes to identify rates of pertussis infection in children less than one year of age and then again at 6 years of age to examine the relationship of immunization status on infection rates in this population. This is an example of which type of study design? a.Correlational, longitudinal b.Correlational, cross-sectional c.Descriptive, longitudinal d.Descriptive, cross-sectional ANS: A Feedback AA correlational study design looks at predictive relationships between variables. A longitudinal study design refers to data collection from the same subjects at different points in time.

BCross-sectional designs examine a group of subjects simultaneously in various stages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

C A descriptive study is used to examine variables as they occur naturally without manipulation.

D Cross-sectional designs examine a group of subjects simultaneously in various stages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

A descriptive study is used to examine variables as they occur naturally without manipulation.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 212 4. Which statement is true about a descriptive study design? a. It is not possible to operationally define variables in this type of study. b. Sample selection and size cannot be controlled in descriptive studies. c. This type of design is used to identify problems occurring in practice.

d.Variables may be manipulated to avoid bias in this type of study.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: C Feedback ADescriptive designs may involve operational definitions of variables, but variables are not manipulated in descriptive studies.

BProtection against bias in a descriptive design is achieved through conceptual and operational definition of variables, sample selection and size, valid and reliable instruments, and data collection procedures that partially control the environment.

CDescriptive designs may be used to develop theories and identify problems with current practice.

DProtection against bias in a descriptive design is achieved through conceptual and operational definition of variables, sample selection and size, valid and reliable instruments, and data collection procedures that partially control the environment.

PTS: 1 DIF: Cognitive level: Understanding REF: pp. 212-213 5. A nurse conducts a study to see whether there are differences in the number of books Latino parents and the number of books African-American parents read to their toddlers each week.

Which type of study will this researcher utilize? a. Comparative descriptive

b.Correlational c.Cross-sectional d.Longitudinal ANS: A Feedback A A comparative descriptive design is used to describe variables and to examine differences in variables in two or more groups that occur naturally in a setting that may have been formed using gender, age, or socioeconomic status.

B A correlational study design looks at predictive relationships between variables.

C Cross-sectional designs examine a group of subjects simultaneously in various stages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

D Longitudinal design refers to data collection from the same subjects at different points in time.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 216 6. A researcher wishes to conduct a correlational study to determine whether there is a relationship between stress levels and relapse rates among patients who have chronic conditions. In order to determine the existence of a relationship between these two variables, the researcher will attempt to:

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.manipulate the level of stress in study subjects. b.obtain a large range of possible scores. c.provide lengthy descriptions of subjects behaviors. d.randomly assign subjects to study groups.

ANS: B Feedback A Correlational studies do not involve manipulation of a variable.

B In correlational designs, a large range in the variable scores is necessary to determine the existence of a relationship.

C Providing lengthy descriptions of subjects behaviors is a necessary part of the discussion of the results, but it does not determine the existence of a relationship.

D Subjects in correlational studies are not randomly assigned to study groups.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 217 7. If a researcher wishes to describe variables and to examine many relationships in a study, which type of study design will the researcher employ? a.Correlational b.Descriptive c.Descriptive correlational d.Descriptive cross-sectional ANS: C Feedback ACorrelational studies seek to examine relationships among variables without manipulation of a treatment by the researcher.

BA descriptive study is used to examine variables as they occur naturally without manipulation of variables.

CA descriptive correlational design is used to describe variables and examine relationships among these variables. Using this design facilitates the identification of many interrelationships in a situation.

DCross-sectional designs examine a group of subjects simultaneously in various stages of development, illness severity, or recovery to identify changes in a phenomenon across stages.

PTS: 1 DIF: Cognitive level: Applying REF: pp. 218-220 8. A nurse researcher conducts a study to determine whether women who breastfeed their infants experience better sleep in the first two postpartum months. This study will employ which type of research design?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.Correlational b.Descriptive c.Descriptive correlational d.Predictive correlational ANS: D Feedback ACorrelational studies seek to examine relationships among variables without manipulation of a treatment by the researcher.

BA descriptive study is used to examine variables as they occur naturally without manipulation of variables.

CA descriptive correlational design is used to describe variables and examine relationships among these variables.

DA predictive correlational design is used to predict the value of one variable based on the values obtained for another variable or variables.

PTS: 1 DIF: Cognitive level: Comprehension REF: MCS: 220 9. A researcher theorizes a set of relationships among concepts used to describe why patients with chronic illness are often depressed. To test the accuracy of these hypothesized relationships, which type of study will be used? a. Descriptive correlational b. Grounded theory c. Model testing

d.Predictive correlational ANS: C Feedback AA descriptive correlational design is used to describe variables and examine relationships among these variables.

BGrounded theory research is designed to generate theory and to develop new concepts.

CThe model testing design requires all concepts relevant to the model be measured and the relationships among these concepts examined.

DA predictive correlational design is used to predict the value of one variable based on the values obtained for another variable or variables.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 221 10. A researcher conducts a study to examine possible contributors to glycemic control in a group of subjects who have type 2 diabetes mellitus in a local community. A convenience sample

Gray Burns and Grove’s The Practice of Nursing Research (9e)

of patients includes patients from 28 to 65 years old who range in weight from normal to obese, with time since diagnosis ranging from several months to several years. To determine causality in this study, the researcher will: a.discuss outcomes in terms of the probability that education will improve glycemic control. b.increase the manipulation of the independent variable to allow greater control by the researcher. c.identify multicausal variables that may influence the outcome of glycemic control measures. d.limit the study to younger persons only to minimize the effects of extraneous variables.

ANS: C Feedback A Probability addresses relative and not absolute causality and may be used when given effects are not produced consistently.

B In this case, increasing the manipulation of the independent variable does not alter the influence of multiple causes.

C Multicausality is the presence of multiple causes for an effect. In this study, patient age, weight, and length of time of diagnosis may all influence the outcome and should be addressed as factors that may alter the results.

D Limiting the study to patients of a certain age only controls for one extraneous variable.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 223 11. A study in which subjects are assigned by the researcher into experimental and control groups increases: a. ias.

b.control. c.manipulation d.validity.

ANS: A Feedback ABias occurs when the attitudes or motivations of the researcher cause a deviation from a true measurement of the study variables. This may occur when researchers control assignment to study groups.

BControl is used to manage manipulation of variables and to reduce extraneous factors in the environment that might alter outcomes.

CManipulation of independent variables is used to evaluate changes in dependent variables.

DResearcher control over assignment into groups does not increase a studys validity.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

PTS: 1 DIF: Cognitive level: Understanding REF: MCS: 223 12. In a quasi-experimental study examining the effects of nonpharmacologic treatments on postoperative pain management, the researcher trains nursing staff so that all experimental group subjects receive the same types of treatments. This is an example of: a.bias. b.manipulation. c.reliability. d.validity.

ANS: B Feedback A Bias refers to interference by the researcher that influences the outcome of a study.

B Manipulation is a form of control used in quasi-experimental and experimental studies and may involve control of the intervention so that it is applied consistently.

C Reliability and validity are related to consistency and trustworthiness of measurement tools.

D Reliability and validity are related to consistency and trustworthiness of measurement tools.

PTS: 1 DIF: Cognitive level: Applying REF: MCS: 224 13. A researcher conducts a quasi-experimental study to determine whether there is appropriate weight gain among premature infants who are fed according to cue-based protocols. The researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fed according to cue-based protocols and those fed according to standard protocols. The reviewer critiquing the study notes that not all nurses completed the cue-based feeding module. This would affect which type of validity? a. Construct validity b. External validity c. Internal validity d. Statistical conclusion validity

ANS: D Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. This can be threatened by anything interfering with consistent implementation of a variable, including inadequate training of individuals who implement the intervention.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 224-225 14. A researcher conducts a quasi-experimental study to determine whether there is improved weight gain among premature infants who are fed according to cue-based protocols. The researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fed according to cue-based protocols and those fed according to standard protocols. The reviewer notes that components of cue-based feedings are not clearly identified. This is a threat to: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: A Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 15. A researcher conducts a quasi-experimental study to determine whether there is improved weight gain among premature infants who are fed according to cue-based protocols. The researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fed according to cue-based

Gray Burns and Grove’s The Practice of Nursing Research (9e)

protocols and those fed according to standard protocols. Which might be a threat to internal validity in this study? a. The concept of cue-based feeding is not well defined. b. The study sample is homogeneous. c. Some infants developed gastroenteritis. d. Not all nurses received cue-based protocol education.

ANS: C Feedback AInadequate definitions of constructs are threats to construct validity.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample. A study with a more homogenous sample is less likely to have findings that can be generalized to other populations.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. If not all nurses received cue-based education, the intervention implementation will be unreliable.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 16. A researcher conducts a quasi-experimental study to determine whether there is improved weight gain among premature infants who are fed according to cue-based protocols. The researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed infants and notes a statistical difference in weight gain between infants fed according to cue-based protocols and those fed according to standard protocols. The reviewer notes that parents who gave consent to participate in the study were from a higher socioeconomic class than the population as a whole. This is a threat to: b. onstruct validity.

b.external validity. c.internal validity. d.s tatistical conclusion validity.

ANS: B Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 17. A researcher develops a 7-point Likert scale to evaluate feelings of well-being in patients who are undergoing chemotherapy. The researcher administers this measure to other, similar patients in other medical centers. This is done in order to: c. decrease mono-operation bias. b. improve the test-retest reliability. c. increase interrater reliability. d. strengthen the operational definition of constructs.

ANS: B Feedback AMono-operation bias occurs when only one measure is used to evaluate an outcome.

BTo improve the reliability of the measurement tool, it should be tested in various settings to determine whether it gives consistent measures each time it is used.

CInterrater reliability refers to consistent results that occur when various people administer study measures.

DEvaluating the consistency of a measurement tool does not affect the operational definition of constructs.

PTS: 1 DIF: Cognitive level: Analysis REF: pp. 225-226 18. In a research study, ambulatory clinic nurses teach children with asthma how to monitor peak expiratory flow volumes and how to use metered-dose inhalers to determine whether asthma control scores improve. The researcher discovers inconsistencies in how these measures were taught and how well the children understood the concepts. This represents a lack of: a.control of extraneous variables. b.internal validity. c.intervention fidelity. d.precision of measurement.

ANS: C Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ATo control for extraneous variables, the researcher would identify characteristics of subjects or settings that might influence outcomes.

BInternal validity looks at the influence of extraneous variables on study outcomes.

CConsistent implementation of the treatment is referred to as intervention fidelity. If the method of administering a research intervention varies from one person to another, the chance of identifying a true difference based on the independent variables decreases.

DPrecision of measurement refers to whether or not the tools yield the same readings or findings from one test to another.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 226 19. A researcher wishes to conduct a study of a small number of subjects on a large hospital intensive care unit. To minimize problems associated with extraneous variables in the study setting, the researcher will: a.ensure double-blind data collection methods. b.randomly assign subjects to treatment and control groups. c.test the reliability of study measures. d.t rain a small number of nurses to administer the intervention.

ANS: D Feedback ADouble-blind data collection, random assignment of subjects, and reliability of test measures are important to improve control and reduce bias.

BExtraneous variables in complex settings can influence scores on the dependent variable.

CDouble-blind data collection, random assignment of subjects, and reliability of test measures are important to improve control and reduce bias.

DOne way to reduce the effect of extraneous variables is to train a small number of staff to administer the intervention to improve consistency.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 20. A researcher reviews demographic characteristics of potential study subjects, such as age and gender, to determine whether these characteristics may influence the outcome of the study. This is done to help ensure: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: C Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 226 21. An important measure to decrease threats to internal validity in an experimental study is to: a.apply the intervention consistently. b. improve the precision of measurement methods. c. increase the sample size. d. randomly assign subjects to study groups.

ANS: D Feedback AConsistent application of the intervention and improved precision of measurements help minimize threats to statistical conclusion validity.

BConsistent application of the intervention and improved precision of measurements help minimize threats to statistical conclusion validity.

CIncreasing sample size minimizes threats to external validity.

DAn important threat to internal validity is any concern about subject selection and assignment to groups. Randomly assigning subjects to treatment and control groups helps to minimize this threat.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 224-225 22. Which action will the researcher take to improve construct validity? a. Allow data collectors to know which subjects are assigned to which groups b. Ensure that operational definitions reflect theoretical constructs c. Make sure that the researcher is involved in data collection d. Utilize only one measurement method to measure study variables

ANS: B Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

A Allowing data collectors to know which subjects are assigned to which groups and involving the researcher in data collection both increase the risk of bias.

B Construct validity depends on adequate definition and measurement of constructs. The conceptual definition should emerge from the concept analysis and the operational definition should clearly reflect both.

C Allowing data collectors to know which subjects are assigned to which groups and involving the researcher in data collection both increase the risk of bias.

D Using only one measurement tool increases the risk of mono-operation bias.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 23. A researcher wishes to study the effects of effective sleep hygiene on sleep quality and behavior among children diagnosed with attention deficit disorder. To minimize mono-operation bias, the researcher will: a.accurately describe conceptual and operational definitions. b.adequately discuss construct validity in the introduction. c.evaluate multiple sleep hygiene techniques. d.u tilize a double-blind data collection methodology.

ANS: C Feedback A Construct validity is improved with adequate description of conceptual and operational definitions.

B Construct validity is improved with adequate description of conceptual and operational definitions.

C Mono-operation bias occurs when only one method of measurement is used to assess a construct and can be minimized with the use of multiple measures.

D Use of double-blind data collection methods helps to minimize bias.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225|MCS: 228 24. Multiple replications of an initial study conducted in different populations produce findings that do not match those in the initial study. The initial study may lack which type of validity? a. Construct validity b. External validity c. Internal validity d. Statistical conclusion validity

ANS: B

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 25. In order to increase participation among potential subjects of a larger population, the researcher will: a.limit the time and effort required to participate in the study. b.provide demographic information about those who refuse to participate. c.provide instruments that are detailed to increase the amount of data collected. d.offer potential subjects a financial incentive to participate in the study.

ANS: A Feedback ALimiting the investment demands on subjects helps to improve participation.

BProviding demographic information about those who do not participate is an important part of the discussion of limitations of a study but does not ensure generalization to a larger population.

CDetailed instruments may be time consuming and may limit participation to a small sample size.

DOffering financial incentives does not ensure a sample that is representative of the larger population.

PTS: 1 DIF: Cognitive level: Analyzing REF: MCS: 225 26. In order to attribute causality of a posttest measure in an experimental study, the independent variable will be: a.administered to control group subjects only. b.administered to subjects selected by the researcher. c.administered to treatment group subjects. d.defined loosely to avoid bias.

ANS: C

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback AThe independent variable is administered to the treatment group and not the control group.

BSelection of subjects by the researcher increases the likelihood of bias.

CTo improve determinations of causality, the independent variable should be administered consistently to all subjects in the treatment group.

DThe independent variable should be precisely defined.

PTS: 1 DIF: Cognitive level: Applying REF: pp. 229-230 27. In a study to examine the effects of a newly modified anxiety-reducing nursing action on a group of subjects who have cancer, the control group will receive: a.an alternative intervention. b.no intervention. c.the newly modified intervention. d.the standard intervention.

ANS: D Feedback AAn alternative intervention would invite comparison, but if it is new, it would also be experimental.

BOffering no intervention is often unethical.

CGiving the newly modified intervention would not create a difference between the treatment and the control groups.

DIn many nursing studies, offering no intervention (when one exists) to subjects in the control group is considered unethical. Subjects in this group generally receive the standard intervention as a comparison to those in the treatment group.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 230-232 28. In a quasi-experimental study design, the group that receives standard care is usually referred to as the: a.comparison group. b.control group. c.experimental group. d.treatment group.

ANS: A Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

AIn a quasi-experimental study, the group that does not receive treatment is usually referred to as the comparison group.

BSubjects not receiving treatment in an experimental group are generally referred to as the control group.

CGroups that receive the intervention in either type of study are referred to as experimental or treatment groups.

DGroups that receive the intervention in either type of study are referred to as experimental or treatment groups.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 230-232 29. In a quasi-experimental study using a convenience sample of subjects from a local high school, the researcher asks potential subjects to volunteer for placement in either a low sugar diet program or a regular sugar diet program. This technique for assigning participation may compromise: a.construct validity. b.external validity. c.internal validity. d.statistical conclusion validity.

ANS: C Feedback AConstruct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions.

BExternal validity is concerned with the extent to which findings can be generalized beyond the study sample.

CInternal validity looks at the influence of extraneous variables on study outcomes.

DStatistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

PTS: 1 DIF: Cognitive level: Analyzing REF: pp. 232-233 30. Which type of study is considered strongest for testing the effectiveness of an intervention? a.Experimental b.Pretest/Posttest c.Quasi-experimental d.Randomized controlled trial ANS: D

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Feedback A Experimental designs involve manipulation independent variables, but without random assignment of subjects to groups, which can weaken the study by increasing the potential for bias.

B Pre-test/Post-test designs are a type of quasi-experimental study design that generally doesnt use random assignment of subjects.

C Quasi-experimental studies do not have complete control over variables and usually do not use random assignment of subjects.

D Randomized controlled trials are noted to be the strongest methodology for testing the effectiveness of a treatment due to the elements of the design that limit the potential for bias.

PTS: 1 DIF: Cognitive level: Remembering REF: MCS: 232|MCS: 237|MCS: 238|MCS: 241 31. When using Consolidated Standards for Reporting Trials (CONSORT) guidelines to critically appraise a randomized controlled trial (RCT), the nurse will make sure that the study: a. is designed to definitively test a hypothesis. b. is conducted in a laboratory to minimize setting bias.

c.uses subjects selected by the researcher for participation. d.uses a descriptive or correlational design.

ANS: A Feedback ARCTs should be designed to be a definitive test of the hypothesis that the intervention caused the defined dependent variables.

BRCTs should be conducted in a clinical setting and not a laboratory.

CSubjects selected by the researcher may be biased.

DDescriptive or correlational designs are not RCTs.

Chapter 12. Qualitative Research Methods MULTIPLE CHOICE 1. In addition to the aim or goal of the study, the purpose statement for a qualitative study should include The phenomenon of interest, the population, and the a. Setting b. Rationale for conducting the study c. Theoretical framework used

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Hypothesis ANS: A The purpose statement for a qualitative study should include the phenomenon and population being studied and the setting. The rationale for conducting the study is not included in the purpose statement for qualitative research. The theoretical framework used is not a part of the purpose statement. Qualitative studies do not use hypothesis statements since stating expected outcomes and relationships are not consistent with the philosophical orientation of this approach.

Instead, research questions or objectives are used.

DIF: Cognitive Level: Comprehension REF: MCS: 266 2. In contrast to quantitative research study participants who are selected to be as representative of a population as possible, qualitative research participants are selected because they a. Are philosophically attuned to the use of narratives and narrative analysis as the best means to convey their experience to the researcher and to others b. Meet the requirements for involvement in the study that the researcher specified at the outset of the studys implementation c. Also are representative of the population d. Have experienced the phenomenon of interest ANS: D The criterion for selecting participants for a qualitative study is that they have experienced the phenomenon of interest. The participants view of the value of narrative research and analysis is not the reason that study participants in a qualitative study are selected. In qualitative methodology, the method of sampling may differ as the study progresses, since the researcher may be led to interview a broader range of subjects than originally intended by what early participants relate. Although representativeness of the sample, especially through random sampling, is important to external validity (that is, the extent to which the samples findings can be applied to the population) for quantitative methods, it is not a characteristic of qualitative research.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Comprehension REF: MCS: 267 3. All of the following statements related to sample size are true characteristics of qualitative methodology except for which of the following? a. The criterion of theoretical sufficiency is used to determine when the sample size is adequate. b. Samples used in qualitative research are typically much smaller than in quantitative research. c. The criterion of data saturation is used to determine when the sample size is adequate. d. When asked to indicate in an institutional review board (IRB) proposal how large the sample will be, the qualitative researcher should indicate between 25 and 50 subjects to capture an adequate sample.

ANS: D The text authors recommended including a projected sample size of 12 to 25 participants when submitting a study for IRB approval. The criterion of theoretical sufficiency has been proposed as a means for determining when the sample size is adequate. This refers to the process where data are collected until the research question can be adequately addressed. It contrasts with the more established term data saturation as a criterion to determine when the sample size is adequate, and is preferred by some researchers who believe that it is more appropriate because one can never completely know (or be saturated with) all there is to know about a topic. Samples for qualitative research studies are notably smaller than samples used in quantitative studies.

Data saturation, or gathering data to the point where one is no longer learning new information about the phenomenon, is a term used to determine when the sample size is adequate.

DIF: Cognitive Level: Analysis REF: MCS: 268 4. The qualitative researchers awareness of personal biases and past experiences that might influence his or her responses to participants or their data so that the data can be honestly and intellectually analyzed is termed a. An etic view b. Reflexivity

Gray Burns and Grove’s The Practice of Nursing Research (9e)

c. A co-constructive process d. An emic view ANS: B Reflexivity is the term used to describe the researchers awareness of personal biases and past experiences that might influence how he or she responds to the participants and analyzes data in an intellectually honest way. An etic view is one that reflects the outsiders perspective and tends to occur when the qualitative interviewer is not careful about establishing a relationship characterized by openness and trust. As a result, the view of the phenomenon obtained by the interviewer is an outsiders perspective. The co-constructive process is a term used to describe the mutual influence the qualitative researcher and the study participant have on one another in generating findings. An emic view is the perspective of the participant. Qualitative interviewers should interact with the participants in a way that is open, fosters trust, and encourages the emic (or participants) view to emerge.

DIF: Cognitive Level: Comprehension REF: MCS: 268 5. Probing is a strategy used in interviews to a. Make it clear that the interviewer is in charge. b. Limit the range of responses. c. Elicit more information in a specific area. d. Ensure a variety of interpretations of the question by different subjects.

ANS: C In probing, the interviewer asks participants to elaborate further on a topic through the use of non-threatening but thought-provoking questions. Although the questions are controlled by the researcher, the interviewer needs to establish a permissive atmosphere where the participant is encouraged to respond fully and honestly to the questions asked. Verbally or non-verbally asserting that the interviewer is in charge hinders this process. Structured questions may limit the range of responses given by participants, but this is not the purpose of probing. Ensuring a variety of interpretations of the question by different subjects is not the purpose of probing.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Interview questions should be designed so that each subjects interpretation of the question is as consistent as possible while still encouraging the respondent to answer fully and honestly.

DIF: Cognitive Level: Comprehension REF: MCS: 272 6. A clinical nurse at a large urban hospital has decided to conduct a descriptive qualitative study related to staff nurses perceptions of the causes of various types of violence against nurses in their facility. As part of his research design, he hosts a series of focus groups with staff nurses during each of three shifts. What is considered the main advantage of using a focus group strategy as opposed to one-on-one interviews for data collection? a. Individuals who are alike on some characteristic are more likely to feel safer or less anxious expressing their views, especially with difficult experiences, when participating in a focus group rather than in a one-on-one interview. b. Focus groups allow the researcher to gather a lot of information in a short time. c. Focus groups require less planning than one-on-one interviews do, because interviewers should talk little and listen more. d. It is more efficient and less expensive to transcribe one interview with several participants rather than to transcribe several individual interviews.

ANS: A The assumption underlying focus groups is that in settings that are permissive and nonthreatening, participants are more likely to express and to clarify their views than they would be in individual interviews, especially for sensitive topics. This allows for richer data collection.

Focus groups often generate a great deal of information from the participants perspectives and do so in a short period of time, but this is not the primary advantage of using this data collection strategy. Conducting a focus group involves a great deal of advance planning to ensure that the interviewer asks relevant questions in a way that is non-intrusive, non-threatening, and safe. Both one-on-one and focus group interviews require careful planning. Transcribing tapes from both individual and group interviews can be time-consuming and challenging. This, however, is not the primary reason to conduct a focus group about the phenomena of interest instead of a one-onone interview.

DIF: Cognitive Level: Application REF: MCS: 269

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7. What is the typical size and duration of a focus group interview? a. 4 to 12 participants; 3 1/2 hours b. 3 participants; 30 minutes c. At least 12 participants; 3 hours d. 4 to 12 participants; 45 to 90 minutes ANS: D Involving 4 to 12 participants in a discussion that lasts 45 to 90 minutes is typical for focus groups. Four to 12 participants is considered an appropriate size for a focus group, although 3 1/2 hours is longer than the typical focus group runs. Three participants is smaller than the typical number of participants, and a half-hour is less time than is needed to generate a rich discussion of the phenomenon of interest. Involving more than 12 participants in a focus group may limit hearing the perspective of less vocal members of the group and can be unwieldy. In addition, 3 hours is longer than typical focus groups last.

DIF: Cognitive Level: Knowledge REF: MCS: 278 8. If a researcher decides to transcribe a recorded one-hour interview or focus group in order to better understand her data, she might need to spend up to how much time creating a verbatim transcript? a. 1 hour b. 2 hours c. 4 hours d. 6 hours ANS: D Verbatim transcription of a 1-hour interview or focus group may require up to 6 hours.

DIF: Cognitive Level: Application REF: MCS: 278 9. The role of the facilitator involves all of the following except to

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. Encourage group members to go beyond the current discussion or debate to encourage sharing of perspectives. b. Instruct participants that all points of view are valid and helpful and to not ask speakers to defend their positions. c. Prepare for the facilitation experience by developing a few preconceived ideas about the topic in order to direct the discussion most effectively. d. Reflect on inconsistencies among the views of participants and with their own thinking.

ANS: C Facilitators should prepare themselves to be effective moderators of the discussion, but to not develop preconceived ideas about the topic as this may hinder their ability to hear the perspectives of the group members. Encouraging group members to stretch their thinking and to share their perspectives is the role of an effective facilitator. It is important to instruct group members at the outset of the meeting that all views are valid and helpful to the researcher in understanding the topic. Once rapport is established with the group, one of the facilitators roles is to reflect on inconsistencies among the participants and in their own thinking to challenge ideas and increase group interaction.

DIF: Cognitive Level: Synthesis REF: MCS: 275 10. A researcher is interested in studying the experiences of gay (G), lesbian (L), and transgender (T) youth in the middle school setting. With parental consent and the students assent to participate, she provided a group of 12 students with disposable digital cameras and had them each take 15 photos that illustrate their experiences, both positive and negative, as a GLT adolescent. The researcher then developed the photos and asked participants to discuss what they documented. This is an example of what type of qualitative data collection technique? a. Thick description b. Photovoice or photo novella c. Participatory research d. Data immersion ANS: B

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Photovoice (or photo novella) is a technique for gathering data from participants that reflect their individual perspectives of a phenomenon. This strategy involves asking individuals to record their experiences and perceptions with photos that are then analyzed for meaning with input from participants. Thick description is a term used to describe a richness and depth of information gathered from effective qualitative interviews. Involving study participants in collecting data via taking digital photographs would be a participatory strategy but is not specific term for this technique. Data immersion is a term commonly used to describe the researchers experience of being immersed and fully invested in reading and thinking about the data.

DIF: Cognitive Level: Analysis REF: MCS: 277 11. The primary disadvantage to the use of Internet-based data collection is that a. It can be difficult to obtain consent. b. It limits the sample to those who can read and write, use computers, and have Internet access. c. It can only be used with quantitative research methods. d. The subject pool tends to be limited.

ANS: B The main disadvantage of Internet-based data collection has to do with sampling those who are able to read and write, are computer-literate, and who have Internet access. Thus, the poorly educated, elderly, disabled, or disadvantaged may be underrepresented. Researchers who conduct Internet-based research are often able to obtain consent by noting a statement like Completion and submission of the survey implies consent. Data can be effectively collected for a qualitative study using the Internet. Although there are some sampling limitations in terms of certain populations, the subject pool in general tends to be very large given the extensiveness of the online community not limited by geographic space.

DIF: Cognitive Level: Analysis REF: MCS: 277 12. In addition to sample bias and ethical issues (e.g., securing consent, assuring anonymity, and protecting site security), a third concern about factors that may affect the credibility of Internetmediated study findings is

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. The interviewers ability to establish rapport with study participants b. The fact that use of a pseudonym might cause participants to make up information about the phenomenon c. The researchers ability to transcribe the data gathered through online interviews d. Reliability and validity of data, although terms most often applied to quantitative research, might be an issue since the researcher cant verify whether or not participants meet inclusion criteria for the study ANS: D Not being able to ensure that participants meet inclusion criteria and being unable to control distractions during data collection are the biggest threats to the validity and reliability of the research findings gathered by Internet-mediated data collection. A skilled and personable interviewer may be able to establish good rapport and to effectively conduct online interviews with study participants. Use of a pseudonym, as well as site controls, helps ensure that participants identities are not made public. Plans to carefully capture interviews digitally, notetaking, and careful data transcription minimize problems with transcription of data.

DIF: Cognitive Level: Analysis REF: MCS: 278 MULTIPLE RESPONSE 1. Which of the following statements are true statements about qualitative research methodology? (Select all that apply.) a. Qualitative researchers develop questions and then determine which philosophical approach to use to answer the question. b. Qualitative analyses involve using words rather than numbers as the basis of analysis. c. Because the methods used for sampling, data gathering, and analysis are more flexible for qualitative research than for quantitative research, qualitative research is considered a less rigorous approach to nursing research. d. As with quantitative research, qualitative researchers are not able to modify sampling and data gathering processes once the study begins, since this leads to problems with internal validity.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: A, B Qualitative researchers typically first do a literature search and develop their research question and then determine which philosophical approach (e.g., ethnography, phenomenology) needs to be used to address the research question. Note that some qualitative researchers will defer the review of literature until after data collection to avoid biasing their analysis and data interpretation. In qualitative research, narratives (transcriptions of respondents stories about their experiences) and written observations are analyzed for themes and patterns. Although strict positivists would argue that qualitative methodology is less rigorous than quantitative approaches to research, most nursing researchers believe that qualitative research employs the same careful skills in analytical reasoning and is as rigorous in seeking knowledge about human experience.

Internal validity is not a criteria applied to qualitative research. In qualitative approaches, data analysis begins as data are gathered and insights may suggest the need to modify the original methodology. Such changes, however, need to be supported with a clear rationale.

DIF: Cognitive Level: Synthesis REF: MCS: 264 2. Which of the following are true statements regarding data analysis in qualitative research? (Select all that apply.) a. Qualitative data analysis involves examining and interpreting data in order to elicit meaning, gain understanding, and develop empirical knowledge. b. Although qualitative data analysis may identify additional data that may need to be collected, once the data collection period is over, the researcher is discouraged from going back to participants to gather additional information. c. Data analysis in qualitative research occurs concurrently with data collection. d. Researchers are encouraged to dwell with the data by immersing themselves in transcripts, tapes, and interview notes to make sense not only of what participants have said but also of meanings underlying expressions, emphasis, and nonverbal communications.

ANS: A, C, D The purpose of qualitative data analysis is to examine and interpret data to elicit meaning and understanding to add to the professions body of knowledge. Data analysis occurs concurrently with data collection. Researchers must immerse themselves with the data to obtain the deepest

Gray Burns and Grove’s The Practice of Nursing Research (9e)

understanding possible of the phenomenon being investigated. As long as the qualitative researcher has additional questions, he or she has not reached data saturation; going back to participants to gather additional information to clarify meanings is expected.

DIF: Cognitive Level: Synthesis REF: MCS: 266 3. Which of the following are accurate statements about the interview process used by qualitative researchers? (Select all that apply.) a. It is sufficient to develop interviewing skills once the interviewing of study participants begins since the qualitative research process involves co-construction of data; learning to interview is part of the process the researcher is expected to experience once data collection begins so that the interviewer enters the study without bias or preconceived ideas. b. When participants appear to begin speaking about a subject that seems unrelated to the focus of the study, an effective strategy is to ask obtain the respondents perspective by asking how the new subject is related to his/her previous comments. c. The interviewer should dress in either business attire or a nursing uniform when conducing interviews or focus groups. d. When a study participant appears to be fatigued or in pain from illness or treatments, the interviewer should offer to stop the interview, to take a break, or to reschedule for another day.

ANS: B, D When the interviewer does not understand how a topic might be related to the topic being discussed, it is an effective strategy to obtain the participants perspective; then, if there still appears to be no link, the interviewer can redirect the interview. The interviewer must not inflict unnecessary harm upon participants. Even though interviews are not generally considered invasive, they may be invasive to the psyche. Researchers who have less experience with interviewing should work to develop interview skills before they start interviewing study participants, since interviewing is a skill that directly affects the quality of the data produced. It is generally not a good idea for the interviewer to dress for an interview in business attire or a nursing uniform since this may emphasize power differences in the relationship. Interviewers should consider how the participant is likely to be dressed and select their own clothing accordingly.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Chapter 13. Outcomes Research MULTIPLE CHOICE 1. The goal of outcomes research is to: a. etermine the most cost-effective nursing interventions in patient care.

b.examine the end results of patient care from various health interventions. c.help providers make end-of-life decisions about patient care. d.improve patient satisfaction with nursing care.

ANS: B Feedback A Cost-effectiveness is one possible outcome, but other patient outcomes may be more important.

B Outcomes research focuses on the end results of health care practices and interventions.

C Outcomes research is not solely about end-of-life care and is not focused on end-of-life decision making.

D Patient satisfaction is one result but is not the goal of all outcomes research.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 467 2. What is the key construct in Donabedians theory of outcomes research? a.Efficiency of health care delivery b.Healthy outcomes c.Professional accountability d.Quality of care ANS: D Feedback AEfficiency, healthy outcomes, and professional accountability all may be examined during outcomes research, but none of these is the key construct.

BEfficiency, healthy outcomes, and professional accountability all may be examined during outcomes research, but none of these is the key construct.

CEfficiency, healthy outcomes, and professional accountability all may be examined during outcomes research, but none of these is the key construct.

DQuality of care is the overriding construct of Donabedians theory of outcomes research.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp. 468-469 3. Which is an example of a type of nursing service that might be evaluated in outcomes research? a. Application of wound care products b. Clinical care protocol implementation c. Glucose monitoring for newly diagnosed diabetics d. Using a Braden Scale for skin assessment

ANS: B Feedback AApplication of products, monitoring patient status, and using measurement scales are all examples of nursing interventions.

BNursing services can include staffing and education of nurses as well as implementation of protocols and standards of care.

CApplication of products, monitoring patient status, and using measurement scales are all examples of nursing interventions.

DApplication of products, monitoring patient status, and using measurement scales are all examples of nursing interventions.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: pp. 468-469 4. Which would be an example of an interdependent role for nurses in the Nursing Role and Effectiveness Model? a.Administering a medication to a patient b.Arranging for home health care services c.Initiating a fall risk protocol d.Performing an admission assessment ANS: B Feedback ADependent role functions include execution of medical orders and physician-initiated treatments.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

BInterdependent role functions in the Nursing Role Effectiveness Model include communication, case management, and coordination of care.

CDependent role functions include execution of medical orders and physician-initiated treatments.

DIndependent role functions include assessment, diagnosis, and nursing-initiated treatments.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 469-470 5. In an outcome study, a researcher demonstrates a link between the number of mothers who successfully breastfeed their infants and the number of maternal-child nurses who are baccalaureate prepared. This illustrates: a.interdependent nursing role functions. b.nursing-sensitive patient outcomes. c.patient-sensitive outcomes. d.the Nursing Role Effectiveness Model.

ANS: B Feedback AInterdependent nursing functions are those that include both nurse-initiated and physicianinitiated treatments.

BOutcomes that are nursing sensitive are those that are influenced by nursing care decisions and actions as well as those associated with nursing staffing, education, and assignments.

CPatient-sensitive outcomes are those that are influenced by different aspects of patients, such as age, gender, or disease process.

DThe Nursing Role Effectiveness Model examines outcomes that are nursing sensitive.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 471-472 6. The development of the Uniform Hospital Discharge Data Set and the Universal Minimum Health Data Set was helped by: b. establishing guidelines for outcomes research.

b.identifying the contribution of nursing care to patient outcomes. c.prescribing data elements to be monitored in outcomes research. d.reporting financial and statistical data from hospitals.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: C Feedback AThe data sets helped facilitate standards about data elements but did not establish guidelines for outcomes research.

BThe Nursing Role Effectiveness Model helped to identify the contribution of nursing care to patient outcomes.

CThe data sets facilitated consistency in data collection among health care organizations by prescribing the data elements to be gathered.

DThe Canadian Institute for Health Information established a reporting system to report financial and statistical data from hospitals.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 472 7. Which government agency supports research to improve the outcomes and quality of health care? a.AHRQ b.ARRA c.CIHI d.FDA ANS: A Feedback AThe Agency of Healthcare Research and Quality (AHRQ) supports research designed to improve the outcomes and quality of health care.

BThe American Recovery and Reinvestment Act (ARRA) is not a government agency; funding from this act allowed AHRQ to expand its work in support of comparative effectiveness research.

CThe Canadian Institute for Health Information (CIHI) helped to establish national Canadian standards for collecting and reporting financial and statistical data from health service organizations.

DThe Federal Drug Administration (FDA) regulates the research and distribution of medications.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: MCS: 472

Gray Burns and Grove’s The Practice of Nursing Research (9e)

8. Which organization includes nursing-sensitive outcomes measures in its performance measurement portfolio? a. Agency of Healthcare Research and Quality

b.Department of Health and Human Services c. National Guideline Clearinghouse d. National Quality Forum ANS: D Feedback AThe Agency of Healthcare Research and Quality supports research designed to improve the outcomes and quality of health care.

BThe Department of Health and Human Services includes the Agency of Healthcare Research and Design.

CThe National Guideline Clearinghouse is a resource for evidence-based guidelines.

DThe National Quality Forum was created as a national standard-setting organization for health care performance measures and includes nursing-sensitive measures in its portfolio.

PTS: 1 DIF: Cognitive level: Remembering (Knowledge) REF: MCS: 474 9. The National Quality Forum was established in 1999 for which purpose? a. To identify and develop nursing-sensitive quality measures b. To support state and health system efforts to implement and evaluate medical liability reform

models c. To allow the AHRQ to expand its work supporting comparative effectiveness research d. To set standards for health care performance measures ANS: D Feedback AThe NDNQI identifies and develops nursing-sensitive quality measures.

BThe AHRQ supports state and health system efforts to implement and evaluate medical liability reform models.

CThe ARRA allows the AHRQ to expand its work supporting comparative effectiveness research.

DThe National Quality Forum sets standards for health care performance measures.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: MCS: 474 10. To help meet the requirements for Magnet recognition, which organization will a hospital participate in? a. The American Nurses Association (ANA) b. The Agency of Healthcare Research and Quality (AHRQ) c. The National Database of Nursing Quality Indicators (NDNQI) d. The National Quality Forum (NQF)

ANS: C Feedback AAlthough the ANA is the organization that oversees the Magnet Recognition Program, hospitals do not join this organization.

BThe AHRQ supports research designed to improve the outcomes and quality of health care.

CParticipation in NDNQI meets requirements for the Magnet Recognition Program.

DThe NQF was created as a national standard-setting organization for health care performance measures.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 474-475 11. Which is one of the indicators used by the National Database of Nursing Quality Indicators (NDNQI)? a.Assessment, intervention, and reassessment of pediatric pain b.Clinical Laboratory Improvement Amendment (CLIA) standards c.Protocols for monitoring biometric equipment used in hospitals d.The number of hours hospital residents work per week ANS: A Feedback ANDNQI identifies and develops nursing-sensitive quality measures. Assessment, intervention, and reassessment of pediatric pain is one of the indicators it uses.

BCLIA standards are those applied to hospital laboratory personnel and equipment.

CBiometric equipment standards are not nursing-sensitive measures.

DStandards about hospital residents are not nursing-sensitive measures.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: pp. 474-475 12. Which is an important finding in outcomes research about Advanced Practice Nursing (APN) practice? a. APNs provide care that is equivalent to that provided by doctors at a fraction of the cost. b. Care by APNs shows equivalent or improved outcomes to that provided by physicians. c. Hospital readmission rates are slightly higher for patients who use APNs for primary care. d. The level of patient satisfaction is greater with APNs regardless of clinical outcomes.

ANS: B Feedback AStudies are not reported showing equivalent care at reduced cost.

BThere is abundant research demonstrating the safety and effectiveness of APNs. In a search of all random controlled trials comparing APNs to usual care, findings consistently showed that care by APNs resulted in equivalent or improved outcomes.

CStudies do not show increased readmission rates.

DPatient satisfaction is high, but so are positive clinical outcomes.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 476-477 13. What is an important aspect of outcomes research as defined by Donabedian? a. Selection of only proximal outcomes in order to streamline outcomes research b. The need for patients or recipients of care to define which outcomes are desirable c. The need to link outcomes with specific nursing processes d. The use of population groups rather than individuals for outcome studies

ANS: C Feedback AOutcomes research involves studies of all outcomes of nursing care.

BDonabedian does not identify the need to study patient feelings about outcomes or care.

CIn outcomes research, according to Donabedian, there is a need to clearly link identified outcomes with the processes that caused the outcomes.

DDonabedian does not identify the need to use population groups rather than individuals for outcome studies.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

REF: MCS: 477 14. Which is an example of a distal outcome in outcomes research? a. Glucose monitoring skills in patients receiving diabetic teaching b. Hospital readmission rates in patients admitted for myocardial infarction c. Pain scores before and after pain medication d. Patient perception of tobacco advertising among COPD patients

ANS: D Feedback AGlucose monitoring skills, hospital readmission rates, and pain scores are proximal outcomes because they are related directly to nursing interventions and not to external forces.

BGlucose monitoring skills, hospital readmission rates, and pain scores are proximal outcomes because they are related directly to nursing interventions and not to external forces.

CGlucose monitoring skills, hospital readmission rates, and pain scores are proximal outcomes because they are related directly to nursing interventions and not to external forces.

DA distal outcome is one which is removed from proximity to the care or service received and is more influenced by external (nontreatment) factors. Quality of life is an example of a distal outcome.

PTS:1DIF:Cognitive level: Applying (Application) REF: MCS: 478 15. In outcomes research, a Magnet-designated hospital is an example of which type of variable? a.Dependent b.Intervention c.Outcome d.Structural ANS: D Feedback AA dependent variable is one that is affected by manipulation of another variable.

BAn intervention variable is one that is manipulated to examine the effects of this manipulation on a dependent variable.

CAn outcome variable is one that is linked to patient care.

DMagnet designation indicates certain standards of structure including shared governance, implementation of nursing practice, and autonomy.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 478-479 16. A nurse uses a care map to guide nursing interventions for patients with COPD. This is an example of using: a.evidence-based practice. b.practice patterns. c.practice styles. d.standards of care.

ANS: D Feedback AEvidence-based practice includes clinical guidelines, critical paths, and standards of care.

BA practice pattern is a concept representing the variation in what type of care is provided.

CA practice style represents variation in how care is provided.

DA standard of care is a norm according to which quality of care is judged and includes guidelines, critical paths, and care maps.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 480-481 17. What is the role of evidence-based practice in outcomes research? a. Evidence-based practice identifies practice standards that can be evaluated using patient

outcomes. b. Evidence-based practice defines practice styles and patterns used in professional

practice. c.The standards used in evidence-based practice clearly identify desired patient outcomes. d.There is a clear link between evidence-based practice and improved patient outcomes.

ANS: A Feedback AEBP guidelines contain standards and norms against which patient outcomes can be evaluated.

BPractice styles and patterns represent variations in what type of care and how care is delivered and are part of clinical guidelines.

CVery few empirical studies have assessed the impact of EBP on patient outcomes.

DVery few empirical studies have assessed the impact of EBP on patient outcomes.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 480-481 18. What type of sample is generally used in outcomes studies? a.Small sample b.Heterogeneous sample c.Homogeneous sample d.Volunteer sample ANS: B Feedback AA small sample would not provide a heterogeneous sample.

BBecause the target population in outcomes studies is often heterogeneous, it is necessary to obtain large, heterogeneous samples.

CTypical sampling criteria for outcomes research include obtaining a very large, heterogeneous sample in which all patients have the likelihood of being represented.

DA volunteer sample is generally not encouraged, as it does not allow for the researcher to influence the sample characteristics.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 481-482 19. Which type of study design is commonly used in outcomes studies? a. Phenomenological

b.Qualitative c.Quasi-experimental d.Random-control trial ANS: C Feedback APhenomenological and qualitative studies do not account for effects of variables on patient outcomes.

BPhenomenological and qualitative studies do not account for effects of variables on patient outcomes.

CQuasi-experimental studies and observational research designs are most commonly used for outcomes research to provide effectiveness and efficiency.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DRandom controlled trieals also seek to provide evidence about the effects interventions, but, with outcomes studies, the intervention is not limited to medications or clinical procedures..

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(Comprehension) REF: pp. 483-484 20. A researcher identifies a group of Native American subjects who are at risk for type 2 diabetes mellitus and follows this group over time to observe actual rates of acquiring this disease. This is an example of a: a.clinical database. b.prospective cohort study. c.qualitative study. d.quasi-experimental study.

ANS: B Feedback AA clinical database is a collection of data about a group of patients.

BA prospective cohort study is an epidemiologic study in which the researcher identifies a group of people who are at risk for a condition and follows them over time.

CA qualitative study is a nonexperimental study to examine attributes of a group of subjects.

DA quasi-experimental study is one in which the researcher has less control over independent variables than in a random controlled trial.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 484-485 21. A nurse identifies an unusual incidence of acute lymphocytic leukemia (ALL) in school-age children in a nearby community and conducts a study to examine exposure to a variety of water pollutants from a local industry. This is an example of a: a.phenomenological study. b.qualitative study. c.prospective cohort study. d.retrospective cohort study.

ANS: D Feedback

Gray Burns and Grove’s The Practice of Nursing Research (9e)

AQualitative and phenomenological studies are nonexperimental studies to examine attributes of groups of subjects.

BQualitative and phenomenological studies are nonexperimental studies to examine attributes of groups of subjects.

CA prospective cohort study is an epidemiologic study in which the researcher identifies a group of people who are at risk for a condition and follows them over time.

DA retrospective cohort study is an epidemiologic study in which the researcher identifies a group of people who have experienced a particular event and examines possible previous causes for this event.

PTS:1DIF:Cognitive level: Applying (Application) REF: pp. 485-486 22. A researcher wishes to widely disseminate findings of outcomes research in order to influence practice in a variety of settings. Which methods might this researcher use? a.A series of presentations and publications in professional and public forums b.An oral presentation at an international conference c.Publication in scholarly, peer-reviewed journals d.Writing about this research in a chapter of a nursing textbook ANS: A Feedback AEmploying a series of presentations and publications in many venues is the only approach that achieves a widespread dissemination of the research findings.

BAn open forum for exchange of ideas is excellent but is not sufficient in the eyes of outcomes researchers. Outcomes researchers consider wide dissemination of the results to providers and consumers necessary to promote change in health care practices.

CPresenting the findings, even at a prestigious conference, is not sufficient in the eyes of outcomes researchers. Outcomes researchers consider wide dissemination of the results to providers and consumers necessary to promote change in health care practices.

DOutcomes researchers consider wide dissemination of the results to providers and consumers necessary to promote change in health care practices.

Chapter 14. Mixed Methods Research MULTIPLE CHOICE 1. Which method will a researcher use to evaluate a group of qualitative studies?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a.

Meta-analysis

b.

Meta-synthesis

c.

Mixed-methods systematic review

d.

Systematic review

ANS: B Feedback

A

A meta-analysis is a review of quantitative studies by statistically pooling or combining the results from these studies into a single quantitative analysis.

A meta-synthesis is used to pool and combine findings from qualitative studies.

B

C

A mixed-methods systematic review is used to evaluate a combination of quantitative and qualitative studies.

A systematic review is a structured, comprehensive synthesis of the research literature to determine the best research evidence available to help determine best practice.

D 2. A researcher evaluates data from a variety of studies, including those involving qualitative and quantitative research, and uses findings from qualitative studies to interpret synthesized quantitative studies. This is an example of: a.

meta-synthesis.

b.

mixed-method synthesis.

c.

multilevel synthesis.

d.

parallel synthesis.

ANS: D Feedback

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A meta-synthesis is used to pool and combine findings from qualitative studies.

A

B

C

D

A mixed-methods synthesis review is used to evaluate a combination of quantitative and qualitative studies.

A multilevel synthesis involves synthesizing the findings from quantitative studies separately from qualitative studies and integrating the findings in the report.

Parallel synthesis involves the separate synthesis of quantitative and qualitative studies, but the findings from the qualitative synthesis are used in interpreting the synthesized quantitative studies.

3. Intervention research shifts the focus from causal connection to causal explanation. What does this mean? a. It allows correlational research determining connection to stand in the place of causal explanation. b. It provides theoretical explanations of why an independent variable produces an effect, rather than merely reporting findings. c. It may use studies that establish causal connection as impetus points, but it proceeds on to descriptive research whenever possible, to explain. d. It utilizes experimental research, whenever possible, to establish cause definitively.

ANS: B Intervention research is a methodology that holds great promise as a more effective way of testing interventions. It shifts the focus from causal connection to causal explanation. In causal connection, the focus of a study is to provide evidence that the intervention contributes to the outcome. In causal explanation, in addition to demonstrating that the intervention causes the outcome, the researcher must provide scientific evidence to explain why the intervention contributes to changes in outcomes and how it does so. Causal explanation is theory based. Thus, research focused on causal explanation is guided by theory, and the findings are expressed

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theoretically (see Chapter 7). Researchers employ a broad base of methodologies, including qualitative studies, to examine the effectiveness of an intervention. Qualitative approaches offer substantial value to the development, feasibility, and validation of nursing interventions.

4. Why may intervention research involve the efforts of an entire project team? a. A multidisciplinary team provides the grounding, objectivity, and world wisdom to judge whether an intervention really has clinical merit. b. Each member of the team carries out a separate research project at a different site, so that the results can be multi-site and more readily generalizable. c. Institutional review boards will not approve intervention projects unless they are backed by an entire team, including representatives from both nursing and medicine. d. It is rare for one person to be imaginative, clinically current, expert at marketing, skilled in statistics, and adept at both quantitative and qualitative research.

ANS: D Because of the nature of intervention research, one may need to gather a multidisciplinary project team to facilitate distribution of the work and a broader generation of ideas. If both quantitative and qualitative data will be gathered during the research project, the team should include members experienced in various qualitative and quantitative data collection and analysis approaches. Including a team member with marketing expertise will be beneficial, because the final step of the project will be to market the intervention.

5. The presence of drop-down oxygen masks on airplanes represents the process of intervention research. During their development, a prototype was designed and refined. What was the final stage of the testing process for drop-down oxygen masks? a. Testing of oxygen masks was initiated on several actual consumer airline flights. b. An analysis was made of all notes made by the intervention team during meetings. c. Oxygen masks already in use on commercial airlines were revised, according to the original protocol specifications. d. Oxygen masks were tested in labs on human volunteers.

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ANS: A Advanced testing of the intervention occurs after sufficient evidence is available that the intervention is effective in achieving the desired outcomes. The model proposed by Forbes (2009) places this type of testing in phases III and IV, where the intervention is compared to standard of care interventions followed by replication studies with long-term follow-up of the interventions effectiveness. Stage III of intervention testing might involve a single, welldesigned study that indicates a satisfactory ES for an intervention, but often an intervention requires modification through additional studies. Replication studies ensure that an intervention is refined to create the desired effect in practice.

6. Why is treatment fidelity such a major concern in intervention research? a. If treatment fidelity is not maintained, it has a direct influence on statistical conclusion validity and power analysis, especially when samples are large. b. The project team may differ about how an intervention is applied, and these varying ways of application must be discussed before marketing can occur. c. Intervention research can take place over many months. It is important for internal validity that the intervention be applied in the same way every time. d. Interventions, especially those involving products that are centered in the health care realm, must reflect the ethical standards of the profession.

ANS: C Treatment fidelity has to do with the accuracy, consistency, and thoroughness in how an intervention is delivered according to the specified protocol, treatment program, or intervention model. Strict adherence to treatment specifications must be evaluated on an ongoing basis during the course of a study. Intervention fidelity is defined as the adherent and competent delivery of an intervention by the interventionist as set forth in the research plan, and this fidelity is of utmost importance to the inference of the studys internal validity in intervention-based research.

Treatment fidelity is important in the conduct of all intervention-based research, but it is especially critical for complex interventions such as those involving information dissemination, social support, counseling, and other interventions intended to bring about changes in health behaviors and psychosocial outcomes.

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7. In the process of interventional research on the efficacy of omega 3 fish oil in decreasing blood sugar in diabetic adults, which event would appear just before widespread dissemination? a. A randomized clinical trial testing the effects of omega 3 fish oil on blood sugar in 300 ambulatory diabetic adults b. Proof of the safety of the prescribed dose of omega 3 fish oil c. Several replication studies of the effects of omega 3 fish oil on blood sugar in hundreds of ambulatory diabetic adults d. Efficacy studies to establish outcome effects of omega 3 fish oil and optimal treatment regimens in adults ANS: C Theory-based intervention research can begin with a concept analysis of the problem or the intervention intended to address it. By dissecting the components of problems and plausible solutions, investigators can gain clarity of the issues at hand. After pre-clinical work, proof of the safety of an intervention and estimates of effect occur; following that are efficacy studies to establish outcome effects and optimal treatment conditions. Then a randomized controlled trial is conducted. This is followed by replication and/or long-term follow-up.

8. A research project shows that a new intervention involving hypnosis decreases PTSD dramatically in servicemen returning from the Middle East. Thirty-three percent of men and women so treated are functional in daily living and free from symptoms three weeks after treatment. Twenty percent of men and women treated remain free from symptoms at one year.

Calculate the numbers needed to treat (NNT), both at three weeks and at a year. a. The NNT at three weeks is 0.33; the NNT at one year is 0.20. b. The NNT at three weeks is 1; the NNT at one year is 1. c. The NNT at three weeks is 33; the NNT at one year is 20. d. The NNT at three weeks is 3; the NNT at one year is 5.

ANS: D Numbers needed to treat (NNT) is a metric that is defined as the number of patients who would need to be treated with the new intervention to avoid one event that might have occurred with

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standard treatment. It is necessary that NNT be estimated in the context of those deriving a benefit or those who might be harmed by the intervention (Day, 2007). Intuitively, it is an easy concept to grasp as it is expressed in a numeric value. For example, if the NNT is 4 for a benefit from an intervention, then a prescriber of intervention could expect that 1 out of 4 patients treated with the intervention would derive a positive outcome. The NNT is determined by an analysis of the data following the completion of an adequately powered study (e.g., the sample size is adequate) to detect treatment differences. The researcher establishes criteria for the primary outcome measure for the study that is indicative of a positive or undesirable response, and the NNT is expressed in terms of either outcome. Researchers are often required to calculate the NNT for clinical trials prior to submitting a manuscript for publication to influential research journals. NNT are often pooled and analyzed in meta-analyses and systematic reviews of studies.

Moreover, it is a meaningful parameter for practice, as clinicians can be informed of the overall effectiveness of the intervention, as well as the expected response when prescribing an intervention. When interpreting NNT, it is important to determine if the NNT value is for a single administration of the intervention, at a single time point, or overall across multiple time points.

9. Blinding to treatment involves not letting the patient know which intervention is being delivered. If the research subject who exercises daily because he is in the treatment group knows which treatment is being delivered, but the researcher and the research staff do not know, what type of condition exists? a. Single blinding b. Double blinding c. Triple blinding d. Unilateral unblinding ANS: A With single-blinded studies, there are two variations. In one variation, study participants are not aware of their treatment assignment but investigators and research staff may have knowledge of who is in what group. The reverse may be used when participants have knowledge of their treatment group assignment but this information is not available to the investigators and research staff. For example, children involved in research comparing the calming effects of music alone

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compared to music with mothers voice delivered by audiotaped recordings would recognize the contents of the tape if they were alert. Researchers and data collectors may not be told of participant group assignment. Double-blinded studies keep knowledge of study conditions from study participants, investigators, and research staff. When a study is triple-blinded, the participants, researchers, and those involved in data management are unaware of group assignment.

10. The project team in intervention research failed to operationally define the study variables correctly. Which subsequent actions of the team were affected? (Select all that apply.) a. The research question posed failed to address the problem accurately. b. Results were not meaningful to clinicians. c. The methods used to study the problem were inappropriate for intervention research. d. The results could not be discussed effectively, in terms of the hypotheses. e. A type III error was not avoided.

ANS: A, B, D, E The initial focus of the team is to clarify the problem or issue of interest. The project team must be alert to the risk of making a type III error. A type III error involves asking the wrong questiona question that does not address the problem of concern. This error is most likely to occur when the researchers do not thoroughly analyze the problem and, as a result, have a fuzzy or inaccurate understanding of the issue of concern. The solution, then, does not fit the problem.

A study conducted on the basis of a type III error provides the right answer to the wrong question, leading to the incorrect conclusion that the newly designed intervention will resolve the problem.

11. A nurse is developing a prototype for a new product that allows a very close approximation of blood sugar, based on 2 ml of filtered saliva. Which of the following persons should be included in the project team? (Select all that apply.) a. A biostatistician who will perform the calculations that will convert saliva glucose values to blood glucose equivalents

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b. An endocrinologist who will order the insulin based on the reported values c. Working nurses who will be collecting the saliva samples d. Lab technicians who will not be analyzing blood glucose values any longer after the new method is in place e. Patients who will have their saliva tested f. The nurse who is developing the prototype ANS: A, B, C, F Because an intervention research project often involves a study extended over a period of time, sometimes years, nurse researchers are advised to give careful thought to the composition of their research teams. Researchers need to determine (1) who will be included on the project team, (2) what level of expertise is required for team members, (3) how team members will function together, and (4) the roles team members will assume. Because of the nature of intervention research, a multidisciplinary project team will facilitate distribution of the work and a broader generation of ideas. If both quantitative and qualitative data will be gathered during the research project, your team should include members experienced in various qualitative and quantitative data collection and analysis approaches.

12. Why is the process of revision of BLS standards from Airway-Breathing-Circulation to Circulation-Airway-Breathing considered intervention research? (Select all that apply.) a. It is grounded in theory. b. It started qualitatively with ideas and observations about the reasons patients code. c. It was field-tested and then researched using randomized clinical trials. d. The findings were replicated in multiple settings. e. It was initiated by a nurse. f. It emanates from previous research on CPR and its outcomes.

ANS: A, B, C, D, F Project team tasks include gathering initial information, developing an intervention theory, designing the intervention, field-testing the intervention, analyzing results, testing the

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intervention, using a randomized controlled trial, collecting and analyzing data, replicating the results, and disseminating the intervention. Qualitative research may be used if researchers are in the initial phase of developing a model or prototype for an intervention.

Chapter 15. Sampling MULTIPLE CHOICE 1. A researcher is studying sleep habits of household cats that belong to families with small children. The families live in urban areas. In this study, what are the elements? a. Small children b. Household cats c. Families d. Sleep ANS: B The individual units of the population and sample are called elements. The elements are the things the researcher studies. An element can be a person, event, behavior, or any other single unit of study. In this case, the researcher is studying catsnot children, not families, and not sleep.

DIF: Cognitive Level: Analysis REF: MCS: 352 2. A researcher wants to increase the generalizability of a planned experimental studys results.

What can the researcher do, relative to sampling, that will achieve that goal? a. Select a sample larger than that recommended by power analysis. b. Purposively select a sample that is extremely heterogeneous. c. Use random assignment. d. Use random sampling.

ANS: D

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Random sampling increases the extent to which the sample is representative of the target population. Good representativeness enhances generalizability of the results. Selecting a sample larger than the size recommended by power analysis results only is a larger sample, not a more representative one. Purposive selection of a more heterogeneous sample does not increase the samples representativeness. Use of random assignment has no effect on representativeness of the sample, since it is selected before assignment occurs.

DIF: Cognitive Level: Analysis REF: MCS: 357 3. A researcher studies spending habits of teenagers in strip malls. From what kind of population has the researcher selected her sample? a. The accessible population b. The entire population c. The target population d. The target sample ANS: A An accessible population is the portion of the target population to which the researcher has reasonable access. The sample is obtained from the accessible population by a particular sampling method. The target population is the entire set of individuals or elements who meet the sampling criteria. The sample is selected from the accessible population within the target population, since this is the population from which the researcher can actually select subjects.

The sample here is a subset of the accessible population that actually checks into shelters, not the target population of all homeless persons. The entire population is a particular group of people who share one or more characteristics that are the focus of the research.

DIF: Cognitive Level: Application REF: MCS: 351 4. A researcher selects his sample in this way. He paints numbers on 100 ping-pong balls, and he paints half of them blue and half of them green. He puts the blue half onto a large tray, and the green half of them onto another large tray. Then he mixes each group and trains his dog to bring 10 balls from each tray to him, gently and systematically, one at a time. What type of sample is this?

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a. Snowball b. Random c. Stratified random d. Systematic ANS: C Stratified random sampling is used when the researcher knows some of the variables in the population that are critical to achieving representativeness. Variables commonly used for stratification are age, gender, ethnicity, socioeconomic status, diagnosis, geographical region, type of institution, type of care, care provider, and site of care. The dog has no agenda, and the balls are mixed. The dog chooses 10 balls from each stratum. The sample is stratified random.

DIF: Cognitive Level: Application REF: MCS: 359 5. Good morning. You have been selected randomly by our marketing department because of your recent purchase of McCarthys Natural Yogurt, several organic raw vegetables, and two types of tofu. As a woman with interest in safe and healthy products, we are asking you to participate in a brief telephone survey. The discerning student will detect an error in the above statement. What kind of a sampling is this? a. Random sampling b. Convenience sampling c. Purposive sampling d. Systematic sampling ANS: C Marketing research now uses product profiling to identify what consumers buy which products.

A sample based on profiling is a purposive sample: people are contacted because they possess a certain pattern of purchasing. This is also referred to as judgmental or selective sampling. If a sample is purposive, it is not random, convenience, or systematic.

DIF: Cognitive Level: Application REF: MCS: 362

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6. A graduate student has a close friend who is recovering from colon cancer and has a permanent colostomy. For her masters thesis, the student decides to conduct qualitative research on adjustment to living with a permanent colostomy after colon cancer resection. She asks her friend if she has any idea of how to recruit participants for the research. Her friend tells her about a colon cancer support group to which she belongs and volunteers to bring a printout of the research studys purpose and general description to the next support group meeting. If the researcher acquires all of her participants in this way, what is the method of sampling used? a. Snowball sampling b. Cluster sampling c. Purposive sampling d. Simple random sampling ANS: A Network sampling, sometimes referred to as snowballing, holds promise for locating samples difficult or impossible to obtain in other ways or who had not been previously identified for study. Network sampling takes advantage of social networks and the fact that friends tend to have characteristics in common. When the researcher has found a few subjects with the necessary criteria, he or she asks their assistance in getting in touch with others with similar characteristics. The first few subjects are often obtained through a convenience sampling method, and the sample size is expanded using network sampling. In cluster sampling, the researcher develops a sampling frame that includes a list of all the states, cities, institutions, or organizations with which elements of the identified population would be linked. States, cities, institutions, or organizations are selected randomly as units from which to obtain elements for the sample. In purposive sampling, sometimes referred to as purposeful, judgmental, or selective sampling, the researcher consciously selects certain participants, elements, events, or incidents to include in the study.

DIF: Cognitive Level: Application REF: MCS: 366 7. A researcher has already written a study proposal and performed a power analysis, which indicates that the sample size will have to be at least 36 if a type II error is to be avoided.

The

Gray Burns and Grove’s The Practice of Nursing Research (9e)

researcher then decides to set the level of significance at p <.01 rather than p <.05 but wants to maintain power at 0.8. What will the researcher have to do in order to maintain sufficient power? a. Increase the effect size. b. Set beta at 0.60. c. Use a different statistical test. d. Increase the sample size.

ANS: D You determine the sample size needed to obtain sufficient power by performing a power analysis. Power analysis includes the standard power (usually 80%), level of significance (usually set at 0.05 in nursing studies), effect size, and sample size. In order to demonstrate statistical significance at a more stringent level (a decreased alpha), the sample size must be increased. The effect size is determined by the magnitude of effect that the intervention produces and, consequently, cannot be adjusted.

DIF: Cognitive Level: Application REF: MCS: 367 8. A researcher studying depression in relation to five predictor variables decides to include five more variables in the study because the literature reveals that they may also be involved in depression. Consequently, the researcher will do which of the following? a. Use a larger sample size. b. Set beta at a lower level. c. Perform additional reliability and validity tests. d. Change the design of the research from correlational to descriptive.

ANS: A As the number of variables under study grows, the needed sample size increases. Adding variables such as age, gender, ethnicity, and education to the analysis plan can increase the sample size by a factor of 5 to 10 if the selected variables are uncorrelated with the dependent variable. Setting beta lower, performing additional reliability and validity tests, and changing the

Gray Burns and Grove’s The Practice of Nursing Research (9e)

design from correlational to descriptive will not solve the problem of the altered power of the study, due to addition of five variables. Only increasing the sample size will be a practical solution.

DIF: Cognitive Level: Application REF: MCS: 370 9. How does effect size relate to instrument sensitivity? a. If an instrument is sensitive, it will have a large effect size. b. If an instrument is not very sensitive, it will take a large effect size for the instrument to detect a difference. c. As an instrument is better calibrated and becomes more sensitive, it increases effect size. d. If an instrument is extremely sensitive, it will detect a difference even when none exists; because of this effect sizes must be large.

ANS: B Well-developed instruments measure phenomena with precision. The more sensitive the measurement methods used in a study, the better they will detect even a small effect size. A sensitive instrument does not produce an effectit measures it. Effect size is not altered by calibration of instruments; again, sensitivity does not increase effect size. A legitimate instrument detects a difference when one exists, and only when one exists.

DIF: Cognitive Level: Analysis REF: MCS: 370 10. A teacher is supposed to be randomly assigning her students to experimental and control groups, for participation in a learning project mandated by the school district. She has a master list of the alphabetized students, numbered 1 through 30. Which of the following is the most logical way to randomly assign the students to groups? a. Put numbers 1 to 30 in a hat, draw them out one by one, and put them into alternating groups. b. Place the first 15 subjects in one group and the last 15 in the other group. c. Ignore numbers and let the students choose their groups.

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d. Put numbers 1 to 30 in a hat, draw one, placing it in the experimental group. Then find a student with similar gender, attributes, and abilities, and put that one into the control group. Then go back to the hat for the next experimental subject.

ANS: A Random assignment is similar to random selection in that elements are selected at random from the sampling frame. To achieve simple random sampling, elements are selected at random from the sampling frame. This goal can be accomplished in a variety of ways, limited only by the imagination of the researcher. If the sampling frame is small, the researcher can write names on slips of paper, place the names in a container, mix well, and then draw out one at a time until the desired sample size has been reached. Another technique is to assign a number to each name in the sampling frame. The traditional hat draw is a random method for selection and for assigning.

Placing the students into groups by the alphabet is arbitrary, not random. Allowing students to choose their groups turns the study into a quasi-experimental one. Randomly drawing only the experimental subjects one by one and then finding ones with similar attributes to go into the control group is a kind of matching, not random assignment.

DIF: Cognitive Level: Application REF: MCS: 356 11. Which of the following types of sampling is least common in qualitative research? a. Convenience b. Purposive c. Snowball d. Random ANS: D Nonrandom sampling prevails in qualitative research. Of the five methods in the text, purposive sampling, network sampling, and theoretical sampling are more commonly applied in qualitative studies than in quantitative studies. Convenience and quota sampling may also be used, but they are less common.

DIF: Cognitive Level: Application REF: MCS: 362

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12. A pollster wants to obtain a large sample of voters with the least amount of trouble. Each subject is asked to complete a pencil-paper questionnaire containing seven multiple-choice questions. Each person completing the survey receives a $1-off coupon for a population coffee chain. The pollster decides to stand outside twenty different supermarkets for four hours each and ask patrons to participate in the research. Which method of sampling is this? a. Network or snowball sampling b. Purposive sampling c. Convenience sampling d. Cluster sampling ANS: C Convenience sampling involves the nonrandom selection of subjects who meet criteria and are available and willing to be in the study, or basically subjects who are in the right place at the right time. Thus, this is the easiest, most economic method to obtain a large sample. In purposive sampling, sometimes referred to as purposeful, judgmental, or selective sampling, the researcher consciously selects certain participants, elements, events, or incidents to include in the study. In purposive sampling, qualitative researchers select information-rich cases, or those cases that can teach them a great deal about the central focus or purpose of the study. This is almost exclusively a qualitative sampling strategy. Network or snowball sampling takes advantage of social networks to recruit subjects and is almost exclusively a qualitative sampling strategy. Cluster sampling is a type of random sampling.

DIF: Cognitive Level: Application REF: MCS: 358 13. A researcher contacts seven large hospitals and makes arrangements to recruit 55 patients from each of their emergency rooms. If this is cluster sampling, how were the seven large hospitals chosen? a. By size b. By random selection c. By availability d. By researcher familiarity

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ANS: B In cluster sampling, a sampling frame is developed that includes a list of all the states, cities, institutions, or organizations with which elements of the identified population would be linked.

States, cities, institutions, or organizations are selected randomly as units from which to obtain elements for the sample. In some cases, random selection continues through several stages and is then referred to as multistage cluster sampling.

DIF: Cognitive Level: Application REF: MCS: 361 14. To be considered eligible for the study, subjects had to be older than 21 years of age, hold a valid state drivers license, and be able to fire a shotgun. This is an example of which of the following? a. Inclusion plan b. Population element c. Sampling criteria d. Representativeness ANS: C Sampling criteria, also referred to as eligibility criteria or inclusion criteria, include a list of characteristics essential for membership or eligibility in the target population. The criteria are developed from the research problem, the purpose, a review of literature, the conceptual and operational definitions of the study variables, and the design. The sampling criteria determine the target population, and the sample is selected from the accessible population within the target population DIF: Cognitive Level: Application REF: MCS: 363 15. Five hundred persons were chosen to participate, 270 women and 230 men, representative of the population of Portland, Oregon, treated for congestive heart failure at one of its four main hospitals. Patients were selected using a table of random numbers, from a master list of all patients who had been treated for CHF in the previous three months. This is an example of what type of sampling strategy?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. Simple random sampling b. Convenience sampling c. Purposive sampling d. Stratified random sampling ANS: D Stratified random sampling is used when the researcher knows some of the variables in the population that are critical to achieving representativeness. Variables commonly used for stratification are age, gender, ethnicity, socioeconomic status, diagnosis, geographical region, type of institution, type of care, care provider, and site of care. The variable or variables chosen for stratification need to be correlated with the dependent variables being examined in the study.

Subjects within each stratum are expected to be more alike (homogeneous) in relation to the study variables than they are to be like subjects in other strata or the total sample. In stratified random sampling, the subjects are randomly selected on the basis of their classification into the selected strata.

DIF: Cognitive Level: Application REF: MCS: 359 16. A research study examined the partying styles of students in fraternities, in sororities, living in dorms, and living in private residences. Ten students from each group were included in the research. This is an example of which type of sampling strategy? a. Quota sampling b. Cluster sampling c. Purposive sampling d. Stratified random sampling ANS: A Quota sampling uses a convenience sampling technique with an added feature, a strategy to ensure the inclusion of subject types or strata in a population that are likely to be underrepresented in the convenience sample, such as women, minority groups, the elderly, the poor, the rich, and the undereducated. This method may also be used to mimic the known

Gray Burns and Grove’s The Practice of Nursing Research (9e)

characteristics of the target population or to ensure adequate numbers of subjects in each stratum for the planned statistical analyses. The technique is similar to that used in stratified random sampling but the initial sample is not random.

DIF: Cognitive Level: Application REF: MCS: 364 17. A sample is chosen for a study on average heights and weights of adult males in a major city.

The researcher uses a convenience sampling method, enacting this by going door-to-door in a neighborhood in St. Paul, Minnesota. Unbeknownst to the researcher, this neighborhood is very rich in persons of Norwegian descent, who coincidentally are the tallest Caucasians on the planet. The sampling error that occurs is a result of which of the following? a. Random variance b. Refusal rate c. Systematic bias d. Type II error ANS: C Systematic variation, or systematic bias, is a consequence of selecting subjects whose measurement values are different, or vary, in some specific way from the population. Because the subjects have something in common, their values tend to be similar to those of others in the sample but different in some way from those of the population as a whole. These values do not vary randomly around the population mean. Most of the variation from the mean is in the same direction; it is systematic. All the values in the sample may tend to be higher or lower than the populations mean. Random variation is the expected difference in values that occurs when one examines different subjects from the same sample. If the mean is used to describe the sample, the values of individuals in that sample will not all be exactly the same as the sample mean.

Individual subjects values vary from the value of the sample mean. The difference is random because the value of each subject is likely to vary in a different direction.

DIF: Cognitive Level: Application REF: MCS: 354 18. Which of the following is the nonprobability sampling method?

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a. Cluster b. Quota c. Stratified random d. Systematic ANS: B Four sampling designs have been developed to achieve probability sampling: simple random sampling, stratified random sampling, cluster sampling, and systematic sampling.

DIF: Cognitive Level: Comprehension REF: MCS: 358 19. Convenience sampling + stratification = what? a. Stratified random sampling b. Quota sampling c. Purposive sampling d. Cluster sampling ANS: B Quota sampling uses a convenience sampling technique with an added feature, a strategy to ensure the inclusion of subject types or strata in a population that are likely to be underrepresented in the convenience sample, such as women, minority groups, the elderly, the poor, the rich, and the undereducated. This method may also be used to mimic the known characteristics of the target population or to ensure adequate numbers of subjects in each stratum for the planned statistical analyses.

DIF: Cognitive Level: Synthesis REF: MCS: 364 20. A researcher consented 75 subjects, but 15 dropped out of the study while it was still in progress. What was the sample attrition rate? a. 15

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b. 15% c. 20% d. 75% ANS: C Sample attrition rate formula = number subjects withdrawing sample size 100%.

For example, if a study had a sample size of 160 and 40 people withdrew from the study, the attrition rate would be 25%.

DIF: Cognitive Level: Application REF: MCS: 356 21. A researcher consented 400 subjects, but 12 dropped out of the study before it was completed. The rest finished the study. What was the sample retention rate? a. 388 b. 38.8% c. 3% d. 97% ANS: D Sample retention rate formula = number subjects completing study sample size 100%. DIF: Cognitive Level: Application REF: MCS: 356 22. A researcher attempted to recruit all 150 of the patients seen in the emergency department in a three-month period for diverticulitis, but only 120 consented to participate. What is the sample size? a. 150 b. 120 c. 30 d. 80%

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ANS: B A refusal rate is the number and percentage of subjects who declined to participate in the study.

Patients who refuse to participate are not part of the sample, since they were only potential subjects, not actually included in the sample. The refusal rate is calculated by dividing the number of potential subjects refusing to participate by the number of potential subjects meeting sampling criteria and multiplying the results by 100%.

DIF: Cognitive Level: Application REF: MCS: 355 23. A researcher attempted to recruit all 150 of the patients seen in the emergency department in a three-month period for diverticulitis, but only 120 consented to participate. What is the refusal rate? a. 100% b. 80% c. 20% d. 0% ANS: C A refusal rate is the number and percentage of subjects who declined to participate in the study.

High refusal rates to participate in a study have been linked to individuals with serious physical and emotional illnesses, low socioeconomic status, and weak social networks. The higher the refusal rate, the less the sample is representative of the target population. The refusal rate is calculated by dividing the number of potential subjects refusing to participate by the number of potential subjects meeting sampling criteria and multiplying the results by 100%.

DIF: Cognitive Level: Application REF: MCS: 355 24. Using a table of random numbers, the sample of 400 subjects was selected from the list of the license numbers of all registered nurses in the state of Michigan. Each nurse was sent a letter requesting completion of an online survey on workplace bullying. This is an example of what type of sampling method?

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a. Simple random sampling b. Quota sampling c. Convenience sampling d. Purposive sampling ANS: A To achieve simple random sampling, elements are selected at random from the sampling frame.

This goal can be accomplished in a variety of ways, limited only by the imagination of the researcher. A random number table is effective in selecting numbered elements from a master list. Simple random sampling ensures that each element of the population has an equal and independent chance of being chosen.

DIF: Cognitive Level: Application REF: MCS: 358 25. When grounded theory researchers recruit subjects who can provide relevant information to explain a cluster of interlocking ideas that is unclear to the researchers, what kind of sampling is used? a. Theoretical sampling b. Convenience sampling c. Quota sampling d. Network ANS: A Theoretical sampling is usually applied in grounded theory research to advance the development of a selected theory throughout the research process. The researcher gathers data from any individual or group that can provide relevant data for theory generation. The data are considered relevant if they include information that generates, delimits, and saturates the theoretical codes in the study needed for theory generation.

DIF: Cognitive Level: Synthesis REF: MCS: 366

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26. Which is the sampling design that is an example of a probability sampling method? a. Purposive b. Snowball c. Stratified random d. Quota ANS: D There are several types of nonprobability (nonrandom) sampling designs. Each addresses a different research need. The five nonprobability sampling designs described in this textbook are (1) convenience sampling, (2) quota sampling, (3) purposive or purposeful sampling, (4) network or snowball sampling, and (5) theoretical sampling. These sampling methods are applied in both quantitative and qualitative research. However, convenience sampling and quota sampling are applied more often in quantitative, outcomes, and intervention research than in qualitative studies and are discussed in this section.

DIF: Cognitive Level: Comprehension REF: MCS: 362 MULTIPLE RESPONSE 1. If the population is E, and assuming the researcher selects part of the population as a sample, what could be the sample? (Select all that apply.) a. A b. B c. C d. D e. E ANS: A, B, C, D Sampling involves selecting a group of people, events, behaviors, or other elements with which to conduct a study. A sample denotes the selected group of people or elements included in a

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study sample; it is a subset of the population. Every element of the sample is located within the population. In the diagram, A, B, C, and D are totally contained within E. The sampling criteria determine the target population, and the sample is selected from the accessible population within the target population.

DIF: Cognitive Level: Application REF: MCS: 351 2. A researcher e-mails an online survey about multi-tasking and overcommitedness both on and off the job, as they relate to quality of life, to a random selection of 20,000 RNs in all 50 states; this represents about 1% of the population of RNs. The return rate on the tool is 5%. The goal of this sampling method is to obtain a representative sample. Which of the following are correct statements relative to the samples representativeness? (Select all that apply.) a. Since the topic has to do with having too many things going at once, it is likely that the results will be skewed, since RNs who are vastly overcommitted will not complete the survey. b. The sample is automatically representative if randomly selected names were used for the survey e-mailing. c. If the e-mailed subset of the population was randomly selected and the return meets the number required by power analysis, the return is representative. d. Subjects whose perceived quality of life is either very high or very low may be more inclined to participate, since they have an interest in finding more out about this relationship. e. If the 1,000 subjects who return the survey constitute an insufficient number to demonstrate statistical significance, this means that the sample was not truly representative. f. The sample is so huge, it would certainly be representative of the entire population.

ANS: A, D For a sample to be representative, it must be like the target population in as many ways as possible. It is especially important that the sample be representative in relation to the variables being studied and to other factors that may influence the study variables. Random sampling increases the extent to which the sample is representative of the target population. Even if the

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original sample is random, persons who volunteer or consent to participate in a study may differ in important ways from those who are not willing to participate.

DIF: Cognitive Level: Synthesis REF: MCS: 353 3. What would represent a hypothetical population? (Select all that apply.) a. The average population of New Jersey b. Babies born in taxicabs in New York City in the coming year c. The forty-five subjects whose performance supported the study hypothesis d. The percentage of the subjects who score higher than 81 on the Test of Motor Capability e. All of the high school students at Bountiful High School who will earn their Eagle Scout rank in the academic year 20182019 ANS: B, E A hypothetical population assumes the presence of a population that cannot be defined according to sampling theory rules, which require a list of all members of the population. For example, individuals who successfully lose weight would be a hypothetical population. The number of individuals in the population, who they are, how much weight they have lost, how long they have kept it off, or how they achieved the weight loss is unknown. Some populations are elusive and constantly changing. For example, listing all women in active labor in the United States, all people grieving the loss of a loved one, or all people coming into an emergency department would be impossible to identify.

DIF: Cognitive Level: Application REF: MCS: 352 4. If all of the tickets purchased in this weeks state lottery is considered the population, the five winning tickets drawn on Saturday constitute the sample. If the lottery is not fixed, why is this a probability sample? (Select all that apply.) a. Because according to the laws of probability, the group of five people who won is exactly representative of all of the persons who purchased tickets b. Because each ticket purchased has a chance of being included in the sample

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c. Because the tickets drawn have a high probability of being representative of all tickets purchased d. Because use of random sampling increases the probability that those persons whose tickets win will play the lottery again e. Because each ticket probably has an equal chance of being included in the winning group, whether or not random sampling is used ANS: B, C Probability sampling methods have been developed to ensure some degree of precision in estimations of the population parameters. Thus, probability samples reduce sampling error. The term probability sample refers to the fact that every member (element) of the population has a probability higher than zero of being selected for the sample. Since all tickets have a greater than zero chance of winning, and since the tickets drawn have a very good probability of being representative of all tickets purchased, this is a probability sample.

DIF: Cognitive Level: Synthesis REF: MCS: 357 5. Why are broad sampling criteria preferable for descriptive nursing studies? (Select all that apply.) a. The accessible population is often limited in size. b. They include the sample that is the most representative of the population at that site. c. Broad sampling criteria are preferable for studies conducted in natural settings. d. Broad sampling criteria eliminate more extraneous variables than do narrow sampling criteria. e. Generalization is improved with broad sampling criteria.

ANS: A, B, C, E Broad sampling criteria ensure a large target population of heterogeneous or diverse potential subjects. A heterogeneous sample increases ones ability to generalize the findings to a larger target population. In descriptive or correlational studies, the sampling criteria may be defined to ensure a heterogeneous population with a broad range of values for the variables being studied.

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Descriptive studies are usually conducted with minimal control of the study design, because subjects are examined as they exist in their natural setting, such as home, work, or school.

DIF: Cognitive Level: Synthesis REF: MCS: 352 6. The population parameter for firefighters on Long Island is 79% male. The sample statistic for three fire stations is 73% male. Why wasnt the sample statistic the same as the population parameter? a. Sampling error was present. b. Random variation might have occurred. c. Systematic variation might have occurred. d. The sample was fairly small. e. The sample was not perfectly representative. f. The population parameter is inaccurate.

ANS: A, B, C, D, E The difference between a sample statistic and a population parameter is called the sampling error. A large sampling error means that the sample is not providing a precise picture of the population; it is not representative. Sampling error is usually larger with small samples and decreases as the sample size increases. Sampling error reduces the power of a study, or the ability of the statistical analyses conducted to detect differences between groups or to describe the relationships among variables. Sampling error occurs as a result of random variation and systematic variation.

DIF: Cognitive Level: Application REF: MCS: 354 7. What are the true statements about inclusion and exclusion criteria? (Select all that apply.) a. Inclusion and exclusion criteria determine the demographics of the sample. b. Inclusion and exclusion criteria are the opposites of one another. c. Inclusion and exclusion criteria must be mutually exhaustive. d. Inclusion and exclusion criteria must be mutually exclusive.

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e. Inclusion and exclusion criteria must address the study purpose.

ANS: A, E A study might have inclusion or exclusion sampling criteria (or both). Inclusion sampling criteria are those characteristics that a subject or element must possess to be part of the target population.

Exclusion sampling criteria are those characteristics that can cause a person or element to be excluded from the target population. For age, for instance, excluded if under the age of 18 and included if over the age of 18 are not acceptable exclusion/inclusion criteria because they are not mutually exhaustive: what should the researcher do with someone 18include, or exclude?

Similarly, excluded if 65 or younger and included if 65 or older are not mutually exclusiveagain, what does the researcher do with the 65-year-old?

DIF: Cognitive Level: Analysis REF: MCS: 353 8. Large sample sizes are desirable in which types of research? (Select all that apply.) a. Correlational, using an existent database b. Grounded theory c. Phenomenology d. Pilot interventional research e. Multisite randomized clinical trials f. Survey research g. Model testing h. Case study research ANS: A, E, F, G Descriptive case studies tend to use small samples. Groups are not compared, and problems related to sampling error and generalization have little relevance for such studies. A small sample size may better serve the researcher who is interested in examining a situation in depth from various perspectives. Other descriptive studies, particularly those using survey questionnaires, and correlational studies often require large samples. In the past, quasiexperimental and experimental studies often used smaller samples than descriptive and

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correlational studies. The sample size increases in proportion to the number of variables included in data analysis. In quantitative research, the sample size must be large enough to identify relationships among variables or to determine differences between groups. However, in qualitative research, the focus is on the quality of information obtained from the person, situation, or event sampled versus the size of the sample. The intent is an in-depth understanding of a purposefully selected sample and not the generalization of the findings from a randomly selected sample to a target population, as in quantitative research. The number of participants in a qualitative study is adequate when saturation of information is achieved in the study area.

Grounded theory and phenomenology are types of qualitative research. A pilot study is a smaller version of a proposed study conducted to develop and refine the methodology or intervention hence it uses a smaller sample size.

DIF: Cognitive Level: Synthesis REF: MCS: 369 9. A hospital-based nurse researcher at Hospital A conducts experimental research on a rotating bed and its effect on prevention of pressure ulcers in hip fracture patients over 80 years of age with cognitive functional impairment. Because there are so few patients over 80 with fractured hips and cognitive functional impairment, and because the researcher anticipates problems with obtaining consent, a convenience sample is utilized and every patient who meets the criteria and consents is used in the study. The bed, although expensive, is found to be much more effective in preventing pressure ulcers in this population than is turning alone. The study is published. What are the implications of applying these findings, considering the researchers use of a convenience sample? (Select all that apply.) a. The findings can be applied to similar patients who come to Hospital A, with the understanding that data collection will continue and represent a second study, since the research is unreplicated. b. The findings may be applicable to similar patients who come to Hospital B, but without replication, this use cannot be mandated in the research report. c. The rotating bed should not be used outside of Hospital A at all until a replication study is conducted. d. The study findings probably represent a type I error. It is doubtful that use of a rotating bed could produce significant findings with a convenience sample. e. The widespread use of the rotating bed has not been supported.

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f. Generalization is appropriate only extremely cautiously and in the same site in which the study was conducted, with tracking of subsequent data.

ANS: A, B, E, F In convenience sampling, any patients who meet the inclusion criteria are recruited for the study.

Convenience sampling is considered a weak approach to sampling because it provides little opportunity to control for biases. Multiple biases may exist in convenience sampling; these biases range from minimal to serious. Additional studies with large convenience samples that have similar results would indicate the effectiveness of this intervention for practice. Studies with small convenience samples should be replicated to determine the accuracy of the findings and to increase the representation of the population studied. If findings are consistent over replications, then generalization to a larger group is possible.

DIF: Cognitive Level: Analysis REF: MCS: 363 10. Why are convenience samples used so frequently in nursing research? (Select all that apply.) a. More subjects consent if they can understand the sampling method. b. Obtaining a true random sample may be impossible. c. There is low risk of sampling bias. d. There are limited subjects available. e. Nonrandom sampling affects only generalizability, not study integrity.

ANS: A, D, E The majority of nursing studies use nonprobability sampling, especially convenience sampling, to select study samples. In conducting studies in nursing and other health disciplines, there are limited subjects available and often a random sample is not possible to obtain. Researchers often include any subjects willing to participate who meet the eligibility criteria. Nonrandom sampling affects only generalizability, not any other type of validity.

DIF: Cognitive Level: Analysis REF: MCS: 362

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11. If researchers are attempting to recruit subjects who are members of a group is not mainstream and may be disdained, why is snowball sampling often used? a. It is less time-consuming than other methods, for hard-to-access populations. b. It produces a sample that is more representative. c. It increases recruitment success. d. It produces a more diverse sample. e. It increases generalizability.

ANS: A, C Network sampling, which also is referred to as snowball or chain sampling, holds promise for locating samples difficult or impossible to obtain in other ways or who had not been previously identified for study. Network sampling takes advantage of social networks and the fact that friends tend to have characteristics in common.

DIF: Cognitive Level: Evaluation REF: MCS: 353 12. Why would a researcher use an elimination criterion like Must not have baseline liver function tests that are outside the normal range? (Select all that apply.) a. Impaired liver function may have been identified by the researcher as an extraneous variable. b. The intervention planned by the researcher could have an adverse effect on individuals with impaired liver function. c. Liver function tests are possibly being measured in order to detect the independent variables effect on the dependent variable. d. The researcher is attempting to eliminate persons with all lab tests that are outside normal range. e. The dependent variable may be abnormally elevated in persons who do not have normal liver function.

ANS: A, B, C, E

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Exclusion sampling criteria are those characteristics that can cause a person or element to be excluded from the target population. The usual reasons for exclusion criteria are that they are extraneous variables and, if present, they could affect the value of the dependent variable. Other reasons might include increased risk for some groups.

DIF: Cognitive Level: Synthesis REF: MCS: 353 13. Performing a power analysis allows the researcher to calculate adequate sample size. Why is this preferable to accomplish in the design phase of a quantitative study? (Select all that apply.) a. A sample of sufficient size maximizes the chance of detecting statistical significance. b. Performing a power analysis increases the researchs potential for publication. c. Conducting a power analysis decreases the chance of a type I error. d. Conducting a power analysis increases effect size. e. The institutional review paperwork must include a maximum sample size.

ANS: A, E The deciding factor in determining an adequate sample size for correlational, quasi-experimental, and experimental studies is power. Power is the capacity of the study to detect differences or relationships that actually exist in the population. Expressed another way, power is the capacity to correctly reject a null hypothesis. Often the minimum acceptable power for a study is 0.80. If a researcher does not have sufficient power to detect differences or relationships that exist in the population, one might question the advisability of conducting the study. Therefore, it is advisable to conduct the power analysis in the design phase so as to ensure an adequate sample size is obtained. One of the items required by the Institutional Review Board is a description of the subjects the researcher plans to use in the study. This includes the maximum number of subjects anticipated.

DIF: Cognitive Level: Evaluation REF: MCS: 367 14. The researcher conducts a qualitative study that explores the feelings of nurses who care for victims of intentional burning. What sampling methods are most appropriate for this study?

(Select all that apply.)

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a. Quota sampling b. Purposive sampling c. Cluster sampling d. Stratified random sampling e. Systematic sampling f. Snowball sampling g. Theoretical sampling ANS: B, F, G Purposive sampling, network sampling, and theoretical sampling are used more frequently in qualitative studies than in quantitative studies. In purposive sampling, sometimes referred to as purposeful, judgmental, or selective sampling, the researcher consciously selects certain participants, elements, events, or incidents to include in the study. In purposive sampling, qualitative researchers select information-rich cases, or those cases that can teach them a great deal about the central focus or purpose of the study. Network sampling, sometimes referred to as snowball or chain sampling, holds promise for locating samples who are difficult or impossible to obtain in other ways or who had not been previously identified for study. Network sampling takes advantage of social networks and the fact that friends tend to have characteristics in common. Theoretical sampling is usually applied in grounded theory research to advance the development of a selected theory throughout the research process (Munhall, 2012). The researcher gathers data from any individual or group that can provide relevant data for theory generation.

DIF: Cognitive Level: Application REF: MCS: 362 15. Why are convenience samples used so frequently in nursing research, when a random sample would allow for greater generalizability? (Select all that apply.) a. Convenience sampling allows researchers to select not only subsets but qualities associated with them. b. Key informants are desired. c. Random sampling is really not an issue, since little nursing research is replicated.

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d. Subjects are difficult to recruit when they are ill. e. Nurses are limited to the populations they serve; many populations are small and difficult to access.

ANS: D, E Thus, nonprobability sampling methods increase the likelihood of obtaining samples that are not representative of their target populations. However, the majority of nursing studies use nonprobability sampling, especially convenience sampling, to select study samples. In conducting studies in nursing and other health disciplines, there are limited subjects available and often a random sample is not possible to obtain. Researchers often include any subjects willing to participate who meet the eligibility criteria.

DIF: Cognitive Level: Synthesis REF: MCS: 362 16. A study has a power level of .75. What does that mean? (Select all that apply.) a. Study interventions will be statistically significant 75% of the time. b. The study has a 75% chance of detecting differences if they exist. c. The studys sample has a 25% attrition rate, at worst. d. There is a 25% chance of detecting a type I error. e. There is a 25% chance that the study will fail to reveal differences that actually exist.

ANS: B, E Power is the capacity of the study to detect differences or relationships that actually exist in the population. Expressed another way, power is the capacity to correctly reject a null hypothesis.

The minimum acceptable power for a study is commonly recommended to be 0.80 (80%).

However, the researcher can set this lower, if the researcher is willing to risk a larger likelihood of a type II error.

DIF: Cognitive Level: Application REF: MCS: 367

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17. Which of the following are true statements related to determination of minimum sample size? (Select all that apply.) a. In inferential quantitative research, power analysis drives sample size. b. In pilot research, ability to address the purpose for the pilot drives sample size. c. In descriptive research, availability of subjects drives sample size. d. In both quantitative and qualitative research, available funding drives sample size. e. In qualitative research, theoretical saturation drives sample size.

ANS: A, B, C, E Currently, the deciding factor in determining an adequate sample size for correlational, quasiexperimental, and experimental studies is power. Power is the capacity of the study to detect differences or relationships that actually exist in the population. Determining the sample size needed to obtain sufficient power is made by performing a power analysis. In descriptive or descriptive correlational research conducted in a natural setting, it is usual to include all available subjects.Sample size in both quantitative and qualitative research should be determined by the researchers available funding. The number of participants in a qualitative study is adequate when saturation of information is achieved in the study area, which occurs when additional sampling provides no new information, only redundancy of previously collected data. A pilot studys sample size is very smalljust enough to address the reason the pilot was conducted. For instance, a small pilot study can be performed to measure the effect size, so that the researchers can perform an informed power analysis for the subsequent quantitative study, estimating its required sample size appropriately.

DIF: Cognitive Level: Synthesis REF: MCS: 367 18. Why is a large refusal rate a barrier to widespread generalization? (Select all that apply.) a. If a study has a refusal rate higher than thirty percent, it is no longer considered research. b. If researchers cannot recruit subjects into their research studies, their credibility and ethics are under serious scrutiny.

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c. The actual sample is not representative of the population. It is representative only of the elements of the population that chose to participate. d. If many persons refuse to participate, they might refuse to participate in interventions that the study recommends.

ANS: A, B, C Sampling theory was developed to determine mathematically the most effective way to acquire a sample that would accurately reflect the population under study. For a sample to be representative, it must be like the target population in as many ways as possible. It is especially important that the sample be representative in relation to the variables being studied and to other factors that may influence the study variables. A sample must be representative of the demographic characteristics, such as age, gender, ethnicity, income, and education, which often influence study variables. The accessible population must be representative of the target population. If the accessible population is limited to a particular setting or type of setting, the individuals seeking care at that setting may be different from those who would seek care for the same problem in other settings or from those who choose to use self-care to manage their problems. Representativeness is usually evaluated through comparison of the numerical values of the sample (a statistic such as the mean) with the same values from the target population.

DIF: Cognitive Level: Synthesis REF: MCS: 353 19. Why is survey research subject selection considered nonrandom? (Select all that apply.) a. If monetary reward is offered as an inducement, subjects may participate only to get the reward. The sample may include fewer people who are well off financially. b. There is no direct contact with the subjects. c. Follow-up reminders make recruitment long and drawn-out. d. Inducements are essentially manipulative; potential subjects who resent manipulation refuse to return surveys. e. Refusal rates average 50% or more, and this makes the sample nonrepresentative.

ANS: A, D, E

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In conducting a survey study, the researcher may never have personal contact with the subjects.

To recruit such subjects, one must rely on the use of attention-getting techniques, persuasively written material, and strategies for following up on individuals who do not respond to the initial written or e-mail communication. Because of the serious problems of low response rates in survey studies, using strategies to raise the response rate is critical. In some cases, small amounts of money ($1 to $5 dollars) are enclosed with the letter. This may produce a feeling of obligation on the part of the potential participant. Survey research return rate varies from 5% through about 50% for most studies. Interestingly, the accuracy of responses in survey research is slightly better with a lower return!

DIF: Cognitive Level: Comprehension REF: MCS: 376 20. Inclusion criteria differ from sample characteristics. Which of the following are sample characteristics from a study conducted in a neurosurgical critical care unit of a major hospital? (Select all that apply.) a. Mean age 62, with range from 37 through 87 b. Diagnosed with neurologic impairment due to trauma or disease c. Glasgow Coma Scale range 4 to 15 d. Twenty-one male, nineteen female e. Able to speak English or Spanish ANS: A, C, D Inclusion criteria are those characteristics that a subject or element must possess to be part of the target population. Sample characteristics are a description of the subjects who participated in the study; in a nursing study, these often contain information about age, gender, diagnosis, and medical condition.

DIF: Cognitive Level: Synthesis REF: MCS: 351 21. Inclusion criteria differ from sample characteristics. Which of the following are inclusion criteria for a study conducted on an acute care ward of a major hospital? (Select all that apply.)

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a. Mean age 62, with range from 37 through 87 b. Twenty-four male, twelve female c. Glasgow Coma Scale of at least 14 d. Twenty-one post hip replacement, fifteen post knee replacement e. Able to read and write English ANS: C, E Inclusion criteria are those characteristics that a subject or element must possess to be part of the target population. They are like a list of what you are fishing for when you go out in a boat.

Sample characteristics are a description of the subjects who participated in the study; in a nursing study, these often contain information about age, gender, diagnosis, and medical condition. They are like a list of what fish you caught on the fishing trip.

Chapter 16. Measurement Concepts MULTIPLE CHOICE 1. A shepherd in the wilds of eastern Nevada is counting his sheep at the end of a work day.

What is another term for what he is doing? a. Estimating random error b. Measuring c. Using an interval level of measurement d. Calculating risk ratios ANS: B Measurement is the process of assigning numbers to objects, events, or situations in accord with some rule. The numbers assigned can indicate numerical values or categories for the objects being measured for research or practice.

DIF: Cognitive Level: Application REF: MCS: 382

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2. What kind of reliability testing is used extensively in qualitative research? a. Equivalence reliability b. Stability reliability c. External consistency d. Internal consistency ANS: A Equivalence reliability compares two versions of the same paper-and-pencil instrument or two observers measuring the same event. Determining interrater reliability is a concern when studies include observational measurement, which is common in qualitative research. Interrater reliability values need to be reported in any study in which observational data are collected or judgments are made by two or more data gatherers. Consequently, it is used in various types of qualitative research in which data or behaviors are coded.

DIF: Cognitive Level: Analysis REF: MCS: 390 3. Why would interrater reliability be measured in a quantitative research project? a. A verbal quantitative questionnaire is filled out. b. Behavior is observed and classified. c. Phenomenology is the research method. d. Distances are measured.

ANS: B Determining interrater reliability is a concern when studies include observational measurement, which is common in qualitative research. Interrater reliability values need to be reported in any study in which observational data are collected or judgments are made by two or more data gatherers. Consequently, it is used in various types of qualitative research in which data or behaviors are coded or classified.

DIF: Cognitive Level: Analysis REF: MCS: 390

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4. What is the purpose of determining an instruments internal consistency? a. It establishes face validity. b. It demonstrates that the instrument is measuring exactly what the researcher thinks it is measuring. c. It decreases measurement error. d. It is a way of establishing test-retest reliability.

ANS: D Tests of instrument internal consistency or homogeneity, used primarily with paper-and-pencil tests or scales, address the correlation of various items within the instrument. The original approach to determining internal consistency was split-half reliability. This strategy was a way of obtaining test-retest reliability without administering the test twice.

DIF: Cognitive Level: Application REF: MCS: 391 5. A new tool and very short tool is developed. It is to be used instead of a previously validated tool that is very long to administer. What kind of validity concept will be used for testing this new tool? a. Divergent validity b. Convergent validity c. Discriminant analysis d. Content validity ANS: B In examining the validity of the new instrument, it is important to determine how closely the existing instruments measure the same construct as the newly developed instrument (convergent validity). Divergent validity would measure the differences in measurement, between an existing instrument and a newly-developed one. Discriminant analysis measures the difference between two related but not identical concepts. Content validity is the extent to which a measurement represents the concept being measured.

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DIF: Cognitive Level: Application REF: MCS: 400 6. Which one of the following instructions to the research subject will provide the highest possible level of measurement? a. Indicate whether your income is above $20,000 a year or not. b. What was your income last year: $0$20,000; $20,000$60,000; $60,000$100,000; or more than $100,000? c. What was your total income last year, before taxes? Enter amount: d. Did you earn money last year?

ANS: C An important rule of measurement is that one should use the highest level of measurement possible. For example, you can collect data on age (measured) in a variety of ways: (1) you can obtain the actual age of each subject (ratio level of measurement); (2) you can ask subjects to indicate their age by selecting from a group of categories, such as 2029, 3039, and so on (ordinal level of measurement); or (3) you can sort subjects into two categories of under 65 years of age and 65 years of age and older (nominal level of measurement).

DIF: Cognitive Level: Application REF: MCS: 387 7. A band is in on a multi-city tour, and souvenir shirts are ordered from a factory. They are shipped without the size labels. The vendor must then sort them into sizesapparently they are small, medium, large, extra-large, and extra-extra-large. What level of measurement is this? a. Nominal b. Ordinal c. Interval d. Ratio ANS: B Data that can be measured at the ordinal level can be assigned to categories of an attribute that can be ranked. Nominal level of measurement is the lowest of the four measurement levels or

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categories. It is used when data can be organized into categories of a defined property but the categories cannot be ordered. It merely names. In interval level of measurement, distances between intervals of the scale are numerically equal. Interval scales are assumed to be a continuum of values. They are almost exclusively manmade scales, measures, inventories, and so forth. Ratio level of measurement is the highest form of measure and meets all the rules of the lower forms of measures. It uses the real number scale, on which zero means none of the variable being measured.

DIF: Cognitive Level: Application REF: MCS: 386 8. A secretary in a veterinarians office keeps track of how many animals come in for care in a weeks time and what types of animals they are: cat, dog, horse, gerbil, duck, snake, and so forth. What level of measurement is this? a. Nominal b. Ordinal c. Interval d. Ratio ANS: A Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when data can be organized into categories of a defined property but the categories cannot be ordered. It merely names. Data that can be measured at the ordinal level can be assigned to categories of an attribute that can be ranked. In interval level of measurement, distances between intervals of the scale are numerically equal. Interval scales are assumed to be a continuum of values. They are almost exclusively manmade scales, measures, inventories, and so forth. Ratio level of measurement is the highest form of measure and meets all the rules of the lower forms of measures. It uses the real number scale, on which zero means none of the variable being measured.

DIF: Cognitive Level: Application REF: MCS: 386 9. Mark is in third grade and has just learned how to use a ruler to measure. He has become a measuring fool. He measures everything in the house, writing down all the measurements, and

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gaily announcing to his mom, Hey, Mom. Guess what? The salt shaker is four and a quarter inches tall. What level of measurement is this? a. Nominal b. Ordinal c. Interval d. Ratio ANS: D Ratio level of measurement is the highest form of measure and meets all the rules of the lower forms of measures. It uses the real number scale, on which zero means none of the variable being measured. Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when data can be organized into categories of a defined property but the categories cannot be ordered. It merely names. Data that can be measured at the ordinal level can be assigned to categories of an attribute that can be ranked. In interval level of measurement, distances between intervals of the scale are numerically equal. Interval scales are assumed to be a continuum of values. They are almost exclusively manmade scales, measures, inventories, and so forth.

DIF: Cognitive Level: Application REF: MCS: 387 10. Depression is measured by the Beck Depression Inventory, which adds up scores from 21 items to provide a total value ranging from 0 to 63. What level of measurement is this? a. Nominal b. Ordinal c. Interval d. Ratio ANS: C In interval level of measurement, distances between intervals of the scale are numerically equal.

Interval scales are assumed to be a continuum of values. They are almost exclusively manmade

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scales, measures, inventories, and so forth. Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when data can be organized into categories of a defined property but the categories cannot be ordered. It merely names. Data that can be measured at the ordinal level can be assigned to categories of an attribute that can be ranked.

Ratio level of measurement is the highest form of measure and meets all the rules of the lower forms of measures. It uses the real number scale, on which zero means none of the variable being measured.

DIF: Cognitive Level: Application REF: MCS: 387 11. Inclusion criteria and exclusion criteria in sample selection are mutually exclusive and mutually exhaustive. A researcher has a list of all of the studys inclusion and exclusion criteria.

These then must be sorted into an inclusion list and an exclusion list. The method of sorting may be considered a. Nominal b. Categorical c. Interval d. Ratio ANS: A Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when data can be organized into categories of a defined property but the categories cannot be ordered. A study might have inclusion or exclusion sampling criteria (or both). Inclusion sampling criteria are those characteristics that a subject or element must possess to be part of the target population. Exclusion sampling criteria are those characteristics that can cause a person or element to be excluded from the target population. For age, for instance, excluded if under the age of 18 and included if over the age of 18 are not acceptable exclusion/inclusion criteria because they are not mutually exhaustive: what should the researcher do with someone 18include, or exclude? Similarly, excluded if 65 or younger and included if 65 or older are not mutually exclusiveagain, what does the researcher do with the 65-year-old?

DIF: Cognitive Level: Evaluation REF: MCS: 386

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12. A student finds a tool that measures adaptability that she wants to use for her masters thesis. It has 25 items, and they are all of the ordinal level, scaled 0 through 5. The level of measurement of the tool is said by its authors, pragmatics all, to be which of the following? a. Ratio level b. Interval level c. Ordinal level d. Nominal level ANS: D Pragmatists often treat ordinal data from multiple item scales as interval data, using statistical methods to analyze them such as the Pearsons Product-Moment Correlation Coefficient, t-test, and analysis of variance (ANOVA), which are traditionally reserved for interval or ratio level data. Fundamentalists insist that the analysis of ordinal data be limited to statistical procedures designed for ordinal data, such as nonparametric procedures.

DIF: Cognitive Level: Analysis REF: MCS: 388 13. Interval scales of measurement (IQ tests, anxiety inventories, mental status exams) are products of mans invention how frequently? a. Never b. Sometimes c. Frequently d. Always ANS: D In interval level of measurement, distances between intervals of the scale are numerically equal.

Such measurements also follow the previously mentioned rules: mutually exclusive categories, exhaustive categories, and rank ordering. Interval scales are assumed to be a continuum of values. Thus, the researcher can identify the magnitude of the attribute much more precisely.

However, it is not possible to provide the absolute amount of the attribute because of the absence

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of a zero point that really means zero on the interval scale. Interval scales are commonly used for surveys, scales, and inventories.

DIF: Cognitive Level: Analysis REF: MCS: 387 14. Tests of stability reliability, such as test-retest, can reveal random measurement error. Why is systematic measurement error not revealed when stability reliability determinations are made? a. Actually, reliability testing does not reveal the type of error: differences on testretest can indicate problems with both random and systematic measurement error. b. Tests of stability reliability are not powerful enough to pick up systematic measurement error because of its subtlety. c. If an instrument systematically measures all blood pressures 10 points high, it will do so both at baseline and on retesting. d. The direction of the systematic measurement error is reversed on retesting, so it is not visible in the statistical analysis.

ANS: C Stability reliability is concerned with the consistency of repeated measures of the same attribute with the use of the same scale or instrument over time. It is usually referred to as test-retest reliability. This measure of reliability is generally used with physical measures, technological measures, and paper-and-pencil scales. The technique requires an assumption that the factor to be measured remains the same at the two testing times and that any change in the value or score is a consequence of random error.

DIF: Cognitive Level: Analysis REF: MCS: 389 15. Specificity of an instrument used for diagnosis refers to what? a. Its ability to detect error b. Its ability to detect the presence of a condition or illness c. Its ability to detect the absence of a condition or illness d. Its true positives minus its false negatives ANS: C

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Specificity of a screening or diagnostic test is the proportion of patients without the disease who have a negative test result or true negative. A test with high specificity is very good at identifying the patient without any disease.

DIF: Cognitive Level: Comprehension REF: MCS: 407 MULTIPLE RESPONSE 1. Which of the following must be measured indirectly? (Select all that apply.) a. Number of miles from San Francisco to Disneyland b. Level of consciousness c. Height d. Hope e. Liver function ANS: A, D, E An abstract concept is not measured directly; instead, indicators or attributes of the concept are used to represent the abstraction. This is referred to as indirect measurement. In addition, hardto-access physiologic and behavioral variables and huge quantities may be measured indirectly.

DIF: Cognitive Level: Application REF: MCS: 383 2. Which of the statements is true, relative to error? (Select all that apply.) a. True score plus error score equals observed score. b. Random error of measurement increases the mean. c. The mean of the true measurements is equal to the mean of the observed measurements when there is no systematic error. d. No measurement of anything is ever correct. e. Measurement error always exists, if a straightforward measurement like counting is made often enough and by enough people.

ANS: A, C, E

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Observed score = true score + random error. Random error does not influence the mean to be higher or lower but, rather, increases the amount of unexplained variance around the mean.

Measurement error is the difference between what exists in reality and what is measured by an instrument.

DIF: Cognitive Level: Analysis REF: MCS: 383 3. Which of the statements is true relative to systematic error? (Select all that apply.) a. If the amount of the systematic error is known, true scores can be retrieved. b. Systematic error may be decreased by proper instrument calibration. c. Systematic error results in values that vary in one direction from the true scores. d. Systematic error results from researcher fatigue or inattention. e. Systematic error changes the mean but not the relative magnitude of the variance.

ANS: A, B, C, E Observed score = true score + systematic error. Measurement error that is not random is referred to as systematic error. For example, a scale that weighed subjects three pounds more than their true weights demonstrates systematic error. All of the body weights would be higher, and, as a result, the mean would be higher than it should be. Systematic error results in error in one direction. Consequently, the mean is either higher or lower, but the relative magnitude of the variance should remain the same. Systematic error occurs because something else is being measured in addition to the concept.

DIF: Cognitive Level: Analysis REF: MCS: 383 4. What is the true statement, related to stability reliability? (Select all that apply.) a. It is useful for establishing the validity of a physiologic measure. b. It establishes the consistency of repeated measures of the same attribute with the use of the same scale or instrument over time. c. It reveals random error but not systematic error. d. It is sometimes referred to as test-retest reliability.

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e. It may be difficult to interpret whether a measurement has unacceptable stability reliability or whether maturation has affected subjects responses.

ANS: B, C, D, E Stability reliability is concerned with the consistency of repeated measures of the same attribute with the use of the same scale or instrument over time. It is usually referred to as test-retest reliability. Because it measures the same variable in the same manner, it reveals only random error, not systematic error. Test-retest reliability requires the assumption that the factor being measured has not changed between the measurement points. Many of the phenomena studied in nursing, such as hope, coping, pain, and anxiety, do change over short intervals. Thus, it is difficult to determine whether change represents measurement error or valid change.

DIF: Cognitive Level: Analysis REF: MCS: 389 5. For a multimethod measure, a researcher measures anxiety using a 0- to 10-point verbal scale, the Spielberger State-Trait Anxiety Inventory (0 to 40 points), and systolic blood pressure readings (80 to 300 points). What are logical strategies for using these three pieces of information gathered from each subject? (Select all that apply.) a. Add up all three numbers for a total score. b. Rank all three measures as 1-high, 2-medium, and 3-low, and sum the result. c. Determine the most accurate measurement and give it more weight than the others in a ranking. d. Determine the most accurate measurement in the first few subjects and then use it exclusively. e. Report the numbers individually without summing them.

ANS: B, D, E Another effective means of diminishing systematic error is to use more than one measure of an attribute or a concept and to compare the measures. To make this comparison, researchers use a variety of data collection methods, such as scale, interview, and observation. Campbell and Fiske developed a technique of using more than one method to measure a concept, referred to as the multimethod-multitrait technique. Multimethod measurement strategies decrease systematic error

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by combining the values in some way to give a single observed score of anxiety for each subject.

Sometimes, however, it may be difficult logically to justify combining scores from various measures.

DIF: Cognitive Level: Application REF: MCS: 384 6. A researcher administers a test of hopelessness to 50 teen mothers in a continuation high school, in order to norm it for a study planned for the subsequent semester. This norming process is part of the approved research protocol. Retesting in two weeks reveals different values for many of the subjects paired tests. What should the researcher do now, and why? (Select all that apply.) a. Administer the test a third time and see whether there is a trend. The subjects may be becoming more/less hopeless because of an external factor or a Hawthorne effect. b. Calculate statistical tests to determine whether there are about the same amounts of positive change and negative change for the pooled sample, and whether the means are very similar for the two measurements. If so, this represents normal fluctuation of mood. c. After obtaining IRB approval for study revision, ask several of the 50 subjects with large changes about their recent experiences and discover whether there is an underlying reason for the change. d. Use the second value, not the first, for all data analysis. The subjects have evidently re-examined their feelings and discovered new insights. e. Consider the multitrait-multimethod technique for this complex concept. A single measurement doesnt seem to be capturing the concept very well.

ANS: A, B, C, E Stability reliability is concerned with the consistency of repeated measures of the same attribute with the use of the same scale or instrument over time. It is usually referred to as test-retest reliability. Test-retest may include an additional retest, especially when an unanticipated event has occurred. A third measurement may capture the Hawthorne effect. To capture a complex concept, researchers use the multimethod-multitrait technique, or even a mixed methods design, employing a variety of data collection methods, such as scale, interview, and observation. These techniques allow researchers to measure more dimensions of abstract concepts, and the effect of

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the systematic error on the composite observed score decreases. Subjects knowledge of a study could influence their behavior and possibly alter the research outcomes. This threatens the validity or accuracy of the measurements. This change could be due to normal random measurement error. If so, the sum of the error (the measured change) for all subjects should be zero, and the means on the two days should be the same. Random error does not influence the mean to be higher or lower but, rather, increases the amount of unexplained variance around the mean.

On the other hand, test-retest reliability requires the assumption that the factor being measured has not changed between the measurement points. Many of the phenomena studied in nursing, such as hope, coping, pain, and anxiety, do change over short intervals. Perhaps true change has occurred.

DIF: Cognitive Level: Analysis REF: MCS: 389 7. A researcher administers a 40-item instrument that measures anxiety of 30 mothers of 9month-old triplets, repeating it in two weeks. Over half of the scores are higher. Why? (Select all that apply.) a. The mothers are more anxious. The babies are becoming more mobile, and the mothers anxiety is well founded. b. There may have been random error of measurement. The researcher should compare the group means; if they are the same, it is only random error. c. This may represent systematic error of measurement. d. This may have poor validity for this population and concept. e. This test may have poor reliability for this population and concept.

ANS: A, B, E Stability reliability is concerned with the consistency of repeated measures of the same attribute with the use of the same scale or instrument over time. It is usually referred to as test-retest reliability. It reveals random error of measurement. This change in scores could be due to normal random measurement error. If so, the sum of the error (the measured change) for all subjects should be zero, and the means on the two days should be the same. Random error does not influence the mean to be higher or lower but, rather, increases the amount of unexplained

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variance around the mean. Systematic error is not revealed on test-retest. Test-retest does not measure validity but reliability. On the other hand, test-retest reliability requires the assumption that the factor being measured has not changed between the measurement points. Many of the phenomena studied in nursing, such as hope, coping, pain, and anxiety, do change over short intervals.

DIF: Cognitive Level: Analysis REF: MCS: 389 8. A lab scientist is attempting to develop a screening tool that will detect leukemia before children show any symptoms of the disease, because it is most curable in its early stages. The scientist wants a test that will detect all children, whether or not it produces some false positives.

What does the researcher want in terms of that new screening tool? (Select all that apply.) a. Maximum specificity b. A high LR c. Maximum sensitivity d. A high LR+ e. High interrater reliability ANS: A, D Sensitivity is the ability of a test or diagnostic tool to detect patients with the disease. This is referred to as a true positive. Specificity is the ability of a test or diagnostic tool to detect patients without the disease. This is referred to as a true negative. A test with high sensitivity is very good at identifying the diseased patient. A high positive Likelihood Ratio makes a positive diagnosis almost certain. A high negative Likelihood Ratio makes a negative diagnosis almost certain.

Chapter 17. Measurement Methods Used in Developing Evidence-Based Practice Test Bank MULTIPLE CHOICE

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1. In a study of teasing among third-graders, after an intervention on peer interactions, behavioral observers collect the data, rating six behaviors on a 0- to 4-point scale. The observers are not trained by the same person, and there is no measure of interrater reliability. What is likely to happen? a. The variable of teasing will not be measured accurately. b. Peer interactions will not be able to be rated. c. The data will have to be scored independently by the researcher. d. Comparison with norms is unlikely.

ANS: A Every variable must be measured in the same way, every time, or the results of the measurement will not be accurate. Measuring physiological variables using observation requires a quality tool for data collection and consistent use of this tool by data collectors. Thus, if the observations in a study are being conducted using multiple data collectors, it is essential that the consistency or interrater reliability of the data collectors be determined.

DIF: Cognitive Level: Application REF: MCS: 413 2. A researcher plans to conduct interviews with the first four participants in a qualitative study, and then the researcher plans to have an assistant conduct several interviews for the remainder of the interviews. The first thing the researcher does with the research participants is to perform a pilot interview on one participant and to have the assistant conduct a pilot interview on a different participant, and then they compare notes, discussing the process. Why is this a good idea? a. This establishes interrater reliability. b. Their styles may differ, and this way they can imitate one anothers styles. c. Pretesting of the interview protocol is essential. d. They can begin the process of data analysis at once.

ANS: C

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Interviews involve verbal communication between the researcher and the study participant, during which the researcher acquires information. Interviewers must be trained in the skills of interviewing, and the interview protocol must be pretested.

DIF: Cognitive Level: Application REF: MCS: 422 3. A researcher is interested in discovering whether the topics of written family complaints are shared by the majority of patients families in a major university hospital, or whether merely a minority of the patients families are disgruntled. The researcher goes throughout the hospital each day and hands family members a printed form and pencil and asks them to answer the ten questions, all of which have three to five responses, in return for a $3 off coupon to be used in the hospital cafeteria. What is this printed form called? a. A questionnaire b. A Likert scale c. A semantic differential scale d. An interview ANS: A Questionnaires are printed self-report forms designed to elicit information that can be obtained from a subjects written responses. Likert scales determine opinion or attitude and contain a number of declarative statements with a scale after each statement. Semantic differential scales consist of two opposite adjectives with a seven-point scale between them. The subject is to select one point on the scale that best describes his or her view of the concept being examined.

Interviews involve verbal communication during which the subject provides information to the researcher.

DIF: Cognitive Level: Application REF: MCS: 422 4. An outpatient being treated in the infusion center for thalassemia is asked to fill out a form about satisfaction with the center, while he waits for his appointment. The form consists of five questions, each a statement, with six possibilities after it: Strongly Agree, Agree, Slightly Agree, Slightly Disagree, Disagree, and Strongly Disagree. This is an example of which of the following?

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a. A semantic differential scale b. A Likert scale c. A questionnaire d. A paper interview ANS: B A Likert scale determines the opinion or attitude of a subject and contains a number of declarative statements with a scale after each statement. The Likert scale is the most commonly used of the scaling techniques in nursing and health care studies. Response choices in a Likert scale most commonly address agreement, evaluation, or frequency. Agreement options may include statements such as strongly agree, agree, uncertain, disagree, and strongly disagree.

DIF: Cognitive Level: Application REF: MCS: 430 5. A researcher constructs a semantic differential scale that will measure a topic about which people express extreme responses. He pilots it and, at the same time, asks a psychometrician to give his opinion on the scale. The psychometrician suggests that the researcher edit the scale, so that it has some questions for which a 1 or 2 would be a positive finding, and some questions for which a 1 or 2 would be a negative finding. The researcher edits the scale and finds that subjects responses are not quite as extreme as they were originally. What should the researchers response be? a. Resentment. The new scale is giving weaker results, and its analysis will not be able to show statistical significance unless the projected sample size is increased. b. Bewilderment. The scale is exactly the same; the items were merely rearranged. There is nothing that explains this change. c. Gratitude. The new scale measures the concept better because the subjects are thinking about the individual items instead of marking extremes automatically. d. Annoyance. The researcher has probably inadvertently reworded some of his original items, accounting for the less extreme values.

ANS: C

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A semantic differential scale consists of two opposite adjectives with a seven-point scale between them. The subject is to select one point on the scale that best describes his or her view of the concept being examined. The scale is designed to measure the connotative meaning of the concept to the subject. Although the adjectives may not seem to be particularly related to the concept being examined, the technique can be used to distinguish varying degrees of positive and negative attitudes toward a concept. In a semantic differential scale, values from 1 to 7 are assigned to each of the spaces, with 1 being the most negative response and 7 the most positive.

Placement of negative responses to the left or right of the scale should be randomly varied to avoid global responses (in which the subject places checks in the same column of each scale).

DIF: Cognitive Level: Analysis REF: MCS: 431 6. A nurse believes that patient acuity is a poor measure of patient fragility. Consequently, he and another nurse construct an instrument that measures patient fragility. In what order should the various steps of scale testing, conceptual definition, scale construction, instrument validation, and qualitative exploration occur? a. Scale testing, qualitative exploration, scale construction, conceptual definition, instrument validation b. Conceptual definition, qualitative exploration, scale construction, scale testing, instrument validation c. Scale construction, conceptual definition, instrument validation, scale testing, qualitative exploration d. Instrument validation, qualitative exploration, scale construction, conceptual definition, scale testing e. Qualitative exploration, scale testing, scale construction, conceptual definition, instrument validation f. Conceptual definition, instrument validation, scale construction, scale testing, qualitative exploration ANS: B In classic test theory, the following process is used to construct a scale: conceptual definition, scale design, item review, preliminary item tryouts, field testing, item analyses, selection of items to retain, conduct validity studies, reliability estimations, compiling of norms. Other

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methods vary. However, the essential thing is to identify the concept and then proceed with design, either by quantitative or qualitative methods, following with construction, some form of testing for feasibility, and then reliability and validity determination.

DIF: Cognitive Level: Application REF: MCS: 442-443 7. A university that is publicly funded is located in a state that is experiencing serious budget shortfall, and the budget has been halved. The universitys 32 departments are asked to list each of their programs on an index card, resulting in 90 cards. A panel comprised of the president, provost, and five deans each independently arranges the cards into categories of 3 essential, 7 highly desirable, 15 very desirable, 40 mainstream, 15 expendable, 7 immediately expendable, and 3 targeted elimination. This is an example of which methodology? a. Delphi technique b. Semantic differential scale c. Likert scaling d. Q-sort method ANS: D Q-sort methodology is a technique of comparative rating that preserves the subjective point of view of the individual. Cards are used to categorize the importance placed on various words or phrases in relation to the other words or phrases in the list. Each phrase is placed on a separate card. The number of cards should range from 40 to 100. The subject is instructed to sort the cards into a designated number of piles, usually 7 to 10 piles ranging from the most to the least important. The subject is limited in the number of cards that may be placed in each pile, with few at the ends and many in the center, mimicking the normal curve.

DIF: Cognitive Level: Application REF: MCS: 434 8. How would a rating scale item be worded? a. I can be alone for hours and not feel lonely: Strongly Agree, Agree, Undecided, Disagree, Strongly Disagree.

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b. When I walk one block, I feel: (a) healthy and invigorated, (b) no different from the way I ordinarily feel, (c) pleasantly tired, (d) exhausted and out of breath. c. Place a vertical line intersecting this line to show what your anxiety is; the scales ends are 0 for No Anxiety at All, and 10 for The Worst Anxiety I Have Ever Experienced. d. Rank your boss from 1 to 7 on the following quality: sensitivitycallousness.

ANS: B The Likert scale determines the opinion or attitude of a subject and contains a number of declarative statements with a scale after each statement. A rating scale lists an ordered series of categories of a variable that are assumed to be based on an underlying continuum.

The Visual Analog Scale (VAS) is frequently used in health care research since it is easy to construct, administer, and score. VASs can be administered using a drawn, printed, or computergenerated 100-mm line. The research participant is asked to place a mark through the line to indicate the intensity of the sensation or stimulus. A semantic differential scale consists of two opposite adjectives with a seven-point scale between them.

DIF: Cognitive Level: Application REF: MCS: 430 9. A Canadian researcher has had a tool published in English. The tool examines the embedded meanings of life in a country that has colonial roots but still maintains allegiance to the mother country. There is a demand for use of the tool in French-speaking Canadian cities. Which is the type of translation that is most appropriate for this tool? a. Pragmatic translation b. Aesthetic-poetic translation c. Ethnographic translation d. Linguistic translation ANS: C Four types of translations can be performed: pragmatic translations, aesthetic-poetic translations, ethnographic translations, and linguistic translations. Pragmatic translations communicate the

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content from the source language accurately in the target language. The primary concern is the information conveyed. An example of this type of translation is the use of translated instructions for assembling a computer. Aesthetic-poetic translations evoke moods, feelings, and affect in the target language that are identical to those evoked by the original material. In ethnographic translations, the purpose is to maintain meaning and cultural content. In this case, translators must be familiar with both languages and cultures. Linguistic translations strive to present grammatical forms with equivalent meanings. Translating a scale is generally done in the ethnographic mode.

DIF: Cognitive Level: Application REF: MCS: 445 MULTIPLE RESPONSE 1. Which of the following are physiological measures? (Select all that apply.) a. A subjects report of episodes of tachycardia per day b. Score on the Mini Mental Status Exam c. Pulse rate as displayed on an ICUs monitor d. Serum sodium e. Use of a tuning fork to measure bone conduction hearing loss ANS: A, C, D, E Physiological measures include two categories, biophysical and biochemical measures. For example, biophysical measures might include the use of the stethoscope and sphygmomanometer to measure blood pressure and a biochemical measure might include the laboratory value for total cholesterol. Self-report has been used effectively to obtain physiological information and may be particularly useful when the subjects are not in closely monitored settings such as hospitals, clinics, or research facilities. For some variables, selfreport may be the only means of obtaining the information. Such may be the case when study participants experience a physiological phenomenon that cannot be observed or measured by others.

DIF: Cognitive Level: Analysis REF: MCS: 412

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2. Which of the following would be non-physiologic measures that could be used in nursing research? (Select all that apply.) a. Surveys that determine the percentage of counseling appointments that have decreased psychological pain in the 72 hours following each appointment b. Photographs of chimpanzee chromosomes c. Observation ratings of the depth of a pressure ulcer d. Surgical interventions intended to ablate pain e. Opinion surveys of what patients want to have included in their discharge teaching after outpatient surgery ANS: A, E Physiological measures include two categories: biophysical and biochemical measures. For example, biophysical measures might include the use of the stethoscope and sphygmomanometer to measure blood pressure and a biochemical measure might include the laboratory value for total cholesterol. Self-report has been used effectively to obtain physiological information and may be particularly useful when the subjects are not in closely monitored settings such as hospitals, clinics, or research facilities. For some variables, selfreport may be the only means of obtaining the information. Such may be the case when study participants experience a physiological phenomenon that cannot be observed or measured by others.

DIF: Cognitive Level: Application REF: MCS: 412 3. Which of the following are direct measures? (Select all that apply.) a. The patients radial pulse rate b. The dimensions in centimeters of a decubitus ulcer c. The nurses observations of an infants apparent pain d. The physicians measure of the patients deep tendon reflexes e. The patients estimate as to whether his lithium level is within therapeutic range f. The mothers report of her toddlers anxiety level before a blood draw g. The patients serum serotonin levels

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ANS: A, B, D, G Direct measures are more accurate because there is an objective measurement of the study variable. For example, patients might be asked to report any irregular heartbeats during waking hours over a 24-hour period, which is an indirect measurement of heart rhythm, and each patients heart could be monitored with a Holter monitor over the same 24-hour timeframe, which is a direct measurement. Whenever possible, researchers usually select direct measures of their study variables due to the accuracy and precision of these measurement methods. However, if a direct measurement method does not exist, an indirect measurement method could be used in the initial investigation of a physiological variable.

DIF: Cognitive Level: Application REF: MCS: 413-414 4. In an observational study of manifestations of various categories of sundowning behavior in hospitalized super-elders, which of the following are true? (Select all that apply.) a. Checklists based on a rating scale would be helpful ways to record behaviors. b. Rating scales of 1-absent, 2-slight, 3-moderate, and 4-severe could be used. c. A category system should be developed before the study begins. d. The patients assessment of whether or not he is sundowning is valuable. e. There should be no overlap of the categories confused, placid and confused, agitated. f. Research assistants observing the patients should be given similar training. g. Observations should be made under similar circumstances.

ANS: A, B, C, E, F, G The first step in a structured observation is to define carefully what specific behaviors or events are to be inspected or observed in a study. From that point, researchers determine how the observations are to be made, recorded, and coded. In most cases, the research team will develop an observational checklist or category system to direct the collecting, organizing, and sorting of the specific behaviors or events being observed. The observational categories should be mutually exclusive. A numerical value is assigned to each category; and the fineness of the distinctions between categories varies with the scale, making this one of the crudest forms of scaling

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technique. If the observations in a study are being conducted using multiple data collectors, it is essential that the consistency or interrater reliability of the data collectors be determined.

DIF: Cognitive Level: Application REF: MCS: 421 5. An outpatients daughter has been using a diary to track the appearance of her mothers decubitus ulcer when the daughter performs the daily dressing change. The patient has been newly consented for participation in the trial of a new product presumed to accelerate healing and prevent infection. The researcher instructs the daughter in use of the new product and the use of a scale for tracking the ulcers healing. Scale items are change in total area (width times depth), drainage color, surrounding tissue integrity, pain, and smell. What are the advantages of using a scale instead of a diary? (Select all that apply.) a. It reduces all items to a Likert scale. b. It makes wound care easier. c. It forces a level of precision that may or may not be present in a diary. d. It produces numerical data that the researcher can easily analyze in order to provide evidence of difference between the new method and the old method. e. It makes sure that subjects all will have daily recordings of the variables the researcher intends to measure.

ANS: C, D, E A rating scale allows the observer to rate the behavior or event on a scale. Scales, a form of selfreport, are a more precise means of measuring phenomena than are questionnaires. The majority of scales have been developed to measure psychosocial variables. However, self-reports can be obtained on physiological variables such as pain, nausea, or functional capacity by using scaling techniques as discussed earlier in this chapter. This method provides more information for analysis than does the use of dichotomous data, which indicate only that the behavior either occurred or did not occur. Scales, another form of self-reporting, are more precise in measuring phenomena than are questionnaires and have been developed to measure psychosocial and physiological variables. The types of scales include the rating scale, Likert scale, semantic differential scale, and the visual analog scale.

DIF: Cognitive Level: Analysis REF: MCS: 422

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6. Which of the following are true statements regarding the disadvantages of observational methods? (Select all that apply.) a. They may increase subject reactivity. b. When a single interrater is used and observations are opposite, there is no way to resolve the conflict, since each is equally correct. c. They may be used for both quantitative and qualitative research. d. They are more subjective than other types of measurements. e. They allow real-time capture of data. f. They are invariably subject to skepticism unless verified in some manner.

ANS: A, D, F Observational measurement is the use of unstructured and structured inspection to gauge a study variable. Although measurement by observation is most common in qualitative research, it is used to some extent in all types of studies. The researcher must be clear on what is to be observed. The researcher must ensure that each variable is observed in a similar manner in each instance, so much attention must be given to training data collectors, especially when the observations are complex and examined over time. Pilot-testing and assurance of interrater reliability are essential. Observational measurement tends to be more subjective than other types of measurement and is thus often seen as less credible, but in many cases it is the only possible way to obtain important evidence for practice.

DIF: Cognitive Level: Analysis REF: MCS: 421 7. The principal disadvantages of administering open-ended questions are which of the following? (Select all that apply.) a. They are difficult to construct. b. They are time-consuming to analyze. c. They are impractical for use with large samples. d. They cannot produce exhaustive, exclusive answers. e. They force answers.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

f. They can be difficult to interpret.

ANS: B, C, F Data from open-ended questions are often difficult to interpret, and content analysis may be used to extract meaning. Open-ended questionnaire items are not advised if data are being obtained from large samples.

DIF: Cognitive Level: Analysis REF: MCS: 425 8. The principal disadvantages of using a subjects diary either instead of interview data or to supplement interview data would be which of the following? (Select all that apply.) a. Subjective perception at the time of the event is retrievable. b. Private and clandestine topics that have previously been accessible may be obtained through diaries. c. Diaries contain more truthful information than do other sources. d. No contact with the subject is necessary. e. Diaries may be used without consent. f. Information obtained from a diary is thought to be more accurate than that obtained from pure recall.

ANS: A, B, F A diary is a recording of events over time by an individual to document experiences, feelings, or behavior patterns. Diaries are also called logs or journals and have been used since the 1950s to collect data for research from a variety of populations including children, the acute and chronically ill, pregnant women, and the elderly. A diary, which allows recording shortly after an event, is thought to be more accurate than obtaining the information through recall during an interview. In addition, the reporting level of incidents is higher, and one tends to capture the participants immediate perception of situations. The diary technique gives nurse researchers a means to obtain data on topics of particular interest within nursing that have not been accessible by other means.

DIF: Cognitive Level: Analysis REF: MCS: 437

Gray Burns and Grove’s The Practice of Nursing Research (9e)

9. Pre-existent databases used in nursing research for secondary analysis contain data of different sorts. What are these? (Select all that apply.) a. Data collected internally by a health care institution for quality assurance or other review of its processes b. Data collected by unknown people for unknown reasons c. Data collected by governmental and private agencies, such as insurance companies, external to a health care institution d. Records locked by the courts e. Data collected by another researcher for a previous study ANS: A, C, E Nurse researchers are expanding their use of data from existing databases to answer their research questions and test their research hypotheses. Health data is usually categorized into secondary data and administrative data. Secondary data are those data collected during a previous research study. Administrative data are collected within clinical agencies; obtained by national, state, and local professional organizations; and collected by federal, state, and local agencies.

DIF: Cognitive Level: Analysis REF: MCS: 439 10. A researcher isnt sure whether 60-year-old women, the target population of her research, will understand the wording of a questionnaires 50 items assessing knowledge of symptoms of myocardial infarction in women. Consequently, the researcher might logically decide to do which of the following? (Select all that apply.) a. Provide a small glossary defining some of the more technical terms on the questionnaire. b. Conduct a pilot of the questionnaire. c. Use a Q-sort methodology to prioritize the essential questions and decrease the questionnaire down to 20 items. d. Ask a content expert to evaluate the readability of the questionnaire. e. Arrange for several radio and TV public-service announcements, informing the public of the symptoms of myocardial infarction in women.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: B, D Once the research team has satisfactorily developed the interview protocol, they must pretest or pilot-test it, using subjects similar to those who will be included in their study. Pilot-testing will allow them to identify problems in the design of questions, sequencing of questions, or procedure for recording responses.The readability level of an instrument is a critical factor when selecting an instrument for a study. Regardless of how valid and reliable the instrument is, it cannot be used effectively if study participants do not understand the items. Calculating readability is relatively easy and can be performed in a few minutes. Many word processing programs and computerized grammar checkers will report the readability level of written material. Provision of a glossary is counter to the intent of the questionnaire, which is to assess knowledge of symptoms. Arranging for several radio and TV announcements will also undermine the purpose of the intent of the questionnaire. Q-sort methodology is a technique of comparative rating that preserves the subjective point of view of the individual. Using a Q-sort to decrease the number of questions will address length, not readability.

DIF: Cognitive Level: Analysis REF: MCS: 433 11. Which of the following constructs would be inappropriate to measure with a visual analogue scale? (Select all that apply.) a. Dichotomous variables b. Blood pressure c. Visual acuity d. Anxiety e. Playfulness ANS: A, B, C In an effort to resolve this problem, the visual analog scale was developed to measure magnitude, strength, and intensity of the individuals sensations or feelings. The visual analog, sometimes spelled analogue, scale (VAS) is referred to as magnitude scaling. This technique seems to provide interval-level data, and some researchers argue that it provides ratio-level data. It is particularly useful in scaling stimuli. This scaling technique has been used to measure pain,

Gray Burns and Grove’s The Practice of Nursing Research (9e)

mood, anxiety, alertness, craving for cigarettes, quality of sleep, attitudes toward environmental conditions, functional abilities, and severity of clinical symptoms. The stimuli must be defined in a way that the subject clearly understands. Only one major cue should appear for each scale. The scale is a line 100 mm in length with right-angle stops at each end. Bipolar anchors are placed beyond each end of the line.

DIF: Cognitive Level: Application REF: MCS: 433 12. Why is the visual analogue scale (VAS) used so frequently in health care research? (Select all that apply.) a. Validity is the same, regardless of how the visual analogue scale is used. b. It elicits nominal-level data. c. It is easy for clients to understand. d. It is more sensitive to small changes than are numerical and rating scales. e. It requires a minimum of translation to be used in languages other than English. f. It is easy to administer and score.

ANS: C, D, E, F The visual analog scale (VAS) is a magnitude scale particularly useful in scaling stimuli.

Measured stimuli must be defined in a way that the subject clearly understands. Only one major cue should appear for each scale. The scale is a line 100 mm in length with right-angle stops at each end. Bipolar anchors are placed beyond each end of the line. The VAS is frequently used in health care research since it is easy to construct, administer, and score. The VAS is more sensitive to small changes than numerical and rating scales are and can discriminate between two dimensions of pain. Validity of the VAS has most commonly been determined by comparing the VAS scores with other measures of a concept. For example, Winkelman, Norma, Maloney, and Kless (2008) compared VAS scores with dermatome assessment in measuring pain during labor.

The following study excerpt describes the agreement between these two measures of pain in laboring women who received an epidural analgesia.

DIF: Cognitive Level: Analysis REF: MCS: 434

Gray Burns and Grove’s The Practice of Nursing Research (9e)

13. Why might a researcher use a structured interview rather than an unstructured one?

(Select all that apply.) a. The desired data for this interview is quantitative. b. Interview time is limited. c. The researcher is collecting only demographic data for the study. d. The research subjects are confused and garrulous. e. Other data were gathered previously, using an unstructured interview.

ANS: A, C, E Structured interviews are verbal interactions with subjects that allow the researcher to exercise increasing amounts of control over the content of the interview to obtain essential data for a study. The researcher designs the questions before data collection begins, and the order of the questions is specified. In some cases, the interviewer is allowed to further explain the meaning of the question or modify the way in which the question is asked so that the subject can better understand it. In more structured interviews, the interviewer is required to ask the question precisely as it has been designed. If the subject does not understand the question, the interviewer can only repeat it. The subject may be limited to a range of responses previously developed by the researcher, similar to those in a questionnaire. If the possible responses are lengthy or complex, they may be printed on a card so study participants can review them visually before selecting a response. Qualitative research almost invariably uses interviews that are unstructured or semi-structured. Unstructured interviews consist of one or two global open-ended questions developed to gain quality, in-depth data from a limited number of subjects. They are completely controlled by the subject.

DIF: Cognitive Level: Synthesis REF: MCS: 422 14. Which of the following are examples of items that could be included in a visual analogue scale? (Select all that apply.) a. Stronger than Hercules, weak as a kitten b. Passive, nonassertive c. Strongly agree, uncertain

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Stunningly beautiful, repulsively ugly e. Perfect, wrong in all respects ANS: A, B, E The visual analog scaling technique has been used to measure pain, mood, anxiety, alertness, craving for cigarettes, quality of sleep, attitudes toward environmental conditions, functional abilities, and severity of clinical symptoms. The stimuli must be defined in a way that the subject clearly understands. The scale is a line 100 mm in length with right-angle stops at each end.

Bipolar anchors are placed beyond each end of the line. These should be opposite and extreme.

DIF: Cognitive Level: Application REF: MCS: 433 15. A researcher plans to administer a valid research tool in another language. What must be done in order to establish its validity in the second language? (Select all that apply.) a. Reliability testing b. Testing and then back-translating with different translators c. Analysis of values obtained with both scales d. Testing in both languages with bilingual subjects e. Concept analysis ANS: B, C, D Translating an instrument from the original language to a target language is a complex process.

One strategy for translating scales is to translate from the original language to the target language and then back-translate from the target language to the original language by using translators not involved in the original translation. Discrepancies are identified, and the procedure is repeated until troublesome problems are resolved. After this procedure, the two versions are administered to bilingual subjects and scored by standard procedures. The resulting sets of scores are examined to determine the extent to which the two versions yield similar information from the subjects. This procedure assumes that the subjects are equally skilled in both languages.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Chapter 18. Critical Appraisal of Nursing Studies Test Bank MULTIPLE CHOICE 1. A reader of qualitative research notes that a study is identified as Heideggerian phenomenology. The purpose of the study was to explore the lived experience of the long-term process of separating from a longtime partner and subsequently marrying another person, and to elicit descriptions of the experiences meaning. This topic is unexplored in the literature. The sample of 21 was randomly selected from 68 volunteers. Participants interviews were taperecorded and transcribed, and then coded by two raters, whose inter-rater reliability was reported as 95%. The findings revealed that there was a lengthy period of adjustment following separation, and that participants filled this time by denying permanency, creating possibilities, appreciating silence, developing personal strengths, trusting, developing skepticism, starting a new MCS:, and maintaining mental boundaries. The most immediate evaluative critique point about this article relates to which the following? a. It is not clear what the findings contribute to the current body of knowledge. b. The development and implementation of the study methodology is not congruent with its philosophical foundation. c. Tape-recording, transcription, and coding by two raters is not likely to capture the essence of this experience, without video-recording and participant observation. d. The findings do not seem to be a credible reflection of reality.

ANS: B Critical appraisal is not complete with making judgments about the validity of the study.

Synthesis of the evaluative criteria for qualitative studies can be reframed as philosophical congruence, methodological coherence, intuitive comprehension, and intellectual contribution.

Philosophical congruence is the problem here: parts of the development and implementation of the study (sample selection, data analysis) are not congruent with phenomenologic enquiry.

DIF: Cognitive Level: Comprehension REF: MCS: 451

Gray Burns and Grove’s The Practice of Nursing Research (9e)

2. A nurse reader of qualitative research notes that a study is identified as grounded theory research. The topic of study is how women leave a violent relationship. The nurse reader herself has never been in a physically abusive relationship. She has, however, cared for several patients who have told her their personal stories, and she has a cousin who was in a physically abusive relationship for several months. Because of this, she has an immediate understanding and finds the results credible. What aspect of the evaluative criteria for qualitative research does this reflect? a. Intellectual contribution b. Intuitive comprehension c. Methodological coherence d. Philosophical congruence ANS: B Critical appraisal is not complete with making judgments about the validity of the study.

Synthesis of the evaluative criteria for qualitative studies can be reframed as philosophical congruence, methodological coherence, intuitive comprehension, and intellectual contribution.

This particular phenomenon relates to intuitive comprehension.

1. Philosophical congruence: Were the development and implementation of the study congruent with the philosophical foundation of the study?

2. Methodological coherence: Did the data collection, analysis, and interpretation processes fit together to form a coherent approach to address the research problem?

3. Intuitive comprehension: Do the findings provide a credible reflection of reality and expand the readers comprehension of the study topic? If so, how can the findings be used in nursing practice?

4. Intellectual contribution: What do the findings contribute to the current body of knowledge?

5. State the conclusion of the critical appraisal of the study.

DIF: Cognitive Level: Comprehension REF: MCS: 451

Gray Burns and Grove’s The Practice of Nursing Research (9e)

3. What is the most accurate statement related to a studys strengths? a. A studys strengths always involve a level of complexitymultiple research questions, many variables, many references. b. A studys strengths are essentially the elements of the study that the researcher completed in accordance with the design of the study. c. A studys strengths are determined by whether the research results are statistically significant or not. d. A studys strengths are determined by the number of times the article is cited by other authors.

ANS: B The next step in critically appraising a quantitative study requires determining the strengths and weaknesses of the study. To determine the strengths and weaknesses of a study, the reader must have knowledge of what each step of the research process should be like from expert sources.

Then the elements of the research process are compared with the actual study steps. One determines whether the researcher followed the rules for an ideal study.

DIF: Cognitive Level: Analysis REF: MCS: 458 4. In deciding whether a framework is suited to a study, what is the principal question the reader must answer? a. Is a conceptual map provided? b. Is this the best framework for this study? c. Does the framework specify the study variables? d. Is this a theory or merely a framework?

ANS: B The questions a reader must ask are presented in this order: 1. Is the framework presented with clarity? If a model or conceptual map of the framework is present, is it adequate to explain the phenomenon of concern?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

2. Is the framework linked to the research purpose? If not, would another framework fit more logically with the study?

3. Is the framework related to the body of knowledge in nursing and clinical practice?

4. If a proposition or relationship from a theory is to be tested, is the proposition clearly identified and linked to the study hypotheses DIF: Cognitive Level: Analysis REF: MCS: 458 5. Why is the first prerequisite for appraising qualitative studies an appreciation for the philosophical foundation of qualitative research? a. Understanding the research requires a detailed understanding of each qualitative methodology. b. Qualitative research is not based on truth; it takes work for the reader to get past this stumbling block. c. There is no common ground among the qualitative methods. Each requires individual study before reading a research report can be attempted. d. All qualitative research has slightly different ground rules. Without an understanding of the philosophy of the method, appraisal is unfair.

ANS: D The first prerequisite for appraising qualitative studies is an appreciation for the philosophical foundation of qualitative research. Qualitative researchers design their studies to be congruent with one of a wide range of philosophies, such as phenomenology, symbolic interactionism, and hermeneutics, each of which espouses slightly different approaches to gaining new knowledge.

Although unique, the qualitative philosophies are similar in their view of the uniqueness of the individual and the value of the individuals perspective. Without an appreciation for the philosophical perspective supporting the study being critically appraised, the appraiser may not appropriately apply the standards of rigor consistent with that perspective.

DIF: Cognitive Level: Analysis REF: MCS: 463 MULTIPLE RESPONSE

Gray Burns and Grove’s The Practice of Nursing Research (9e)

1. What must the person critically appraising a qualitative research report possess as prerequisites, in order to begin the process? (Select all that apply.) a. Experience in performing qualitative data collection or analysis b. An empathic point of view toward the participants perspectives and reported experiences c. A basic knowledge of different philosophical perspectives d. The willingness to learn about the philosophical perspective supporting the study, in order to apply the standards of rigor that are consistent with that perspective e. Previous experience in critically appraising qualitative research ANS: B, C, D Prerequisites of philosophical foundation, type of qualitative study, and openness to study participants direct the implementation of the following guidelines for critically appraising qualitative studies. Without an appreciation for the philosophical perspective supporting the study being critically appraised, the appraiser may not appropriately apply the standards of rigor consistent with that perspective. A basic knowledge of different qualitative approaches is as essential for appraisal of qualitative studies as knowledge of quantitative research designs is for appraising quantitative studies. Appreciating philosophical perspectives and knowing qualitative approaches are both superficial, however, without empathy for the participants perspective.

Empathy creates an openness to knowing a participant within a naturalistic holistic framework.

One does not need experience in performing qualitative data collection or analysis, nor does one need to have previous experience in critically appraising qualitative research in order to perform this: one must start somewhere.

DIF: Cognitive Level: Analysis REF: MCS: 463 2. Why is identifying the steps of the research process the first step in the critical appraisal process for quantitative research? (Select all that apply.) a. Identifying the steps in the process indicates that the reader knows what these are. b. Identifying the steps is more important than understanding.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

c. Identifying the steps implies that the reader understands everything in the research report. d. Identifying the steps indicates that the reader comprehends the concepts in the research report. e. Identifying the steps of the research process implies understanding the terms the researcher uses in the research report.

ANS: A, D, E The critical appraisal process for quantitative research includes three steps: (1) identifying the steps of the research process, (2) determining study strengths and weaknesses, and (3) evaluating the credibility and meaning of a study to nursing knowledge and practice. These steps occur in sequence, vary in depth, and presume accomplishment of the preceding steps. However, an individual with critical appraisal experience frequently performs several steps of this process simultaneously. Initial attempts to comprehend research articles are often frustrating because the terminology and stylized manner of the report are unfamiliar. Identification of the steps of the research process in a quantitative study is the first step in critical appraisal. It involves understanding the terms and concepts in the report, as well as identifying study elements and grasping the nature, significance, and meaning of these elements.

DIF: Cognitive Level: Analysis REF: MCS: 454 3. What happens during the second step of the quantitative critical appraisal process, in the case in which the reader determines study strengths and weaknesses of a particularly weak research report? a. The reader discovers what elements of the study are in what locations of the report. b. The reader constructs a global appraisal of the researchs lack of rigor. c. The readers task is to analyze the quality of the individual parts of a research report. This inevitably produces an impression not only of what the research did not do, but also of what should have been done. d. The reader is required to examine each part minutely; this leads to an appreciation of what the researcher did well. e. The reader evaluates the goodness of the study.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: C, D The critical appraisal process for quantitative research includes three steps: (1) identifying the steps of the research process, (2) determining study strengths and weaknesses, and (3) evaluating the credibility and meaning of a study to nursing knowledge and practice. Identification of the steps of the research process in a quantitative study is the first step in critical appraisal. The next step in critically appraising a quantitative study requires determining the strengths and weaknesses of the study. To do this, the reader must have knowledge of what each step of the research process should be like from expert sources, such as this textbook and other research sources. Then the ideal ways to conduct the steps of the research process are compared with the actual study steps. During this comparison, the reader examines the extent to which the researcher followed the rules for an ideal study.

DIF: Cognitive Level: Analysis REF: MCS: 454 4. What are the true statements related to evaluation for quantitative research appraisal? (Select all that apply.) a. Evaluation cannot be performed without having completed the previous two steps of the appraisal process. b. Evaluation draws no conclusions about the merit of a particular research study. c. Evaluation critically analyzes the parts of a study and points out their deficits in comparison to an ideal. d. True evaluation implies an examination of related studies, so as to assess significance, credibility, and believability. e. Evaluation includes an assessment of the researchs contribution to nursing knowledge. f. Evaluation plus focused literature review essentially equals concept clustering.

ANS: A, D, E, F The critical appraisal process for quantitative research includes three steps: (1) identifying the steps of the research process, (2) determining study strengths and weaknesses, and (3) evaluating the credibility and meaning of a study to nursing knowledge and practice. During the second step of this process, not the evaluation, the reader examines the extent to which the researcher

Gray Burns and Grove’s The Practice of Nursing Research (9e)

followed the rules for an ideal study. Evaluation involves determining the validity, credibility, significance, and meaning of the study by examining the links between the study process, study findings, and previous studies. The steps of the study are evaluated in light of previous studies, such as an evaluation of present hypotheses based on previous hypotheses, present design based on previous designs, and present methods of measuring variables based on previous methods of measurement. The findings of the present study are also examined in light of the findings of previous studies. Evaluation builds on conclusions reached during the first two stages of the critical appraisal so the credibility, validity, and meaning of the study findings can be determined for nursing knowledge and practice.

DIF: Cognitive Level: Synthesis REF: MCS: 454 5. Which of the following represent the specific attributes that qualitative research must possess in order to be evaluated as acceptable? (Select all that apply.) a. Intellectual contribution b. Methodological congruence c. Evaluative strength d. Philosophical congruence e. Suspension of disbelief f. Intuitive comprehension ANS: A, B, D, F Critical appraisal is not complete with making judgments about the validity of the study.

Synthesis of the evaluative criteria for qualitative studies can be reframed as philosophical congruence, methodological coherence, intuitive comprehension, and intellectual contribution.

DIF: Cognitive Level: Comprehension REF: MCS: 465 6. What would be exemplified by poor overall flow of logic in the study, in terms of the second step of critical appraisal? (Select all that apply.) a. The title of the study mentions the effect of, but the study design is simple descriptive.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. There was a 60% dropout; nonetheless, the researchers claimed that the sample was representative. c. Statistical analyses used are all coherent with the variables levels of measurement. d. The study framework is gratuitous. It does not, in the slightest, help to explain the relationship between the principal study variables. e. The problem statement and the purpose of the study arent closely related. It seems like a big leap to get from the problem to the gap, and to the purpose.

ANS: A, B, D, E The reader must examine the logical links connecting one study element with another. For example, the problem needs to provide background and direction for the statement of the purpose. In addition, you need to examine the overall flow of logic in the study. The variables identified in the study purpose need to be consistent with the variables identified in the research objectives, questions, or hypotheses. The variables identified in the research objectives, questions, or hypotheses need to be conceptually defined in light of the study framework. The conceptual definitions provide the basis for the development of operational definitions. The study design and analyses need to be appropriate for the investigation of the study purpose, as well as for the specific objectives, questions, or hypotheses. Most of the limitations or weaknesses in a study result from breaks in logical reasoning.

DIF: Cognitive Level: Evaluation REF: MCS: 458 7. To what do the logic and form of the findings refer in qualitative critique? (Select all that apply.) a. There were numerous cross-checks, to ensure that what participants reported was objectively true. b. The elements of the research were present in the research report and located so that the reader could easily find them. c. The readers understanding of the phenomenon was better after reading the study than it had been beforehand. d. The findings were presented in a way that made sense, taken as a whole.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

e. The way the report was presented was congruent with its purpose, methods, and findings. f. There was a clear sense that the themes and essences emanated from the statements and perceptions of real people.

ANS: B, C, D, E, F The logic and form of the findings are critical to the appraisal of the study. (1) Were readers able to hear the voice of the participants and gain an understanding of the phenomenon studied? (2) Were readers able to identify easily the elements of the research report? (3) Did the overall presentation of the study fit its purpose, method, and findings? (4) Was there a coherent logic to the presentation of findings?

DIF: Cognitive Level: Analysis REF: MCS: 465 8. In which ways are critical appraisal of quantitative research and critical appraisal of qualitative research the same? (Select all that apply.) a. Both are concerned with how well the author has established the objective truth of the data. b. Both must begin with an appreciation for the philosophical foundation of the research. c. Both define rigor in the same way. d. Both are designed to provide some evaluations about the intrinsic worth of the research. e. In both, the elements of the research report are identified. f. Both examine how well measurements in the data collection phase have maintained their precision.

ANS: B, D, E The first prerequisite for appraising qualitative studies is an appreciation for the philosophical foundation of qualitative research. Qualitative researchers design their studies to be congruent with one of a wide range of philosophies, such as phenomenology, symbolic interactionism, and hermeneutics, each of which espouses slightly different approaches to gaining new knowledge; quantitative research espouses and follows the tenets of the scientific method. Nonetheless, an

Gray Burns and Grove’s The Practice of Nursing Research (9e)

appreciation for each is foundational to the critique process. Phenomenologists agree that there is not a single reality; each individual has his or her own reality. Reality is considered subjective, and as a result, unique to the individual, and, consequently, objective truth need not be checked, since the perception of the individual is that persons truth. Quantitative methods check truthfulness of data. Rigor is defined in quantitative research as in qualitative research, rigor is particular to each different method but, overall, implies adherence to that method. Both types of critical appraisal begin with identification of the elements of the research report.

Chapter 19. Evidence Synthesis and Strategies for Implementing Evidence-Based Practice Test Bank MULTIPLE CHOICE 1. Which is the most accurate statement about translational research? a. Translational research focuses on providing literal and readable translations of research in one of the primary 15 languages in which research is read. b. Translational research is essentially evidence-based practice. c. Translational research attempts to discover something useful in basic scientific discoveries. d. Translational research is applied research based on basic research knowledge.

ANS: D Translational research is an evolving concept that is defined by the NIH as the translation of basic scientific discoveries into practical applications. Basic research discoveries from the laboratory setting need to be tested in studies with humans. In addition, the outcomes from human clinical trials need to be adopted and maintained in clinical practice. Translational research is being encouraged by both medicine and nursing to increase the implementation of evidence-based interventions in practice and to determine if these interventions are effective in producing the outcomes desired in clinical practice.

DIF: Cognitive Level: Analysis REF: MCS: 503

Gray Burns and Grove’s The Practice of Nursing Research (9e)

2. Nursing is said to be a science and an art. If best research evidence represents the science of nursing, what represents the art? a. Clinical expertise b. Patient values and needs c. Synthesis of best research evidence d. Eye-hand coordination ANS: A Evidence-based practice (EBP) is the conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of quality, cost-effective health care. Best research evidence is largely fact-based and is intended to produce consistent interventions, usually of a technical nature. Patient values and needs emanate from the patient.

Clinical expertise provides the art of nursing practice.

DIF: Cognitive Level: Comprehension REF: MCS: 468 3. How is best research evidence produced? a. By the conduct and synthesis of numerous high-quality studies in a health-related area b. By the imaginations of creative health care workers, who design qualitative research that illuminates our understanding c. By dissemination of important results at conferences d. By publications that detail the newest advances in health care ANS: A Best research evidence is produced by the conduct and synthesis of numerous high-quality studies in a health-related area.

DIF: Cognitive Level: Comprehension REF: MCS: 468 4. How are evidence-based practice and best research evidence related?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. With best research evidence publications, there is no evidence-based practice. b. Both evidence-based practice and best research evidence are generated by research. c. Best research evidence is the evidence on which practice is based. d. Best research evidence includes five basic items, one of which is evidence-based practice.

ANS: C Evidence-based practice is the conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of quality, cost-effective health care. Best research evidence is produced by the conduct and synthesis of a number of high-quality studies in a selected health-related area.

DIF: Cognitive Level: Analysis REF: MCS: 468 5. If a trigger is defined as a condition of actual or potential harm to the patient, the nurses, or the institution, the Iowa model becomes a reactive problem-prioritization and problem-solving process. What is its tie-in with evidence-based practice? a. The Iowa model addresses utilization of research findings at an individual level. b. Individual nurses enact an Iowa decision tree when they examine riskmanagement data. c. Available published evidence drives the process, as scholars review the literature and bring it forward for committee focus. d. When evidence is available, it is used for problem-solving.

ANS: D The Iowa Model of Evidence-Based Practice provides direction for the development of EBP in a clinical agency. In a health care agency, triggers initiate the need for change, and the focus should always be to make changes based on best research evidence. These triggers can be problem-focused and evolve from risk management data, process improvement data, benchmarking data, financial data, and clinical problems. The triggers can also be knowledgefocused: for example, new research findings, changes in national agencies or organizational

Gray Burns and Grove’s The Practice of Nursing Research (9e)

standards and guidelines, an expanded philosophy of care, or questions from the institutional standards committee. The triggers are evaluated and prioritized based on the needs of the clinical agency. If a trigger is considered an agency priority, a group is formed to search for the best evidence to manage the clinical concern. In some situations, the research evidence is inadequate to make changes in practice, and additional studies are needed to strengthen the knowledge base.

Sometimes the research evidence can be combined with other sources of knowledge (theories, scientific principles, expert opinion, and case reports) to provide fairly strong evidence for developing research-based protocols for practice. The strongest evidence is generated from metaanalyses of several RCTs and systematic reviews that usually include meta-analyses, and individual studies. Thus, systematic reviews provide the best research evidence for developing evidence-based guidelines. The research-based protocols or evidence-based guidelines would be pilot-tested on a particular unit and then evaluated to determine the impact on patient care. If the outcomes are favorable from the pilot test, the change would be made in practice and monitored over time to determine its impact on the agency environment, staff, costs, and the patient and family. An agency can promote EBP by using the Iowa model to identify triggers for change, implement patient care based on the best research evidence, and monitor changes in practice to ensure quality care.

DIF: Cognitive Level: Synthesis REF: MCS: 493 6. In the Iowa model, what is the focus of intervention? a. The patient level b. The family level c. The institutional level d. The conceptual level ANS: C The Iowa Model of Evidence-Based Practice provides direction for the development of EBP in a clinical agency. In a health care agency, triggers initiate the need for change, and the focus should always be to make changes based on best research evidence. These triggers can be problem-focused and evolve from risk management data, process improvement data, benchmarking data, financial data, and clinical problems. The triggers can also be knowledge-

Gray Burns and Grove’s The Practice of Nursing Research (9e)

focused, such as new research findings, changes in national agencies or organizational standards and guidelines, an expanded philosophy of care, or questions from the institutional standards committee. The triggers are evaluated and prioritized based on the needs of the clinical agency.

If a trigger is considered an agency priority, a group is formed to search for the best evidence to manage the clinical concern.

DIF: Cognitive Level: Analysis REF: MCS: 493 7. A researcher locates twelve research studies that all examine the effect of a different cognitive-behavioral strategy for decreasing painhypnosis, distraction, focusing, music therapy, and so forth. Why would these twelve studies make a poor meta-analysis? a. Cognitive-behavioral interventions are not a suitable focus for all patients, and consequently should not be studied. b. Twelve studies would be too many for synthesis of any kind. c. Secondary analyses of pooled data are not used for meta-analysis on pain, because of interindividual differences in perception. d. The result, if statistically significant, will produce a general recommendation, If in pain, do something cognitive-behavioral, which is meaningless.

ANS: D A meta-analysis is conducted to statistically pool the results from previous studies into a single quantitative analysis that provides one of the highest levels of evidence about an interventions effectiveness. This approach has objectivity, since it includes analysis techniques to determine the effect of an intervention while examining the influences of variations in the studies selected for the meta-analysis. The studies to be included in the analysis need to be examined for variations or heterogeneity in such areas as sample characteristics, sample size, design, types of intervention, and outcomes variables and measurement methods. Heterogeneity in the studies included in a meta-analysis produces broad and meaningless results.

DIF: Cognitive Level: Analysis REF: MCS: 482 MULTIPLE RESPONSE

Gray Burns and Grove’s The Practice of Nursing Research (9e)

1. The Magnet Program represents a credentialing process, whereby organizations of quality are recognized. What does the Magnet Recognition Program require, relative to research and evidence-based practice? (Select all that apply.) a. Nurses will participate in the institutional review process. b. Nursing research will be a budget line item. c. Only nurse researchers will conduct clinical research. d. The institution will keep track of nursing research projects in progress and recently completed. e. Care applied to patients will be, in a large part, supported by research.

ANS: A, B, D Approval for Magnet status is obtained through the American Nurses Credentialing Center (ANCC). The Magnet Recognition Program recognizes evidence-based practice as a way to improve the quality of patient care and revitalize the nursing environment. Selection criteria for Magnet status that require health care agencies to promote the conduct of research and the use of research evidence in practice follow. Some of its point items are availability of current literature, dissemination of current literature, application of current literature to practice, nurse involvement in the institutional review process, research consultants actively involved in mentorship, budget line items for nursing research, tracking of all nursing research activities in progress, and education that has changed practice.

DIF: Cognitive Level: Analysis REF: MCS: 469 2. Evidence-based practice is based on three things. On what would a nurse base practice in a new area of nursing if there is yet no research evidence? (Select all that apply.) a. Nursing theory b. The nurses own clinical expertise c. Client values and needs d. Evidence in parallel, related fields e. Past documentation in the medical record

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: B, C, D Evidence-based practice is the conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of quality, cost-effective health care. Best research evidence is produced by the conduct and synthesis of a number of high-quality studies in a selected health-related area.

DIF: Cognitive Level: Analysis REF: MCS: 468 3. Which of the following statements about the Stetler model of research utilization are true? (Select all that apply.) a. Its goal is to assure that research it utilized. b. It is a framework. c. It facilitates synthesis of research knowledge. d. It is used to update hospital policies. e. In its validation phase, scientific soundness is assessed. f. It provides a step-by-step way to assess and evaluate research findings.

ANS: B, C, D, E, F The Stetler (2001) model provides a comprehensive framework to enhance the use of research findings by nurses to facilitate an evidence-based practice. The use of research findings can be at the institutional or individual level. The five stages of the Stetler model are preparation, validation, comparative evaluation/decision making, translation/application, and evaluation. It is used to synthesize research knowledge, but it does this in a step-by-step way, evaluating each study on its own merits. Ultimately, its use is practice-based.

DIF: Cognitive Level: Analysis REF: MCS: 493 4. What are the basic problems with meta-syntheses of qualitative research? (Select all that apply.) a. Qualitative research itself is a subjective interpretation; a meta-synthesis of qualitative research is a compiling of information generated subjectively.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. If individual studies have different methods, it may be difficult to find common ground and to devise a meaningful interpretation of the results. c. Qualitative research has no implications for practice, so performing a metasynthesis is unjustifiable. d. In qualitative research, multiple valid interpretations may occur if different researchers examine the text. e. The recommendation for practice that results from meta-synthesis of qualitative research lacks statistics. f. The raw data are not available to the qualitative meta-synthesizer.

ANS: A, B, D, F Meta-synthesis is defined as the systematic compiling and integration of qualitative study results to expand understanding and develop a unique interpretation of study findings in a selected area.

The focus is on interpretation rather than the combining of study results as with quantitative research synthesis. Meta-synthesis involves the breaking down of findings from different studies to discover essential features, and then the combining of these ideas into a unique, transformed whole. Meta-summary is a step in conducting meta-synthesis. A process for conducting a metasynthesis is described in the following section. The process of interpretation occurs in the mind of the reader. Corbin and Strauss describe interpretation as translating the words and actions of participants into meanings that readers and consumers can understand. The virtual text grows in size and complexity as the researcher reads and rereads the transcripts. Throughout the process of analysis, the virtual text develops and evolves. Although multiple valid interpretations may occur if different researchers examine the text, all findings must remain trustworthy to the data.

This trustworthiness applies to the unspoken meanings emerging from the totality of the data, not just the written words of the text.

DIF: Cognitive Level: Synthesis REF: MCS: 490 5. Nursing practice has been said to have the potential to be increasingly evidence-based in the next ten years. What are the impediments to enacting EBP? (Select all that apply.) a. A misunderstanding of what EBP is has resulted in mandates and policies; bedside nurses sense that their expertise is being overridden.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. Only about one-seventh of published nursing research is experimental or quasiexperimental. c. Systematic reviews and meta-analyses in nursing are limited. d. Most hospitals do not have computer access to practice evidence. e. Population-based knowledge may or may not translate to the care of individual patients.

ANS: A, B, C, E Barriers to the EBP movement have been both practical and conceptual. One of the most serious barriers is the lack of research evidence available regarding the effectiveness of many nursing interventions. Between 2000 and 2006, published research in major journals was only 7% experimental and 6% quasi-experimental; interventional studies are required for EBP. The systematic reviews and meta-analyses conducted in nursing have been limited. Another concern of the EBP movement is that the development of evidence-based guidelines has led to a cookbook approach to health care. Health professionals are expected to follow these guidelines in their practice as developed. However, the definition of EBP describes it as the conscientious integration of best research evidence with clinical expertise and patient values and needs.

DIF: Cognitive Level: Evaluation REF: MCS: 471 6. A systematic review should address the components specified in PICOS. Why is this so?

(Select all that apply.) a. Interventional research always uses some means of comparison. b. Interventions that are actually naturally occurring conditions should be noted, since they decrease confirmatory power of the collective evidence. c. Study design is essential, since recommendations for change in practice can be based only on some designs. d. Desired outcomes, not actual outcomes of the study, are the focus of the review. e. The specific population from which a sample was drawn, and its similarity to those of others studies reviewed, affects generalizability.

ANS: A, B, C, E

Gray Burns and Grove’s The Practice of Nursing Research (9e)

A systematic review is a structured, comprehensive synthesis of the research literature to determine the best research evidence available to address a health care question. A systematic review involves identifying, locating, appraising, and synthesizing quality research evidence for expert clinicians to use to promote an EBP. Systematic reviews are often conducted by two or more researchers and/or clinicians in a selected area of interest to determine the best research knowledge in that area. Systematic reviews need to be conducted with rigorous research methodology to promote the accuracy of the findings and minimize the reviewers bias. A systemic review or meta-analysis is best directed by a relevant clinical question that focuses the review process and promotes the development of a quality synthesis of research evidence. One of the most common formats used to organize a systematic review is the PICO or PICOS format described in the Cochran Handbook. PICOS are (1) population (or sample), (2) intervention, (3) comparison group or condition, (4) outcomes, and (5) study design. Naturally occurring interventions indicate a non-interventional design; the researcher enacts the research intervention.

Chapter 20. Collecting and Managing Data MULTIPLE CHOICE 1. Planning as a step in the quantitative research process ends when the data collection has begun. Which is the true statement about planning in the qualitative research process? a. Since sample size is not usually decided upon ahead of time, there is no practical reward to planning the qualitative research study ahead of time. b. There is no planning in the qualitative research process; it all emanates from the data collected. c. Everything about a qualitative study is planned ahead of time, except for analysis of the data. d. The researcher may adapt strategies for data collection or analysis well into the study.

ANS: D

Gray Burns and Grove’s The Practice of Nursing Research (9e)

A data collection plan details how the researcher will implement the study. The plan for collecting data is specific to the study being conducted and requires that the researcher consider some of the more common elements of research, mapping out procedures ahead of time. This extensive planning increases the accuracy of the data collected and the validity of the study findings. In qualitative methods, however, the researcher may adapt the data collection or analysis strategies during the study.

DIF: Cognitive Level: Analysis REF: MCS: 517 2. What is the general rule about collecting demographic data during an interview? a. The mood of the qualitative interview, so crucial to quality data capture, may be intruded upon by demographic data collection. b. In quantitative interviews, everything excerpted from medical records must again be verified in face interviews. c. In qualitative interviews, routinely asking twenty or thirty demographic questions sets the stage for actual data collection. d. If data can be obtained in other ways, leave the valuable interview time for actual interviewing.

ANS: D The researcher should consider the importance of each piece of datum and the subjects time required to collect it. If the data can be obtained from patient records or any other written sources, the researcher does not need to ask the subject to provide this information. To collect data from a patients records, the researcher must make sure to include the intent to do so in the consent form and ensure that the institutional review board has authorized the team to do this.

The qualitative researcher has the power to shape the interview agenda. Participants have the power to choose the level of responses they will provide. The researcher might begin the interview by asking a broad question such as Describe for me your experience with or Tell me about. Ideally, the participant will respond as though she or he is telling a story. The researcher responds nonverbally with a nod or eye contact to convey interest in what is being said, and tries to avoid agreeing or disagreeing with what the participant is saying. The less the researcher says, the better.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Comprehension REF: MCS: 517 3. A researcher is collecting data in a hospital during cardiopulmonary resuscitation. The researcher has devised a data collection form that contains five columns for data entry. During the first three data collection periods, the form works reasonably well, although the researcher has to turn the MCS: over and write on the back. During the fourth, however, the CPR incident occurs in the emergency department and includes many procedures and interventions, and the researcher ends up taking a blank piece of paper and recording data on that. Later, it takes him 40 minutes to unscramble and collate the data and record it properly. What must be done now? a. The researcher will go back to the institutional review board and request permission to use a different form. b. The researcher will design a new form, with the assumption that the next CPR incident will be just as complex as the last was. c. The researcher will continue to use the old form, writing on the back when necessary, and pulling out blank pieces of paper, from time to time, for additional data recording. d. The researcher will decrease the amount of data necessary to record by revising the old study protocol, so that fewer research questions are asked.

ANS: B Before data collection begins, the researcher develops or adapts forms on which to record data.

These forms can be used to record demographic data, information from the patient record, observations, or values from physiological measures. The researcher also might need to collect other data that may be extraneous or confounding variables such as the subjects physician, stage of illness, length of illness or hospitalization, complications, date of data collection, time of day and day of week of data collection, and any untoward events that occur during the data collection period. Data collection forms must be designed so that the data are easily recorded. If a form isnt working, design a better form. Data collection forms themselves do not need institutional review board (IRB) approvalthe information to be collected is what the IRB approves.

DIF: Cognitive Level: Application REF: MCS: 517 4. The quantitative researcher collects many pieces of quantitative data as words, not numbers. Prior to statistical analysis, all of the data pieces must be coded. What does this mean?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. The data are transformed into numerals corresponding to words, such as 0no college degree, 1bachelors degree, 2masters degree, 3PhD or EdD. b. The essence of each word is noted; later, these essences emerge as themes. c. The data are typed into a computer, and the computer is instructed to transform the words into binary values, using only 0 and 1, by adding up the numbers of each letter in the alphabet. d. The data regarding protected data are transformed to code names; a list is made and kept in a secure location.

ANS: A Coding is the process of transforming language data into numerical symbols that can be entered easily into the computer. For example, variables such as race, gender, ethnicity, and diagnoses can be categorized and given numerical labels. For gender, the male category could be identified by a 1 and the female category by a 2. The coding categories developed for the research must be both mutually exclusive and mutually exhaustive so, with respect to the latter, inclusion of 3decline to state and 4none of the above might be useful.

DIF: Cognitive Level: Application REF: MCS: 517 5. A nurse is conducting her masters thesis research in the unit in which she works as a staff nurse. The focus of her thesis is burned childrens pain, with versus without a child life specialist assisting the child. She is providing child life specialist presence every other day at the midmorning dressing change. For obvious reasons, she wants to keep everything else consistent for the four contiguous days of data collection. On the second day of four, with the child life specialist present, one child demonstrates poor pain control. The nurse researcher would ordinarily advocate for more pain medication for this child, but if she does, she will not be able to compare the data with that of the previous day. This is an example of which of the following? a. Serendipity b. Subject as object c. Role conflict d. Passive resistance ANS: C

Gray Burns and Grove’s The Practice of Nursing Research (9e)

As a researcher, one is observing and recording events. Nurses who conduct clinical research often experience a conflict between their researcher role and their clinician role during data collection. In some cases, the researchers involvement in the event, such as providing physical or emotional care to a patient during data collection, could alter the event and thus bias the results.

It would be difficult to generalize the findings to other situations in which the researcher was not present to intervene. However, the needs of patients must take precedence over the needs of the study.

DIF: Cognitive Level: Application REF: MCS: 528 MULTIPLE RESPONSE 1. A researcher intends to collect data, including patients ratings of pain and anxiety, during a procedure. No electrical equipment or photography may be used in the procedure room. In order to record the various pain and anxiety ratings, the researcher may plan to use which of the following? (Select all that apply.) a. A plug-in word processor b. A form with large margins, or a column for comments, or both c. A pencil with an eraser d. A form with pre-labeled columns and rows e. A cell phone with camera ANS: B, C, D Before data collection begins, the researcher develops or adapts forms on which to record data.

These forms can be used to record demographic data, information from the patient record, observations, or values from physiological measures. The researcher also might need to collect other data that may be extraneous or confounding variables such as the subjects physician, stage of illness, length of illness or hospitalization, complications, date of data collection, time of day and day of week of data collection, and any untoward events that occur during the data collection period. Data collection forms must be designed so that the data are easily recorded. Pencil and paper are ideal, since they allow for erasure, in case the subject clarifies data.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Application REF: MCS: 517 2. Part of a research study entails that research subjects complete a printed form with checkboxes. The researcher decides ahead of time that any item that has more than one response checked will be treated as unanswered. What are logical ways the researcher can maximize properly answered items, without skewing the data? (Select all that apply.) a. Make a rule that if there are two checked replies, only the first one will be counted. b. When the researcher hands the form to the subjects, the researcher should specify One answer and one answer only for each these items, please, or I wont be able to include the double-answered ones in my report. c. Glance at the forms as they are about to be handed in, and if two boxes for an item are checked, ask the subject to address this. d. In the printed instructions at the top of the form, be sure to state that if a question has more than one response checked, that item will be treated as unanswered. e. Eliminate from the entire study any subject who double-selects an item.

ANS: B, C, D Decision rules for data entry should be finalized during the planning process. The researcher must realize that any decision rule may skew the data. For example, if a subject selects two responses for a single item, will the variable be coded as missing, or does the researcher want to specify that the lowest or highest value should be entered?

DIF: Cognitive Level: Application REF: MCS: 523 3. A researcher is studying the way that ICU nurses prioritize the charting responsibilities for their 12-hour shift. The researcher happens to discover that nurses are administering medications as close to the ordered times as possible but consistently charting the times at which medications are ordered, not the time they are actually administered, even though that may be two or three hours later. What could the researcher do with this information? (Select all that apply.) a. The researcher makes the nurse manager aware of the finding, after the study data have all been collected, because this is essentially a medication charting error. b. Nothing. This is not a focus of the study, and the information must be suppressed.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

c. The researcher takes time to educate individual nurses, so that they understand that what they are doing is not honest. d. The researcher includes the findings in the article, stating that this is a timesaving strategy, since the computer allows charting of meds when ordered (instead of when administered) as a block, saving time. e. The researcher reports this information under Serendipitous Discoveries in the article that results from the study.

ANS: A, B, E Serendipity is the accidental discovery of something useful or valuable. During the data collection phase of studies, researchers often become aware of elements or relationships that they had not previously identified. These aspects may be closely related to the study being conducted or have little connection with it. They come from increased awareness and close observation of the study situation. Because the researcher is focused on close observation, other elements in the situation can come into clearer focus and take on new meaning. Serendipitous findings are important to the development of new insights in nursing theory. They can be important for understanding the totality of the phenomenon being examined.

Educating individual nurses is sure to alienate staff. The manager is the logical choice for a person in whom to confide this information. Obviously, this should be communicated as, Some nurses rather than naming names, since the nurses privacy would be violated by telling their names.

DIF: Cognitive Level: Application REF: MCS: 530 4. How may research data, code-named and stripped of all identifiers, be stored? (Select all that apply.) a. Separate from the master list of identifiers and codes b. Only in a locked box in a safe c. Anywhere the researcher decides to store it that has reasonable security d. Only in the original database from which it was derived e. Only in a password-protected computer, located in a private office or residence

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: A, D In this time of flash drives and thumb drives, it is relatively easy to store data. The original data forms and database must be stored for time frames dictated by the funding source or by the journal publisher. There are several reasons to store data. The data can be used for secondary analyses. For example, researchers participating in a project related to a particular research focus may pool data from various studies for access by all members of the group. Data should be available to document the validity of your analyses and the published results of your study.

Because of nationally publicized incidents of scientific misconduct in which researchers fabricated data and published multiple manuscripts, you would be wise to preserve documentation that your data were obtained as you claim. Issues that have been raised include how long data should be stored, the need for institutional policy regarding data storage, and whether graduate students who conduct a study should leave a copy of their data at the university. Some researchers store their data for only five years after publication, while others store their data until they retire from a research career. Researchers should check with their funding sponsors and publishers for guidelines on how long to keep the data. Most researchers store data in their office or laboratory; others archive their data in a central location with storage fees or retrieval fees. HIPAA mandates protection of anonymity by removing all 18 identifiers for data; a master list of the code-labeled data and the person to whom it belonged must be kept separate from the main data. The master list must be kept in a locked area.

DIF: Cognitive Level: Analysis REF: MCS: 532 5. How may raw research data, with identifiers, obtained from a hospital be stored? (Select all that apply.) a. It must be kept only in the hospitals computer system; at the end of the work day, all excerpted data must be deleted. b. In a locked box in a safe c. In any e-mail account d. On a private website e. In a password-protected computer, located in a private office or residence ANS: B, E

Gray Burns and Grove’s The Practice of Nursing Research (9e)

In this time of flash drives and thumb drives, it is relatively easy to store data. The original data forms and database must be stored for time frames dictated by the funding source or by the journal publisher. There are several reasons to store data. The data can be used for secondary analyses. For example, researchers participating in a project related to a particular research focus may pool data from various studies for access by all members of the group. Data should be available to document the validity of your analyses and the published results of your study.

Because of nationally publicized incidents of scientific misconduct in which researchers fabricated data and published multiple manuscripts, you would be wise to preserve documentation that your data were obtained as you claim. Issues that have been raised include how long data should be stored, the need for institutional policy regarding data storage, and whether graduate students who conduct a study should leave a copy of their data at the university. Some researchers store their data for only five years after publication, while others store their data until they retire from a research career. Researchers should check with their funding sponsors and publishers for guidelines on how long to keep the data. Most researchers store data in their office or laboratory; others archive their data in a central location with storage fees or retrieval fees. HIPAA mandates protection of anonymity by removing all 18 identifiers for data; a master list of the code-labeled data and the person to whom it belonged must be kept separate from the main data. The master list must be kept in a locked area.

DIF: Cognitive Level: Analysis REF: MCS: 532 6. What are the purposes of completing a pilot study? (Select all that apply.) a. It provides nominal and ordinal data with which the researcher can construct better instruments. b. It helps identify problems the researcher might encounter while collecting data. c. It justifies the existence of a research gap. d. It gives the researcher preliminary data to present to the institutional review board in order to obtain permission to conduct research. e. It provides an idea of the timelines of the proposed study, including instrument completion and subject recruitment.

ANS: B, E

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Completing a pilot study may save the researcher difficulty later when the final steps of the research process are implemented. Pilot testing helps to identify problems that might be encountered while collecting data, and helps develop strategies for addressing potential problems. Following approval of the study by your institutional review board (IRB), the studys approved research plan is used to recruit 3 to 5 pilot subjects who meet the eligibility criteria.

The same study data collection methods are utilized, paying special attention to how long it takes to recruit a subject, obtain informed consent, and collect the data. Often, the participant is asked to identify questions or aspects of the process that were unclear or confusing. Based on the pilot study and feedback of the first subjects, data collection forms and methods of data collection may be modified to improve feasibility, validity, and reliability.

DIF: Cognitive Level: Analysis REF: MCS: 532 7. What are the four principal tasks of data collection? (Select the four that apply.) a. Performing constant comparison for qualitative data b. Maintaining research controls as indicated in the study design c. Solving problems that threaten to disrupt the study d. Cross-checking with the literature review e. Collecting data in a consistent way f. Staying with institutional review board permission g. Selecting subjects ANS: B, C, E, G In both quantitative and qualitative research, the investigator performs four tasks during the process of data collection. These tasks are interrelated and occur concurrently rather than in sequence. The tasks are: (1) selecting subjects, (2) collecting data in a consistent way, (3) maintaining research controls as indicated in the study design, and (4) solving problems that threaten to disrupt the study.

Chapter 21. Introduction to Statistical Analysis Test Bank

Gray Burns and Grove’s The Practice of Nursing Research (9e)

MULTIPLE CHOICE 1. A researcher who has conducted experimental research finds that in his 145-person hospital study the patients who are ambulated on the evening of abdominal surgery are less likely than the control group to develop postoperative pneumonia. What does the researcher infer? a. The control group resembled the experimental group in all important characteristics. b. Early ambulation and pneumonia are strongly related. c. Evening-of-surgery ambulation will prevent some cases of postoperative pneumonia in abdominal surgery patients. d. Careful support of the abdomen is important for postoperative ambulation in patients who have had abdominal surgery.

ANS: C Statisticians use the term inference or infer in somewhat the same way that a researcher uses the term generalize. Inference requires the use of inductive reasoning. One infers from a specific case to a general truth, from a part to the whole, from the concrete to the abstract, from the known to the unknown. When using inferential reasoning, one can never prove things; one can never be certain. However, the rules that have been established with regard to statistical procedures so as to increase the probability that inferences are accurate. Inferences are made cautiously and with great care. Researchers use inferences to infer from the sample in their study to the larger population.

DIF: Cognitive Level: Analysis REF: MCS: 537 2. What is this particular distribution called? a. Bimodal b. Normal c. Camelesque d. Negatively skewed ANS: A

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Another characteristic of distributions is their modality. Most curves found in practice are unimodal, which means that they have one mode and frequencies progressively decline as they move away from the mode. Symmetrical distributions are usually unimodal. However, curves can also be bimodal or multimodal. accurately reflect the shape of the population from which the sample was taken.

DIF: Cognitive Level: Application REF: MCS: 540 3. A researcher reports that the heights of men aged 53 living in Rapid City, South Dakota, are between 57 and 60 and that the confidence interval is calculated at the p <.05 level. What does this mean? a. If the heights of men in Rapid City, South Dakota, do not fall within the confidence interval at least 5% of the time, a type I error has occurred. b. If a 53-year-old man in Rapid City, South Dakota, is measured, there is a 95% chance that his height will fall in the 57 through 60 interval. c. Ninety-five percent of the 53-year-old men living in Rapid City, South Dakota, are between 57 and 60. d. The heights of the men in the sample were all between 57 and 60, and the sample was representative of 95% of the men in town.

ANS: B When the probability of including the value of the parameter within the interval estimate is known, this is referred to as a confidence interval. Calculating a confidence interval involves the use of two formulas to identify the upper and lower ends of the interval. A confidence interval is actually an estimate.

DIF: Cognitive Level: Synthesis REF: MCS: 541 4. There are four data sets: A: 1, 1, 1, 1, 1, 10, 10, 10, 10 B: 2, 2, 2, 2, 4, 8, 8, 8, 9

Gray Burns and Grove’s The Practice of Nursing Research (9e)

C: 3, 4, 4, 5, 5, 5, 6, 6, 7 D: 1, 2, 3, 4, 5, 6, 7, 8, 9 What is the mean of the four individual data sets? a. 5, 5, 5, 5 b. 1, 4, 5, 5 c. 1, 2, 5, 5 d. 5 ANS: A The measures of central tendency are descriptive statistics. The statistics that represent measures of central tendency are the mean, median, and mode. All of these statistics are representations or descriptions of the center or middle of a frequency distribution. The mean is the arithmetic average of all of a variables values. The median is the exact middle value (or the average of the middle two values if there is an even number of observations). The mode is the most commonly occurring value in a data set. In a normal curve, the mean, median, and mode will be equal or approximately equal DIF: Cognitive Level: Analysis REF: MCS: 538 5. There are four data sets: A: 1, 1, 1, 1, 1, 10, 10, 10, 10 B: 2, 2, 2, 2, 4, 8, 8, 8, 9 C: 3, 4, 4, 5, 5, 5, 6, 6, 7 D: 1, 2, 3, 4, 5, 6, 7, 8, 9 What is the median of the four individual data sets? a. 5, 5, 5, 5

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. 1, 4, 5, 5 c. 1, 2, 5, 5 d. 5 ANS: B The measures of central tendency are descriptive statistics. The statistics that represent measures of central tendency are the mean, median, and mode. All of these statistics are representations or descriptions of the center or middle of a frequency distribution. The mean is the arithmetic average of all of a variables values. The median is the exact middle value (or the average of the middle two values if there is an even number of observations). The mode is the most commonly occurring value in a data set. In a normal curve, the mean, median, and mode will be equal or approximately equal.

DIF: Cognitive Level: Analysis REF: MCS: 538 6. There are four data sets: A: 1, 1, 1, 1, 1, 10, 10, 10, 10 B: 2, 2, 2, 2, 4, 8, 8, 8, 9 C: 3, 4, 4, 5, 5, 5, 6, 6, 7 D: 1, 2, 3, 4, 5, 6, 7, 8, 9 What is the mode of the four individual data sets? a. 5, 5, 5, 5 b. 1, 4, 5, 5 c. 1, 2, 5, none d. 1 ANS: C

Gray Burns and Grove’s The Practice of Nursing Research (9e)

The measures of central tendency are descriptive statistics. The statistics that represent measures of central tendency are the mean, median, and mode. All of these statistics are representations or descriptions of the center or middle of a frequency distribution. The mean is the arithmetic average of all of a variables values. The median is the exact middle value (or the average of the middle two values if there is an even number of observations). The mode is the most commonly occurring value in a data set. In a normal curve, the mean, median, and mode will be equal or approximately equal.

DIF: Cognitive Level: Analysis REF: MCS: 538 7. Which of the following is the best example of a normally distributed data set? a. 1, 1, 1, 1, 1, 10, 10, 10, 10 b. 2, 2, 2, 2, 4, 8, 8, 8, 9 c. 3, 4, 4, 5, 5, 5, 6, 6, 7 d. 1, 2, 3, 4, 5, 6, 7, 8, 9 ANS: C The measures of central tendency are descriptive statistics. The statistics that represent measures of central tendency are the mean, median, and mode. All of these statistics are representations or descriptions of the center or middle of a frequency distribution. The mean is the arithmetic average of all of a variables values. The median is the exact middle value (or the average of the middle two values if there is an even number of observations). The mode is the most commonly occurring value in a data set. In a normal curve, the mean, median, and mode will be equal or approximately equal.

DIF: Cognitive Level: Analysis REF: MCS: 538 8. One hundred students took an exam; the mean of the test was 45%, and the median was 38%; seventy students scored below the mean, but three scored more than 96%. This would represent what type of distribution? a. Normal

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. Positively skewed c. Negatively skewed d. Leptokurtic ANS: B Any curve that is not symmetrical is referred to as skewed or asymmetrical. Skewness may be exhibited in the curve in a variety of ways. A curve may be positively skewed, which means that the largest portion of data is below the mean. A curve can also be negatively skewed, which means that the largest portion of data is above the mean. A normal curve is symmetric and has no skew. Few samples will be perfectly symmetrical; however, as the deviation from symmetry increases, the seriousness of the impact on statistical analysis increases. In a positively skewed distribution, the mean is greater than the median, which is greater than the mode. In a negatively skewed distribution, the mean is less than the median, which is less than the mode.

DIF: Cognitive Level: Analysis REF: MCS: 540 9. In the following illustration of a negatively skewed curve, which line represents the mode? a. First dotted line b. Second dotted line c. Third dotted line ANS: C In a skewed distribution, the mean, median, and mode are not equal. In a negatively skewed distribution, the mean will be less than the median, which will be less than the mode.

DIF: Cognitive Level: Application REF: MCS: 540 10. Which of the following distribution curves demonstrates the least amount of variation in the scores? a. The least amount of variation would be in the first curve. b. The least amount of variation would be in the second curve.

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c. The least amount of variation would be in the third curve. d. The amount of variation cant be defined by the curve.

ANS: A Kurtosis explains the degree of peakedness of the distribution curve, which is related to the spread of the variance of scores. An extremely peaked curve is referred to as leptokurtic, an intermediate degree of kurtosis as mesokurtic, and a relatively flat curve as platykurtic. The less peaked the curve, the more variation is present.

DIF: Cognitive Level: Application REF: MCS: 541 11. is the symbol for which of the following? a. Sample mean b. Population mean c. Population variance d. Sample variance ANS: A Use of the terms statistic and parameter can be confusing because of the various populations referred to in statistical theory. A statistic (such as a mean, ) is a numerical value obtained from a sample. A parameter is a true (but unknown) numerical characteristic of a population. For example, is the population mean or arithmetic average. The mean of the sampling distribution (mean of samples means) can also be shown to be equal to . Thus, a numerical value that is the mean () of the sample is a statistic; a numerical value that is the mean of the population () is a parameter.

DIF: Cognitive Level: Comprehension REF: MCS: 537 12. A researcher conducts a statistical test that reveals that the four groups analyzed differed. The researcher wants to discover which one or ones of the four differed from the others. The researcher must then perform a post hoc analysis. What will this involve?

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a. Design of a second research study, using a new sample b. Descriptive statistics about the sample demographics c. Qualitative research generating new themes and ideas d. A second statistical test using the original data ANS: D Post hoc analyses are commonly performed in studies with more than two groups when the analysis indicates that the groups are significantly different but does not indicate which groups are different. A post hoc analysis must be performed to determine which of the three groups are significantly different. In other studies, the insights obtained through the planned analyses generate further questions that can be examined with the available data.

DIF: Cognitive Level: Application REF: MCS: 545 13. Where would one find approximately 95% of the scores in the following example if scores are normally distributed?

Scores ranged from 30 to 68, M = 45, SD = 7. a. Between 37 and 61 b. Between 38 and 52 c. Between 31 and 59 d. Between 30 and 68 ANS: C The range, standard deviation, and variance are statistics that describe the extent to which the values in the sample vary from one another. The most common of these statistics to be reported in the literature is the standard deviation, because of its direct association with the normal curve.

If the frequency distribution of any given variable is approximately normal, knowing the standard deviation of that variable allows us to know what percentages of subjects values on that variable fall between +1 and 1 standard deviation. Referring back to the hypothetical frequency distribution of pain in Figure 21-1, when we calculate a standard deviation, we know that

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34.13% of the subjects pain scores were between the mean pain score and 1 standard deviation above the mean pain score. We also know that 34.13% of the subjects pain scores were between the mean pain score and 1 standard deviation below the mean. The middle 95.44% of the subjects scores were between 2 standard deviation and +2 standard deviations.

DIF: Cognitive Level: Evaluation REF: MCS: 541 14. If a researcher wishes to predict with 97.5% accuracy, the level of significance would be a. .05 b. .01 c. .25 d. .025 ANS: D If one wishes to predict with 95% accuracy, the level of significance (p) is 1 minus 95% = .05. In nursing research, alpha is usually set at 0.05, meaning that the researcher will allow a 5% or lower chance of making a type I error.

DIF: Cognitive Level: Application REF: MCS: 535 MULTIPLE RESPONSE 1. A researcher states in an article that a new experimental treatment, trialed in the outpatient setting in a tri-physician practice in northern Oregon, produces better outcomes than the control treatment for patients with COPD. Thep-value given is p <.05. What does this mean? (Select all that apply.) a. There is better than a 95% chance that at the research site mentioned in the article the experimental treatment really DOES produce better outcomes for patients with COPD. b. The probability of error is 95%. c. There is very little chance that the intervention is effectiveless than a 5% chance, in fact.

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d. There is better than a 95% chance that the experimental treatment will produce better outcomes for all COPD patients. e. There is less than a 5% chance that the researcher has reached this conclusion in error.

ANS: A, D, E Probability theory addresses statistical analysis as the likelihood of accurately predicting an event or the extent of an effect. In probability theory, the meaning of statistical results is interpreted by the researcher in light of his or her knowledge of the field of study. Probability is expressed as a lowercase p, with values expressed as percentages or as a decimal value ranging from 0 to 1.

DIF: Cognitive Level: Synthesis REF: MCS: 535 2. A null hypothesis is stated. The null hypothesis is, There is no difference between 10 mcg and 20 mcg of vitamin D3 in prevention of osteoporosis. What are the implications of this statement, concerning that hypothesis and type I error? (Select all that apply.) a. Rejecting the null hypothesis when it actually is false means that the researcher has made a type I error in concluding that there is a difference between 10 mcg and 20 mcg of vitamin D3 in preventing osteoporosis. b. Making the statement is itself a type I error. c. Whether the null hypothesis is true or not makes no difference in terms of type I error. d. Whether or not the researcher rejects the null hypothesis makes no difference in terms of type I error. e. Rejecting the null hypothesis when it actually is false means that the researcher concludes that there is a difference between 10 mcg and 20 mcg of vitamin D3 in preventing osteoporosis, and there is no error. f. Rejecting the null hypothesis when it actually is true means that the researcher concludes that there is no difference between 10 mcg and 20 mcg of vitamin D3 in preventing osteoporosis, but the researcher thinks there is and has made a type I error.

ANS: E, F

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Type I error is the probability of rejecting the null hypothesis when it is in fact true. It is also called alpha []. In nursing studies, this is usually .05, which equals 5%. To test the null hypothesis, the researcher consults a statistics website or book, to discover the decision point or cutoff point, which is the value at which rejecting the null hypothesis would be the wrong decision only 5% of the time. Then the researcher calculates the statistic, based on the data. If the value of the statistic is less than the cutoff point, the null hypothesis standsit is not rejected. If the value of the statistic is more than the cutoff point, the null hypothesis is rejected. This will be the correct decision 95% of the time.

DIF: Cognitive Level: Analysis REF: MCS: 535 3. A null hypothesis is stated. The null hypothesis is, There is no difference between one baby aspirin every day and no baby aspirin at all in prevention of myocardial infarction. What are the implications of this statement, concerning that hypothesis and type II error? (Select all that apply.) a. Accepting the null hypothesis when it actually is true means that the researcher has made a type II error in concluding that there is no difference between 10 mcg and 20 mcg of vitamin D3 in preventing osteoporosis. b. Making the statement is itself a type II error. c. Whether the null hypothesis is true or not makes no difference in terms of type II error. d. Whether or not the researcher rejects the null hypothesis makes no difference in terms of type II error. e. Accepting the null hypothesis when it actually is true means that the researcher concludes that there is no difference between 10 mcg and 20 mcg of vitamin D3 in preventing osteoporosis, and there is no error. f. Accepting the null hypothesis when it actually is false means that the researcher concludes that there is no difference between 10 mcg and 20 mcg of vitamin D3 in preventing osteoporosis, when there actually IS a difference. The researcher has therefore made a type II error.

ANS: E, F Type II error is the probability of retaining the null hypothesis when it is in fact false. In nursing research, type II error is usually set at .20. This means that a type II error, failure to detect a

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difference when it indeed exists, will occur 20% of the time. One minus beta [] equals the power of the study. This is the research studys power to detect a difference when it indeed does exist.

DIF: Cognitive Level: Analysis REF: MCS: 535 4. As researcher designs a study to measure the effect on patient satisfaction of the nurse stating to the patient at least once a day, Youre a good person. The researcher sets the alpha (type I error) for the study at p <.10 because the intervention is free, it needs next to no time to enact, and it is harmless. If the alpha is set at .10, what is the effect on the beta [] and on type II error?

(Select all that apply.) a. Beta [] stays the same. b. Type II error becomes less likely. c. Type II error becomes more likely. d. Beta [] decreases. e. Beta [] increases as well. f. Type II error stays the same.

ANS: B, D The researcher chooses the probability of making a type I error when setting alpha [], and if the researcher sets the probability of making a type I error quite low, perhaps only 1%, the probability of making a type II error, [], increases. By the same token, if the researcher sets the probability of making a Type I error quite high, perhaps 10%, the probability of making a type II error decreases.

DIF: Cognitive Level: Analysis REF: MCS: 536 5. In statistical hypothesis testing, which of the following occur before the data are collected?

(Select all that apply.) a. The beta (type II error) is set. b. A power analysis is conducted. c. The null hypothesis is accepted or rejected.

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d. The alpha (type I error) is set. e. The primary null hypothesis is stated.

ANS: A, B, D, E The following steps outline each of the components of statistical hypothesis testing. The null hypothesis is stated. The study alpha (type I error) is set. The study beta (type II error) is set. A power analysis is performed. The study is conducted. The statistic is computed, based on the data obtained. The obtained statistic is compared with the critical value for the alpha chosen. If the obtained statistic is greater than the critical value, the null hypothesis is rejected; if the obtained statistic is less than the critical value, the null hypothesis is accepted.

DIF: Cognitive Level: Analysis REF: MCS: 535 6. If beta, , is the probability of making a type II error, what is 1 minus ? (Select all that apply.) a. Alpha [] b. A relationship exists c. The power of the study d. The likelihood that the null hypothesis is incorrect e. The probability of not making a type II error ANS: C, E Power is the probability that a statistical test will detect an effect when it actually exists.

Therefore, power is the inverse of type II error and is calculated as 1 . Recall that type II error is the probability of retaining the null hypothesis when it is in fact false. When the researcher sets type II error at 0.20 prior to conducting a study, this means that the power of the planned statistic has been set to 0.80. In other words, the statistic will have an 80% chance of detecting an effect if it actually exists.

DIF: Cognitive Level: Analysis REF: MCS: 536 7. A researcher is concerned about the power of his study. His planned interventional study examines the effect upon depression of instituting twice-yearly trips with a Road Scholar

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program for widows and widowers who have, 1 to 2 years before, lost a spouse to a long illness.

What strategies could make type II error less likely? (Select all that apply.) a. Decreasing the effect size b. Increasing the alpha from .05 to .10 c. Increasing the beta from .20 to .30 d. Decreasing the beta from .20 to .10 e. Decreasing the alpha from .05 to .025 f. Increasing the sample size ANS: B, D, F Power is the probability that a statistical test will detect an effect when it actually exists.

Therefore, power is the inverse of type II error and is calculated as 1 . Recall that type II error is the probability of retaining the null hypothesis when it is in fact false. When the researcher sets type II error at 0.20 prior to conducting a study, this means that the power of the planned statistic has been set to 0.80. In other words, the statistic will have an 80% chance of detecting an effect if it actually exists. Often, reported studies failing to reject the null hypothesis (in which power is unlikely to have been examined) will have a low power level to detect an effect if one exists.

Until recently, the researchers primary interest was in preventing a Type I error. Therefore, great emphasis was placed on the selection of a level of significance but little on power. This point of view is changing. Power analysis involves determining the required sample size needed to conduct the study. Cohen identified four parameters of power: (1) significance level, (2) sample size, (3) effect size, and (4) power. If three of the four are known, the fourth can be calculated by using power analysis formulas. Effect size is a constant; it is the degree to which the phenomenon is present in the population or the degree to which the null hypothesis is false.

Consequently, if the researcher wants to increase a studys power, the sample size must be increased, or the level of significance must be set at a less stringent level.

DIF: Cognitive Level: Analysis REF: MCS: 536 8. Findings can be statistically significant be clinically not significant. Which of the following studies with statistically significant findings exemplify this? (Select all that apply.)

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a. Seventy-five seconds of UV light daily can completely reverse the symptoms of allergic dermatitis. b. Eating a cup of salad greens daily increases ones life expectancy by 2 years. c. Petting a cat for five minutes daily increases ones endorphin levels. d. Exercise Program Delta causes weight loss of 6.3 pounds per year in morbidly obese women. e. Talking to a crying baby calms the baby more than ignoring it; picking up the baby calms it more than talking to it. f. Medication R15B, taken daily from age 13, completely controls cystic acne by age 23.

ANS: C, D, E, F The findings of a study can be statistically significant but may not be clinically important. For example, one group of patients might have a body temperature 0.1 F higher than that of another group. Data analysis might indicate that the two groups are statistically significantly different.

However, the findings have little or no clinical importance due to the small difference in temperatures between groups. Persons with dermatitis would find the UV light treatment almost miraculous. Two extra years of life may be clinically important to those with good quality of life.

Increasing endorphins is not due only to petting cats, so this study is not particularly significant, clinically. A weight loss of 6.3 pounds per year is not large enough to make a significant difference in the life of a morbidly obese woman. Picking up crying babies is something that even ones grandmother knows; this is not clinically useful. A medication that controls cystic acne ten years later is of little use to the adolescent who is miserable with acne.

DIF: Cognitive Level: Analysis REF: MCS: 537 9. A measured value is within two standard deviations of the mean but not within one standard deviation, and it is greater than the mean. The distribution is very close to a normal distribution.

What does this signify? (Select all that apply.) a. This particular value is not an outlier. b. In the data set, almost 2/3 of the values are closer to the mean than this one is. c. The data point falls within the majority of the measured values, in terms of its closeness to the mean.

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d. In the data set, at least 4% of the values are further from the mean than this particular value is. e. In this data set, between 65% and 95% of the values are smaller in value than this one is.

ANS: A, B, D, E The range, standard deviation, and variance are statistics that describe the extent to which the values in the sample vary from one another. The most common of these statistics to be reported in the literature is the standard deviation, because of its direct association with the normal curve.

If the frequency distribution of any given variable is approximately normal, knowing the standard deviation of that variable allows the reader to know what percentages of subjects values on that variable fall between +1 and 1 standard deviation. In a normal distribution, when a standard deviation is calculated, 34.13% of the values are between the mean score and 1 standard deviation above the mean. Similarly, 34.13% of the values are between the mean score and 1 standard deviation below the mean. The middle 95.44% of the subjects scores are between +2 standard deviations and 2 standard deviations.

DIF: Cognitive Level: Synthesis REF: MCS: 541 10. Which of the following are true about a type II error? (Select all that apply.) a. It is more likely to occur when p <.01 rather than when p <.05. b. It is extremely likely to occur when p <.001. c. It occurs when the null hypothesis is true but rejected. d. It is a possibility only when there are statistically nonsignificant results in a study. e. It is a possibility only when there are statistically significant results in a study.

Chapter 22.

Test Bank MULTIPLE CHOICE 1. The following is the frequency distribution for a set of data. What is the sets mode?

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X

f

5

1

4

0

3

2

2

3

1

1

a. 5 b. 4 c. 3 d. 1 ANS: C The measures of central tendency are mode, median (MD), and mean (). The mode is the numerical value or score that occurs with the greatest frequency in a data set. It does not necessarily indicate the center of the data set.

DIF: Cognitive Level: Analysis REF: MCS: 555 2. In the data set below, what is the mean ()?

X

f

5

4

4

2

3

1

2

1

1

2

a. 4 b. 3.5 c. 3 d. 2.5

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ANS: B The measures of central tendency are mode, median (MD), and mean (). The mean is the arithmetic average of all a variables values in a study and is the most commonly reported measure of central tendency. The mean is the sum of the scores divided by the number of scores being summed. Mean () = N = 35 10 = 3.5.

DIF: Cognitive Level: Analysis REF: MCS: 555 3. The median is represented by which score for the following data set?

Data set: 1, 2, 4, 7, 7, 8, 10, 10, 10, 18 a. 10 b. 8 c. 7.5 d. 7 ANS: C The median (MD) is the score at the exact center of the ungrouped frequency distribution. It is the 50th percentile. To obtain the MD, sort the values from lowest to highest. If the number of values is an uneven number, exactly 50% of the values are above the MD and 50% are below it.

If the number of values is an even number, the MD is the average of the two middle values. The median for this set is 7.5, since the data set contains an even number of values, and the two numbers in the middle are 7 and 8. Their average is 7.5.

DIF: Cognitive Level: Analysis REF: MCS: 553 4. Which of the following measures is the most helpful both for providing a quantification of dispersion and for providing a way to interpret how far away from the mean each individual score is? a. Standard deviation b. Difference scores

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c. Range d. Magnitude ANS: A Measures of dispersion, such as the range, difference scores, variance, and standard deviation, provide important insight into the nature of the data. The standard deviation is an important statistic, both for understanding dispersion within a distribution and for interpreting the relationship of a particular value to the distribution.

DIF: Cognitive Level: Analysis REF: MCS: 554 5. Which of the following measures is merely a simple difference score? a. Standard deviation = 2.41 b. Difference scores = 2, 2, 1, +2, and +3 c. Range = 8 d. Variance = 5.80 ANS: A The simplest measure of dispersion is the range. In published studies, range is presented in two ways: (1) the range is the lowest and highest scores, or (2) the range is calculated by subtracting the lowest score from the highest score. In this form, the range is a difference score that uses only the two extreme scores for the comparison. The range is generally reported in published studies but is not used in further analyses.

DIF: Cognitive Level: Analysis REF: MCS: 554 6. The data set is: 2, 3, 6, 7, 12. A measure of dispersion is calculated, and it is about 3.5. What is this measure of dispersion? a. The difference score b. The variance c. The range

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d. The standard deviation ANS: D The definition of standard deviation (SD) is the average difference between the mean and each of the scores in the set. Standard deviation (SD) is a measure of dispersion that is the square root of the variance. SD is the most precise analysis technique for examining the distribution of scores.

SD includes difference scores in its calculation but does not involve the use of standardized scores.

DIF: Cognitive Level: Application REF: MCS: 555 7. The data set is as follows: Ford, Ford, Chevy, Toyota, Ford, Ford, Chevy, Dodge, Dodge, Dodge, Ford, Subaru, Chevy, Toyota, Chevy. What measures of central tendency and dispersion will be used with this set? a. Difference scores b. Range c. Median d. Mode ANS: D The data are not inherently numerical in nature and represent only a nominal level of measurement. None of the listed measures of variability are suitable for nominal-level data. The mode is the only measure of central tendency appropriate for nominal data. The mode is the numerical value or score that occurs with the greatest frequency in a data set.

DIF: Cognitive Level: Application REF: MCS: 552 8. Twenty student nurses take the NCLEX examination. If the average of the twenty scores is known, how many degrees of freedom are there in the sample? a. 18 b. 19

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c. 20 d. 21 ANS: B The concept of degrees of freedom was used originally in reference to computing a confidence interval, but it applies to any statistical computation. Degrees of freedom are the number of independent pieces of information that are free to vary in order to estimate another piece of information. If, for instance, the mean and the total n are known, if all of the values except one are known, the last one can be calculated. However, if all except two are known, one has the freedom to vary, and the other ones value is then set. In calculations, the degrees of freedom (df) are n 1. This means that there are n 1 independent observations in the sample of n data points that are free to vary (to be any value).

DIF: Cognitive Level: Application REF: MCS: 558 MULTIPLE RESPONSE 1. The Stanford Binet Intelligence Quotient is a normed intelligence test, and its IQ measures are quite normally distributed. Its standard deviation is 16. If the test were perfectly normal in its distribution, this would mean which of the following? (Select all that apply.) a. There are more people with IQs of 100 than any other number. b. For every person with an IQ of 120, there is one with an IQ of 80. c. More than 95% of people have IQs between 68 and 132. d. If someones IQ is measured as 109, and years later it is measured as 112, someone elses IQ has dropped three points. e. About 14% of people have IQs between 117 and 132. f. Excluding people with IQs of exactly 100, half of the remainder have IQs lower than 100, and the other half have IQs higher than 100.

ANS: A, B, C, E, F The normal curve is a perfectly symmetrical frequency distribution. The value at the exact center of a normal curve is the mean of the values. When a frequency distribution is shaped like the

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normal curve, we know that 34.13% of the subjects scored between the mean and 1 standard deviation above the mean and 34.13% of the subjects scored between the mean and 1 standard deviation below the mean. This means that 68.26% of the subjects scored between 1 and +1 standard deviations. Because the normal curve is perfectly symmetrical, it is known that 50% of the subjects scored above the mean, and 50% of the subjects scored below the mean.

Furthermore, 95.44% of the subjects scored between 2 and +2 standard deviations.

DIF: Cognitive Level: Synthesis REF: MCS: 555 2. Female graduate nurses scored an average of 89% on the first midterm examination. Male graduate nurses also scored an average of 89% on the first midterm examination. What does this mean? (Select all that apply.) a. The same number of men and women failed the test. b. If the passing score is 75%, fewer students failed in both groups than the number that passed. c. The overall combined average on the midterm, for both classes, is 89%. d. Both classes have the same range. e. Both classes have identical variances and standard deviations. f. The median score is the same for both classes. g. The mode score is the same for both classes.

ANS: B, C The most commonly used measure of central tendency is the mean. The mean is the sum of the scores divided by the number of scores being summed. Consequently, it provides an average of the scores for each group. Combination of the groups provides the same group mean, since the means are identical. The values for mode and median are not provided, so no conclusions can be drawn about these. Measures of dispersion (standard deviation, range, variance) are not provided, and cannot be assumed to be identical between groups. Since 100% (the highest possible passing score) and 74.9% (the highest possible failing score) average 87.5% and the overall combined mean is higher than this, more students passed than failed in both groups, and this is true, as well, for the combined group.

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DIF: Cognitive Level: Synthesis REF: MCS: 553 3. Descriptive statistics are found in which of the following? (Select all that apply.) a. All quantitative descriptive research reports b. Some qualitative research reports c. All quantitative inferential research reports d. No qualitative research reports e. Some quantitative inferential research reports ANS: A, B, C For some types of studies, descriptive statistics will be the only approach to analysis of the data.

For other studies, descriptive statistics are the first step in the data analysis process, to be followed by inferential statistics.Data analysis begins with descriptive statistics in any study in which the data are numerical, including some qualitative studies.

DIF: Cognitive Level: Application REF: MCS: 550 4. There is a data set A: 3, 3, 3, 5, 6, 6, 8, 9, 9, 12, 13.

The data set B is created.

It is identical to A, except for its much larger last value.

Data set B: 3, 3, 3, 5, 6, 6, 8, 9, 9, 12, 83.

What is the effect of increasing the largest value upon the descriptive statistics of the data set?

(Select all that apply.) a. The mean increases. b. The median increases. c. The mode increases. d. The sets distribution changes from perfectly normal to somewhat skewed. e. The standard deviation increases.

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f. The variance increases. g. The range increases.

ANS: A, D, E, F, G The mode is the numerical value or score that occurs with the greatest frequency in a data set; unless this is the largest value, the mode will be unaffected. The median (MD) is the score at the exact center of the ungrouped frequency distribution; it is unaffected by a change in the value of the largest value. The mean is the arithmetic average of all a variables values in a study and is the most commonly reported measure of central tendency. The mean is sensitive to extreme scores such as outliers, and it will be affected by a large increase in the largest value. Measures of dispersion or variability are measures of individual differences of the members of the population and sample. Since they indicate how different the scores are, they all are affected by an extreme value.

DIF: Cognitive Level: Evaluation REF: MCS: 552 5. The confidence interval for five-year survival after Stage I breast cancer in a large sample of women living in Texas is 87.5% to 93.3%, at a p <.05 level of significance. What does this mean? (Select all that apply.) a. Texan women in the near future will be likely to have about a 90% chance of living five years after they are newly diagnosed with Stage I breast cancer. b. Women in Texas with Stage I breast cancer have a 95% chance of 90% survival, over a five-year period. c. Women in Texas with Stage I breast cancer have an 86% chance of five-year survival. d. In any sample of women in Texas newly diagnosed with Stage I breast cancer, there is about a 95% chance that their collective survival five years from now will be around 90%. e. Women in Texas can feel 95% confident that they will survive Stage I breast cancer.

ANS: A, D

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To determine how closely the sample mean approximates the population mean, the standard error of the mean is used to build a confidence interval. For that matter, a confidence interval can be created for many statistics, such as a mean, proportion, and odds ratio. At the p <.05 level, it merely signifies that there is a window of possibilities, and future samples have a 95% chance of falling within that window.

DIF: Cognitive Level: Application REF: MCS: 558 6. A researcher wants to select a way to measure how values in a research study are dispersed around the mean, and how homogeneous or heterogeneous they are, for a ratiolevel variable. The researcher might select which of the following? (Select all that apply.) a. Mode b. Range c. Frequency distribution d. Mean e. Standard deviation ANS: B, E Measures of dispersion or variability are measures of individual differences of the members of the population and sample. They indicate how values in a sample are dispersed around the mean.

These measures provide information about the data that is not available from measures of central tendency. They indicate how different the scores arethe extent to which individual values deviate from one another. If the individual values are similar, measures of variability are small and the sample is relatively homogeneous in terms of those values. When there are wide variations or differences in the scores, the sample is considered heterogeneous. The heterogeneity of sample scores or values is determined by measures of dispersion or variability. The measures of dispersion most commonly reported in nursing research are range, difference scores, variance, and standard deviation. All are useful for ratio-level data.

Chapter 23: Using Statistics to Examine Relationships Test Bank

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MULTIPLE CHOICE 1. Which of the following correlation coefficients shows the strongest relationship? a. .10 b. .85 c. .80 d. .42 ANS: B Pearsons product-moment correlation is represented by the letter r, and the value of the r is always between 1.00 and +1.00. A value of zero indicates no relationship between the two variables. The further the value from zero, the stronger the relationship. The number indicates the strength of the relationship, and the sign connotes whether that relationship is positive or negative (inverse). Consequently, a relationship of .60 is exactly as strong as a relationship of .60, although one is a positive relationship and the other a negative, or inverse, one. Values greater than .50 or less than .50 indicate strong correlations.

DIF: Cognitive Level: Analysis REF: MCS: 561 2. The Pearson product-moment correlation for two variables, fear of embarrassment and anxiety just before making an oral presentation, is r = .78, with a coefficient of determination of 0.6084. This means that what percentage of anxiety just before making an oral presentation can be attributed to fear of embarrassment? a. About 0.61% b. About 61% c. About 0.78 d. About 78% ANS: B

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One can also assess the magnitude of association by obtaining the coefficient of determination for the Pearson correlation. Computing the coefficient of determination simply involves squaring the r value. The r2 (multiplied by 100%) represents the percentage of variance shared between the two variables. In other words, the coefficient of determination explains how much of the change in value of one variable can be attributed to the fluctuation in value of the other variable.

DIF: Cognitive Level: Analysis REF: MCS: 564 3. What does the correlational diagram X Y mean? a. X obviously precedes Y in time. b. X is interchangeable with Y. c. There is a relationship between X and Y. d. Either X causes Y, or Y causes X. ANS: C Correlational analyses identify relationships or associations among variables. In the diagram, the arrow points to both variables, further confirming that one doesnt cause the other: X is merely related to Y and nothing more.

DIF: Cognitive Level: Comprehension REF: MCS: 560 4. A researcher develops a new instrument for measuring adjustment to widowhood in dependents whose spouses were killed in armed conflict. The researchers initial instrument contains 55 items, and he wants to trim these down to 25 or 30 but doesnt want to lose any of the main concepts. What method of statistical analysis will the researcher use, in order to pare this tool down to a manageable size without loss of content? a. Kendalls tau b. Spearmans rho c. Linear regression analysis d. Factor analysis

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ANS: D Factor analysis is one of the statistical techniques designed to examine interrelationships among large numbers of variables to reduce them to a smaller set of variables, and to identify clusters of variables that are most closely linked together (factors).

DIF: Cognitive Level: Application REF: MCS: 566 5. A study examines the relationship between strength of belief in previous lives (Yes, Not Sure, and No) and percentage of butterfat in milk most commonly purchased (Non-Fat, 1%, 2%, Whole). The data could be analyzed by which of the following statistical tests? a. Kendalls tau b. Pearsons product-moment correlation c. Principal components analysis d. Bland and Altman plot ANS: A If one or both of two study variables do not meet the assumptions for a Pearsons correlation, or if the variables are scaled on an ordinal scale of measurement (rather than interval or ratio), both the Spearman rank order correlation and Kendalls tau are more appropriate statistics. The Spearman rank-order correlation and Kendalls tau calculations involve converting the data to ranks, thereby discarding any variance or normality issues associated with the original values.

DIF: Cognitive Level: Analysis REF: MCS: 560 6. A Pearsons correlational analysis examines the relationship between variable A, hours of sleep per week, and B, symptom severity, in 43 women with post-polio syndrome. In accessing the table of values, the researcher uses which of the following numbers for degrees of freedom? a. 2 b. 4 c. 41

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d. 43 ANS: C Every inferential statistic has is own formula for degrees of freedom (numbers of values that are free to vary). The formula for degrees of freedom (df) for a Pearson r is n 2. Thus, in this case, the df is 43 2 = 41.

DIF: Cognitive Level: Analysis REF: MCS: 563 MULTIPLE RESPONSE 1. In the results and conclusions sections of a research paper about pre-delinquent behavior, the researcher mentions the strong correlational relationship between the number of incidents of predelinquent behavior and the number of hours the mother works outside the home. What does the author imply by stating this? (Select all that apply.) a. Some sort of test of correlation was performed and it reached statistical significance. b. As number of hours worked outside the home varied, so did the frequency of incidents of pre-delinquent behavior. c. Having a mother work many hours outside the home causes pre-delinquent behavior. d. Incidents of pre-delinquent behavior cause mothers to work more and more hours outside the home. e. As number of hours worked outside the home increased, so did the frequency of incidents of pre-delinquent behavior. f. The researchers avoided a type II error, in relation to the association between these two variables. g. The researchers operationalized the two study variables.

ANS: A, B, F, G Correlational analysis provides two pieces of information about the data: the nature or direction of the linear relationship (positive or negative) between the two variables and the magnitude (or strength) of the linear relationship. No direction of relationship is stated heremerely the fact that

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the variables are strongly correlated, meaning that as one varied, the other varied. Since the relationship between these two variables was statistically significant, no type II error occurred.

The probability of failing to reject the null hypothesis when it is in fact false is called type II error, and it is related to using a sample that is of insufficient size. Operationalization of a variable indicates how it will be measured or manipulated in a study; without operationalization, no measurement can occur.

DIF: Cognitive Level: Synthesis REF: MCS: 561 2. In the results and conclusions sections of a research article about adult morbid obesity and a history of being underweight during the first two years of life, the researcher mentions the strong negative correlation between these two variables. What does the author imply by stating this?

(Select all that apply.) a. Some sort of test of correlation was performed and it reached statistical significance. b. A person with morbid obesity is more likely than someone without it to have been underweight during the first two years of life. c. A person with morbid obesity is less likely than someone without it to have been underweight during the first two years of life. d. Having been underweight during the first two years of life prevents morbid obesity in adulthood. e. The researchers avoided a type I error, in relation to the association between these two variables. f. The researchers operationalized the two study variables.

ANS: A, C, E Correlational analysis provides two pieces of information about the data: the nature or direction of the linear relationship (positive or negative) between the two variables and the magnitude (or strength) of the linear relationship. In a negative linear relationship, when one value is high, the other value tends to be low. The probability of rejecting the null hypothesis when it is in fact true is called type I error, and it is impossible to know whether it has occurred until replication research takes place. Operationalization of a variable indicates how it will be measured or manipulated in a study; without operationalization, no measurement can occur.

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DIF: Cognitive Level: Synthesis REF: MCS: 561 3. What does bivariate correlational analysis do? (Select all that apply.) a. Provides an idea of which variable causes the other one b. Reflects a two-way connection or pattern c. Measures the strength of multiple relationships connected with a concept d. Measures the strength of the relationship between two variables e. Determines the direction of the relationship between two variables ANS: B, D, E Bivariate correlational analysis measures the magnitude of linear relationship between two, and only two, variables and is performed on data collected from a single sample. Correlational analysis provides two pieces of information about the data: the nature or direction of the linear relationship (positive or negative) between the two variables and the magnitude (or strength) of the linear relationship.

DIF: Cognitive Level: Comprehension REF: MCS: 560 4. What is the connection between a scatter plot and a calculation of correlation? (Select all that apply.) a. Constructing a scatter plot allows the researcher to visualize in advance whether a calculation of linear correlation is likely to reveal a relationship between the variables. b. Constructing a scatter plot produces a correlation coefficient, as does calculating correlation. c. A calculation of correlation should be performed before constructing a scatter plot, because the calculation is more scientific. d. The scatter plot provides a visual representation of the connection between two variables; a correlational calculation provides a quantification of the connection between the same variables. e. Just like calculation of correlation, constructing a scatter plot provides a way to quantify explained variance.

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ANS: A, D Scatter plots or scatter diagrams provide useful preliminary information about the nature of the relationship between variables. The researcher should develop and examine scatter diagrams before performing correlational analysis. Scatter plots may be useful for selecting appropriate correlational procedures, but most correlational procedures are useful for examining linear relationships only. A scatter plot can easily identify nonlinear relationships; if the data are nonlinear, the researcher should select statistical alternatives such as nonlinear regression analysis. A scatter plot is created by plotting the values of two variables on an x and y axis.

DIF: Cognitive Level: Analysis REF: MCS: 560 5. For which of the following levels of measurement would a parametric statistical test like the Pearson product-moment correlation be used? a. Nominal level b. Ordinal level c. Interval level d. Ratio level e. Dichotomous ANS: C, D The Pearson product-moment correlation coefficient is conducted to determine the relationship between two variables measured at least at the interval level of measurement. Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when data can be organized into categories of a defined property but the categories cannot be ordered. In interval level of measurement, distances between intervals of the scale are numerically equal.

However, it is not possible to provide the absolute amount of the attribute because of the absence of a zero point that actually means none of the measured quantity, on the interval scale. Ratio level of measurement is the highest form of measure and meets all the rules of the lower forms of measures: mutually exclusive categories, exhaustive categories, rank ordering, equal spacing between intervals, and a continuum of values. In addition, ratio-level measures have absolute zero points.

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DIF: Cognitive Level: Analysis REF: MCS: 561 6. Which of the following variables are able to be analyzed using Pearsons productmoment correlation? (Select all that apply.) a. Age b. Race c. Gender d. Score on the Spielberger State Trait Anxiety Inventory e. Years of education f. Temperature g. Nickname h. Size of hospital gown worn ANS: A, D, E, F Use of the Pearson product-moment correlation assumes that the variables are at the interval or ratio level of measurement. In this example, they would be only the four: age, score on the STAI, years of education, and temperature. Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when data can be organized into categories of a defined property but the categories cannot be ordered. In interval level of measurement, distances between intervals of the scale are numerically equal. However, it is not possible to provide the absolute amount of the attribute because of the absence of a zero point that actually means none of the measured quantity, on the interval scale. Ratio level of measurement is the highest form of measure and meets all the rules of the lower forms of measures: mutually exclusive categories, exhaustive categories, rank ordering, equal spacing between intervals, and a continuum of values. In addition, ratio-level measures have absolute zero points.

DIF: Cognitive Level: Application REF: MCS: 561 7. Twelve research studies show a strong correlation between low levels of education and poverty. A social scientist declares that the cure for poverty is in free education for all of the children of the poor. What are valid arguments against this declaration? (Select all that apply.)

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a. The scientist believes that a low level of education, in and of itself, causes poverty, but no study has demonstrated this. b. It is possible that low levels of education cause Item B, and Item B causes poverty. c. It is possible that multigenerational poverty causes lower levels of education. d. It is possible that low levels of education and poverty are both caused by social injustice. e. Twelve correlational research studies are not enough to demonstrate cause: at least 50 studies of 100 subjects each would be required for this.

ANS: A, B, C, D Correlational analysis provides two pieces of information about the data: the nature or direction of the linear relationship (positive or negative) between the two variables and the magnitude (or strength) of the linear relationship. A positive correlation is not an indication of causality, no matter how strong the statistical result.

DIF: Cognitive Level: Application REF: MCS: 561 8. The calculated Pearsons r was .95 in a research study on number of hours parents spent at childrens sporting events and number of arrests those children had experienced by age 30. What does this Pearsons value signify? (Select all that apply.) a. No relationship b. Weak linear relationship c. Moderate linear relationship d. Strong linear relationship e. Positive relationship f. Inverse relationship g. Negative relationship ANS: D, F, G

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Pearsons product-moment correlation is represented by the letter r, and the value of the r is always between 1.00 and +1.00. A value of zero indicates no relationship between the two variables. The further the value from zero, the stronger the relationship. The number indicates the strength of the relationship, and the sign connotes whether that relationship is positive or negative (inverse). Consequently, a relationship of .60 is exactly as strong as a relationship of .60, although one is a positive relationship and the other a negative, or inverse, one. Values greater than .50 or less than .50 indicate strong correlations.

Chapter 24: Using Statistics to Predict Test Bank MULTIPLE CHOICE 1. A researcher is studying daily carbohydrate intake and the next days first morning Accu-Chek value. After drawing a scatter plot, the researcher develops a multiple regression equation. What does the value R represent? a. The line of best fit b. The amount of change in Accu-Chek values that daily carbohydrate intake predicts c. Daily carbohydrate intake times Accu-Chek value d. The correlation between daily carbohydrate intake and the next days first morning Accu-Chek value ANS: D R is defined as the correlation between the actual y values and the predicted y values using the new regression equation. The R2 represents the percentage of variance in y explained by the predictor and is called the coefficient of determination.

DIF: Cognitive Level: Application REF: MCS: 572 2. A researcher is studying stress and various factors that seem to be related to it, in women with terminally ill spouses.Among other things, the researcher finds out that depression contributes to total stress; depression contributes to lack of exercise; a decreased amount of exercise

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contributes to depression; exercise relieves stress; guilt contributes to depression; exercise has no effect on guilt, but it affects total stress; stress worsens depression; and stress decreases motivation to perform exercise. This is an example of what problem commonly encountered in regression analyses? a. Multicollinearity b. Hazard ratio c. Odds ratio d. Predictive validity ANS: A Multicollinearity occurs when the independent variables in a multiple regression equation are strongly correlated with one another. The presence of multicollinearity does not affect predictive power; rather it causes problems related to generalizability and the stability of the findings. The first step in identifying multicollinearity is to examine the bivariate correlations among the independent variables.

DIF: Cognitive Level: Application REF: MCS: 573 3. Why does a researcher decide to calculate odds ratio instead of calculating linear regression when comparing whether a person voted in the last election and the persons gender? a. Voting records are sealed. b. Both predictor and dependent variable are dichotomous. c. Odds ratio is a simpler calculation. d. Strength of relationship is not an issue.

ANS: B When both the predictor and the dependent variable are dichotomous (having only two values; also called binary), the odds ratio is a commonly used statistic to obtain an indication of association. Linear regression is used to determine relationships with interval or ratio data. The odds ratio (OR) is defined as the ratio of the odds of an event occurring in one group to the odds

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of it occurring in another group. Put simply, the OR is a way of comparing whether the odds of a certain event is the same for two groups.

DIF: Cognitive Level: Analysis REF: MCS: 575 MULTIPLE RESPONSE 1. A researcher collects a nationally based set of data about cholesterol levels and age at first circulatory incident (myocardial infarction or cerebrovascular accident). The researcher performs a linear regression analysis in order to do which of the following? (Select all that apply.) a. Estimate the age at which circulatory incidents are likely to occur, given the cholesterol level. b. Determine how well the data fit the theoretical framework. c. Calculate the strength of the relationship between cholesterol levels and circulatory incidents. d. Determine whether there is a linear relationship between cholesterol levels and circulatory incidents. e. Derive the formula for the line of best fit. f. Obtain information from which to construct a better scatter plot.

ANS: A, C, D, E Simple linear regression provides a means to estimate the value of a dependent variable based on the value of an independent variable. Through regression, the strength of the relationship between two variables can be determined. Simple linear regression is an effort to explain the dynamics within the scatter plot by developing a formula for a straight line that best fits the data.

This has nothing to do with a theoretical framework. A scatter plot precedes development of a regression formula.

DIF: Cognitive Level: Application REF: MCS: 570 2. A researcher is studying number of cats in the home, and number of rodents plus crawling insects in the home, daily carbohydrate intake and the next days first morning Accu-Chek value.

After drawing a scatter plot, the researcher develops a multiple regression equation and

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determines R as .75 and R2 as .5625. What does the calculated value R2 represent? (Select all that apply.) a. It means the standard error, squared. b. It is the amount of rodent plus insect count that can be explained by the number of cats. c. It stands for the standard deviation of the data set y, squared. d. It estimates shrinking regression. e. It is the coefficient of determination. f. It is the explained variance.

ANS: B, E, F R is defined as the correlation between the actual y values and the predicted y values using the new regression equation. The R2 represents the percentage of variance in y explained by the predictor and is called the coefficient of determination.

DIF: Cognitive Level: Application REF: MCS: 573 3. Which of the following terms in correlational research mean the same thing? (Select all that apply.) a. Predictor variable b. Dichotomous variable c. Dependent variable d. Multicollinearity e. Independent variable ANS: A, E The independent (predictor) variable or variables are identified as being predictive of variation in the value of the dependent (outcome) variable. Multicollinearity refers to highly correlated predictor variables that are difficult to tease out from one another. A dichotomous variable has only two possible values.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Comprehension REF: MCS: 574 4. A researcher conducts research on optimism. The researcher is calculating a multiple regression equation to predict levels of optimism and wishes to consider religious affiliation as one of the predictor variables. The researcher creates several dummy variables for this purpose. Why must this be done? (Select all that apply.) a. It is safer to create more variables than fewer, since they may each contribute. b. Multiple regression requires that the researcher enter numerical values, not names such as Lutheran, Orthodox Jewish, Buddhist, Islamic, and so forth. c. Reducing nominal or categorical data to one or a series of dichotomous values allows mathematical computation of the regression equation. d. Religious affiliation is a protected entity under HIPAA and must be coded before it is used in calculations. e. The researchers aim is to develop a formula with which to calculate optimism, given certain other variables, so these must all be represented as numbers.

ANS: B, C, E Variables in a regression equation can take many forms. Traditionally, as with most multivariate analyses, variables are measured at the interval or ratio level. However, researchers also use categorical or dichotomous variables, by assigning the terms numbers to represent them (referred to as dummy variables). These numbers are further converted to binary numbers; after this, they are entered one digit at a time as a series of dummy variables. For instance, if a nominal or categorical variable has two values, one dummy variable may be used (0, 1). If a nominal or categorical variable has three or four values, however, two different dummy variables are used to represent them. For five to eight values, three dummy variables are used, and so forth.

DIF: Cognitive Level: Analysis REF: MCS: 574 5. What is a multiple regression equation? (Select all that apply.) a. One that represents the mathematical effect that several independent variables have on the dependent variable b. One in which the x-values are multiplied by one another

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c. One that explains more of the variance in y than does a single linear regression equation d. An experimental model for determining best practices e. One that uses more than one predictor variable to predict the value of the outcome variable f. One that explains all of the variance in the dependent variable, in terms of several independent variables ANS: A, C, E Multiple regression is an extension of simple linear regression in which more than one independent variable is entered into the analysis. Because the relationships between multiple predictors and y are tested simultaneously, the calculations involved in multiple regression analysis are very complex. Multiple regression is best conducted using a statistical software package. A multiple regression formula explains some or all of the variance in the dependent variable; it cannot explain all of it.

DIF: Cognitive Level: Analysis REF: MCS: 573 6. Why does a researcher decide to use logistic regression instead of linear regression to calculate survival odds after suffering an out-of-hospital heart attack, in persons of various ages, genders, and cardiac diagnoses? (Select all that apply.) a. Survival versus non-survival is a dichotomous variable. b. Having a heart attack is a variable that has many possible outcomes. c. Linear regression is less logical than is logistic regression. d. Age is a ratio-level variable. e. Gender is a nominal-level variable. f. Cardiac diagnosis is a nominal-level variable.

ANS: A, D, E, F Logistic regression replaces linear regression when the researcher wants to test a predictor or predictors of a dichotomous dependent variable. Logistic regression can have continuous

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predictors or nominal predictors or a combination of the two, with no assumptions regarding normality of the distribution.

DIF: Cognitive Level: Analysis REF: MCS: 576 7. Which of the following dependent variables is suitable for logistic regression analysis?

(Select all that apply.) a. How many compressions were delivered in the first minute post-code b. Serum sodium value c. Born on earthnot born on earth d. Height at adulthood e. Birth gender f. Whether a patient with cancer goes into remission ANS: C, E, F Logistic regression replaces linear regression when the researcher wants to test a predictor or predictors of a dichotomous dependent variable. Logistic regression can have continuous predictors or nominal predictors or a combination of the two, with no assumptions regarding normality of the distribution.

DIF: Cognitive Level: Analysis REF: MCS: 576 8. A researcher decides to study how many college freshmen with continuous enrollment graduate within four years, four-and-a-half years, five years, five-and-a-half years, and six years, and to analyze this according to what their majors at graduation are, as well as other demographic variables. Why would a Cox proportional hazards regression analysis be suitable for this research? (Select all that apply.) a. Demographic variables could affect time until graduation. b. The data of people who do not graduate at all may be informative. c. Attendance at college can present hazard. d. A predictor of the dependent variable is time-related.

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e. Only people who actually graduate by the end of twelve semesters will have their data analyzed.

ANS: A, B, D The purpose of a regression analysis is to predict or explain as much of the variance in the value of a dependent variable as possible. The major difference between using Cox regression as opposed to linear regression is the ability of survival analysis to handle cases where survival time is unknown. Whereas logistic regression yields odds ratios for each predictor to represent the relationship between that predictor and y, Cox regression yields hazard ratios.

DIF: Cognitive Level: Application REF: MCS: 570 9. Which of the following statements about prediction is true? (Select all that apply.) a. Simple linear regression can predict possible changes in A, given B. b. Multicollinearity is used to provide definitive attribution in predicting dependent variables with similar outcomes. c. Multiple regression can provide information about the strongest predictors, C, D, E, and F, associated with an outcome variable G. d. Odds ratio is used to predict the likelihood of a dichotomous event, in the light of a different dichotomous variable. e. Logistic regression is used to predict a dichotomous variable, using a variety of other variables. f. Cox hazard regression can predict the likelihood of an event occurring at certain points in time.

ANS: A, C, D, E, F Simple linear regression provides a means to estimate the value of a dependent variable based on the value of an independent variable. Multicollinearity occurs when the independent variables in a multiple regression equation are strongly correlated with one another. Multiple regression is an extension of simple linear regression in which more than one independent variable is entered into the analysis. When both the predictor and the dependent variable are dichotomous (having only two values; also called binary), the odds ratio is a commonly used statistic to obtain an indication of association. Logistic regression replaces linear regression when the researcher wants to test a

Gray Burns and Grove’s The Practice of Nursing Research (9e)

predictor or predictors of a dichotomous dependent variable. Logistic regression can have continuous predictors or nominal predictors or a combination of the two, with no assumptions regarding normality of the distribution. The major difference between using Cox regression as opposed to linear regression is the ability of survival analysis to handle cases where survival time is unknown. Whereas logistic regression yields odds ratios for each predictor to represent the relationship between that predictor and y, Cox regression yields hazard ratios.

Chapter 25: Using Statistics to Determine Differences Test Bank MULTIPLE CHOICE 1. What does the two-way chi-square test measure? a. Whether one variable seems related to another one b. Whether two variables cause one another c. Whether an intervention changes the dependent variables value d. Change over time ANS: A The chi-square (c) test compares differences in proportions of nominal level variables. A twoway chi-square is a statistic that tests whether proportions in levels of one variable are significantly different from proportions of the second variable. In other words, it detects whether one nominal variable seems to be related to another one.

DIF: Cognitive Level: Analysis REF: MCS: 587 2. In an ANOVA calculation evaluating causation, the mean square within groups value represents the ordinary amount of variation that exists in the data set. What does the mean square between groups value represent? a. The effect that the interventional conditions produce b. The average of all variations in the data set

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c. Total variation d. The differences that exist among the several interventional conditions ANS: A The term mean square (MS) is used interchangeably with the word variance. The formulas for ANOVA compute two estimates of variance: the between groups variance and the within groups variance. The between groups variance represents differences between the groups/conditions being compared, and the within groups variance represents differences among (within) each groups data. Therefore, the formula is F = MS between/MS within.

DIF: Cognitive Level: Analysis REF: MCS: 585 3. Which of the following tests is essentially a comparison of means? a. Mann-Whitney U b. Chi-square c. ANOVA d. t-test ANS: D One of the most common parametric analyses used to test for significant differences between group means of two samples is the t-test. In its calculation, the numerator is the difference scores of the means of the two samples. In addition, the test uses the pooled standard deviation of the two samples as the denominator.

DIF: Cognitive Level: Comprehension REF: MCS: 580 4. Why is post hoc statistical testing not performed with a two-group ANOVA? a. A researcher is reluctant to perform a post hoc analysis that would require a more stringent level of significance. b. The F-statistic would be invalidated by the second test.

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c. If hypothesis testing reveals that a difference between groups exists, it is obvious what two groups those are. d. Sample sizes are not large enough for this analysis.

ANS: C Post hoc tests have been developed specifically to determine the location of group differences after ANOVA is performed on data from more than two groups. The post-hoc analyses performed after the ANOVA preserves the same level of analysis as the ANOVA itself. The Fstatistic is not invalidated by performing a post hoc analysis. Sample size is not a consideration when performing a post hoc analysis.

DIF: Cognitive Level: Analysis REF: MCS: 586 5. What is unique about chi-square analysis? a. It is almost always statistically significant. b. It is used for two nominal variables c. It demands normal distribution, even of dichotomous variables. d. It is parametric.

ANS: B The chi-square (c) test compares differences in proportions of nominal level variables. Statistical significance may or may not exist. The test does not demand normal distribution, and it is nonparametric.

DIF: Cognitive Level: Analysis REF: MCS: 587 MULTIPLE RESPONSE 1. Below the third table in a research report, concerning switching infants to cows milk at six months of age instead of 12 months, is a notation: t(22) = 0.76, p = .41 What does this mean?

(Select all that apply.)

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a. A t-test was performed. b. Apparently 24 subjects participated in the study. c. There was a difference between groups. d. The difference between groups was not statistically significant. e. If there was an intervention, the intervention was more effective than the control condition. f. The results are generalizable. g. The researcher failed to reject the null hypothesis. h. A type I error occurred.

ANS: A, B, C, D, G One of the most common parametric analyses used to test for significant differences between group means of two samples is the t-test. It is conducted to discover whether a difference exists between two groups, or between a previous condition and the current condition in paired subjects. Degrees of freedom are equal to n 2. Not enough is known about the research to discern in which group the intervention was more effective. In this example, there was a difference between groups, but it was apparently not statistically significant, since p = .41, according to the notation below the graph. Only p-values of .05 and less would be statistically significant. If the researcher failed to reject the null hypothesis, no type I error could have occurred.

DIF: Cognitive Level: Synthesis REF: MCS: 580 2. A researcher is studying the effect upon pain of providing hypnosis with dental work. The researchers three groups are (1) hypnosis before and during the procedure, (2) hypnosis before but not during the procedure, and (3) no hypnosis. If the researcher plans to use an ANOVA for the statistical analysis, which would be an acceptable way to measure pain, for this study?

(Select all that apply.) a. Present versus absent b. Worse Some A Lot Unbearable c. 0- to 100-point verbal numerical scale d. Systolic blood pressure readings

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e. The force with which the subject squeezes a rubber ball with pressure gauge attached ANS: C, D, E The parametric statistics used to determine differences that are covered in this chapter are the independent samples t-test, paired or dependent samples t-test, and analysis of variance (ANOVA). ANOVA requires that the dependent variable be at the interval or ratio level: a verbal numerical scale, systolic blood pressure readings, and force with which the subject squeezes a rubber ball are all interval or ratio level variables.

DIF: Cognitive Level: Analysis REF: MCS: 580 3. A statistician measures the difference in songbird warble variation in twenty-five mockingbirds, both before and after nutritional supplementation with Dr. Petit Oiseaus Musical Bird Seed. Warble variation is determined by a computer program that detects sound frequency and pattern changes during a 15-minute period twice a day, and this data is averaged to represent number of warble variations per minute. What considerations determine choice of a test for this research? (Select all that apply.) a. The sample size is small to moderate. b. There is one group of birds and all receive the treatment. c. A before-after type of design is used. d. The independent variable is nominal level. e. Birds are divided into two groups. f. The independent variable is ratio level. g. The dependent variable is ratio level.

ANS: A, B, C, D, G The parametric statistics used to determine differences that are covered in this chapter are the independent samples t-test, paired or dependent samples t-test, and analysis of variance (ANOVA). If the assumptions for parametric analyses are not achieved or if study data are at the ordinal level, then the nonparametric analyses of Mann-Whitney U, Wilcoxon signed-ranks test,

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and Kruskal-Wallis H are appropriate techniques to use to test the researchers hypotheses. In this study, one group is compared before and after treatment. In such an instance, a paired t-test can be used, if the dependent variable is at the ratio or interval level. This test is particularly useful when only small samples are available for analysis; the sample is large enough.

DIF: Cognitive Level: Analysis REF: MCS: 580 4. A statistician measures the difference in songbird warble variation in twenty-five mockingbirds, both before and after nutritional supplementation with Dr. Petit Oiseaus Musical Bird Seed. Warble variation is determined by a cranky librarian, who characterizes the birds, before and after treatment, as one of the following Lots of Notes There! Fair Variety, and Quite The Redundant Little Song. What considerations determine choice of a test for this research?

(Select all that apply.) a. The sample size is small to moderate. b. There is one group of birds and all receive the treatment. c. A before-after type of design is used. d. The independent variable is nominal level. e. Birds are divided into two groups. f. The dependent variable is ordinal level. g. The dependent variable is ratio level.

ANS: B, C, D, F The parametric statistics used to determine differences that are covered in this chapter are the independent samples t-test, paired or dependent samples t-test, and analysis of variance (ANOVA). If the assumptions for parametric analyses are not achieved or if study data are at the ordinal level, then the nonparametric analyses of Mann-Whitney U, Wilcoxon signed-ranks test, and Kruskal-Wallis H are appropriate techniques to use to test the researchers hypotheses. In this study, one group is compared before and after treatment, and the dependent variable is at the ordinal level of measurement. In such an instance, a Wilcoxon signed-ranks test is appropriate.

This test is useful when a paired t-test would otherwise be performed, if only the dependent variable werent ordinal.

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DIF: Cognitive Level: Analysis REF: MCS: 580 5. A researcher designs a study to measure whether receiving a free season pass to a beautiful ski resort near Bountiful, Utah, increases the number of days a subject who has lived in the area for 1 to 3 years skis during the season. An independent samples t-test of correlation is used to measure the effect of receiving a season pass upon number of ski days. If, instead, the researcher decided to measure the subjects responses by asking them to check one of these four replies on a survey, Much more often than last year, More often than last year, Just about the same as last year, or Less often than last year, why would the independent samples t-test have to be abandoned for a Mann-Whitney U test instead? (Select all that apply.) a. The variable of skiing is measured at the nominal instead of the ratio level. b. The variable of skiing is now measured at the ordinal instead of ratio level. c. The variable amount skied is now measured at the nominal level instead of the ratio level. d. The variable amount skied is now measured at the ordinal level instead of the ratio level. e. Both variables levels have changed. f. The independent samples t-test used demands ratio-level or interval-level data. g. The Mann-Whitney U test allows for ordinal level values, but not nominal.

ANS: D, F, G The parametric statistics used to determine differences that are covered in this chapter are the independent samples t-test, paired or dependent samples t-test, and analysis of variance (ANOVA). If the assumptions for parametric analyses are not achieved or if study data are at the ordinal level, then the nonparametric analyses of Mann-Whitney U, Wilcoxon signed-ranks test, and Kruskal-Wallis H are appropriate techniques to use to test the researchers hypotheses. If the data do not meet the assumptions involving normality and/or equal variances for an independent samples t-test, then the nonparametric alternative is the Mann-Whitney U test. The MannWhitney U calculations involve converting the data to ranks, thereby discarding any variance or normality issues associated with the original values. In some studies, the data collected is ordinal level and the Mann-WhitneyU test is appropriate for analysis of the data.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Analysis REF: MCS: 580 6. Which of the following tests are parametric statistics that may be used to measure, clarify, or evaluate causation? (Select all that apply.) a. t-test for independent samples b. Mann-Whitney U test c. t-test for dependent samples d. Wilcoxon signed-rank test e. ANOVA f. Tukey Honestly Significant Difference (HSD) g. Kruskal-Wallis test h. Chi-square ANS: A, C, E, F The parametric statistics used to determine differences that are covered in this chapter are the independent samples t-test, paired or dependent samples t-test, and analysis of variance (ANOVA). In addition, the Tukey Honestly Significant Difference test is a post hoc test used to clarify which variables are related, after an ANOVA shows a significant difference.

DIF: Cognitive Level: Analysis REF: MCS: 580 7. What are the principal reasons why any nonparametric test of causality was used instead of a parametric one? (Select all that apply.) a. The assumptions for parametric analyses were not achieved. b. The effect that the interventional conditions produced was not measurable. c. The data were not normally distributed. d. The dependent variable was measured at the ordinal level. e. The results were not statistically significant.

ANS: A, C, D

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If the assumptions for parametric analyses are not achieved or if study data are at the ordinal level, then the nonparametric analyses of Mann-Whitney U, Wilcoxon signed-ranks test, and Kruskal-Wallis H are appropriate techniques to use to test the researcher hypotheses. T-tests and ANOVA assume a normal distribution and measurement of the dependent variable at the interval/ratio level.

DIF: Cognitive Level: Analysis REF: MCS: 580 8. What do the t-test and the ANOVA have in common? (Select all that apply.) a. They are both used when the dependent variable is ordinal. b. They both assume a normal distribution. c. They both compare groups to decide if they are the same or different. d. They both can be used to compare two groups. e. They both require secondary post hoc analyses. f. They both use the same statistical tables for interpretation of results. g. They are both parametric analyses.

ANS: B, C, D, G The t-test and ANOVA are both parametric analyses; as such, they both assume a normal distribution and cannot be used when the dependent variable is ordinal. Both are used to compare groups, and both can actually be used when there are two groups, although for more than one only the ANOVA is used. If used with three or more categories, the ANOVA requires secondary post hoc analysis if its results are statistically significant. They use the t-test and F-test, respectively, and each has a separate table.

DIF: Cognitive Level: Application REF: MCS: 580 9. Which of the following results would represent statistical significance, if the level of significance were set at .05 for each? (Select all that apply.) a. t = 8.43, p <.01 b. X2 = 10.83, p <0.1

Gray Burns and Grove’s The Practice of Nursing Research (9e)

c. F = 2.37, p <0.07 d. r = 0.2, p = .23 e. rs = .74, p = .049 ANS: A, E The obtained result from the calculation of the statistic is compared with the appropriate table, at the level of significance set by the researcher at the outset of the study. If that is p <.05, it is essential that the correct value be retrieved from the table, for comparison. Researchers often set the level of significance at .05. By that criterion, the two statistically significant values above are p <.01 and p = .049.

Chapter 26. Interpreting Research Outcomes MULTIPLE CHOICE 1. A researcher studies the effect on reading comprehension level of providing fourth-grade boys who are slow and ponderous readers with illustrated comic books for a six-week summer session instead of textbooks, hypothesizing that reading associated with pictures will results in a higher reading comprehension level. The researcher set a level of significance at p <.05. Analysis of the data from a study indicates that there was a significant difference between the two groups, which were randomly selected and composed of 100 subjects each. However, the experimental comic book groups scores improved less than did the scores of the boys who used the textbooks. The measured p-level was 0.026. What type of finding is this? a. Significant results that are in keeping with those predicted by the researcher b. Nonsignificant results c. Significant results that oppose those predicted by the researcher d. Mixed results ANS: C Significant results opposite those predicted, if the results are valid, are an important addition to the body of knowledge. An example would be a study in which the researchers proposed that

Gray Burns and Grove’s The Practice of Nursing Research (9e)

social support and ego strength were positively related. If the study showed that high social support was related to low ego strength, the result would be the opposite of that predicted. Such results, when verified by other studies, indicate that the theory being tested needs modification and refinement. Because these types of studies can affect nursing practice, this information is important.

DIF: Cognitive Level: Application REF: MCS: 594 2. The analysis of the data from a study indicates that there was a significant difference between the two groups, which were randomly selected and composed of 100 subjects each. The instruments measuring stress, mood, and various scaled measures of emotion were well normed, widely tested, and suitable. As the researcher begins interpretation of the data, she discovers that during data collection one of her assistants had recorded the demographic item household size incorrectly, understanding the item as number of people who live with you. There is no way to determine which research assistant worked with which research subject. What effect did this way of recording the data have on the study findings? a. That item cannot be analyzed as a ratio item and will have to be treated in a different way. b. None, because the numbers will be the same either way the data are collected. c. That particular item will have to be discarded, because it can no longer be analyzed. d. None, because post hoc statistical analysis will automatically adjust for this type of error.

ANS: A Many activities that occur during data collection affect the meaning of study results. Did your study have a high refusal rate for subject participation, or was the attrition high? Was the sample size sufficient? Did strategies for acquiring a sample eliminate important groups whose data would have influenced the results? Did you and your research team achieve intervention fidelity when the treatment was implemented? Did unforeseen events occur during the study that might have changed or had an impact on the data? Were measurement techniques consistent? What impact do inconsistencies have on interpreting results?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Methodological limitations result from factors such as nonrepresentative samples, weak designs, single setting, limited control over treatment (intervention) implementation, instruments with limited reliability and validity, limited control over data collection, and improper use of statistical analyses. Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when data can be organized into categories of a defined property but the categories cannot be ordered. Data that can be measured at the ordinal level can be assigned to categories of an attribute that can be ranked. In interval level of measurement, distances between intervals of the scale are numerically equal. Interval scales are assumed to be a continuum of values. Ratio level of measurement is the highest form of measure and meets all the rules of the lower forms of measures.

DIF: Cognitive Level: Synthesis REF: MCS: 592 3. In a cross-sectional study, a researcher studies career trajectories in nurses over the past twenty years. There are five correlational research hypotheses. Why are mixed results, related to significance of findings, to be expected? a. The study is cross-sectional, and the economy has made bedside care a more practical decision over the past few years. b. Groups across time cannot be expected to have the same responses to career advancement. c. The study is merely correlational. d. Five statistical hypotheses are being tested; not all of these can be expected to demonstrate statistical significance.

ANS: D Mixed results are probably the most common outcome of studies. In this case, one variable may uphold the characteristics predicted whereas another does not, or two dependent measures of the same variable may show opposite results.

DIF: Cognitive Level: Analysis REF: MCS: 594 4. A researcher working for a company that produces a standardized exam that predicts whether or not nursing students will pass the national licensure exam tests this tool at a level of

Gray Burns and Grove’s The Practice of Nursing Research (9e)

significance of = .01, with power = .91. The results are statistically significant. What interpretation can the researcher justifiably make? a. Findings are important to nursing schools, and valuable for them. b. The exam should be used by all nursing schools. c. There is good evidence that the results can be replicated, with similar results. d. Results will be the same if the study is repeated with another sample.

ANS: C The researcher chooses the probability of making a Type I error when setting , the level of significance. Nursing researchers usually set a level of significance of p <.05. A level of significance of p <.01 is much more stringent, and decreases the possibility of error to 1%.

Significant results that coincide with the researchers predictions are the easiest to explain and, unless weaknesses are present, validate the proposed logical links among the elements of the study. There is good evidence that the reports are reproducible.

DIF: Cognitive Level: Analysis REF: MCS: 594 5. Which of the following interpretations is acceptable as worded? a. The study proved that cigarette smoking causes lung cancer. Financial incentives must be offered by insurance companies to all persons who cease smoking. b. Findings suggest that antihypertensives influence both length and quality of life, and that their use is more beneficial than formerly realized. c. The positive correlation between owning a dog who demands to be walked daily and the owners cardiovascular health indicates that all people should own dogs. d. Results imply that all humans who use amphetamines will have shortened life spans, and patient teaching needs to include this vital information.

ANS: B Implications of research findings for nursing are the meanings of the conclusions for the body of nursing knowledge, theory, and practice. Implications for practices are often based, in part, on whether treatment decisions or outcomes would be different in view of the study findings. The

Gray Burns and Grove’s The Practice of Nursing Research (9e)

study implications provide specific suggestions for implementing the findings in practice. Even when the results are significant and in keeping with those predicted by the researcher, the researcher must consider alternative explanations for the positive findings and cannot use the word should or its synonyms. One study does not prove that smoking causes lung cancer. A correlational study merely provides evidence of association.

DIF: Cognitive Level: Analysis REF: MCS: 599 6. A researcher studies the effect upon pain control of providing pet therapy for children on a pediatric ward. While conducting the study, the researcher becomes aware of a strong correlation between parental presence and hours of childrens sleep. What is this correlation? a. The ability to consent far more subjects than were originally projected: a lucky occurrence b. A relationship between variables that were not hypothesized or predicted from the framework: serendipitous finding c. The identification of a variable that affects the dependent variable and distorts its value: extraneous variable d. A condition that affects generalization: limitation ANS: B Serendipitous results are relationships found between variables that were not hypothesized and not predicted from the framework guiding the study. These unexpected results are also called serendipitous results. Most researchers examine as many elements of data as possible in addition to those directed by the research objectives, questions, or hypotheses. They can use these findings to develop or refine theories and to formulate later studies. In addition, serendipitous results are as important as evidence in developing the implications of the study. However, researchers must deal carefully with serendipitous results when considering their meaning, because the study was not designed to examine these results.

DIF: Cognitive Level: Analysis REF: MCS: 595 7. A researcher summarizes the findings and then makes generalizations. Why does the researcher refer to the literature before making generalizations?

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. If the current study is a replication of previous research, its generalizations will be identical to those of the study it replicates. b. If there is no previous research in this area, no generalizations can be made. c. If the current study is the second by this researcher, its generalizations will be to the population from which the second sample was drawn, and will specifically exclude the sample from the first study. d. If there is a lone study in this area, generalizations are narrow; if there is previous research of a parallel nature, more widespread generalization is in order.

ANS: D Generalization extends the implications of the findings from the sample studied to a larger population or from the situation studied to a larger situation. If there is previous identical or very similar research in this area, generalizations can be made to the populations from which this and other studies were drawn, thus increasing generalizability. Generalizations based on accumulated evidence from many studies are called empirical generalizations. These generalizations are important for verifying theoretical statements or developing new theories. Empirical generalizations are the base of a science and contribute to scientific conceptualization, which provide a basis for generating evidence-based guidelines to manage specific practice problems.

DIF: Cognitive Level: Analysis REF: MCS: 598 8. Near the end of a research article, the researcher states that the findings contribute to nursings body of knowledge and they also provide evidence that the intervention may be helpful in the population from which the sample was drawn. What does this comment address? a. Serendipitous findings b. Implications c. Generalizations d. Limitations ANS: B Implications are the meanings of conclusions for the body of knowledge, theory, and practice.

Implications are based on the conclusions and are more specific than conclusions. They provide

Gray Burns and Grove’s The Practice of Nursing Research (9e)

specific suggestions for implementing the findings. Generalization extends the implications of the findings from the sample studied to a larger population or from the situation studied to a larger situation. Serendipitous findings are relationships found between variables that were not hypothesized and not predicted from the framework guiding the study. Limitations are restrictions or problems in a study that may decrease the generalizability of the findings.

DIF: Cognitive Level: Application REF: MCS: 598 MULTIPLE RESPONSE 1. The analysis of the data from a study indicates that there was a significant difference between the two groups, which were randomly selected and composed of 100 subjects each. The instruments measuring stress, mood, and various scaled measures of emotion were well normed, widely tested, and suitable. As the researcher begins interpretation of the data, she discovers that during data collection one of her assistants had recorded the demographic item household size incorrectly, understanding the item as number of people who live with you. The original paper surveys are still available, and the ones this particular assistant collected are all clearly marked with her initial on each MCS:. How can this data item be saved? (Select all that apply.) a. Erroneous values can be identified and eliminated from the data analysis for this single item. b. Erroneous values can be located and re-entered as the true values, since the systematic error has been identified, quantified, and attributed. c. Data analysis may proceed and the error noted in the final report as a methodological limitation. d. An overlapping ordinal measurement can be used, in which the categories are 0-1, 1-2, 2-3, and so forth. e. The data may be analyzed as a nominal variable and so coded.

ANS: A, B Many activities that occur during data collection affect the meaning of study results.

Methodological limitations result from factors such as nonrepresentative samples, weak designs, single setting, limited control over treatment (intervention) implementation, instruments with limited reliability and validity, limited control over data collection, and improper use of

Gray Burns and Grove’s The Practice of Nursing Research (9e)

statistical analyses. Nominal level of measurement is the lowest of the four measurement levels or categories. It is used when data can be organized into categories of a defined property but the categories cannot be ordered. Data that can be measured at the ordinal level can be assigned to categories of an attribute that can be ranked. In interval level of measurement, distances between intervals of the scale are numerically equal. Interval scales are assumed to be a continuum of values. Ratio level of measurement is the highest form of measure and meets all the rules of the lower forms of measures. To be meaningful, measurements must be mutually exclusive.

Changing the data to a nominal or ordinal measurement will not save the item. Reporting the item as erroneous does not save the item.

DIF: Cognitive Level: Synthesis REF: MCS: 592 2. A researcher has conducted a study that uses a measurement tool for agitation, normed in a hospital setting, in an outpatient mental health setting. After completion of the data analysis phase, which of the following is the next logical step in evaluating the evidence? a. Recalibration of all instruments used for physiologic measurements b. Review of the literature c. Identification of statistically significant findings d. Examination of the measurement tools reliability in this setting e. Re-evaluation of the tools validity in this population ANS: D, E One assumption often made in interpreting study results is that the study variables were adequately measured. This adequacy is determined by examining the fit of operational definitions with the framework and through validity and reliability information. Although reliability and validity of measurement strategies are reviewed before use, one must reexamine the measures at this point to determine the strength of evidence available from the results. For example, did the measurement truly reflect the concept in the study population? Were the validity and reliability of instruments examined in the present study? The validity and reliability of measurement methods are critical to the validity of results.

DIF: Cognitive Level: Application REF: MCS: 591

Gray Burns and Grove’s The Practice of Nursing Research (9e)

3. A researcher studies the effect of a computerized hospital charting system on nurses compliance with charting the exact times of tracheostomy care, periodic turning of patients, and bed baths. The researcher hypothesizes that instituting the new charting system would improve compliance. The sample size is 120. The level of significance is set at .05 and the power at 80%. Findings are nonsignificant, at p = .146. How might this be discussed by the researcher?

(Select all that apply.) a. The null hypothesis was accepted. There was no difference in compliance when paper charting was replaced with computer charting, in terms of the variables of tracheostomy care, periodic turning, and bed bath charting. b. Nurses do not chart consistently the tracheostomy care, periodic turning, and bed baths they deliver, regardless of charting system. c. The effect size was smaller than expected; a repeat power analysis revealed that the sample size of 120 was insufficient to demonstrate a significant difference. d. This study showed no significant difference between the two charting methods, in terms of compliance. e. Had the level of significance been set at 0.15, the findings would have reached statistical significance.

ANS: A, C, D, E Unpredicted nonsignificant or inconclusive results are the most difficult to explain. These results are often referred to as negative results. The negative results could be a true reflection of reality.

In this case, the reasoning of the researcher or the theory used by the researcher to develop the hypothesis is in error. If so, the negative findings are an important addition to the body of knowledge. With nonsignificant results, it is important to determine if adequate power of 0.8 or higher was achieved for the data analysis. Thus, the researcher needs to conduct a power analysis to determine if the sample size was adequate to prevent the risk of a type II error. A type II error means that in reality the findings are significant, but, because of weaknesses in the methodology, the significance was not detected. Negative results, in any case, do not mean that there are no relationships among the variables or differences between groups; they indicate that the study failed to find any.

DIF: Cognitive Level: Application REF: MCS: 594

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4. A nurse manager in a trauma intensive care unit conducts a quality improvement evaluation project. During this process, she discovers that patients with adult respiratory distress syndrome almost always have better outcomes when they are placed in the five beds located further away from the nursing station. Examining the data, she discovers that the room doors in these five rooms are consistently half-closed or three-quarters closed. In addition, nurses have been documenting that these patients sleep more than the other ten patients on the unit. What are the nurses options for generalizing the findings? a. There is no practical use for this research; no generalization is appropriate. b. Findings should be generalized immediately, and in print. These are important findings. c. The nurse can present the findings at conferences, but generalization is limited to the hospital in which the data were collected. d. The nurse manager can obtain permission from an institutional review board to conduct a formal research study, in order to formally test hypotheses, and then generalize the findings of this second study. e. Arrangements should be made immediately on the unit to keep all patients doors half-closed or three-quarters closed.

ANS: C, D Methodological limitations limit the credibility of the findings and restrict the population to which the findings can be generalized. Methodological limitations result from factors such as nonrepresentative samples, weak designs, single setting, limited control over treatment (intervention) implementation, instruments with limited reliability and validity, limited control over data collection, and improper use of statistical analyses. Quality improvement research, by definition, is methodologically limited, because of its location-specific findings and lack of controls.

DIF: Cognitive Level: Analysis REF: MCS: 594 5. If, after power analysis, a researchers interventional study findings are nonsignificant, what might this imply? (Select all that apply.) a. The effect size was smaller than originally expected.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. The effect size was larger than originally expected. c. The operational definition of the independent variable was faulty. d. The operational definition of the dependent variable was faulty. e. A type I error occurred. f. A type II error occurred. g. The intervention is not an effective one.

ANS: A, C, D, F, G Negative results could be due to inappropriate methodology, a deviant sample, problems with internal validity, inadequate measurement, poor variable definition, the use of weak statistical techniques, or faulty analysis. Negative results, in any case, do not mean that there are no relationships among the variables or differences between groups; they indicate that the study failed to find any. The sample size was initially judged to have been adequate enough to prevent the risk of a type II error, based on initial calculations, but if the effect size was very small, a type II error might have occurred. The negative results could be a true reflection of reality. In this case, the reasoning of the researcher or the theory used by the researcher to develop the hypothesis is in error.

DIF: Cognitive Level: Evaluation REF: MCS: 594 6. How are markedly negative results of a multi-site interventional nursing study with a huge sample and stringent level of significance helpful? a. They rule out the usefulness of the intervention for all clients. b. They provide evidence that may change clinical practice, if the intervention is currently being applied in practice to all health care clients. c. They contribute to the total body of nursing knowledge. d. They may indicate different directions for theoretical ideas. e. They establish the fact that the intervention is not universally effective with all clients. f. They allow only cautious generalization.

ANS: B, C, D, E

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The negative results could be a true reflection of reality. In this case, the reasoning of the researcher or the theory used by the researcher to develop the hypothesis is in error. Since this was a huge multi-site interventional study, it establishes the fact that the intervention does not work with a sizable number of clients. This is useful to know.

DIF: Cognitive Level: Application REF: MCS: 594 7. In interpreting the findings of a study, the researcher should do which of the following?

(Select all that apply.) a. Discuss the findings, with respect to clinical implications. b. Boldly and fearlessly identify the limitations of the study. c. Make cautious and well-founded conclusions, based on the findings. d. Based on the existing literature, plus this study, recommend further research. e. Make excuses for limitations. f. Relate findings back to the purpose and framework of the study. g. Generalize broadly.

ANS: A, B, C, D, F Interpretation includes several intellectual activities, such as examining evidence, forming conclusions, identifying study limitations, generalizing the findings, considering implications, and suggesting further research. Generalizations should be specific to the population from which the sample was drawn, and should be based on the total contribution of research, to date. Excuses should not be made.

DIF: Cognitive Level: Analysis REF: MCS: 600 8. A researcher has just completed a study demonstrating the effectiveness of three daily servings of freshly pressed tomato juice for prevention of cancers of the gastrointestinal tract. The results were statistically significant at the p <.01 level. During interpretation, which of the following will the researcher employ? (Select all that apply.)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. Examination of the results, in comparison with similar literature about fresh tomatoes and cancer, to decide whether the sum of all knowledge constitutes sufficient evidence for widespread generalization b. Exploration of the clinical significance of the findings, as opposed to the statistical significance c. Initiation of discussions with manufacturers of juice machines, so as to take advantage of the anticipated increase in sales d. Formation of some sort of conclusions, relative to the study findings and related literature e. Promulgation of the results to the popular media, so that as many people as possible in the world can advantage themselves of the intervention f. Recommendations for further studies on fresh tomato juice and its apparent effects on health g. Consideration of implications related to nursings body of knowledge ANS: A, B, D, F, G The process of interpreting research outcomes for quantitative, outcomes, and intervention studies includes the following: (1) examining study evidence, (2) determining findings, (3) forming conclusions, (4) identifying limitations, (5) generalizing the findings, (6) considering implications for practice, and (7) suggesting further studies.

DIF: Cognitive Level: Application REF: MCS: 590 9. The United States census is an example of a huge descriptive research project that uses the entire population as the sample. What are some of the limitations of generalizing census findings back to the entire population? (Select all that apply.) a. Although all homes must fill out a census report, the homeless population often cannot be accessed, surveyed, and counted, so the homeless population is underrepresented in the findings. b. Persons whose primary language is something other than English or Spanish, and who do not speak either language, are more likely to be missed in the census. c. The survey method of data collection relies on self-report; some misrepresentation or error is inevitable.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. The population changes continuously, and the one described in the census isnt very much like the population on the day the results are published. e. Persons in the United States who are no longer here legally but plan to stay do not fill out a report.

ANS: A, B, C, E Limitations are restrictions or problems in a study that may decrease the generalizability of the findings. All studies have limitations, and these might be theoretical and/or methodological in nature. Theoretical limitations are weaknesses in a study framework and conceptual and operational definitions of variables that restrict the abstract generalization of the findings.

Methodological limitations are factors in the study design that can limit the credibility of the findings and restrict the population to which the findings can be generalized.

DIF: Cognitive Level: Analysis REF: MCS: 598 10. Choose which of the following limitations are methodological, in a study of home UV treatment of depressive illnesses. (Select all that apply.) a. A study performed in Afghanistan is published only in a British journal. b. The operational definitions are not in line with the conceptual definitions. c. The study framework is related to the social costs of depressive illness. d. The subjects excluded from participation in a study of depressive illness and UV home treatment were those who had been hospitalized in the past for depression. e. A multi-site study examining UV home treatment and depressive illness is conducted only in major west coast urban centers.

ANS: A, B, D, E Limitations are restrictions or problems in a study that may decrease the generalizability of the findings. All studies have limitations, and these might be theoretical and/or methodological in nature. Theoretical limitations are weaknesses in a study framework and conceptual and operational definitions of variables that restrict the abstract generalization of the findings.

Methodological limitations are factors in the study design that can limit the credibility of the findings and restrict the population to which the findings can be generalized. Studies can be

Gray Burns and Grove’s The Practice of Nursing Research (9e)

generalized to the population from which the sample was drawn; a sample drawn from one geographic area can, in general, be generalized back only to that area. The findings from a study conducted in Afghanistan (and published in English in a British journal) can be generalized back to Afghanistan. Studies conducted in one language and published in another may be flawed in other ways.

Chapter 27. Disseminating Research Findings MULTIPLE CHOICE 1. A masters student states, in her thesis, that despite public awareness programs to educate the public about the safety of pediatric immunizations, a staunch core of highly educated and wellinformed parents continues to attribute the rise in childhood autism to vaccination. Because of this, recent efforts have been brought to bear in the qualitative arena, attempting to identify and isolate factoids and half-truths that perpetuate the myth. Nonetheless, mostly because belief structures appear bound by geography, not enough is known about reasons that some clusters of parents postpone or avoid vaccination. The quotation is an example of a appears in the

and

section of the research report.

a. Objective, methods b. Purpose statement, introduction c. Problem statement, introduction d. Literature review, results ANS: C The problem statement identifies the specific gap in the knowledge needed for practice. The introduction of a research report discusses the background and significance of the problem; identifies the problem statement and purpose, reviews the relevant empirical and theoretical literature, describes the study framework, and identifies the research purpose (aims, objectives, questions, or hypotheses if applicable).

DIF: Cognitive Level: Application REF: MCS: 604

Gray Burns and Grove’s The Practice of Nursing Research (9e)

2. Prior to conducting a grounded theory study, in which eleven women undergoing radiation for breast cancer were interviewed multiple times, the researchers conducted a pilot study in which they interviewed three women every two weeks from the time radiation was planned until four weeks after it was completed. The purpose for the pilot study was to refine the interview instrument and to discover whether women would be willing to be interviewed this frequently about such a private topic. The pilot was not published separately, and the researcher wants to include information about revisions in the instrument during the pilot phase. Where would this be included in the research report? a. Introduction b. Methods c. Results d. Appendix ANS: B If the research project included a pilot study, in the methods section the researcher will briefly describe the planning, implementation, and results obtained from the pilot study. Any changes made in the research project based on the pilot study are mentioned here.

DIF: Cognitive Level: Application REF: MCS: 605 3. Prior to conducting a grounded theory, in which eleven women undergoing radiation for breast cancer were interviewed multiple times, the researchers conducted a pilot study in which they interviewed three women every two weeks from the time radiation was planned until four weeks after it was completed. The purpose for the pilot study was to refine the interview instrument and to discover whether women would be willing to be interviewed this frequently about such a private topic. The pilot was not published separately, and the institutional review board application indicated the researchers intent to include information in the research report about what going through the process of radiation therapy was like for the three pilot study women, in addition to the eleven main study women. In this case, if it were not included in the method section, where would the information about the process of going through radiation therapy obtained from the pilot study women be included?

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a. Introduction b. Results c. Discussion d. Appendix ANS: B If the research project included a pilot study, in the methods section the researcher will briefly describe the planning, implementation, and results obtained from the pilot study. Any changes made in the research project based on the pilot study are mentioned here. However, data analysis in qualitative research occurs concurrently with data collection. In addition, analysis of an interviews data may result in additional questions being asked in subsequent interviews to confirm or not confirm initial interpretations of the data. Because of this, information related to the phenomenon and obtained in the pilot phase may be included in the results section.

DIF: Cognitive Level: Application REF: MCS: 605 4. All subjects were asked whether they would be willing to participate in this descriptive study, while they waited to be seen by a gastroenterologist, prior to their initial colonoscopies. They were given basic information about the research and told that participation was strictly voluntary, according to guidelines from the institutional review board (IRB) for the clinics and hospital.

The research had been approved as minimal risk by the IRB. All thirty-one subjects asked to participate agreed to do so. During the write-up of the study, the researcher should include this information about this process in which of the following sections? a. Abstract b. Introduction c. Methods d. Appendix ANS: C

Gray Burns and Grove’s The Practice of Nursing Research (9e)

The data collection process was clear and concise; IRB approval was indicated; subjects informed consent was described; use of trained data collectors was addressed; and timing and setting was discussed.

DIF: Cognitive Level: Application REF: MCS: 607 5. Lazaruss coping paradigm suggests that it is the appraisal of a stressor as potentially harmful that begins the avoidance cascade. Thomason further characterized adaptations to management of chemotherapy symptomatology as mere reflections of a primary appraisal of potential harm, providing a set point for intensity of reactions. We used these conceptual connections to formulate testable assumptions for this study. Where in the research report would this quotation be located? a. Introduction b. Methods c. Results d. Discussion ANS: A The introduction of a research report discusses the background and significance of the problem, identifies the problem statement and purpose, reviews the relevant empirical and theoretical literature, describes the study framework, and identifies the research purpose (aims, objectives, questions, or hypotheses if applicable).

DIF: Cognitive Level: Application REF: MCS: 604 6. Thomasons set-point theorizations explain, in part, why patients in chemotherapy who reported high levels of apprehension and anxiety prior to initiation invariably reported more severe average symptomatology levels. In addition, their symptoms were ameliorated less completely by standard therapeutic interventions, such as antiemetics and soporifics. Where in the research report would this quotation be located? a. Introduction

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. Methods c. Results d. Discussion ANS: D In the discussion section, the researchers major findings, which are generated through an interpretation of the results, should be discussed in relation to the overriding conceptual framework as well as the research problem, purpose, and questions, or hypotheses.

DIF: Cognitive Level: Application REF: MCS: 630 7. What part of the research report names the study design? a. Introduction b. Methods c. Results d. Discussion ANS: B In the methods section the researcher describes the study design, sample, setting, methods of measurement, data collection process, and plan for data analysis.

DIF: Cognitive Level: Comprehension REF: MCS: 605 8. The results of an applied research study for anxiety management in children were published in both a highly respected nursing research journal and a second journal specific to pediatrics that focused on practice issues. The first article contained detailed statistical analyses and discussions of the results, as an extension of the authors previous basic research. The second presented the research in much simpler language, providing pictures of the children and discussing practice applications. Why does this represent or not represent duplicate publication? a. It does represent duplicate publication, because both articles reported results of the same study.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

b. It does not represent duplicate publication, because the language was completely different in the two articles, and the journal audience was different. c. It does represent duplicate publication, because the second article was a paraphrase of the first. d. It does not represent duplicate publication, because the second article referenced the first and focused heavily on practice applications, which were not included in the first.

ANS: D Duplicate publication is the practice of publishing the same article or major portions of the article in two or more print or electronic media without notifying the editors or referencing the other publication in the reference list.

DIF: Cognitive Level: Analysis REF: MCS: 632 9. In the results section of a thesis measuring the effectiveness on a geriatric ward of using a procedure room for all painful procedures including IV starts, a masters student lists the four principal study findings, one by one, following each with an explanation of how each finding contributes to nursing knowledge. The major thesis advisor directs the student to fix this in the second draft of the thesis. Why does the thesis advisor require this? a. This entire segment of the thesis should appear in the discussion section. The results section contains all of the study findings, with detailed statistics on each. b. A thesis should not explain how its findings contribute to nursing knowledge. c. This is applied research. Its findings should apply only to practice. d. Findings appear in the results section, which includes only facts and nothing else.

The explanation part of the above must be placed in the discussion section.

ANS: A The discussion section includes conclusions, study limitations, implications for nursing, and recommendations for further research. Implications of the findings for nursing practice and theory development are explored, and suggestions are provided for further research.

DIF: Cognitive Level: Application REF: MCS: 618

Gray Burns and Grove’s The Practice of Nursing Research (9e)

MULTIPLE RESPONSE 1. In which parts of the research report could the reader find the one most important result of the study? (Select all that apply.) a. Abstract b. Introduction c. Methods d. Table 1 e. Results f. Discussion g. References h. Appendix ANS: A, E, F An abstract is usually about 200 to 300 words and describes the problem, purpose, framework, methods, sample size, key results, and conclusions. The results section reveals what was learned from the study and includes the results generated from the studys statistical analyses. The discussion section includes the studys major findings, limitations, conclusions, implications, and recommendations for further research.

DIF: Cognitive Level: Synthesis REF: MCS: 603 2. There was a research gap before the study was performed. The research filled the research gap. In what part of the research report would the research gap be identified? In what part of the research report would the researchers way of filling the research gap be reported? (Select all that apply.) a. Abstract References b. Abstract Abstract c. Introduction Discussion d. Introduction Methods

Gray Burns and Grove’s The Practice of Nursing Research (9e)

e. Abstract Methods f. Methods Methods g. Results Discussion h. Introduction Discussion ANS: D, E An abstract is usually about 200 to 300 words and describes the problem, purpose, framework, methods, sample size, key results, and conclusions. In describing the problem and purpose, it strongly implies the gap. The introduction of a research report discusses the background and significance of the problem, identifies the problem statement and purpose, reviews the relevant empirical and theoretical literature, describes the study framework, and identifies the research purpose. The summary of the literature review clearly identifies what is known, what is not known or the gap in knowledge, and the contribution of this study to the current knowledge base.

The methods section of a research report describes how the study was conducted.

DIF: Cognitive Level: Synthesis REF: MCS: 605 3. What part of the research report may provide potential applications of the findings in practice? (Select all that apply.) a. Abstract b. Introduction c. Methods d. Results e. Discussion ANS: A, E An abstract is usually about 200 to 300 words and describes the problem, purpose, framework, methods, sample size, key results, and conclusions. Conclusions can include potential applications for practice. The discussion section ties the other sections of the research report together, and includes major findings, limitations of the study, conclusions drawn from the findings, implications of the findings for nursing, and recommendations for further research.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Synthesis REF: MCS: 603 4. A masters thesis uses Husserlian phenomenology as its method. In the research report, the student has mentioned the method by name and has adhered to all of the tenets of that method.

The thesis advisor requires the student to include in the thesis a two- to five-MCS: summary of the philosophy of Husserlian phenomenology. Why does the thesis advisor require this? (Select all that apply.) a. The thesis advisor is not familiar with the method and cannot evaluate the thesis without this information. b. It is important that the thesis makes clear what Husserlian phenomenology implies, relative to the researchers part in data collection and data analysis. c. Several assumptions of the thesis may emanate from Husserlian phenomenology, and they should be consistent with its philosophy. d. The reader of the thesis, and publications emanating from it, may not be clear as to what Husserlian phenomenology is. An explanation is in order. e. The reader can follow the analysis better when the method is better understood. f. The philosophy that underlies qualitative research is, in essence, the studys theoretical framework. A framework should include a summary of its main points.

ANS: B, C, D, E, F The philosophical perspective of the researcher guides the questions asked and the methods selected for conducting a specific study. Both quantitative and qualitative researchers have philosophical perspectives. Qualitative studies are based on a wide range of philosophies, such as phenomenology, symbolic interactionism, constructivism, and hermeneutics, each of which espouses slightly different approaches to gaining new knowledge. Most qualitative researchers do not identify specific theoretical frameworks during the design of their studies, as is expected for quantitative studies. Instead, the philosophical basis provides theoretical grounding for qualitative studies without predisposing the data analysis to a single interpretationthis is another way to say that the philosophy is the studys theoretical framework. As such, it deserves a few MCS: of exposition, to aid the readers understanding.

DIF: Cognitive Level: Synthesis REF: MCS: 616

Gray Burns and Grove’s The Practice of Nursing Research (9e)

5. A researcher presents the results of a recent research project at several conferences. Duplicate publications are not acceptable and represent self-plagiarism, but duplicate presentations seem valued. Which of the following facts explains this? (Select all that apply.) a. Duplicate conference presentations are valued only when they occur in widely separated geographic areas. b. Questions and comments from conference audiences can contribute to the researchers ongoing analysis and inspire new analyses of data. c. If similar research by the same author is ongoing, each conference presentation can include new insights and interpretations, reflecting work in progress. d. Reaching a broad audience necessitates presentation at several conferences. e. Self-plagiarism is a term that refers to the printed word, not to conference presentations. f. If a researcher submits a different abstract to each conference that publishes printed conference abstracts, there is no self-plagiarism.

ANS: B, C, D, E, F Duplicate publication is the practice of publishing the same article or major portions of the article in two or more print or electronic media without notifying the editors or referencing the other publication in the reference list. Duplicate publication does not refer to oral presentations.

However, if portions of an article have been presented at a scientific meeting in the form of an oral podium or poster presentation, this should be acknowledged along with funding sources and any potential conflict of interest.

DIF: Cognitive Level: Analysis REF: MCS: 632 6. Which of the following are considered poor scholarly writing and, consequently, should not appear in a published research report? (Select all that apply.) a. Subjects who could not decide whether to select A, B, or C as item options were instructed to leave the item blank. b. Regardless of amount of the independent variable of electricity that was applied, dependent variable changes were negligible thus indicating lack of causation. c. Any subject desiring to retract their permission for the study had his or her name removed from the master list.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Erstwhile subjects had little insight into the retained fragments of their sublimated ignoscency.

ANS: B, C, D A quality research report has no errors in punctuation, spelling, or sentence structure. It is also important to avoid confusing words, clichs, jargon, and excessive wordiness and abbreviations.

Word processing programs have tools commands that have the capacity to proofread manuscripts for errors.

DIF: Cognitive Level: Synthesis REF: MCS: 629 7. Which of the following additional items are considered poor scholarly writing and, consequently, should not appear in a published research report? (Select all that apply.) a. Subjects A and B completed the trial in half the time taken by other subjects, without caffeine enhancement. Hah! b. Subject attrition was nil. Not one person dropped out of the study, even in progress. Except the ones we kicked out, of course. c. Subjects responses were markedly different across groups. d. The intervention group was expected to document symptoms at least daily, using a journal. Twice-daily documentation was encouraged. e. Instruments were calibrated, both before, and after, use: they were cleaned, as well; using soap and water.

ANS: A, B, C, E A quality research report has no errors in punctuation, spelling, or sentence structure. It is also important to avoid confusing words, clichs, jargon, and excessive wordiness and abbreviations.

Word processing programs have tools commands that have the capacity to proofread manuscripts for errors.

DIF: Cognitive Level: Synthesis REF: MCS: 629 8. Which of the following represent poor scholarly writing and, consequently, should not appear as they are written in a journal article? (Select all that apply.)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. Regretfully nobody in the control group survived past three years this is because of the continued effects of the disease process itself if untreated it is fatal. b. Results of the study indicated that causation was directional in the A, B, F, and K groups however none were identified as impacting the final outcome. c. We as experienced researchers cannot explain why the intervention failed in not one, but three consecutive mini-trails, numbers 5, 6, and 7, becoming suddenly effective in the subsequent twenty-three mini-trials. We checked and rechecked instrument calibrations, controlled diligently for intra-rater reliability, recomputed coefficients of change, trended all data, reentered data manually, examined the effect of sixteen potentially extraneous variables, and ultimately ended as baffled as we started. d. The results were a complete surprise. 44% of the control subjects experienced spontaneous remissions. e. Attrition continued over the course of the experiment, with additive attrition of 2% in the first quarter, 5% in the second quarter, 16% in the third quarter, and 25% in the fourth. In the second year, attrition claimed another half of the sample.

Data collection was suspended after the eighth quarter, since the results had limited applicability, due to extensive attrition. f. An inadequate sample threatened to end the study. Inclusion criteria were broadened, to include those who had participated in clinical research, in the past, but there were no takers. g. There was no way of determining whos answers had been positive on the pre-test, until the post-test was completed.

ANS: A, B, C, D, F, G A quality research report has no errors in punctuation, spelling, or sentence structure. It is also important to avoid confusing words, clichs, jargon, and excessive wordiness and abbreviations.

Word processing programs have tools commands that have the capacity to proofread manuscripts for errors.

DIF: Cognitive Level: Synthesis REF: MCS: 629 9. There are several steps in the process of converting a masters thesis into a publishable article: selecting a journal, writing a query letter, preparing an original manuscript, submitting the manuscript for review, and performing the revisions the editor indicates. Why should preparation of the manuscript not occur first? (Select all that apply.)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. It would be foolish to write a manuscript without knowing the maximum length of manuscript that a journal accepts. b. If the response to several query letters is negative, it is best to abandon attempts to get the information into print. c. Various journals use different formatting. Waiting until editor interest is expressed saves unneeded reformatting. d. Some journals limit the number of items in the reference list. It is best to know this before editing the thesis down to the length of an article. e. Every contact with an editor results in at least a request for revisions. An initial manuscript cannot be prepared without editor input.

ANS: A, C, D Developing a manuscript for publication includes the following steps: (1) selecting a journal, (2) developing a query letter, (3) preparing a manuscript, (4) submitting the manuscript for review, and (5) revising the manuscript. A query letter should be no more than one MCS: and usually includes the abstract as well as the researchers qualifications for writing the article. If the response to the query letter is possible, then a manuscript should be prepared, according to the formatting and specifications of that publication. A negative response to a query letter merely implies that the journal is not interested in the topic of the submitted abstract.

DIF: Cognitive Level: Comprehension REF: MCS: 628 10. What should an abstract for quantitative research contain? (Select all that apply.) a. The name of the research method used b. A brief statement of the problem c. The research purpose d. The population or sample e. The major study findings f. Conclusions g. The research hypothesis h. The research question

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: A, B, C, D, E, F Most research reports include an abstract that summarizes of the key aspects of the study. An abstract is a terse summary, often between 200 and 300 words, that describes the problem, purpose, framework, methods, sample size, key results, and conclusions.

DIF: Cognitive Level: Application REF: MCS: 603 11. What else should an abstract for quantitative research contain? (Select all that apply.) a. The research question b. Operationalized variables c. The research hypothesis d. The major study findings e. Conclusions f. References ANS: D, E Most research reports include an abstract that summarizes of the key aspects of the study. An abstract is a terse summary, often between 200 and 300 words, that describes the problem, purpose, framework, methods, sample size, key results, and conclusions.

DIF: Cognitive Level: Application REF: MCS: 603 12. What are the proper components of a query letter? (Select all that apply.) a. Suggestions for further research b. A description of the research problem c. The sample demographics d. Discussion of one or more of the major findings e. Academic or professional titles held by the letter writer f. Details of the study methodology g. The meaning of the study findings

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: B, D, E, G A query letter is developed to determine an editors interest in reviewing a manuscript for publication. A query letter should be no more than one MCS: and usually includes the abstract, as well as the researchers qualifications for writing the article.

DIF: Cognitive Level: Comprehension REF: MCS: 628 13. A researcher who has just submitted a trimmed-down version of her doctoral dissertation to a journal editor receives the following. What type of letter is it? (Select all that apply.)

Dear Ms. Smith: We have received your manuscript and are returning it to you. Our journals focus is exclusively quantitative research, and your manuscript uses a mixed methodology. Despite notable strengths of the quantitative portion, which contains cutting-edge information about medication errors and their correlates, our peer reviewers feel that you might be better served in seeking a venue that allowed both aspects of the study to be presented. The Nursing Journal of Mixed Methodologies springs to mind.

Nonetheless, if you should wish to resubmit only the quantitative portion, essentially as it stands, we should be quite interested in returning it to the peer reviewers.

Please see the one accompanying suggestion for table insertion. a. An outright rejection b. An acceptance c. An acceptance with minor revisions d. A rejection of the manuscript as currently written e. A suggestion for an alternative avenue of publication f. A compliment ANS: C, D, E, F

Gray Burns and Grove’s The Practice of Nursing Research (9e)

After reviewing a manuscript, the journal editor will reach one of four possible decisions: (1) acceptance of the manuscript as submitted, (2) acceptance of the manuscript pending minor revisions, (3) tentative acceptance of the manuscript pending major revisions, or (4) rejection of the manuscript. Accepting a manuscript as submitted is extremely rare. At the end of the revision process, the editor will send the author a letter that indicates final acceptance and the likely date of publication.

DIF: Cognitive Level: Analysis REF: MCS: 630 14. What are the advantages of presenting a poster session, displayed for two hours a day for three days at a well-attended conference, instead of a 15-minute verbal presentation with a 5minute question period, at a breakout session? (Select all that apply.) a. For authors who suffer presentation anxiety, a poster presentation can be much less stressful, since it provides many small conversations instead of a large lecture. b. A poster session allows the researcher to display more information than a verbal presenter can. c. A poster presentation provides the opportunity for one-to-one interaction with the viewers. d. The poster presentation may reach more people than does the verbal presentation. e. A verbal presentation requires more time to develop than does a poster.

ANS: A, C, D Research findings are communicated at conferences and meetings through verbal and poster presentations. With presentations, researchers have an opportunity to share their preliminary findings, answer questions about their studies, interact with other interested researchers, and receive immediate feedback on their study. A 15-minute verbal presentation would consist of a 15-slide show (PowerPoint or otherwise). A poster session is a visual presentation of your study, all on one surface, with either three or four columns. Posters usually take from 10 to 20 hours to develop based on the complexity of the study and the experience of the researcher. Novice researchers usually need more than 20 hours to develop a poster. One major advantage of a poster session is the opportunity for one-to-one interaction between the researcher and the

Gray Burns and Grove’s The Practice of Nursing Research (9e)

viewer. At the end of the poster session, individuals interested in a study will frequently stay to speak to the researcher. A quality poster is easily comprehended in 5 minutes or less.

DIF: Cognitive Level: Analysis REF: MCS: 630 15. A journal states on its editorial MCS:, A query letter is required before article submission to this refereed journal. If a manuscript is requested, both hard copy and an electronic copy will be required. After initial acknowledgement of receipt, authors will receive a response from the editor within four months. What does this statement mean? (Select all that apply.) a. Within four months, the author will be notified whether the article is accepted. b. The author will be notified immediately of the manuscripts acceptance. c. Only the editor reviews manuscripts. d. The journal uses peer review. e. If authors send a manuscript without an initial query, it will be returned. f. If authors send a query letter, they will be requested to send a manuscript. g. If a manuscript is accepted, it will be published within four months. h. No manuscripts are ever accepted.

ANS: A, D, E A query letter is developed to determine an editors interest in reviewing a manuscript for publication. A query letter should be no more than one MCS: and usually includes the abstract as well as the researchers qualifications for writing the article. Journals that require a query letter will not accept manuscripts without that initial query. A refereed journal is peer-reviewed and uses referees or expert reviewers to determine whether a manuscript is acceptable for publication. Most refereed journals require manuscripts to be reviewed anonymously, or blinded, by two or three reviewers. Most academic institutions support the refereed system and may only recognize publications that appear in peer reviewed journals for faculty seeking tenure and promotion.

DIF: Cognitive Level: Comprehension REF: MCS: 629

Gray Burns and Grove’s The Practice of Nursing Research (9e)

16. A masters student has just completed a thesis. Which of the following are considered dissemination of the results? (Select all that apply.) a. Interactions with the thesis committeethrough reading the thesis, they have been informed of the results b. Presentation of a poster session at a professional conference c. Presentation of an oral (podium) presentation at a professional conference d. Presentation of a guest lecture about the thesis results at a university e. Having an article about the research results published by a journal f. Having an article about the research results published by a popular magazine ANS: B, C, D, E, F Communicating research findings, the final step in the research process, after completion of the thesis, involves developing a research report and disseminating it through presentations and publications to audiences of nurses, health care professionals, policy makers, and health care consumers.

Chapter 28. Writing Research Proposals MULTIPLE CHOICE 1. When a researcher writes a proposal for studying the amount of fear preoperative patients experience, which element of the proposal justifies conducting the study in the first place? a. Identification of a research gap b. Choice of a framework c. Selection of an appropriate methodology d. Conduct of a systematic review ANS: A After the review of the literature, the gap in the knowledge base is identified, with a description of how the proposed study is expected to contribute to fill that particular gap. Your proposal

Gray Burns and Grove’s The Practice of Nursing Research (9e)

should identify the target population to which your study findings will be generalized and the accessible population from which the sample will be selected. Outline the inclusion and exclusion criteria you will use to select a study participant or subject, and present the rationale for these sample criteria. For example, a participant might be selected according to the following sample criteria: female age 18 to 60 years, hospitalized, and 1 day postabdominal surgery. The rationale for these criteria might be that the researcher wants to examine the effects of a selected pain management intervention on adult females who have recently experienced hospitalization and abdominal surgery. The sampling method and the approximate sample size are discussed in terms of their adequacy and limitations in investigating the research purpose (Thompson, 2002).

Usually, a power analysis is conducted to determine an adequate sample size to identify significant relationships and differences in studies.

DIF: Cognitive Level: Application REF: MCS: 639 2. Why do student research proposals usually require greater detail than those developed for review by funding organizations? a. Student research proposals have a minimum MCS: limit, because faculty want their students to experience the worst-case scenario while in school, where support is readily available. b. Institutional review boards are very apprehensive about students performing research, and for this reason they require more detailed justification than do other proposals. c. Students do not write well, so their proposals tend to be more involved. d. The students proposal often contains the first three or four chapters of the students thesis or dissertation; funding proposals usually contain a much less detailed literature review.

ANS: D The content of a student proposal usually requires greater detail than does a proposal developed for an agency or funding organization. The proposal is often the first three or four chapters of the students thesis or dissertation, and the proposed study is discussed in the future tensethat is, what the student will do in conducting the research. A student research proposal usually includes a title MCS: with the title of the proposal, the name and credentials of the investigator, the university name, and the date.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Analysis REF: MCS: 636 MULTIPLE RESPONSE 1. A formal, detailed research proposal is written. Which of the following would be reasons that a researcher would write a detailed research proposal? (Select all that apply.) a. It is submitted before a nurse manager performs a quality improvement review of compliance with a new IV start protocol. b. It is required by a thesis or dissertation committee. c. It is submitted to gain institutional review board approval. d. It is to be submitted for a funding grant. e. It is written to obtain support from ones peers for a study conducted in a hospital medical-surgical unit.

ANS: B, C, D Researchers need to develop a quality study proposal to facilitate university and clinical agency institutional review board approval, obtain funding, and successfully conduct the study. In addition, student researchers develop proposals to communicate their research projects to the faculty and members of university and agency institutional review boards. Student proposals are written to satisfy requirements for a degree and are usually developed according to guidelines outlined by the faculty. The content of a student proposal usually requires greater detail than does a proposal developed for an agency or funding organization.

DIF: Cognitive Level: Application REF: MCS: 635 2. What is the difference between a quantitative research proposal and a quantitative research report? (Select all that apply.) a. The proposal precedes the study and is written to obtain permission or clearance for the research to be funded, take place, be approved at the research site, and so forth. b. They are identical. c. The research proposal does not contain results or a discussion section.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. The research report follows the study and includes both results of the study and a full discussion. e. The research report contains a framework, but the proposal does not.

ANS: A, C, D A research proposal is a written plan that identifies the major elements of a study, such as the research problem, purpose, and framework, and outlines the methods and procedures to conduct the proposed study. A proposal is a formal way to communicate ideas about a study to seek approval to conduct the study and obtain funding. Researchers, seeking approval to conduct a study, submit the proposal to a select group for review and, in many situations, verbally defend the proposal. Receiving approval to conduct research has become more complicated because of the increasing complexity of nursing studies, the difficulty involved in recruiting study participants, and rising concerns over legal and ethical issues. The research report includes four major sections or content areas: (1) introduction, (2) methods, (3) results, and (4) discussion of the findings. The introduction customarily contains both the literature review and the study framework.

DIF: Cognitive Level: Synthesis REF: MCS: 635 3. Which of the following elements do a research proposal and a research report have in common? (Select all that apply.) a. Discussion b. Review of the literature c. Results d. Framework e. Methods f. Research problem g. Research purpose h. Introduction ANS: B, D, E, F, G, H

Gray Burns and Grove’s The Practice of Nursing Research (9e)

A research proposal is a written plan that identifies the major elements of a study, such as the research problem, purpose, and framework, and outlines the methods and procedures to conduct the proposed study. A proposal is a formal way to communicate ideas about a study to seek approval to conduct the study and obtain funding. Researchers, seeking approval to conduct a study, submit the proposal to a select group for review and, in many situations, verbally defend the proposal. Receiving approval to conduct research has become more complicated because of the increasing complexity of nursing studies, the difficulty involved in recruiting study participants, and rising concerns over legal and ethical issues. The research report includes four major sections or content areas: (1) introduction, (2) methods, (3) results, and (4) discussion of the findings. The introduction customarily contains both the literature review and the study framework.

DIF: Cognitive Level: Analysis REF: MCS: 635 4. A researcher writes a preproposal. What exactly is a preproposal? (Select all that apply.) a. A justification for a research study b. A request for institutional review board approval c. A brief overview of a proposed project d. A first draft of a proposal e. A short document exploring funding opportunities for a research study ANS: C, E Sometimes a researcher will send a preproposal or query letter rather than a proposal to a funding institution. A preproposal is a short document of four to five MCS: plus appendices that explores the funding possibilities for a research project. The parts of the preproposal are logically ordered as follows: (1) letter of transmittal, (2) proposal for research, (3) personnel, (4) facilities, and (5) budget. The proposal provides a brief overview of the proposed project, including the research problem, purpose, methodology (brief description), and, most important, a statement of the significance of the work to knowledge in general and the funding institution in particular. By developing a preproposal, researchers are able to determine the agencies interested in funding their study and limit submission of their proposals to only institutions that indicate an interest.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Comprehension REF: MCS: 636 5. When conducting a review of a proposal, which of the following questions would be concerns of an institutional review board (IRB)? (Select all that apply.) a. Is this study congruent with our hospitals research agenda? b. What will be the impact of this study on our hospital and its clients? c. Is this proposal literate and well written? d. Does this study have any scientific merit? e. What prior research experience does this author have? f. Will the human subjects studied be protected from harm? g. What is the quality of this study?

ANS: A, B, D, F, G Clinical agencies and health care corporations review studies for the following reasons: (1) to evaluate the quality of the study, (2) to ensure that adequate measures are being taken to protect human subjects, and (3) to evaluate the impact of the study on the reviewing institution. Most agency IRBs screen proposals for (1) scientific merit, (2) protection of human rights, (3) congruence of the study with the agencys research agenda, and (4) impact of the study on patient care.

DIF: Cognitive Level: Comprehension REF: MCS: 645 6. Why does a qualitative research proposal contain both the research philosophy and general method and the applied method of inquiry? What is the distinction between these? (Select all that apply.) a. The research philosophy and general method are the name of the method phenomenology, grounded theory, and so forth. b. The general method is the way the researcher plans to collect the data. c. The applied method of enquiry is the way the researcher plans to collect the data. d. The applied method refers to whether the study is phenomenology, grounded theory, ethnography, and so forth.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

e. They are both the same.

ANS: A, B Qualitative research proposal guidelines are unique for the development of knowledge and theories using a variety of qualitative research methods. A qualitative proposal usually includes the following content areas: (1) introduction, (2) research philosophy and general method, (3) applied method of inquiry, and (4) current knowledge, limitations, and plans for communication of the study findings. The research philosophy and general method section introduces the reader to the philosophical and conceptual foundation for the qualitative research method (phenomenological research, ethnographic research, grounded theory research, exploratorydescriptive qualitative research, or historical research) selected for the proposed study.

Identifying the methods for conducting a qualitative study is a difficult task because sometimes the specifics of the study design emerge during the study. Unlike quantitative research, in which the design is a fixed blueprint for a study, the design in qualitative research emerges or evolves as the study is conducted. Thus, you must document the logic and appropriateness of the qualitative method and develop a tentative plan for conducting your study. Because this plan is tentative, reserve the right to modify or change the plan as needed during the conduct of the study. However, the design or plan must (1) be consistent with the philosophical approach, study purpose, and specific research aims or questions, (2) be well conceived, and (3) address prior criticism, as appropriate.

DIF: Cognitive Level: Analysis REF: MCS: 640 7. Why should a qualitative research proposal intended for institutional board review address methods, since methods can be flexible in qualitative research? (Select all that apply.) a. The committee must be aware of anything that will be done to the participants, including interviewing. b. The committee must adjudge potential harm that emanates from discussion of disturbing topics. c. The committee must be apprised of planned methods at the beginning of the study; researchers must ask for permission if they decide to add anything to the methods while the study is in progress.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. The forms for institutional review include this section, but it isnt really addressed in qualitative research, since there is no intervention, per se. e. The committee must determine the relative risk of accidental disclosure of potentially embarrassing information.

ANS: A, B, C, E The sensitive nature of some qualitative studies increases the risk for participants, which makes ethical concerns and decisions a major focus of the study. The institutional review board must know how the researcher will minimize harm to research subjects.

DIF: Cognitive Level: Synthesis REF: MCS: 640 8. Why might proposal revisions be required? (Select all that apply.) a. The review process may reveal unreasonable impact on one area of the institution, since other research is in progress; a change of venue could be indicated. b. Funding becomes unavailable and the proposal must be revised, in accordance with cuts. c. Several potential subjects refuse to participate in the research study. d. The study methodology is weak, and the reviewers suggestions will improve the strength of the methodology. e. The researcher has inadvertently submitted materials that contain errors.

ANS: A, B, D, E Reviewers sometimes suggest changes in a proposal that improve the study methodology; however, some of the changes requested may benefit the institution but not the study. Remain receptive to the suggestions, explore with the committee the impact of the changes on the proposed study, and try to resolve any conflicts. Usually reviewers make valuable suggestions that might improve the quality of a study or facilitate the data collection process. Revision of the proposal is often based on these suggestions before the study is implemented. Sometimes a study requires revision while it is being conducted because of problems with data collection tools or subjects participation. However, if clinical agency personnel or representatives of funding institutions have approved a proposal, the researcher needs to examine the situation seriously

Gray Burns and Grove’s The Practice of Nursing Research (9e)

before making major changes in the study. Before revising a proposal, address three questions: (1) What needs to be changed? (2) Why is the change necessary? (3) How will the change affect implementation of the study and the study findings?

Chapter 29. Seeking Funding for Research MULTIPLE CHOICE 1. What do the Association of Womens Health, Obstetric, and Neonatal Nurses, National Gerontological Nursing Association, and Emergency Nurses Association have in common, relative to funded research? a. All three were established based on funded research. b. All provide proofreaders, free of charge, who will assist with grant writing. c. All three fund research. d. All three provide research guidance and funding through Sigma Theta Tau. ANS: C Many of the specialty practice nursing organizations provide support for studies relevant to their specialty, including nurse practitioner groups. These organizations often provide guidance to budding new researchers who need assistance in beginning the process of planning and seeking funding for research. To determine the resources provided by a particular nursing organization, search their website or contact the organization by e-mail, letter, or phone. Three of these are the Association of Womens Health, Obstetric, and Neonatal Nurses; National Gerontological Nursing Association; and Emergency Nurses Association.

DIF: Cognitive Level: Analysis REF: MCS: 668 2. A researcher receives a rejection letter concerning a proposal submitted for major funding. What should now be done? a. The researcher should not apply for another grant for at least a year. b. The comments in the letter should be reviewed, so as to rewrite the proposal for the next review cycle.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

c. A formal protest should be filed. d. The contact person for the grant should be reached by e-mail as soon as possible.

ANS: B The researchers reaction to a rejected proposal is usually anger and then depression. The frustrated researcher may abandon the proposal, stuff it in a bottom drawer somewhere, and forget it. There seems to be no way to avoid the anger and depression after a rejection because of the significant emotion and time invested in writing the proposal. However, after a few weeks it is advisable to examine the rejection letter again. The comments can be useful in rewriting the proposal for resubmission. The learning experience of rewriting the proposal and evaluating the comments will provide a background for seeking funding for another study.

A skilled grant writer will have approximately one proposal funded for every five submitted. The average is far less than this.

DIF: Cognitive Level: Comprehension REF: MCS: 671 3. What is the percentage rejection rate for new grant writers? a. Less than 20% b. Approximately 50% c. 80% d. Greater than 80% ANS: D A skilled grant writer will have approximately one proposal funded for every five submitted. The average is far less than this.

DIF: Cognitive Level: Analysis REF: MCS: 671 MULTIPLE RESPONSE 1. Why is seeking research funding important? (Select all that apply.)

Gray Burns and Grove’s The Practice of Nursing Research (9e)

a. Funding implies both scientific and social merit. b. Funding allows the researcher to hire assistants who attend to the tasks of research, leaving the researcher free for design of more and better projects. c. The academic reputation of the researcher increases as grant funding increases. d. Research cannot be conducted unless formal funding is obtained. e. Well-designed studies can be expensive, especially those with complex designs. f. A funded study is much more likely to be published.

ANS: A, B, C, E Seeking funding for research is important, both for the researcher and for the profession. Welldesigned studies can be expensive. As the rigor and complexity of the study design increase, the cost tends to increase. By obtaining funding, the researcher can conduct a complex, welldesigned study. Funding indicates that others have reviewed the study and recognize its scientific and social merit. In fact, the scientific credibility of the profession is related to the quality of studies conducted by its researchers. Thus, scientific credibility and funding for research are interrelated. The profession of nursing has invested a great deal of energy in increasing the sources of funding and amount of money available for nursing research. Each award of funding enhances the status of the researcher and increases the possibilities of greater funding for later studies. In addition, funding provides practical advantages. For example, funding may reimburse part or all of the researchers salary and release the researcher from other responsibilities, allowing the researcher to devote time to conducting the study. Funding provides the researcher with the resources to hire research assistants and study coordinators to facilitate data collection and enhance your productivity.

DIF: Cognitive Level: Analysis REF: MCS: 663 2. What are the advantages of a research apprenticeship? (Select all that apply.) a. Entry into a functional research team b. Extremely good wages c. Experience gained in grant writing d. A chance to read proposals that have been funded

Gray Burns and Grove’s The Practice of Nursing Research (9e)

e. The opportunity to learn research and grantsmanship f. A chance to read proposals that have not been funded g. A guaranteed job after the apprenticeship ends ANS: A, C, D, E, F Volunteering to assist with the activities of another researcher is an excellent way to learn research and grantsmanship. Graduate students can gain this experience by becoming graduate research assistants. Through an apprenticeship, one may gain experience in writing grants and reading proposals that have been funded. Examining proposals that have been rejected can be useful if the comments of the review committee are available. The criticisms of the review committee point out the weaknesses of the study and clarify the reasons why the proposal was rejected. Examining these comments on the proposal can increase ones insight as a new grant writer and prepare a novice for similar experiences. However, some researchers are sensitive about these criticisms and may be reluctant to share them. If an experienced researcher is willing, it is enlightening to hear his or her perceptions and opinions about the criticisms. Ideally, by working closely with an experienced researcher, one has the opportunity to demonstrate ones commitment and the researcher may ultimately invite the novice to become a permanent member of a research team.

DIF: Cognitive Level: Synthesis REF: MCS: 666 3. Why is serving on a research committee or institutional review board useful for the person interested in gaining research funding? (Select all that apply.) a. People who serve on research committees are given priority funding approval. b. Seeing the mistakes others make creates an awareness of common errors. c. Contacts with researchers can be made. d. When ones own proposals are reviewed, the committee will feel more inclined to approve them. e. Reading a clear, organized proposal provides a template.

ANS: B, C, E

Gray Burns and Grove’s The Practice of Nursing Research (9e)

Research committees and institutional review boards exist in many health care and professional organizations. Through membership on these committees, contacts with researchers can be made.

Also, many research committees are involved in reviewing proposals for the funding of small grants or granting approval to collect data in an institution. Often reading proposals for approval for human subjects research or for funding can give the novice researcher insight into the importance of clarity and organization in the research proposal. Reviewing proposals and making decisions about funding help researchers become better able to critique and revise their own proposals before submitting them for review.

DIF: Cognitive Level: Synthesis REF: MCS: 667 4. What is the difference between a nursing project grant proposal and a nursing research grant?

(Select all that apply.) a. A research grant is awarded for a promising planned study. b. Research grants and project grants are identical. c. A project grants program can be academic or clinical. d. A research grant is awarded for outstanding past research. e. A project grant is awarded to support a novel program.

ANS: A, C, E Two main types of grants are sought in nursing: project grants and research grants. Project grant proposals are written to obtain funding for the development of new educational programs in nursing, such as a program designed to teach nurses to provide a new type of nursing care or a project to support nursing students seeking advanced degrees. These grants may fund a project manager to achieve the goals of the grant. Although these programs may involve evaluation, they seldom involve research. For example, the effectiveness of a new approach to patient care may be evaluated, but the findings can seldom be generalized beyond the unit or institution in which the patient care was provided. The emphasis is on implementing the project, not on conducting research. Research grants provide funding to conduct a study. Although the two types of grant proposals have similarities, they have important differences in writing techniques and flow of ideas, as well as content.

Gray Burns and Grove’s The Practice of Nursing Research (9e)

DIF: Cognitive Level: Synthesis REF: MCS: 667 5. Many hospitals and universities have access to both SPIN and The Foundation Directory. Why are these useful for a researcher? (Select all that apply.) a. They provide leads for thousands of grant opportunities. b. They provide information only for small grants of less than $5,000 each. c. They provide information on federal agencies, private foundations, and corporate foundations. d. They are computerized information resources. e. They provide funding information; all fees are then used to support future grants.

ANS: A, C, D A computerized information system, the Sponsored Programs Information Network (SPIN), can assist researchers in locating the most appropriate funding sources to support their research interests. The database contains approximately 2,000 programs that provide information on federal agencies, private foundations, and corporate foundations. Many universities and research institutions have access to SPIN. Other databases include private funding as well.

DIF: Cognitive Level: Analysis REF: MCS: 669 6. A new researcher obtains a large grant and proceeds to hire nine assistants, as the grant specifies. The new researcher hires a statistician, three persons to collect data, one person to schedule and coordinate the activities of the persons collecting data, one person to help with qualitative data analysis, one person to begin writing for the grant renewal, one person to write the interim report, and one person to manage the grant budget, writing weekly checks to the research assistants based on their submitted timecards. Which of these activities is appropriate for a hired assistant? (Select all that apply.) a. Advising the research team about appropriate statistical tests b. Recalculating the study power after data collection on the first thirty subjects, to be sure of the effect size c. Performing initial qualitative coding of raw data

Gray Burns and Grove’s The Practice of Nursing Research (9e)

d. Writing the first draft of a renewal grant e. Writing the interim report for the institutional review board f. Managing the grant budget g. Writing weekly checks to the research assistants ANS: A, B, C, G Although the supporting institution is ultimately responsible for dispensing and controlling grant monies, the primary investigator (PI) is responsible for keeping track of budget expenditures and making decisions about how the money is to be spent. If funding is through a federal agency, the PI will be required to provide interim reports as well as updates on the progress of the study. The PI interviews, hires, trains, and oversees grant personnel. During a large study with several investigators and other grant personnel, the PI coordinates activities, often through formal meetings of all grant workers at intervals to share ideas and solve problems. Federal grants require the PI to submit interim reports according to preset deadlines. The PI often writes the renewal grant as soon as the first grant has been made, so that continuous research activity can be accomplished. In theory, the PI could be planning one study, collecting data on a second study, analyzing data on a third study, and writing papers for publication on a fourth study. A full-time researcher could have completed one funded study, be in the last year of funding for a second study, be in the first year of funding for a third study, and be seeking funding for a fourth study.

DIF: Cognitive Level: Application REF: MCS: 671 7. What are two national nursing organizations that provide small grants not linked to a nursing specialty area? (Select the two that apply.) a. The Society for Pediatric Nurses b. American Nurses Foundation c. The Board of Registered Nursing d. The American Cancer Society e. Sigma Theta Tau, International f. The National Association of Hospitals and Clinics

Gray Burns and Grove’s The Practice of Nursing Research (9e)

ANS: B, E Two national nursing organizations that provide small grants not linked to a specialty are the American Nurses Foundation and Sigma Theta Tau, International. These grants are usually for less than $7,500 each year, are very competitive, and are awarded to new investigators with promising ideas. Receiving funding from these organizations is held in high regard.