Chapter 13

6. A nurse studies the effects of teaching the MyPlate.gov materials to preschoolers by providing this education to preschoolers in a single day care center and then following their BMI scores over a 5-year period and comparing their scores to those of children from another day care center. In this study, which element is represented by the O in the PICOS acronym? a. BMI scores b. Five-year follow-up c. MyPlate.gov materials d. Preschoolers

ANS: A In PICOS, the O stands for outcomes, which, in this study, are the BMI measures thought to be affected by the intervention.

5. To develop a clinical question when reviewing the effectiveness of nursing interventions, the nurse will use which format? a. PICOS b. PRISMA c. Study design d. Systematic review

ANS: A PICOS (Population, Intervention, Comparison of intervention, Outcomes, and Study design) is the most common format for developing a research question by nurse researchers.

8. What must a researcher describe to identify that a comprehensive, systematic literature search was conducted? a. All key search terms and databases used in the search b. A list of grey literature sources used in the review c. The date restrictions applied to the literature search d. The use of literature only from prestigious journals

ANS: A The key search terms, different databases searched, and search results need to be recorded in the systematic review and meta-analysis publications in order to indicate that a comprehensive search was performed.

17. Which is the strongest source of research and evidence for developing evidence-based guidelines? a. Meta-analyses of specifically focused research questions b. Panels of experts sharing their opinions on best practices c. Quasi-experimental studies d. Rigorous experimental studies

ANS: A The strongest source of research evidence is synthesized to develop recommendations for practice and generally comes from meta-analyses. Often consultants, other researchers, and additional expert clinicians are asked to review the guidelines as well.

15. Which method will a researcher use to evaluate a group of qualitative studies? a. Meta-analysis b. Meta-synthesis c. Mixed-methods systematic review d. Systematic review

ANS: B A meta-synthesis is used to pool and combine findings from qualitative studies.

12. In a meta-analysis, the researcher displays a symmetrical funnel plot of the data from a group of studies. This indicates: a. heterogenicity of study samples. b. limited publication bias. c. methodological bias. d. reporting bias.

ANS: B A symmetrical funnel plot indicates limited publication bias and occurs with homogeneity of study samples.

7. Which type of research literature would be included in grey literature sources? a. Book chapters b. Dissertations c. Journal articles d. Textbooks

ANS: B Grey literature sources tend to be those that are not published and may include dissertations or theses.

9. What is true about a meta-analysis? a. It helps to determine whether studies should be replicated. b. It identifies and appraises previous research. c. It pools results from previous studies into a single quantitative analysis. d. It replicates previous studies to confirm statistical results.

ANS: C A meta-analysis is a review of quantitative studies by statistically pooling or combining the results from these studies into a single quantitative analysis.

18. When using the Stetler Model of research utilization, the nurse researcher reviews the risks, resources, and readiness of staff associated with making changes in practice based on evidence. Which part of the model is this? a. Phase I: Preparation b. Phase II: Validation c. Phase III: Comparative Evaluation d. Phase IV: Translation/Application ANS: C

ANS: C In the Comparative Evaluation phase, the researcher substantiates the evidence, evaluates the fit of the health care setting, determines the feasibility of using research findings, and identifies concerns with current practice using the three Rs of risks, resources, and readiness.

4. What is the purpose of the PRISMA statement? a. To help researchers develop a clinical question before a review b. To help determine whether studies reviewed should be replicated c. To improve reporting of meta-analyses and systematic reviews d. To outline the abstract when reporting on meta-analyses and other reviews

ANS: C The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was developed in 2009 to improve the quality of reporting for systematic reviews and meta-analyses and includes 27 items to ensure that this is done.

2. Which standards were developed to help nursing students develop the skills, knowledge, and attitudes needed to continuously improve quality and safety? a. EBP b. IRB c. QSEN d. Magnet

ANS: C The Quality and Safety Education for Nursing, or QSEN, project was implemented to improve prelicensure nurses knowledge, skills, and attitudes necessary to continuously improve quality and safety in health care systems.

10. Which is true about the literature search criteria for a meta-analysis? a. They include only published works from refereed journals. b. They include the full range of related sources based on the topic. c. They usually are narrowly focused around the research question. d. They use works from a single database in order to remain consistent.

ANS: C The search criteria for a meta-analysis are usually narrowly focused around the research question.

3. When addressing a health care question to determine best practice, the nurse identifies and appraises quality research using a structured, comprehensive synthesis of the research literature to determine the best research evidence available. This is an example of a: a. literature review b. meta-analysis. c. meta-synthesis. d. systematic review.

ANS: D A systematic review is a structured, comprehensive synthesis of the research literature to determine the best research evidence available to help determine best practice.

16. 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 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.

1. Which is true about evidence-based practice? a. Evidence-based guidelines are unrelated to accreditation regulations. b. Evidence-based practice is determined only through experimental studies. c. Most nursing interventions are based on evidence-based principles. d. The use of evidence-based practice results in improved patient outcomes.

ANS: D The greatest benefits of EBP are improved outcomes for patients, providers, and health care agencies.

13. What is true about reporting the mean difference between two groups in a meta-analysis? a. It is a measure of differences between nominal data for the two groups. b. It is an estimate of the effect of differences between the two groups of subjects. c. It is not used to examine differences in ratio-level data. d. It is appropriate only when the same scale is used to measure outcomes.

ANS: D The mean difference is reported in a meta-analysis to identify the effect of an intervention but is appropriate only if the outcome is measured by the same scale in all the studies.

14. In a meta-analysis, a researcher wishes to examine differences in temperatures of subjects in two groups but notes that one study uses a centigrade scale and the other study uses a Fahrenheit scale. Which statistic will the researcher apply in this case? a. Dichotomous data reporting b. Funnel plot c. Mean difference d. Standardized mean difference

ANS: D The standardized mean difference is a summary statistic reported in a meta-analysis when the same outcome is measured by different scales.

11. A study yielding negative results is withheld for publication for several years, contributing to which type of bias? a. Citation bias b. Location bias c. Outcome-reporting bias d. Time-lag bias

ANS: D Time-lag bias occurs when results of some studies are released several years after those from other studies, meaning that the later results cannot be reported.

19. Which research discipline seeks to develop practical applications based on research knowledge? a. Meta-analysis b. Meta-synthesis c. Rigorous experimental studies d. Translational research

ANS: D Translational research is a new type of research to improve the translation of research knowledge into practice.