Evidence Base Practice Midterm Exam
A nurse considers how to apply EBP in the nurse's practice setting. Which activity would be a valid application of the EBP process?
Develop policies and procedures for client care based on compiled research.
A nurse studies the potential impact of nursing research on the profession. Which statement best describes the value of research?
"Research generates knowledge for a variety of roles."
The variables signifying standard or usual care would be included in which PICOT component?
(C) Component
Which of the following examples do not require IRB approval?
An evidence-based project
Study participant's right to privacy is protected through:
Confidentiality procedures
A researcher has narrowed a search of electronic databases to 15 potential references. Which action in the screening process would be the most appropriate next step in identifying useful articles?
Reading the reports in their entirety
Descriptive theories are deductive and describe characteristics of individuals or groups by summarizing their commonalities. True or False?
False
Which research activity would be expected of a nurse who had taken a research course at the baccalaureate level?
Understand the research process and identify researchable problems.
A nurse studying evidence-based practice (EBP) reviews the formal definition. Which components are key to EBP? (Select all that apply.)
A. Client values and preferences B. The latest research evidence C. Clinician expertise
When beginning a literature search for relevant evidence, the researcher selects databases to review. Which database is most likely to include nursing studies?
CINAHL
When the nurse searches for nursing topics, what electronic database includes the most nursing literature?
CINAHL
A nurse considers differences in resources for evidence-based practice and research utilization. Which resource is unique to EBP?
Evidence-based practice guideline
A nurse summarizes the pattern of levels of evidence for practice. Which type of report would likely contain the strongest evidence?
Systematic review of quantitative studies
Clinical practice guidelines are based on systematic reviews and provide specific recommendations for EBP decision making.
True
A nurse considers both supports and challenges to an EBP approach in the nurse's institution. Which factors would be supportive of EBP?
Staff receive release time to participate in journal clubs
Which of the following are research activities in which all nurses can engage? (Select all that apply)
A. Help develop an idea for a research study B. Offer information to patients about the research study C. Collect research information
A nurse researcher gave the option for study participants to change their mind and withdraw from the study at any time. Which of the five human rights was being adhered to?
Self-determination
When considering best evidence for clinical decision making, evidence hierarchies provide sources based on the strength of the evidence they provide. Which of the following provides the strongest level of evidence for clinical decision making?
Systematic review
One advantage of meta-analysis as an integration is:
Objectivity
Which of the following is an example of a nondirectional hypothesis?
There is a relationship between fast-food intake and childhood obesity.
Which role specifically describes the nurse who develops policies and procedures for a health care agency, after analyzing the available research?
Critique relevant research studies.
A nurse researcher wants to determine whether there is a relationship between levels of anxiety and blood pressure in a population of men between the ages of 40 and 60 years. Which theory would the researcher use to support this study?
Explanatory
The primary purpose for conducting community health research is to:
Gain new knowledge that will improve health services
A health care system is interested in improving health promoting activities for its employees. Their research team is investigating a theoretical model to serve as a basis for conducting a study to determine factors that affect health promoting activities in healthcare workers. Which theory would be best to use in conducting this study?
Health promotion model
The role of the nurse in serving diverse communities includes strategic emphasis on health promotion, disease prevention, and risk reduction. True or False?
True
The nurse reviews the Sources of Evidence Pyramid. Rank order the list of types of evidence from top (highest level) to bottom (lowest level).
1)Systematic review 2)Randomized controlled trial 3)Quasi-experimental study 4)Single qualitative study 5)Case report
When a nurse conducts a literature search, what is the advantage of having a well-thought-out search strategy? (Select all that apply.)
A. Decreases frustration B. Locates more relevant and useful resources C. Saves time
Two nurse researchers are reviewing a qualitative research study. Which characteristics would they know apply qualitative research design? (Select all that apply.)
A. Personal B. Flexible C. Holistic
A nurse is trying to produce the best search results possible using keyword searches. What is an appropriate tip to provide in order to achieve this goal? (Select all that apply.)
A. Use Boolean logic (e.g. AND/OR operators) B. Use wildcard characters.
Individual nurses can put research into practice through the EBP process. What is the first step?
Ask questions that reflect uncertainties in clinical practice.
A researcher begins the searching process by entering key terms. The search yields over 180 potential articles. Which action in the screening process would be the most appropriate next step in identifying useful articles?
Identify MeSH terms in making keywords more specific.
A nurse researcher wants to study how adults cope with chronic illness. Which individual would be considered part of a vulnerable population, and should receive additional protection if included in a research study?
John, ulcerative colitis, hospitalized in the ICU with GI bleeding
A nurse reviews examples of evidence-based practice (EBP). A practice that is considered evidence-based would:
Consider client preferences when planning care.
Nurses prepared at all levels of education have a role to play in research. Which role is expected of all registered nurses?
Consumers
A nurse researcher develops a purpose statement for a quantitative study. Which component is included in a well-structured purpose statement for nursing research?
Identifies key study variables
A nurse researcher learns to identify secondary sources in the literature. Which source would be considered secondary?
Literature review
The nurse differentiates between types of systematic reviews. Which type includes only qualitative studies?
Meta-synthesis
A researcher designs a study to explore coping behaviors in caring for patients with serious diagnoses like the client in the video. Which theory would best fit this research design?
Middle-range theory
Meta-synthesis is defined as the critical appraisal of what type of research?
Qualitative
Research traditions have their roots in various discipline traditions. Which discipline does the research tradition of grounded theory stem from?
Sociology
Challenges to EBP include a lack of organizational support for research and implementation of evidence-based nursing. True or False?
True
The MEDLINE database uses a vocabulary called MeSH to index articles. True or False?
True
Community nurse researchers engage in a variety of research roles. Which role specifically describes the nurse who conducts a study on the availability of healthy food options in the community?
Design and implement studies.
A researcher explores how social support is related to health in older adults. What type of theory would this issue relate to?
Explanatory theory
A researcher studies the effect of a therapeutic mattress on the incidence of pressure ulcers in debilitated clients. What type of theory would this research draw from?
Predictive theory
The nurse who evaluates educational approaches to improving blood sugar control in adults with type 2 diabetes is addressing which type of prevention measure?
Secondary prevention
In examining the concept of disease prevention, primary prevention consists of strategies early or during the active stages of illness and injury. True or False?
False
Maslow's hierarchy of needs is an example of a middle-range nursing theory developed by a nurse to describe a phenomenon of interest to nurses. True or False?
False
When studying caring in nursing, focusing on the caring between nurse and client, which theories would be of most interest to a researcher?
Jean Watson's Theory
Once the nurse researcher has devised a search strategy and retrieved potential primary source materials, the next step is to discard irrelevant or inappropriate references. True or False?
False
The research hypothesis states that there is no relationship between the study variables. True or False?
False
When using the PICOT format to develop a clinical question, a time frame must always be specified. True or False?
False
In determining a problem statement, the nurse considers several ideas. What is a major source of ideas for research problems? (Select all that apply.)
A. Nursing literature B. Theories or conceptual frameworks C. Personal nursing experience
As a member of an institutional review board, a nurse researcher uses the Belmont Report as a guide. What are the three primary ethical principles addressed by the Belmont Report? (Select all that apply.)
A. Respect for human dignity B. Justice C. Beneficence
When addressing highly emotional issues, a nurse researcher uses interview strategies to minimize subjects' anxiety. Which ethical principle does this most clearly represent?
Beneficence
A nurse differentiates between research utilization and evidence-based practice (EBP). Which dimension applies only to research utilization?
Changes to practice are based solely on research findings.
Which database contains a collection of systematic reviews that can be used to answer clinical questions?
Cochrane Collection Database
A nurse receives an overview of research. The statements "to improve the care of people in a clinical setting" and "to develop greater autonomy and strength as a profession" are both examples of which aspect of nursing research?
Goals
A nurse learns how to write PICOT questions. When writing these clinical questions, what component is not always specified?
Time
The EBP movement has caused concern for some nurses and researchers who worry that qualitative research is not being given enough consideration in evidence hierarchy used to support clinical decision making. True or False?
True
A number of resources exist for evidence-based practice (EBP) including preappraised evidence. From the following choices, select the resources that are considered preappraised evidence. (Select all that apply.)
A. Clinical practice guidelines B. Systematic reviews C. Meta-analysis
In the video case, Julie's nurse preceptor is working on an evidence-based practice project on investigating how to help patients find a primary care provider (PCP) and establish a medical home with that provider. Which factors do researchers (like Julie's preceptor) consider during the development of a problem statement of a research project? (Select all that apply.)
A. Cost of not fixing the problem B. Background and nature of the problem C. Impact of the problem on patient outcomes D. How the problem impacts nursing E. How many people are affected by the problem
Which of the following research questions represents correct use of the PICOT format for a clinical question?
A. In patients older than the age of 65 years, how does immunization with influenza vaccine compared with no immunization with flu vaccine influence the possibility of contracting influenza during flu season?
Which of the following are examples of research misconduct? (Select all that apply.)
A. Plagiarism B. Fabrication C. Falsification
Julie sees how important research is for nursing practice and envisions herself participating in the development of a research study in a few years. She wonders about the sources for research problems used as a basis to develop research studies. From what sources do ideas for research problems come? (Select all that apply.)
A. Social issues, Ideas from external sources B. Theories, Published articles/literature C. Clinical experience
Models of EBP guide practice in large organizations. Which models are directly related to EBP? (Select all that apply.)
A. Stetler Model B. Iowa Model C. A-GAME Model
The primary purpose of the research literature review is: (Select all that apply.)
A. Suggest appropriate research methods B. Construct a conceptual framework C. Assist in developing the research question
A researcher who conducts original research studies independently with the goal of expanding nursing knowledge is educated at what level?
Doctorate
An Institutional Review Board (IRB) reviewed a study on hypertension in adults. Only Caucasian participants were included as study subjects. Which IRB safeguard was violated by this study?
Ensuring subject selection is fair
A nurse is looking across all of the studies reviewed to date and asks questions such as, "What is the pattern of evidence?", "How much evidence is there?", and "How consistent is the evidence?" The nurse is in what stage of the literature review process?
Evaluate and analyze the studies.
A nurse researcher reviews the literature on fall prevention on the hospital medical surgical unit. Which type of literature presents the strongest evidence for practice?
Experimental study
The ethical principle of justice includes research participant's right to:
Fair Treatment
An institutional review board reviews the scientific merits of completed research. True or False?
False
Historically, the EBP movement originated in the discipline of medicine in the United States. True or False?
False
When conducting a literature review, a nurse researcher locates a systematic review that includes quantitative studies. This design is considered a high-level, primary source because it:
Follows a predetermined and rigorous research method of analysis.
When studying ethics in research, the nurse learns about researcher responsibilities. What is an example of researcher misconduct?
Ignoring data outliers and changing final results
A nurse researcher is looking for an EBP model to guide and implement EBP projects at her health care institution. Which model is most appropriate for the researcher to use if her focus is institutional EBP projects?
Iowa Model
Using the PICOT format for developing a clinical question, the letter "P" represents which component of the question?
Population
In the process of conducting a literature review, the nurse researcher is using studies written by the researchers who conducted the studies. This type of information source is known as:
Primary
A nurse researcher develops an informed consent form, revealing study risks and benefits. Which ethical principle is most closely linked to informed consent?
Respect for human dignity
A nurse differentiates between the Stetler Model and the Iowa Model of evidence-based practice. Which statement accurately describes these models?
The Iowa Model focuses on institutional EBP efforts.
The nurse locates a meta-analysis study on a clinical topic. When evaluating the research question or hypothesis for the individual studies, what characteristic is to be expected?
The questions or hypotheses across studies should be essentially identical.
A nurse researcher differentiates between primary and secondary sources of literature. Which source would be considered primary?
The research report of a clinical trial in a research journal
The purpose statement of a research study identifies the population of interest and the relationship between study variables. True or False?
True
The right of research study participants to be free from harm and discomfort includes physical harm as well as psychological harm. True or False?
True
When conducting a literature review, a researcher should use mostly primary sources in order to ensure the quality of the evidence used to support the study is strong and relevant. True or False?
True
When conducting a literature review, it is important to locate relevant studies. One bibliographic database that is particularly helpful to nurse researchers is CINAHL. True or False?
True
ll research studies using human subjects must be approved by an institutional review board. True or False?
True
Which of the following is an example of a qualitative research question?
What is the lived experience of adult children caring for a parent who experienced a stroke within the last 6 months?
In conducting a subject search in an electronic database, the nurse would most likely initiate the search by typing in:
A keyword or phrase.
After reading the article suggested by a coworker, the nurse from the video recognizes that which statements concerning frameworks are true? (Select all that apply.)
A. Frameworks may be implicit or explicit B. All studies have a framework
Which of the following is an ethical principle for protecting human research subjects?
Beneficence
After entering a key word into the MEDLINE database, the search results yielded 10,100 results. One method to restrict search results is to use a:
Boolean operators
A researcher wants to investigate a single phenomenon in order to analyze issues that are important to the history of an entity under study. This type of investigation is known as:
Case Study
A researcher studies a theory about the grieving process which identifies its major elements or events. What type of theory would this be?
Descriptive theory
Research utilization considers the patient's needs, the provider, and the health care delivery system as well as current research in clinical decision making.
False
Secondary sources can be substituted for primary sources when conducting a literature review if the researcher does not have enough time or resources to find primary sources. True or False?
False
The nurse studies the role of research on health promotion and disease prevention. Immunizations, education classes, and using seatbelts are examples of what type of prevention measure?
Primary prevention
A nurse studies how theoretical frameworks relate to research. Which factors is part of a theoretical framework?
Proposed relationships between the variables in a study design
Which statement is an example of a goal of nursing research?
Provide evidence based nursing practice
The nurse is functioning in what role when he uses systematic inquiry to develop evidence about issues of importance to nurses and their patients?
Researcher
A nurse researcher is interested in developing an answerable question to solve a clinical problem and improve patient care. The first step is developing background and foreground questions. Which of the following is a characteristic of a background question?
They are foundational questions about a clinical issue.
The last major transgression of ethical principles in the conduct of research occurred in the experiments conducted by the Nazis. True or False?
False
Nurse researchers work in a variety of roles and settings. What are the three primary domains where nursing research has an impact?
Public policy, nursing practice, nursing professional status
A nurse researcher is interested in finding information about pancreatic cancer on an electronic database. One of the first tasks she must undertake to begin the database search for the desired information is:
Select Key Words
The variables of "hospitalized adults with diabetes, infants with feeding problems, and immunocompromised adults" would be included in which PICOT component?
(P) Population
A nurse is completing a literature review. The nurse has several ideas for a focus, but has not nailed down a specific topic to examine. Which step would be most helpful to follow at this stage of the process?
Formulate a clear research question.
A nurse researcher develops a problem statement for a study. What component is included in a well-structured problem statement for nursing research?
Gap in knowledge about the problem
The variables that represent the end result of the intervention being tested (results such as wound healing or improved mobilization) would be included in which PICOT component?
(O) Outcome
A nurse learns about asking clinical questions in a standard format. Rank order these terms to match the standard EBP acronym.
1)Population 2)Intervention 3)Comparison 4)Outcome 5)Time
The nurse determines the strength of evidence for application to practice, based on study design. Rank order these types of reports based on the Hierarchy of Evidence.
1)Systematic review of all relevant RCTs 2)Evidence obtained from well-designed RCTs 3)Evidence from controlled trials without randomization 4)Evidence from single descriptive studies 5)Evidence from the opinion of experts
A nurse studying research and human rights protection reviewed the Tuskegee syphilis study and Nazi war crimes. These horrific research studies violated which human rights? (Select all that apply.)
A. Fair treatment B. Self-determination C. Privacy and dignity D. Protection from discomfort and harm
In defining evidence-based practice, three distinct components are integrated. Which factors reflect these three components? (Select all that apply.)
A. Synthesis of the most relevant research B. Client preferences and values C. The practitioner's clinical expertise
Primary sources are those conducted directly with patients or sample groups. Which of the following are considered to be primary sources? (Select all that apply.)
A. Randomized control trial B. Systematic review C. Nonrandomized control trial
A nurse reviews a study on nutrition in children. Which phrase describes the following statement: "Children who watch an average of two or more hours of television per day will have higher BMIs than children who watch less than two hours of television per day?"
It is a directional research hypothesis.
A researcher hypothesized that students transferred classroom material to clinical practice when they determined that the classroom material was useful. Knowles's adult learning theory was used as a theoretical framework for the study. The researcher's study does what in relation to Knowles's theory?
Supports the theory
Sources of research problems often come from the interests of the researcher. Which of the following are commonly found sources of research problems? (Select all that apply.)
A. Nursing literature B. Social issues C. Clinical experience
A risk that is expected to be no greater than those ordinarily encountered in daily life is considered to be what type of risk?
Minimal risk
When conducting a research literature search, which activity is the most reliable way to identify new scholarly references?
Note relevant citations in the articles being reviewed.
Julie is reading a research article related to patient use of the emergency department (ED) for non-urgent problems. What statement would she identify as a research purpose statement?
Overall, our hope is to understand why patients with a PCP choose the ED for non-urgent problems so we can discover what might be done to help remedy ED overcrowding.
As Julie learns more about research, she reads about research hypotheses. Which research hypothesis below would Julie recognize as a null hypothesis?
There is no difference in the rate of falls and the age of the patient.
The nurse examines characteristics of systematic reviews. Which quality would always be part of systematic reviews?
They are developed through standard sampling and data procedures.
A nurse is reading an article on models and theories in nursing research. The nurse with a bachelor of science in nursing understands that both models and theories are:
Useful in generating hypotheses
A nurse researcher enters a numerical code on the data sheet for each participant completing a questionnaire. No other identifying information is listed on the questionnaire. This is an example of the human rights protection of:
Anonymity.
The nurse studies historic ethical violations in research, including the Nazi medical experiments conducted during World War II. Which ethical document was written as a result of these experiments?
Nuremburg Code
Evidence-based practice (EBP) consists of identifying the best evidence and integrating it with other factors to make clinical decisions. Components of EBP include which of the following? (Select all that apply.)
A. Evidenced-based theories B. Patient preferences C. External evidence from research D. Clinical expertise
Which type of evidence based on the evidence hierarchy is considered to be the strongest?
Systemic Review
In differentiating between quantitative and qualitative research, what is a component of the purpose statement in a qualitative study?
The phenomenon
