EBP Exam 2

33. During a study about nurses' ability to teach lifestyle changes in patients with coronary artery disease, the researcher discovers that many nurses have negative attitudes about obesity. The researcher develops a survey to examine these attitudes. This is an example of a. grounded theory research. b. intraproject sampling. c. saturation of information. d. verification of information.

ANS: B Intraproject sampling is done during data collection and analysis when new information is needed to gain insight into a phenomenon or concept that arises during the study. Grounded theory research is concerned with development of theories. Saturation of information occurs when additional sampling provides no new information, only redundancy of previously collected data. Verification of information occurs when researchers are further able to confirm hunches or theories. DIF: Cognitive level: Applying

6. A nurse researcher monitors women with breast cancer for depression before and throughout their chemotherapy treatment. This is an example of which type of study design? a. Cross-sectional b. Longitudinal c. Comparative description d. Correlational

ANS: B Longitudinal design refers to data collection from the same subjects at different points in time. 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. Correlational studies seek to examine relationships among variables without manipulation of a treatment by the researcher. Cross-sectional designs involve data collection on variables at one point in time. DIF: Cognitive level: Applying

14. 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 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. Bias refers to interference by the researcher that influences the outcome of a study. Reliability and validity are related to consistency and trustworthiness of measurement tools. DIF: Cognitive level: Applying

15. A nurse researcher understands there are numerous concepts relevant to quantitative research designs. What concept best describes the following example, "Patient diagnosis, age, pre-surgical condition, and complications after surgery are interrelated causes of the length of patients' hospital stays"? a. Probability b. Multicausality c. Causality d. Bias

ANS: B Multicausality is the presence of multiple causes for an effect. Studies developed from a multicausal perspective will include more variables than those using a strict causal orientation. Causality basically means that things have causes, and causes lead to effects. Bias means a slant or deviation from the true or expected. Probability addresses relative rather than absolute causality. DIF: Cognitive level: Analyzing

4. A researcher conducts a study to identify the relationship of lifestyle choices to the development of chronic diseases. The researcher surveys subjects and identifies diabetes mellitus, coronary artery disease, and renal disease in study subjects. These measures represent which level of measurement? a. Interval b. Nominal c. Ordinal d. Ratio

ANS: B Nominal level measurement is used when data can be organized into categories of a defined property, such as a disease diagnosis, but when categories cannot be rank ordered. Interval level measurement uses interval scales, which have equal numerical distances between intervals. Ordinal level measurement is used when data collected can be rank ordered. Ratio level measurement uses all aspects of other types of measurement: mutually exclusive categories, exhaustive categories, ordered ranks, equally spaced intervals, and a continuum of values. DIF: Cognitive level: Applying (Application)

39. The goal of sampling theory is to a. clearly define sample types used in research studies. b. determine the best way to achieve representative samples. c. develop methods for collecting data more efficiently. d. provide frameworks for data analysis.

ANS: B Sampling theory was developed to determine the best way to acquire a sample that accurately reflects the population under study. Part of sampling theory is defining sample types, but this is not the goal of sampling theory. Part of sampling theory is developing methods for collecting data, but this is not the goal of sampling theory. Sampling theory does not provide frameworks for data analysis. DIF: Cognitive level: Understanding

11. A researcher reviews study data about head circumference in newborns and notes that study personnel are measuring from the end of the measuring tape and not from the zero point, which is 1 cm from the end. This is an example of which type of measurement error? a. Indirect b. Random c. Reliability d. Systematic

ANS: D Systematic error is the variation in measurement values from the calculated average that occurs systematically either because the instrument is also measuring something else, or because the instrument is set to a scale that is off the true measure. In this case, the personnel are inadvertently adding a centimeter to the measurements. Indirect error is an error that occurs when measuring indirect concepts. Random error occurs randomly, when the difference between the measured value and the true value is without pattern or direction. Reliability error occurs when a measurement method is not consistent. DIF: Cognitive level: Analyzing (Analysis)

4. A researcher wishes to conduct a study to determine the effects of an intervention on high school students. In this study, high school students represent the a. accessible population. b. elements of the population. c. sample population. d. target population.

ANS: D The target population is the entire set of individuals who meet the sampling criteria. An accessible population is the portion of the target population to which the researcher has reasonable access. An element is an individual unit of a study population. A sample is that group of people who are representing the entire population and participating in the study. Samples are expected to represent an entire population. DIF: Cognitive level: Applying

2. A researcher wishes to evaluate the management of chemotherapy side effects in children with acute lymphocytic leukemia (ALL). Children with ALL in this study are an example of which of the following? a. Accessible population b. Element of the population c. Sample population d. Target population

ANS: D The target population is the entire set of individuals who meet the sampling criteria. The accessible population is that portion of the entire population that the researcher can use. An element is an individual unit in a study. A sample is a subset of the population that represents that population. DIF: Cognitive level: Applying

30. During the data collection phase of a qualitative study, the researcher notes previously untheorized links among concepts. The researcher will continue to collect data until a. a quota of each subject type is achieved. b. saturation of information is noted. c. the desired sample size is attained. d. verification of information occurs.

ANS: D Verification of information occurs when theoretical models or hunches are confirmed. When new links are noted during the study, data collection should continue until verification of this information has occurred. Quota sampling seeks participants who are representative of the general population. Saturation of information occurs when additional sampling provides no new information, only redundancy of previously collected data. Achieving the desired sample size helps to improve the power of the study and improve the significance of findings. DIF: Cognitive level: Applying

15. When using stratified random sampling, the researcher can a. achieve greater control over subject selection. b. avoid discussion of the effects of extraneous variables. c. lower the costs associated with sampling. d. use a smaller sample size.

ANS: D With stratification, the researcher can use a smaller sample size and achieve the same degree of representativeness in relation to the stratified variable as a large sample acquired through simple random sampling. The researcher does not achieve greater control of subject selection, since random selection is still used. Discussion of extraneous variables should always occur, even with stratified random sampling techniques. There is no guarantee that costs will be less with this type of sampling technique. DIF: Cognitive level: Understanding

3. The individual units of the population and sample are called _________________.

ANS: elements An element can be a person, event, object, or any other single unit of study. When elements in a study are persons, they are referred to as participants or subjects. DIF: Cognitive level: Remembering

13. A researcher enters a list of subjects from a sampling frame into a computer and the computer randomly assigns subjects to control or treatment groups. This is an example of a. cluster sampling. b. simple random sampling. c. stratified random sampling. d. systematic sampling.

ANS: B Simple random sampling is the most basic of the probability sampling plans and is achieved by randomly selecting elements from the sampling frame. It can be done by computer, as in this case. Cluster sampling occurs when the researcher selects subjects from groups of subjects within the larger population, as with groups from specific regions or cities. Stratified random sampling occurs by ensuring that the proportions of characteristics among the population are represented in both the control and experimental groups. Systematic sampling is used when an ordered list of all members of the population is available and involves selecting every kth individual on the list. DIF: Cognitive level: Comprehension

9. A researcher begins a study with 250 subjects, and 50 subjects drop out before the study is concluded. The researcher will declare 20% as the sample a. acceptance rate. b. attrition rate. c. refusal rate. d. retention rate.

ANS: B The sample attrition rate is the percentage of subjects who withdraw from a study after the study has begun. The acceptance rate is the percentage of subjects who meet eligibility requirements who consent to participate. The refusal rate is the percentage of subjects who meet eligibility requirements who refuse to participate. The retention rate is the percentage of subjects who remain in the study after the study has begun. DIF: Cognitive level: Analyzing

20. Which of these sampling techniques is least likely to produce findings that are generalizable to a larger population? a. Cluster b. Convenience c. Quota d. Systematic

ANS: B There is little opportunity to control for bias in a convenience sample. Cluster sampling is a type of random sampling and is much stronger than convenience sampling. Quota provides for a more representative sample than convenience sampling, so it is stronger. Systematic sampling is a type of random sampling and is much stronger than convenience sampling. DIF: Cognitive level: Understanding

20. 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 to a. decrease mono-operation bias. b. improve the test-retest reliability. c. increase interrater reliability. d. strengthen the operational definition of constructs.

ANS: B To 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. Mono-operation bias occurs when only one measure is used to evaluate an outcome. Interrater reliability refers to consistent results that occur when various people administer study measures. Evaluating the consistency of a measurement tool does not affect the operational definition of constructs. DIF: Cognitive level: Analyzing

12. A researcher wishes to identify all school-age children who have type 2 diabetes mellitus in a local community to develop a sampling methodology for a study of this population. Which might serve as a barrier to obtaining this information? a. Affordable Care Act (ACA) b. Consolidated Omnibus Budget Reconciliation Act (COBRA) c. Health Insurance Portability and Accountability Act (HIPAA) d. Institutional Review Board (IRB)

ANS: C HIPAA contains guidelines about sharing patient information and may serve as a barrier to obtaining names of potential subjects. The ACA does not address the sharing of patient information. COBRA is concerned with healthcare coverage after termination of coverage. IRBs govern the use of human subjects in research. DIF: Cognitive level: Comprehension

23. 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 Internal validity looks at the influence of extraneous variables on study outcomes. Construct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions. External validity is concerned with the extent to which findings can be generalized beyond the study sample. Statistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. DIF: Cognitive level: Analyzing

32. 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 Internal validity looks at the influence of extraneous variables on study outcomes. Construct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions. External validity is concerned with the extent to which findings can be generalized beyond the study sample. Statistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. DIF: Cognitive level: Analyzing

32. A researcher begins with a registry of all patients with HIV in the United States. The researcher uses a computer to generate a random sample from the list, and then those individuals agree to participate in a study. What kind of sample has been created? a. Cluster b. Convenience c. Simple random d. Stratified random

ANS: C Simple random sampling is when every member of the population has an equal chance of selection for the sample. Cluster sampling occurs when a researcher develops a sampling frame that consists of a larger division than the one desired and it is chosen randomly; then subjects from the chosen subsets are selected randomly. A convenience sample is based on any member of the target population that is easily accessible to the researcher. In a stratified sample, knowledge about characteristics of the population is used to create a sample that is representative of the larger population. DIF: Cognitive level: Applying

34. In a study investigating type 2 diabetic patients' ability to make lifestyle changes, the researcher randomly selects a sample from a list of all patients diagnosed with type 2 diabetes in the United States. The researcher also selects the sample by randomly selecting patients diagnosed for 3 years or longer and those who are newly diagnosed. What sampling technique is used in this study? a. Cluster b. Quota c. Stratified random d. Systematic

ANS: C Stratified random sampling is used when certain characteristics of the group are identified and then proportionately included in the randomly chosen sample. In cluster sampling, a researcher develops a sampling frame that includes a list of all the possible elements of the identified population, and those are randomly selected. Then the sample is randomly selected from those groups. Quota sampling is a type of convenience sampling in which a predetermined number of subjects is drawn from groups within the population to ensure appropriate representation. Systematic sampling is selecting every kth individual from a listing of the population. DIF: Cognitive level: Applying

14. A researcher who wishes to study the effects of a prenatal breastfeeding education program on the length of time African-American inner-city women breastfeed infants learns that 70% of women in the target population are unmarried. To achieve stratified random sampling in a sample of 50 subjects, the researcher will a. conduct the study using unmarried subjects only. b. randomly assign all subjects to control versus experimental groups. c. select a random sample of 35 unmarried and 15 married subjects. d. select 25 subjects who are married and 25 who are not married.

ANS: C Stratified random sampling is used when the researcher knows some of the variables in the population that are critical for achieving representativeness, such as marital status. In this case, subjects are randomly selected, but stratification by marital status to match the target population proportions helps to improve generalizability of the findings. Using only married subjects makes the results ungeneralizable to unmarried subjects. Randomly assigning subjects without stratification does not make the groups representative. Having equal numbers from each group is possible if subjects are randomly assigned and not selected. DIF: Cognitive level: Applying

19. Which statement is true about systematic sampling? a. A nonrandom starting point is used when selecting subjects. b. It can be used when the desired sample size is unknown. c. It provides a random chance for inclusion as a subject. d. Subjects have an equal chance for inclusion in the study.

ANS: C Systematic sampling provides a random but not equal chance for inclusion. A random starting point is used in this type of sampling. Systematic sampling is used when the desired sample size is known. Subjects do not have an equal chance for inclusion. DIF: Cognitive level: Understanding

25. Which statement is true about effect size? a. There is one type of effect size measure used in research studies. b. The effect size is the extent to which the null or statistical hypothesis is true. c. The effect size is the extent to which the null or statistical hypothesis is false. d. When the effect size is small, detecting it is easier and can be done with a smaller sample.

ANS: C The effect size is the extent to which the null or statistical hypothesis is false. In other words, the strength of the expected relationship between two variables or differences between two groups. There are different types of effect size measures and each corresponds to the type of statistic computed. When the effect size is large, detecting it is easier and can be done with a smaller sample. DIF: Cognitive level: Understanding

2. A nurse researcher used a systematic sampling design. The known population size is 2800 and the desired sample size is 140. The sampling size (k) of the gap between elements selected from the list, as a numeral, is ______________.

ANS: 20 Systematic sampling is used when an ordered list of all members of the population is available. The process involves selecting every kth individual on the list, using a starting point selected randomly. The formula for calculating k is: k = Population size ÷ by the desired sample size. k = 2800 subjects in the population ÷ 140 desired sample size = 20 DIF: Cognitive level: Applying

1. If 100 potential participants meeting sampling criteria are approached to participate in a research study, and 5 patients refuse, then the refusal rate as a numeral would be _________________ percent.

ANS: 5 In published studies, researchers may identify a refusal rate, which is the percentage of subjects who declined to participate in the study, and their reasons for not participating. The formula for calculating the refusal rate in a study is as follows: Refusal rate = (Number refusing participation ÷ number meeting sampling criteria approached) 100%. Refusal rate = (5 ÷ 100) 100% = 0.05 100% = 5%. DIF: Cognitive level: Applying

12. Which statement is true about a cross-sectional design? a. This design includes a time element that involves data collection on variables at one point in time. b. This design includes a time element that involves data collection on variables at different points in time. c. This design involves collecting data from the same study participants at multiple points in time and might also be referred to as repeated measures. d. This design looks at predictive relationships between variables.

ANS: A A cross-sectional design involves data collection on variables at one point in time. 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 longitudinal design refers to data collection from the same variables at different points in time and is also referred to as repeated measures. A correlational study design looks at predictive relationships between variables. DIF: Cognitive level: Understanding

23. Prior to initiating a research study, a researcher conducts a power analysis to determine the sample size necessary for a power level of 0.8 and an alpha of 0.05. The researcher will a. apply a quota sampling technique to improve generalizability. b. decrease the sample size to minimize costs. c. increase the sample size to avoid a type II error. d. use stratified random sampling to minimize error.

ANS: C The minimum acceptable level of power for a study is 0.8, which results in a 20% chance of a type II error. This study has a 40% chance of such an error and is unacceptable. To increase the power, the researcher should increase the sample size. Quota sampling and stratified random sampling do not necessarily affect a study's power. DIF: Cognitive level: Analyzing

10. 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 The model testing design requires all concepts relevant to the model be measured and the relationships among these concepts examined. A descriptive correlational design is used to describe variables and examine relationships among these variables. Grounded theory research is designed to generate theory and to develop new concepts. A predictive correlational design is used to predict the value of one variable based on the values obtained for another variable or variables. DIF: Cognitive level: Applying

37. A nurse researcher compares the outcomes of administration of a bronchodilator either via nebulizer or by metered-dose inhaler and collects data on subjects in a pediatric inpatient hospital unit. This is an example of which type of setting? a. Controlled b. Field c. Natural d. Partially controlled

ANS: D A partially controlled setting is an environment that is manipulated or modified in some way by the researcher. A hospital unit allows researchers control over the environment in this way. A controlled setting is an artificially controlled environment that allows a high level of control by the researcher and usually involves research centers or laboratories. A natural, or field, setting occurs naturally, without control by the researcher. DIF: Cognitive level: Applying

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 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. A correlational study design looks at predictive relationships between variables. 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. Longitudinal design refers to data collection from the same subjects at different points in time. DIF: Cognitive level: Applying

9. 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 A predictive correlational design is used to predict the value of one variable based on the values obtained for another variable or variables. Correlational studies seek to examine relationships among variables without manipulation of a treatment by the researcher. A descriptive study is used to examine variables as they occur naturally without manipulation of variables. A descriptive correlational design is used to describe variables and examine relationships among these variables. DIF: Cognitive level: Comprehension

3. A nurse researcher wishes to identify rates of pertussis infection in children less than 1 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 A 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. 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. DIF: Cognitive level: Applying

7. The benefit to using a sample that utilizes narrow sampling criteria is that there is increased a. control of extraneous variables. b. generalizability. c. heterogenicity. d. range of values and scores.

ANS: A A sample that is narrowly defined is more homogeneous and has greater control of extraneous variables. The narrower the sample, the less generalizable it is. A narrow sample is homogeneous, not heterogeneous. A narrow sample will have a smaller range of values and scores. DIF: Cognitive level: Understanding

5. A researcher wishes to study the effects of a nursing intervention on children with cancer and obtains a sample of school-age children hospitalized for cancer treatment in a local hospital. This sample represents the a. accessible population. b. general population. c. target population. d. theoretical population.

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. A general population is the population, not just those meeting eligibility criteria. The target population is the entire set of individuals who meet the sampling criteria. The theoretical population is the same as the target population, which is the entire set of individuals who meet the sampling criteria. DIF: Cognitive level: Understanding

13. A study in which subjects are assigned by the researcher into experimental and control groups increases a. bias. b. control. c. manipulation d. validity.

ANS: 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. Control is used to manage manipulation of variables and to reduce extraneous factors in the environment that might alter outcomes. Manipulation of independent variables is used to evaluate changes in dependent variables. Researcher control over assignment into groups does not increase a study's validity. DIF: Cognitive level: Understanding

42. Which is a type of probability sampling? a. Cluster b. Convenience c. Network d. Quota

ANS: A Cluster sampling is a type of probability sampling. Convenience, network, and quota sampling are all types of nonprobability sampling. DIF: Cognitive level: Remembering

16. When conducting a study in which it is not possible to determine the true number of subjects who meet eligibility criteria and obtaining a random sample would be time consuming and expensive, the researcher will use which sampling method? a. Cluster sampling b. Simple random sampling c. Stratified random sampling d. Systematic sampling

ANS: A Cluster sampling is often used when the researcher is unable to identify the individual elements making up the population and when obtaining a random sample is time consuming or expensive. Simple random sampling is the most basic random sampling technique and is usually used when the population is clearly identifiable. Stratified random sampling is used when the researcher knows some of the variables in the population that are critical for achieving representativeness. Systematic sampling is used when an ordered list of all members of the population is available and involves selecting every kth individual on the list. DIF: Cognitive level: Remembering

24. 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 An 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. Consistent application of the intervention and improved precision of measurements help minimize threats to statistical conclusion validity. Increasing sample size minimizes threats to external validity. DIF: Cognitive level: Analyzing

35. To decrease the time needed to achieve saturation in information in a qualitative study, the researcher will a. broaden the scope of the study. b. increase the number of theoretical concepts. c. keep definitions of concepts vague. d. narrow the study's scope.

ANS: D If a topic is difficult to define and has a broad scope, it will take more subjects to obtain quality data. To decrease the time needed for data collection, the researcher will narrow the scope of the study. Increasing the number of concepts, using vague definitions, and broadening the scope of the study will all result in increased time needed to collect data. DIF: Cognitive level: Analyzing

30. 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 In 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. An alternative intervention would invite comparison, but if it is new, it would also be experimental. Offering no intervention is often unethical. Giving the newly modified intervention would not create a difference between the treatment and the control groups. DIF: Cognitive level: Analyzing

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 Longitudinal design refers to data collection from the same subjects at different points in time. Correlational studies seek to examine relationships among variables without manipulation of a treatment by the researcher. 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 of variables. DIF: Cognitive level: Applying

12. A researcher wishes to study the effects of preoperative teaching on anxiety levels among toddlers and preschoolers undergoing surgery. To reduce the potential for measurement error, the researcher will a. ask study subjects to describe feelings of anxiety. b. develop a new tool to measure anxiety levels in children. c. rely on multiple observers to collect data for this study. d. use a standardized checklist of anxiety behaviors.

ANS: D Measurement will be more precise if researchers use a well-developed, reliable scale. Using a checklist of anxiety behaviors reduces the likelihood of observer error. The technique of asking subjects to describe feelings provides in-depth data, but not precise measures, and is used in qualitative research. A new tool that has not been evaluated for reliability and validity has an increased chance of error. Increasing the number of observers increases the likelihood of error. DIF: Cognitive level: Analyzing (Analysis)

22. 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. train a small number of nurses to administer the intervention.

ANS: D One way to reduce the effect of extraneous variables is to train a small number of staff to administer the intervention to improve consistency. Double-blind data collection, random assignment of subjects, and reliability of test measures are important to improve control and reduce bias. Extraneous variables in complex settings can influence scores on the dependent variable. DIF: Cognitive level: Analyzing

33. 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 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. Experimental designs involve manipulation of independent variables, but without random assignment of subjects to groups, which can weaken the study by increasing the potential for bias. Pretest/posttest designs are a type of quasi-experimental study design that generally doesn't use random assignment of subjects. Quasi-experimental studies do not have complete control over variables and usually do not use random assignment of subjects. DIF: Cognitive level: Remembering

10. A researcher may use which strategy to reduce the potential for measurement error when evaluating obesity in study subjects? a. Measure weight, abdominal girth, and BMI on all subjects. b. Train multiple data collectors to take measurements. c. Use scales in several different clinical settings to obtain data. d. Utilize a single measure, such as BMI, applied to all subjects.

ANS: A Obesity is less precise than some concepts, so multiple methods to measure obesity should be used to minimize measurement error. Using multiple data collectors and multiple instruments, such as scales, increases the risk of measurement error. Using multiple data collectors and multiple instruments, such as scales, increases the risk of measurement error. Obesity is less precise than some concepts, so multiple methods to measure obesity should be used to minimize measurement error. DIF: Cognitive level: Analyzing (Analysis)

43. Which is a type of nonprobability sampling? a. Purposeful b. Simple random c. Stratified random d. Systematic

ANS: A Purposeful sampling is a type of nonprobability sampling. Simple random, stratified random, and systematic sampling are all types of probability sampling. DIF: Cognitive level: Remembering

35. 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 RCTs should be designed to be a definitive test of the hypothesis that the intervention caused the defined dependent variables. RCTs should be conducted in a clinical setting and not a laboratory. Subjects selected by the researcher may be biased. Descriptive or correlational designs are not RCTs. DIF: Cognitive level: Applying MULTIPLE RESPONSE

7. A study measuring the effects of a new diuretic medication records hourly urine output of subjects. This measure represents which level of measurement? a. Interval b. Nominal c. Ordinal d. Ratio

ANS: D Ratio level measurement uses all aspects of other types of measurement: mutually exclusive categories, exhaustive categories, ordered ranks, equally spaced intervals, and a continuum of values. Interval level measurement uses interval scales, which have equal numerical distances between intervals. Nominal level measurement is used when data can be organized into categories of a defined property, such as a disease diagnosis, but when categories cannot be rank ordered. Ordinal level measurement is used when data collected can be rank ordered. DIF: Cognitive level: Applying (Application)

8. A researcher uses a sample whose members have characteristics like those of the population from which it is drawn. This is an example of a a. cluster sample. b. purposive sample. c. random sample. d. representative sample.

ANS: D Representativeness means that the sample, accessible population, and target populations are alike in as many ways as possible. Knowing a sample as a cluster sample, purposive sample, or random sample tells how it was created but does not define a representative sample. DIF: Cognitive level: Understanding

18. A researcher conducts a pilot study using a convenience sample of children with seizure disorders. A reviewer of this study's manuscript may conclude that the findings of this study a. are generalizable to most children with seizures. b. have little credibility; they are extremely biased. c. provide no useful information. d. should be replicated using a wider population.

ANS: D Representativeness of the sample is a concern in convenience sampling, and generalizability is therefore limited. In a convenience sample, representativeness of the sample is a concern, and generalizability is therefore limited. Not all studies with a convenience sample are more biased than studies with other sampling methods. Intervention studies with a convenience sample can certainly provide useful information, even though further testing might be needed to be able to apply the findings to a large population. DIF: Cognitive level: Analyzing

16. 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 Statistical 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. Construct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions. External validity is concerned with the extent to which findings can be generalized beyond the study sample. Internal validity looks at the influence of extraneous variables on study outcomes. DIF: Cognitive level: Analyzing

1 The goal of appropriate sampling in research is to a. accurately reflect the characteristics of the target population. b. completely define the traits of the accessible population. c. identify all attributes of the sample population. d. study an entire population.

ANS: A Sampling involves selecting a group of people, events, behaviors, or other elements with which to conduct a study. Samples are expected to represent a target population of subjects who meet eligibility criteria for inclusion in the study. The accessible population are those people who are available for participation in the study. The accessible population may not be representative of the target population. The aim of sampling is to represent the target population, not to merely identify characteristics of the sample population. The goal of sampling is to study a representative sample of the larger population on which conclusions about the larger population may be drawn. DIF: Cognitive level: Applying

29. A researcher conducting a qualitative study knows that saturation of information has occurred when a. additional sampling reveals redundant information. b. data collected confirms theoretical models. c. subjects participating are representative of the general population. d. the desired sample size has been reached.

ANS: A Saturation of information occurs when additional sampling provides no new information, only redundancy of previously collected data. Verification of information occurs when theoretical models or hunches are confirmed. Stratified and quota sampling seek participants who are representative of the general population. Achieving the desired sample size helps to improve the power of the study and improve the significance of findings. DIF: Cognitive level: Applying

9. Which is an accurate statement about measurement error? a. Some error is always present in any measurement strategy. b. There is no difference between the true measure and what is actually measured. c. Direct measures, which generally are expected to be highly accurate, are not subject to error. d. With indirect measures, the element being measured can be seen directly.

ANS: A Some error is always present in any measurement strategy. Measurement error is the difference between the true measure and what is actually measured. Direct measures, which generally are expected to be highly accurate, are subject to error. With indirect measures, the element being measured cannot be seen directly. DIF: Cognitive level: Understanding (Comprehension)

10. A pilot study reveals a wide variation in measurement values among subjects with an overall mean value that is higher than among the general population. By increasing the sample size in a subsequent study, the researcher expects to a. decrease the variation of scores among subjects. b. increase the variation of scores among subjects. c. decrease the mean value of scores among subjects. d. increase the mean value of scores among subjects.

ANS: A The random variation of scores is the expected difference in values that occurs when different subjects from the same sample are examined. As sample size is increased, this variation decreases. The systematic variation is related to selecting subjects whose measurement values differ from those of the population. Increasing the sample size has no effect on mean scores. DIF: Cognitive level: Analyzing

2. Which of the following are accurate statements about the research setting when conducting research? Select all that apply. a. Three common settings for conducting nursing studies are natural, partially controlled, and highly controlled. b. All studies are strengthened by having more than one setting, making the sample more representative of the accessible population. c. The selection of a setting in quantitative and qualitative research is based on the purpose of the study, accessibility of the setting or sites, and number and types of participants available in the setting. d. Laboratories are considered a highly controlled setting in which experimental studies often are conducted. e. Conducting a study in a natural setting means that the researcher manipulates or changes the environment for the study.

ANS: A, C, D The research setting is the site or location used to conduct a study. Three common settings for conducting nursing studies are natural, partially controlled, and highly controlled. The selection of a setting in quantitative and qualitative research is based on the purpose of the study, accessibility of the setting or sites, and number and types of participants available in the setting. The setting needs to be clearly described in the research report, with a rationale for selecting it. Laboratories, research or experimental centers, and test units in hospitals or other healthcare agencies are highly controlled settings in which experimental studies often are conducted. Some studies are strengthened by having more than one setting, making the sample more representative of the target population. Conducting a study in a natural setting means that the researcher does not manipulate or change the environment for the study. DIF: Cognitive level: Understanding (Comprehension) COMPLETION

1. Which of the following are true statements about representativeness of a sample in quantitative research? Select all that apply. a. In quantitative research, you need to evaluate representativeness in terms of the setting, characteristics of the subjects, and distribution of values on variables measured. b. Representativeness means that the sample, accessible population, and target population are different in as many ways as possible. c. The setting identified in a study does not influence the representativeness of the sample. d. Researchers who gather data from subjects across a variety of settings have a more representative sample of the target population than those limiting the study to a single setting. e. Studies that obtain data from large databases have less representative samples. f. A sample must be representative in terms of characteristics such as age, gender, ethnicity, income, and education, which often influence study variables.

ANS: A, D, F In quantitative research, you need to evaluate representativeness in terms of the setting, characteristics of the subjects, and distribution of values on variables measured. Researchers who gather data from subjects across a variety of settings have a more representative sample of the target population than those limiting the study to a single setting. A sample must be representative in terms of characteristics such as age, gender, ethnicity, income, and education, which often influence study variables. Representativeness means that the sample, accessible population, and target population are alike in as many ways as possible. The setting identified in a study does influence the representativeness of the sample. Studies that obtain data from large databases have more representative samples. DIF: Cognitive level: Understanding (Comprehension)

38. Which setting is the most highly controlled setting? a. A nursing home unit b. A research sleep lab c. A school-based clinic d. An intensive care unit

ANS: B A research sleep lab is a special unit designed to conduct research or to collect data and allows the most control by the researcher. A nursing home unit and an intensive care unit allow for partial control. A school-based clinic allows for the least control. DIF: Cognitive level: Understanding

25. 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 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. 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. Using only one measurement tool increases the risk of mono-operation bias. DIF: Cognitive level: Analyzing

40. Which type of research study tends to require a larger sample size than the others? a. Case study b. Descriptive study c. Experimental study d. Quasi-experimental study

ANS: B Descriptive studies often require very large samples. Multiple variables may be examined, and extraneous variables are likely to affect subject response(s) to the variables under study. Case studies are, by definition, composed of a very small sample, possibly even just one individual. Experimental studies often have fewer subjects than a descriptive or correlational study. Quasi-experimental studies often have fewer subjects than a descriptive or correlational study. DIF: Cognitive level: Remembering

2. Which can be measured using direct measurement? a. Anxiety level b. Blood pressure c. Diagnosis d. Feelings

ANS: B Direct measurement allows for measures of concrete factors, such as a person's height, weight, or blood pressure. Indirect measurement involves measuring abstract concepts such as anxiety or feelings. Nominal level measurement is used when data can be organized into categories of a defined property, such as a disease diagnosis, but when categories cannot be rank ordered. Indirect measurement involves measuring abstract concepts such as anxiety or feelings. DIF: Cognitive level: Applying (Application)

6. In a study of patients who have dementia, a researcher wishes to examine the effects of moderate exercise on patients' abilities to perform self-care. The researcher decides to use subjects between 70 and 80 years of age who have been diagnosed with dementia for less than 1 year. A patient who is 65 years old meets a. eligibility criteria. b. exclusion criteria. c. inclusion criteria. d. sampling criteria.

ANS: B Exclusion criteria are characteristics that the researcher does not want in the elements or subjects of the study. Inclusion criteria, eligibility criteria, and sampling criteria are those characteristics that the subject or element must possess to be part of the target population. DIF: Cognitive level: Applying

19. 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. This is a threat to a. construct validity. b. external validity. c. internal validity. d. statistical conclusion validity.

ANS: B External validity is concerned with the extent to which findings can be generalized beyond the study sample. Construct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions. Internal validity looks at the influence of extraneous variables on study outcomes. Statistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. DIF: Cognitive level: Analyzing

27. 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 External validity is concerned with the extent to which findings can be generalized beyond the study sample. Construct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions. Internal validity looks at the influence of extraneous variables on study outcomes. Statistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. DIF: Cognitive level: Analyzing

7. 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. 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 In correlational designs, a large range in the variable scores is necessary to determine the existence of a relationship. Correlational studies do not involve manipulation of a variable. 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. Subjects in correlational studies are not randomly assigned to study groups. DIF: Cognitive level: Applying

41. In qualitative research, the sampling plan is developed to a. decrease systematic bias. b. increase the representativeness of the findings related to the phenomena. c. minimize the need for discussion of cultural elements of the study. d. reduce sampling error.

ANS: B In qualitative research, a sampling plan is developed to increase representativeness of the findings related to the phenomenon, processes, or cultural elements being studied. Decreasing systematic bias and reducing sampling error are the goals of sampling in quantitative research. Decreasing systematic bias and reducing sampling error are the goals of sampling in quantitative research. The cultural elements of the study are unrelated to sample size. DIF: Cognitive level: Remembering

45. Which of the following is true about sample size in a qualitative study? a. It is determined by the sensitivity of the measurement tools. b. It is considered adequate when the researcher detects no new knowledge. c. It is influenced by the expected effect size and the probability of a type II error. d. It is determined by the number of variables and data analysis techniques.

ANS: B In qualitative research, the researcher looks for data saturation, which is reached when no new information is being discovered from additional subjects. Quantitative research sample size is influenced by the sensitivity of the measurement tools, effect size, probability of a type II error, number of variables, and data analysis techniques. DIF: Cognitive level: Understanding MULTIPLE RESPONSE

17. 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 Construct validity is concerned with the fit between conceptual and operational variables and requires adequate conceptual and operational definitions. External validity is concerned with the extent to which findings can be generalized beyond the study sample. Internal validity looks at the influence of extraneous variables on study outcomes. Statistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world. DIF: Cognitive level: Analyzing

44. Which of the following is true about convenience sampling? a. It tends to be less expensive and easier to conduct. b. It requires fewer subjects to achieve a representative sample. c. It is used more often in quantitative research. d. It allows the researcher greater control over extraneous variables.

ANS: A Convenience sampling is less expensive and a relatively easy method of obtaining subjects. The number of subjects needed is not determined by sampling technique but by the type of data collected. Convenience sampling is not used less often in qualitative research. Convenience sampling offers less control over extraneous variables. DIF: Cognitive level: Understanding

1. A researcher conducts a study to examine the effects of breastfeeding on infant weight at age 6 months. Which type of measurement is used to measure the infants' weight? a. Direct b. Indirect c. Nominal d. Ordinal

ANS: A Direct measurement allows for measures of concrete factors, such as a person's height or weight. Indirect measurement measures abstract ideas or characteristics and often must use more than one measure to measure all aspects of the concept. Nominal level measurement is used when data can be organized into categories of a defined property, such as a disease diagnosis, but when categories cannot be rank ordered. Ordinal level measurement is used when data collected can be rank ordered. DIF: Cognitive level: Applying (Application)

31. 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 In a quasi-experimental study, the group that does not receive treatment is usually referred to as the comparison group. Subjects not receiving treatment in an experimental group are generally referred to as the control group. Groups that receive the intervention in either type of study are referred to as experimental or treatment groups. DIF: Cognitive level: Analyzing

21. A nurse conducts a study to examine the effects of a new intervention on FEV1 levels in patients with COPD and uses all patients admitted to a hospital during a 2-month period. This is an example of which type of sampling method? a. Convenience b. Network c. Quota d. Random

ANS: A In convenience sampling, the researcher uses subjects as they are available until the desired sample size is reached. Network sampling uses social networks to obtain subjects who might not be readily accessible otherwise. Quota sampling involves convenience sampling but adds techniques to ensure that certain subject types are represented. Random sampling attempts to ensure that all potential subjects have equal, random chances to participate. DIF: Cognitive level: Remembering

17. A researcher plans to utilize a systematic random sampling method from a population of 5000 eligible subjects, using a sample of 200 subjects. Beginning at a randomly selected point on the list of subjects, what is the gap between elements? a. 25 b. 50 c. 100 d. 200

ANS: A In systematic sampling, the researcher selects every kth individual on a list, beginning at a randomly selected starting point. The population size is divided by the desired sample size to give the gap between elements. 5000/200 = 25. A gap of 50 between elements would be correct for a sample size of 100 subjects. A gap of 100 between elements would be correct for a sample size of 50 subjects. A gap of 200 between elements would be correct for a sample size of 25 subjects. DIF: Cognitive level: Applying

31. In a qualitative study, a sample may be too small if a. the depth of information is low. b. the effect size is too large. c. the saturation of information is high. d. the scope of the study is narrow.

ANS: A Information gained in a qualitative study must be in depth and of high quality to be meaningful. If the depth or quality is low, the sample size should be increased. The effect size is related to the effects of the independent variables on the dependent variables and is a measure of quantitative studies. When saturation of information levels is low, the sample size is too low. A narrow scope means that a smaller sample may be used. DIF: Cognitive level: Understanding

6. A researcher studying the effects of an intervention on symptoms measures the time from intervention to absence of symptoms and reports this in the number of days. This measure represents which level of measurement? a. Interval b. Nominal c. Ordinal d. Ratio

ANS: A Interval level measurement uses interval scales, which have equal numerical distances between intervals. Nominal level measurement is used when data can be organized into categories of a defined property, such as a disease diagnosis, but when categories cannot be rank ordered. Ordinal level measurement is used when data collected can be rank ordered. Ratio level measurement uses all aspects of other types of measurement: mutually exclusive categories, exhaustive categories, ordered ranks, equally spaced intervals, and a continuum of values. DIF: Cognitive level: Applying (Application)

28. 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 Limiting the investment demands on subjects helps to improve participation. Providing 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. Detailed instruments may be time consuming and may limit participation to a small sample size. Offering financial incentives does not ensure a sample that is representative of the larger population. DIF: Cognitive level: Analyzing

28. A researcher conducts a survey of patients seen in an inner-city ambulatory clinic to determine barriers to receiving health care. The target population includes African-American, Hispanic, and Somali immigrant patients, as well as a variety of foreign-born students from a nearby university. The researcher chooses subjects from the African-American, Hispanic, and Somali immigrant populations to participate. This is which type of sampling? a. Network b. Purposive c. Quota d. Theoretical

ANS: B With purposive sampling, the researcher consciously selects certain participants to include in the study and may or may not include all typical subject types. Network sampling takes advantage of social networks and the fact that friends tend to have characteristics in common. Quota sampling involves techniques to ensure that certain subject types are represented to improve the representativeness of the total population. Theoretical sampling is used in qualitative research to develop a selected theory and subjects are selected based on their ability to provide relevant, varied, and rich information for theory generation. DIF: Cognitive level: Applying

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 Experimental and quasi-experimental studies are designed to examine causality between a researcher-implemented treatment and a study outcome. Correlational 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. Longitudinal 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. DIF: Cognitive level: Comprehension

2. A nurse researcher understands that to critically appraise the RCTs reported in nursing journals, specific guidelines are followed. To assess the quality of RCTs reports, which of the following are accurate statements? Select all that apply. a. The study has low internal validity. b. Outcomes are measured consistently with quality measurement methods. c. Study participants are drawn from a reference population through clearly defined criteria. d. The study is conducted in a laboratory setting. e. The intervention is clearly described and consistently implemented. f. The design meets the criteria of a nonexploratory study.

ANS: B, C, E Dependent variables or outcomes are measured consistently with quality measurement methods. Study participants are drawn from a reference population using clearly defined criteria. Baseline values are comparable in all groups included in the study. Selected participants are then randomly assigned to treatment and comparison groups. The intervention is clearly described and consistently implemented to ensure interventions fidelity. The study has high internal validity, conducted in a clinical setting, and the study design meets the criteria of an experimental study. DIF: Cognitive level: Analyzing (Analysis)

3. Which of the following are true statements about external validity? Select all that apply. a. External validity is concerned with the fit between the conceptual and operational definitions of variables and that the instrument measures what it is supposed to in the study. b. External validity is concerned with the extent to which study findings can be generalized beyond the sample used in the study. c. External validity is focused on determining if the study findings are accurate or are the result of extraneous variables. d. Threats to external validity include mono-operation bias and inadequate definitions of constructs. e. Threats to external validity include interaction of selection and intervention, setting and intervention, and/or history and intervention. f. Threats to external validity include participation selection, participant attrition, history, and maturation.

ANS: B, E External validity is concerned with the extent to which study findings can be generalized beyond the sample used in the study. Threats to external validity include interaction of selection and intervention, setting and intervention, and/or history and intervention. Construct validity is concerned with the fit between the conceptual and operational definitions of variables and that the instrument measures what it is supposed to in the study. Internal validity is focused on determining if the study findings are accurate or are the result of extraneous variables. Threats to construct validity include mono-operation bias and inadequate definitions of constructs. Threats to internal validity include participation selection, participant attrition, history, and maturation. DIF: Cognitive level: Analyzing (Analysis)

1 Which of the following are true statements about randomized controlled trials (RCTs)? Select all that apply. a. The RCT design is noted to be the weakest methodology for testing the effectiveness of an intervention. b. In a RCT design, participants are randomized to the intervention and control groups to reduce selection bias. c. Blinding or withholding of study information from data collectors, participants, and their healthcare providers can enhance the potential for bias. d. RCTs may be carried out in a single setting or in multiple geographic locations to decrease sample size and obtain a more representative sample. e. RCTs, when appropriately conducted, are considered the gold standard for determining the effectiveness of healthcare interventions.

ANS: B, E In a RCT design, participants are randomized to the intervention and control groups to reduce selection bias. RCTs, when appropriately conducted, are considered the gold standard for determining the effectiveness of healthcare interventions. An RCT design is noted to be the strongest methodology for testing the effectiveness of an intervention. Blinding or withholding of study information from data collectors, participants, and their healthcare providers can reduce the potential for bias. RCTs may be carried out in a single setting or in multiple geographic locations to increase sample size and obtain a more representative sample. DIF: Cognitive level: Analyzing (Analysis)

8. 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 A 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. Correlational studies seek to examine relationships among variables without manipulation of a treatment by the researcher. A descriptive study is used to examine variables as they occur naturally without manipulation of variables. 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. DIF: Cognitive level: Applying

36. Which type of setting is most commonly used in qualitative research? a. Controlled b. Multiple c. Natural d. Partially controlled

ANS: C A natural, or field, setting is a real-life, uncontrolled environment and is often used for descriptive and correlational quantitative research and in qualitative studies. Controlled and partially controlled settings are more commonly used in quantitative research. Researchers may choose to conduct a study using multiple settings, but this is not as common as using natural settings in qualitative research. DIF: Cognitive level: Understanding

34. Which statement is true about a quantitative research design? a. A research design is a blueprint for conducting a quantitative study that minimizes control over factors that could interfere with the validity of the findings. b. A research design is a blueprint for conducting a quantitative study that minimizes control over factors that could interfere with the reliability of the findings. c. A research design is a blueprint for conducting a quantitative study that maximizes control over factors that could interfere with the validity of the findings. d. A research design is a blueprint for conducting a quantitative study that maximizes control over factors that could interfere with the reliability of the findings.

ANS: C A research design is a blueprint for conducting a quantitative study that maximizes control over factors that could interfere with the validity of the findings. All other statements are incorrect. DIF: Cognitive level: Remembering

3. A researcher wishes to conduct a survey of attitudes about illness among young adults with cystic fibrosis. The researcher contacts a nearby regional medical cystic fibrosis clinic, where 250 young adults who have cystic fibrosis are seen. A group of 50 young adults are selected to complete the survey. These 50 people are the a. accessible population. b. elements of the population. c. sample population. d. target population.

ANS: C A sample is that group of people who are representing the entire population and participating in the study. Samples are expected to represent an entire population. The accessible population is that portion of the entire population that the researcher can use; which, in this case, would be the 250 patients at this medical center. The target population is the entire set of individuals who meet the sampling criteria. An element is an individual unit of a study population. DIF: Cognitive level: Applying

24. A researcher tests a measurement tool in a pilot study and notes a wide variance in scores. To improve the significance of the study's findings in subsequent studies, the researcher will a. apply quota sampling techniques. b. decrease the sample size. c. increase the sample size. d. use cluster sampling techniques.

ANS: C As variance in instrument scores increases, the sample size needed to obtain significance increases, so the researcher should increase the sample size in subsequent studies. Quota and cluster sampling techniques help to increase the representativeness of the sample but do not affect the significance of the measurement findings. DIF: Cognitive level: Applying

21. 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 Consistent 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. To control for extraneous variables, the researcher would identify characteristics of subjects or settings that might influence outcomes. Internal validity looks at the influence of extraneous variables on study outcomes. Precision of measurement refers to whether or not the tools yield the same readings or findings from one test to another. DIF: Cognitive level: Analyzing

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 Descriptive designs may be used to develop theories and identify problems with current practice. Descriptive designs may involve operational definitions of variables, but variables are not manipulated in descriptive studies. Protection 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. DIF: Cognitive level: Understanding

18. 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 Internal validity looks at the influence of extraneous variables on study outcomes. Inadequate definitions of constructs are threats to construct validity. External 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. Statistical 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. DIF: Cognitive level: Analyzing

26. 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. utilize a double-blind data collection methodology.

ANS: 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. Construct validity is improved with adequate description of conceptual and operational definitions. Use of double-blind data collection methods helps to minimize bias. DIF: Cognitive level: Analyzing

11. 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 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. Probability addresses relative and not absolute causality and may be used when given effects are not produced consistently. In this case, increasing the manipulation of the independent variable does not alter the influence of multiple causes. Limiting the study to patients of a certain age only controls for one extraneous variable. DIF: Cognitive level: Analyzing

26. A researcher will conduct a qualitative study about partners of patients diagnosed with sexually transmitted diseases. This researcher will use which sampling technique to achieve the best representation of this population? a. Accidental sampling b. Cluster sampling c. Network sampling d. Simple random sampling

ANS: C Network sampling is useful for locating samples that are difficult or impossible to obtain in other ways. Network sampling takes advantage of social networks and the fact that friends tend to have characteristics in common. Accidental or convenience sampling would not be likely to yield an adequate sample of individuals with sexually transmitted diseases. Cluster sampling would not be the best method for finding the desired sample in this case. Simple random sampling would not work well because the researcher is looking for a specific subgroup of the general population. DIF: Cognitive level: Applying

5. Among subjects with coronary artery disease, a researcher identifies three levels of symptoms which can be categorized by severity. This represents which level of measurement? a. Interval b. Nominal c. Ordinal d. Ratio

ANS: C Ordinal level measurement is used when data collected can be rank ordered. Interval level measurement uses interval scales, which have equal numerical distances between intervals. Nominal level measurement is used when data can be organized into categories of a defined property, such as a disease diagnosis, but when categories cannot be rank ordered. Ratio level measurement uses all aspects of other types of measurement: mutually exclusive categories, exhaustive categories, ordered ranks, equally spaced intervals, and a continuum of values. DIF: Cognitive level: Applying (Application)

22. A researcher wishes to examine whether a teaching program for parents increases adherence to a drug regimen among children with seizure disorders. A convenience sample of children in a large teaching hospital is proposed. To prevent confounding of the results by socioeconomic status and type of health insurance, the researcher will utilize which additional sampling technique? a. Cluster b. Network c. Quota d. Theoretical

ANS: C Quota sampling involves convenience sampling but adds techniques to ensure that certain subject types are represented. Cluster sampling occurs when the researcher selects subjects from groups of subjects within the larger population, as with groups from specific regions or cities. Network sampling uses social networks to obtain subjects who might not be readily accessible otherwise. Theoretical sampling is used in qualitative research to develop a selected theory. Subjects are selected based on their ability to provide relevant, varied, and rich information for theory generation. DIF: Cognitive level: Applying

27. The type of nonprobability design that is most likely to yield a representative sample is a. convenience sampling. b. accidental sampling. c. quota sampling. d. network sampling.

ANS: C Quota sampling involves convenience sampling but adds techniques to ensure that certain subject types are represented. Convenience sampling, also called accidental sampling, is a relatively weak approach because it provides little opportunity to control for biases. Network sampling uses social networks to obtain subjects who might not be readily accessible otherwise. DIF: Cognitive level: Remembering

11. To decrease the probability of systematic variation in a study to evaluate the effects of a teaching program on disease management, the researcher will use which sampling process? a. Cluster sampling b. Convenience sampling c. Random sampling d. Systematic sampling

ANS: C Random sampling decreases the probability of systematic bias. Cluster, convenience, and systematic sampling increase the risk that the sample population has attributes that differ from the general population. DIF: Cognitive level: Comprehension

3. Which is a true statement about measurement theory? a. A measurement method used by one individual will consistently produce different results when used by another individual. b. Measurement theory was recently developed by musicians, statisticians, and other scholars to guide how things are measured. c. The purpose of measurement is to obtain trustworthy data that can be used to address the study purpose and objectives, questions, or hypotheses. d. The levels of measurement, from low to high, are ratio, interval, nominal, and ordinal.

ANS: C The purpose of measurement is to obtain trustworthy data that can be used to address the study purpose and objectives, questions, or hypotheses. The rules of measurement promote consistency in how individuals perform measurements; so a measurement method used by one individual will consistently produce similar results when used by another individual. Measurement theory was developed many years ago, by mathematicians, statisticians, and other scholars to guide how things are measured. The levels of measurement, from low to high, are nominal, ordinal, interval, and ratio. DIF: Cognitive level: Understanding (Comprehension)

8. The nurse researcher understands that the levels of measurement, from low to high, are a. nominal, interval, ratio, and ordinal. b. nominal, ordinal, ratio, and interval. c. nominal, ordinal, interval, and ratio. d. nominal, interval, ordinal, and ratio.

ANS: C The traditional levels of measurement were developed by Stevens (1946), who organized the rules for assigning numbers to objects so that a hierarchy in measurement was established. The levels of measurement from low to high are nominal, ordinal, interval, and ratio (NOIR). DIF: Cognitive level: Understanding (Comprehension)

29. 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 To improve determinations of causality, the independent variable should be administered consistently to all subjects in the treatment group. The independent variable is administered to the treatment group and not the control group. Selection of subjects by the researcher increases the likelihood of bias. The independent variable should be precisely defined. DIF: Cognitive level: Applying