Chapter 1 Introduction to Nursing Research
& Evidence-Based Practice - Study Guide &
Exam Review 2026/2027
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
150 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This exam assesses foundational competencies in nursing research and evidence-based practice, including
research paradigms, the EBP process, levels of evidence, study designs, sampling, measurement, ethical
conduct, and critical appraisal of quantitative and qualitative literature. Items require application of core
concepts to clinical scenarios and interpretation of research methods.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 75% (minimum 38/50 correct).
HIGHP - Page 1 of 49
,1. A nurse researcher is designing a study to explore how family caregivers make sense of
a new dementia diagnosis. Which paradigm and methodological approach best aligns with
the study's purpose?
[ ] A. Postpositivist paradigm using a randomized controlled trial
[ ] B. Constructivist paradigm using semi-structured interviews and thematic analysis
[ ] C. Pragmatist paradigm using a sequential explanatory mixed-methods design
[ ] D. Critical theory paradigm using a correlational survey
CORRECT: B. Constructivist paradigm using semi-structured interviews and thematic analysis
Constructivism holds that reality is socially constructed and best accessed through participants' lived
experiences, making qualitative interviews and thematic analysis appropriate. Postpositivism and RCTs test
hypotheses under controlled conditions, which would not capture meaning-making. Pragmatism and critical
theory address different aims (action-oriented or power-focused) and correlational surveys cannot explore
interpretive processes in depth.
2. A clinical team wants to implement an evidence-based fall prevention protocol. Which
action reflects the step of 'appraising the evidence' in the EBP process?
[ ] A. Asking whether a new bed alarm reduces falls in hospitalized older adults
[ ] B. Searching CINAHL and PubMed for systematic reviews on fall prevention
[ ] C. Using the Johns Hopkins Evidence-Based Practice tool to rate study quality and strength
[ ] D. Monitoring fall rates after implementing the new protocol
CORRECT: C. Using the Johns Hopkins Evidence-Based Practice tool to rate study quality and
strength
Appraisal involves critically evaluating the quality, validity, and applicability of retrieved evidence using
validated tools such as the Johns Hopkins or GRADE frameworks. Formulating the question (A) and
searching (B) are earlier steps, while monitoring outcomes (D) reflects the evaluation step after
implementation.
3. A systematic review with meta-analysis of 12 randomized controlled trials reports a
pooled risk ratio of 0.72 (95% CI 0.60-0.86) for a nurse-led hypertension intervention. How
should the nurse interpret this finding?
[ ] A. The intervention has no statistically significant effect because the CI does not include 1.0
[ ] B. The intervention reduces the risk of the outcome by 28%, and the result is statistically significant
[ ] C. The intervention increases risk by 28%, but the finding is not significant
[ ] D. The result cannot be interpreted without the p-value
CORRECT: B. The intervention reduces the risk of the outcome by 28%, and the result is statistically
significant
A risk ratio of 0.72 indicates a 28% relative risk reduction favoring the intervention, and the 95% CI excludes
1.0, confirming statistical significance. Option A misstates CI interpretation; Option C reverses direction;
HIGHP - Page 2 of 49
, Option D is incorrect because the CI already conveys significance and precision.
4. Which statement best distinguishes a quasi-experimental design from a true
experimental design?
[ ] A. Quasi-experimental designs lack manipulation of the independent variable
[ ] B. Quasi-experimental designs lack random assignment to groups
[ ] C. Quasi-experimental designs use only qualitative data
[ ] D. Quasi-experimental designs cannot include a control group
CORRECT: B. Quasi-experimental designs lack random assignment to groups
The defining feature of a true experiment is random assignment; quasi-experiments manipulate the
intervention but lack randomization, often using intact groups. Option A is wrong because manipulation is
present; Option C confuses paradigms; Option D is false because quasi-experiments may use comparison
groups.
5. A researcher wants to survey nurses' attitudes toward AI documentation tools. Which
sampling method is most likely to introduce selection bias that limits generalizability?
[ ] A. Simple random sampling from the state licensure database
[ ] B. Stratified random sampling by hospital type
[ ] C. Convenience sampling of nurses attending a single conference
[ ] D. Systematic sampling from an alphabetized employee list
CORRECT: C. Convenience sampling of nurses attending a single conference
Convenience sampling recruits accessible participants who may differ systematically from the target
population, threatening external validity. Random, stratified, and systematic methods reduce selection bias by
giving all eligible nurses a known chance of selection.
6. A study reports a Cronbach's alpha of 0.62 for a new resilience scale. How should the
nurse researcher interpret this value?
[ ] A. Excellent internal consistency; acceptable for clinical use
[ ] B. Acceptable test-retest reliability; no revision needed
[ ] C. Marginal internal consistency; the scale may need revision or more items
[ ] D. Strong construct validity; the scale measures resilience accurately
CORRECT: C. Marginal internal consistency; the scale may need revision or more items
Cronbach's alpha estimates internal consistency; values 0.70 are generally acceptable, and 0.62 is marginal,
suggesting item revision or addition. Options A and B misstate thresholds and reliability types, while Option D
confuses reliability with validity.
HIGHP - Page 3 of 49
, 7. A nurse wants to know whether a new wound care protocol is superior to the current
standard. Which PICO question is correctly structured?
[ ] A. In patients with chronic wounds, does the new protocol reduce healing time compared with
standard care?
[ ] B. Does wound care improve outcomes in hospitalized patients?
[ ] C. What are nurses' perceptions of wound care protocols?
[ ] D. How does the new protocol compare with the old protocol?
CORRECT: A. In patients with chronic wounds, does the new protocol reduce healing time compared
with standard care?
A well-built PICO question specifies the population (chronic wounds), intervention (new protocol), comparison
(standard care), and outcome (healing time). Options B, C, and D omit key PICO elements or are too broad,
making them less searchable and answerable.
8. A researcher obtains informed consent from participants but later discovers that some
data were collected before the consent form was signed. Which ethical principle is most
directly violated?
[ ] A. Beneficence
[ ] B. Justice
[ ] C. Respect for persons
[ ] D. Fidelity
CORRECT: C. Respect for persons
Respect for persons requires voluntary, informed participation and protects autonomy; collecting data before
consent undermines this principle. Beneficence concerns maximizing benefits and minimizing harms; justice
concerns fair distribution of burdens and benefits; fidelity concerns faithfulness to commitments.
9. A nurse is appraising a qualitative study and notes that the researcher used member
checking and prolonged engagement. These strategies primarily strengthen which aspect
of the study?
[ ] A. Internal validity
[ ] B. External validity
[ ] C. Trustworthiness
[ ] D. Statistical power
CORRECT: C. Trustworthiness
Member checking and prolonged engagement are credibility strategies that enhance the trustworthiness
(credibility) of qualitative findings. Internal and external validity are quantitative concepts, and statistical
power is irrelevant to qualitative research.
HIGHP - Page 4 of 49
& Evidence-Based Practice - Study Guide &
Exam Review 2026/2027
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
150 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This exam assesses foundational competencies in nursing research and evidence-based practice, including
research paradigms, the EBP process, levels of evidence, study designs, sampling, measurement, ethical
conduct, and critical appraisal of quantitative and qualitative literature. Items require application of core
concepts to clinical scenarios and interpretation of research methods.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 75% (minimum 38/50 correct).
HIGHP - Page 1 of 49
,1. A nurse researcher is designing a study to explore how family caregivers make sense of
a new dementia diagnosis. Which paradigm and methodological approach best aligns with
the study's purpose?
[ ] A. Postpositivist paradigm using a randomized controlled trial
[ ] B. Constructivist paradigm using semi-structured interviews and thematic analysis
[ ] C. Pragmatist paradigm using a sequential explanatory mixed-methods design
[ ] D. Critical theory paradigm using a correlational survey
CORRECT: B. Constructivist paradigm using semi-structured interviews and thematic analysis
Constructivism holds that reality is socially constructed and best accessed through participants' lived
experiences, making qualitative interviews and thematic analysis appropriate. Postpositivism and RCTs test
hypotheses under controlled conditions, which would not capture meaning-making. Pragmatism and critical
theory address different aims (action-oriented or power-focused) and correlational surveys cannot explore
interpretive processes in depth.
2. A clinical team wants to implement an evidence-based fall prevention protocol. Which
action reflects the step of 'appraising the evidence' in the EBP process?
[ ] A. Asking whether a new bed alarm reduces falls in hospitalized older adults
[ ] B. Searching CINAHL and PubMed for systematic reviews on fall prevention
[ ] C. Using the Johns Hopkins Evidence-Based Practice tool to rate study quality and strength
[ ] D. Monitoring fall rates after implementing the new protocol
CORRECT: C. Using the Johns Hopkins Evidence-Based Practice tool to rate study quality and
strength
Appraisal involves critically evaluating the quality, validity, and applicability of retrieved evidence using
validated tools such as the Johns Hopkins or GRADE frameworks. Formulating the question (A) and
searching (B) are earlier steps, while monitoring outcomes (D) reflects the evaluation step after
implementation.
3. A systematic review with meta-analysis of 12 randomized controlled trials reports a
pooled risk ratio of 0.72 (95% CI 0.60-0.86) for a nurse-led hypertension intervention. How
should the nurse interpret this finding?
[ ] A. The intervention has no statistically significant effect because the CI does not include 1.0
[ ] B. The intervention reduces the risk of the outcome by 28%, and the result is statistically significant
[ ] C. The intervention increases risk by 28%, but the finding is not significant
[ ] D. The result cannot be interpreted without the p-value
CORRECT: B. The intervention reduces the risk of the outcome by 28%, and the result is statistically
significant
A risk ratio of 0.72 indicates a 28% relative risk reduction favoring the intervention, and the 95% CI excludes
1.0, confirming statistical significance. Option A misstates CI interpretation; Option C reverses direction;
HIGHP - Page 2 of 49
, Option D is incorrect because the CI already conveys significance and precision.
4. Which statement best distinguishes a quasi-experimental design from a true
experimental design?
[ ] A. Quasi-experimental designs lack manipulation of the independent variable
[ ] B. Quasi-experimental designs lack random assignment to groups
[ ] C. Quasi-experimental designs use only qualitative data
[ ] D. Quasi-experimental designs cannot include a control group
CORRECT: B. Quasi-experimental designs lack random assignment to groups
The defining feature of a true experiment is random assignment; quasi-experiments manipulate the
intervention but lack randomization, often using intact groups. Option A is wrong because manipulation is
present; Option C confuses paradigms; Option D is false because quasi-experiments may use comparison
groups.
5. A researcher wants to survey nurses' attitudes toward AI documentation tools. Which
sampling method is most likely to introduce selection bias that limits generalizability?
[ ] A. Simple random sampling from the state licensure database
[ ] B. Stratified random sampling by hospital type
[ ] C. Convenience sampling of nurses attending a single conference
[ ] D. Systematic sampling from an alphabetized employee list
CORRECT: C. Convenience sampling of nurses attending a single conference
Convenience sampling recruits accessible participants who may differ systematically from the target
population, threatening external validity. Random, stratified, and systematic methods reduce selection bias by
giving all eligible nurses a known chance of selection.
6. A study reports a Cronbach's alpha of 0.62 for a new resilience scale. How should the
nurse researcher interpret this value?
[ ] A. Excellent internal consistency; acceptable for clinical use
[ ] B. Acceptable test-retest reliability; no revision needed
[ ] C. Marginal internal consistency; the scale may need revision or more items
[ ] D. Strong construct validity; the scale measures resilience accurately
CORRECT: C. Marginal internal consistency; the scale may need revision or more items
Cronbach's alpha estimates internal consistency; values 0.70 are generally acceptable, and 0.62 is marginal,
suggesting item revision or addition. Options A and B misstate thresholds and reliability types, while Option D
confuses reliability with validity.
HIGHP - Page 3 of 49
, 7. A nurse wants to know whether a new wound care protocol is superior to the current
standard. Which PICO question is correctly structured?
[ ] A. In patients with chronic wounds, does the new protocol reduce healing time compared with
standard care?
[ ] B. Does wound care improve outcomes in hospitalized patients?
[ ] C. What are nurses' perceptions of wound care protocols?
[ ] D. How does the new protocol compare with the old protocol?
CORRECT: A. In patients with chronic wounds, does the new protocol reduce healing time compared
with standard care?
A well-built PICO question specifies the population (chronic wounds), intervention (new protocol), comparison
(standard care), and outcome (healing time). Options B, C, and D omit key PICO elements or are too broad,
making them less searchable and answerable.
8. A researcher obtains informed consent from participants but later discovers that some
data were collected before the consent form was signed. Which ethical principle is most
directly violated?
[ ] A. Beneficence
[ ] B. Justice
[ ] C. Respect for persons
[ ] D. Fidelity
CORRECT: C. Respect for persons
Respect for persons requires voluntary, informed participation and protects autonomy; collecting data before
consent undermines this principle. Beneficence concerns maximizing benefits and minimizing harms; justice
concerns fair distribution of burdens and benefits; fidelity concerns faithfulness to commitments.
9. A nurse is appraising a qualitative study and notes that the researcher used member
checking and prolonged engagement. These strategies primarily strengthen which aspect
of the study?
[ ] A. Internal validity
[ ] B. External validity
[ ] C. Trustworthiness
[ ] D. Statistical power
CORRECT: C. Trustworthiness
Member checking and prolonged engagement are credibility strategies that enhance the trustworthiness
(credibility) of qualitative findings. Internal and external validity are quantitative concepts, and statistical
power is irrelevant to qualitative research.
HIGHP - Page 4 of 49
