TEST BANK FOR NURSING RESEARCH METHODS AND CRITICAL APPRAISAL FOR EVIDENCE- BASED PRACTICE 9TH EDITION BY GERI LOBIONDO-WOOD, AND JUDITH HABER

TEST BANK FOR NURSING RESEARCH METHODS AND CRITICAL APPRAISAL FOR EVIDENCE- BASED PRACTICE 9TH EDITION BY GERI LOBIONDO-WOOD, AND JUDITH HABER   Chapter 01: Integrating Research, Evidence-Based Practice, and Quality Improvement Processes LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. Nursing research is significant to the profession of nursing because it promotes: a. more specifically defined nursing practice responsibilities. b. decreased liability within the practice of nursing. c. generation of a specialized body of nursing knowledge for use in nursing practice. d. expansion of the scope of nursing practice into other disciplines. ANS: C Feedback A Research aids in documenting accountability of nurses, but professional guidelines already exist regarding responsibility. Each state has a Nurse Practice Act with rules and regulations that define scope of practice. B Liability is a legal concept related to a nurse’s legal scope of practice and professional standards of practice. Research does not change a nurse’s liability. C Nursing research generates a specialized scientific knowledge base that empowers the nursing profession to anticipate and meet constantly shifting challenges of health care delivery to multiple populations. It provides a foundation for evidence-based nursing care and quality improvement activities. D Although research can doNcuUmReSntInNuGrsTinBCcOouMntability, each state’s Nurse Practice Act defines the scope of nursing practice for that state. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 6 2. Nurses need to be able to understand the nursing research process: a. to identify potential subjects for clinical research studies. b. to assist as accurate data collectors in clinical research studies. c. to teach patients and families the importance of participating in research. d. to evaluate nursing research reports for relevance to their own clinical practice. ANS: D Feedback A Subject identification is determined by the nurse researcher. B Data collectors need to understand their role in the study; they do not need to understand the entire research process. C Subject recruitment is the responsibility of the nurse researcher. D Nurses need to understand the research process in order to critically read research reports and determine if nursing practice should incorporate the research findings as valid evidence. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 7 3. An aspect of the scientific investigation of nursing practice that is also a fundamental concept of American Nurses Association (ANA)’s Code for Nurses is: a. professional accountability. b. standards of care. c. legal scope of practice. d. advanced practice nursing activities. ANS: A Feedback A Scientific investigation promotes accountability, a hallmark of the nursing profession and a fundamental concept of the ANA’s Code for Nurses. B Standards of care are defined by ANA, as well as specialty nursing organizations. The Code for Nurses states that nurses should conform to standards, but standards per se are not part of the Code. C Legal scope of practice is defined by each state’s Nurse Practice Act and elaborated in its rules and regulations. D The ANA Code applies to nursing practice in general, not advanced practice. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 7 4. The action that demonstrates the role of a knowledgeable consumer of nursing research is: a. designing a nursing research study. b. analyzing data to determineNaUsRtuSdIy’Ns GouTtBco.mCeOs.M d. implementing an intervention found to be effective in one clinical case study. ANS: C Feedback A A consumer uses and applies research to practice but is not responsible for designing a study. B A consumer does not conduct data analysis of a study; the study’s primary investigator analyzes data. C A consumer of nursing research needs to understand the research process to determine the merit and relevance of evidence presented in research studies. D A consumer would not implement an intervention on the basis of a single case study. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 7 5. Members of the nursing staff are to participate in a unit-based clinical research study. Which research-related actions would be expected of a nurse with a baccalaureate nursing degree? a. Using critical appraisal skills to understand and assess the steps of the research process b. Providing expert nursing consultation about the way in which clinical services are delivered c. Developing research methods to monitor and evaluate the quality of nursing practice in the clinical setting d. Providing leadership in the application of scientific knowledge to nursing practice ANS: A Feedback A A baccalaureate-prepared nurse should be able to use skills of critical appraisal to both understand and appraise the steps of the research process. B Nurses prepared at the baccalaureate level in nursing are at the bedside implementing protocols, whereas expert consultation is generally reserved for nurses prepared at the master’s or higher-degree level (advanced education). C Developing research methods is generally reserved for nurses with advanced education. D Providing leadership in research application is generally reserved for nurses with advanced education. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 7 6. Which statement describes the role of the nurse in research? a. Nurses must be prepared at the baccalaureate or higher level of education to have any role in nursing research. b. Nurses with master’s or higher levels of education are solely responsible for applying research to clinical practice. c. The research role of nursesNpUreRpaSrIedNaGt TboBth.CbaOcMcalaureate and master’s levels of education includes critical appraisal skills. d. Regardless of the nursing education level, only the nurse with the most comprehensive understanding of statistical methods should interpret research findings. ANS: C Feedback A Having a role in nursing research or implementing findings is not limited to nurses with baccalaureate or higher levels of education. B Nurses with master’s or higher levels of education provide leadership to supervise how research findings are applied in the clinical area. However, all levels of nurses can apply research findings to practice. C To use research in evidence-based practice, the nurse must not necessarily be able to conduct research but should be able to understand and appraise the steps of the research process to read the research literature critically and use it to inform clinical decisions. D Data analysis is usually conducted by nurses with master’s or higher levels of education. However, interpretation of research findings can be performed by any nurse who can critically analyze the research performed. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 7 7. What is the primary value of evidence-based nursing practice? a. Implementing the most cost-effective nursing practices when providing patient care b. Incorporating research findings with clinical expertise when individualizing patient care c. Separating nursing research as unique from the research of other disciplines d. Developing new nursing theories to promote the growth of nursing science ANS: B Feedback A Cost-effective nursing interventions can occur based on evidence, but it is not the primary value of evidence-based nursing practice. B Evidence-based practice allows the nurse to systematically integrate the best available research evidence with individual clinical expertise, as well as the patient’s values and preferences, when making clinical decisions. C Developing a unique body of nursing knowledge is important, but it is not the primary value of developing evidence-based nursing practice. Also, nurse researchers should be able to collaborate with researchers in other disciplines. D Developing abstract nursing theory is important, but evidence-based nursing is focused on the more concrete application of knowledge in clinical practice. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 14 8. A novice nurse researcher is coNmUpRarSinIgNthGeTpBro.cCesOseMs used in nursing research and in evidence-based practice. What differences, if any, exist between the two processes? a. As scientific processes, they are fundamentally the same and should result in parallel outcomes. b. Both processes involve testing a question with an appropriate design and specific methodology. c. In a research study the question is tested with an appropriate design and specific methodology, whereas in evidence-based practice, the question is used to search the research literature to find answers. d. In evidence-based practice, qualitative studies are critically appraised to answer a clinical question, whereas in nursing research, quantitative studies are reviewed to provide a foundation for the study. ANS: C Feedback A The research process and the evidence-based practice process, though similar, have fundamental differences as well. B This definition applies to the research process, not the evidence-based practice process. C Nursing research includes developing a design for a study, whether quantitative or qualitative, reviewing the literature, and carrying out a specific methodology to find answers to a question. In contrast, evidence-based practice includes a review of completed research studies to identify answers to a clinical question. D Both the research process and the evidence-based practice process include critical review of quantitative and qualitative studies. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 7 9. A nurse is analyzing a research article. Where in the article is the nurse likely to find the research question and study purpose? a. Introduction b. Data analysis c. Findings d. Data collection ANS: A Feedback A The research question and study purpose is generally found early in the report: in the abstract, the introduction, or at the end of the literature review or conceptual framework section. B The research question and study purpose are defined before the data analysis section of the research article. C The research question and study purpose are defined before the findings section of the research article. D The research question and study purpose are defined before the data-collection section of the research article. PTS: 1 DIF: CogNniUtivReSLIevNelG: TUnBCstOanMding (Comprehension) REF: Page 8, Table 1.1 10. The nurse researcher is conducting a research study using subjects who will be interviewed regarding their experience with postpartum depression. Why would the researcher select a qualitative, rather than a quantitative, research design? a. Quantitative research is usually conducted in natural settings using data that are words rather than numbers. b. Qualitative research seeks to explain cause-and-effect relationships between variables. c. Quantitative research typically uses a convenience sample, seeking to answer a clinical question about a human experience. d. Qualitative research collects data from a small number of subjects, allowing for in-depth study of a phenomenon. ANS: D Feedback A Qualitative, not quantitative, research is usually conducted in natural settings using data that are words rather than numbers. B Quantitative, not qualitative, research seeks to explain cause-and-effect relationships between variables. C Qualitative, not quantitative, research seeks to answer a question about a human experience. D Qualitative research typically collects data from a small number of subjects, thus allowing for in-depth study of a phenomenon while using a subjective approach. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 8 11. The nurse is analyzing a research article. To determine if an integrative review was performed as part of the study, the nurse must understand that this type of review is: a. a summary of research studies on a focused topic that used a specific statistical methodology. b. a synthesis of the research and theoretical literature on a specific area without a statistical analysis. c. a synthesis of qualitative articles on a focused topic using a specific qualitative methodology. d. a summary of articles in an attempt to develop a clinical practice statement or clinical guidelines. ANS: B Feedback A Meta-analysis summarizes articles on a focused topic that used a specific methodology. B An integrative review is a synthesis of research or theoretical literature on a specific area that follows specific steps of literature integration without statistical analysis. C Meta-synthesis is a synthesis of qualitative articles on a focused topic using specific qualitative methodNoUloRgyS.INGTB.COM D Clinical guidelines are practice statements designed to assist clinicians about health care decisions for specific conditions or situations. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 19 12. When assessing the strength of a body of evidence used in a research study for consistency, the nurse should determine: a. extent to which the study’s design, implementation, and analysis minimize bias. b. number of studies that have evaluated the research question, including overall sample size across studies. c. degree to which studies with similar and different designs investigated the same research questions and report similar findings. d. significance of the findings based on the statistical methods used for data analysis. ANS: C Feedback A Quality refers to the extent to which the study’s design, implementation, and analysis minimize bias. B Quantity refers to the number of studies that have evaluated the research question, including overall sample size across studies. C Consistency is the degree to which studies that had similar and different designs (but investigate the same research question) reported similar findings. D Quantity refers to the strength of the findings in the statistical analyses. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 14 13. The nurse is analyzing a qualitative research article. In which section of the article is the nurse likely to find a summary of legal-ethical issues considered in the study? a. Data collection or procedures b. Findings or results c. Discussion or implications d. Abstract or introduction ANS: A Feedback A Legal-ethical issues are typically discussed in the article’s data-collection or procedures section, usually when discussing the sample. B The research results are typically found in the findings or results sections. C Recommendations are typically found in the discussion or implications sections. D The research question and study purpose are typically found in the abstract or introduction. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 8, Table 1.1 14. The nurse is analyzing a qualitaNtiUvRe SreIseNaGrcTh BCclOe.MIn which section of the article should the nurse expect to find a discussion of the research findings? a. Procedures b. Methods c. Sample d. Results ANS: D Feedback A Data analysis is typically included in the data analysis or procedures section. B Instruments and their validity and reliability are included in the methods or instruments sections. C The research sample and legal-ethical issues are included in the sample or subjects section. D The discussion of the findings will be located in the results or discussion section. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 8, Table 1.1 15. The nurse is using the critical reading process to analyze a research article. The nurse identifies the main theme of the article and states it in two sentences, using the nurse’s own words. The nurse is using a strategy to promote which type of understanding? a. Preliminary b. Comprehensive c. Analysis d. Synthesis ANS: B Feedback A Strategies for preliminary understanding include activities such as using a dictionary and identifying key variables of the study. B Strategies for comprehensive understanding include restating the main idea or theme of the article in one’s own words. C Strategies for analysis understanding include using criteria to critique the steps of the research process used in the study. D Strategies for synthesis understanding include writing a summary of the strengths and weaknesses of the study. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 12 16. The nurse is using the critical reading process to analyze a research article. The nurse is using a list of criteria to determine how well the researcher performed each step of the research process. The nurse is using a strategy to promote which type of understanding? a. Preliminary b. Comprehensive c. Analysis d. Synthesis ANS: C STUVIA.COM Feedback A Strategies for preliminary understanding include activities such as highlighting or underlining identified steps of the research process. B Strategies for comprehensive understanding include restating the main idea or theme of the article in one’s own words. C Strategies for analysis understanding include using criteria to critique the steps of the research process used in the study. D Strategies for synthesis understanding include writing a summary of the strengths and weaknesses of the study. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 10 17. Which of the following is a critical step for the quality improvement process in health care settings? a. Outlining general long-range goals b. Identifying current successful practices c. Testing practice changes slowly and tentatively d. Adopting a practice change as a new standard of care ANS: D Feedback A Quality improvement includes identifying specific, immediate goals, not long-range goals. B The quality improvement process includes identifying practices that pose problems, rather than identifying successful practices. C Quality improvement includes testing practice changes rapidly, not slowly. D The goal of quality improvement activities is to bring about changes in practice that will make a positive difference in patient care. Therefore, adopting a practice change is a critical step in the process. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 20 MULTIPLE RESPONSE 1. Which statements describe the actions of the baccalaureate nurse graduate as a participant in the nursing research process? (Select all that apply.) a. Administering care at the bedside according to a research protocol b. Providing leadership by helping others apply scientific knowledge to practice c. Sharing with nursing colleagues research findings that are pertinent to practice d. Designing and conducting nursing research studies e. Functioning as a primary investigator for a research study ANS: A, C Feedback Correct Following a researcNh UprRoStoIcoNlGatTtBhe.bCeOdsMide is an activity consistent with the practice of a nurse prepared at the baccalaureate level. Sharing research evidence with colleagues is an activity consistent with the practice of a nurse prepared at the baccalaureate level. Incorrect Leadership related to scientific investigation is more appropriate for a nurse prepared at the master’s or higher-degree level. Designing and conducting research studies are activities more appropriate for a nurse with doctoral preparation. Functioning as a primary investigator is an activity appropriate for a nurse with doctoral preparation. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 7 2. Which aspects of the nursing research process are common to nurses at all educational levels? (Select all that apply.) a. Disseminating research findings in research reports b. Maintaining the protection of patients who are subjects in a study c. Using one’s expertise to develop theoretical explanations for findings d. Knowing the relationship between research and nursing practice e. Being a member of a collaborative team that applies research to practice ANS: B, D, E Feedback Correct All nurses are responsible for protecting the rights of patients. All nurses should be aware that research is related to practice. All nurses can be a part of a clinical team that applies research to practice. Incorrect Disseminating research in scientific reports is an activity generally performed by nurses with master’s or higher educational preparation. Developing theoretical explanations for findings is an activity generally performed by nurses with master’s or higher educational preparation. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 7 3. For the baccalaureate nursing student, education in nursing research should result in: (Select all that apply.) a. mastering the development of research protocols. b. gaining basic understanding of the research process. c. learning how research is related to clinical nursing practice. d. developing skill as a primary investigator in research. e. becoming a knowledgeable consumer of nursing research. ANS: B, C, E Feedback Correct The student should gain an initial understanding of the importance of research in nursing practice. The student should learn how research is related to clinical nursing practice. STUVIA.COM The student should learn skills in the critical analysis of research to assist in decisions about applying research findings in nursing practice. Incorrect Mastery of research protocol development is generally attained at the master’s or higher-degree level of education. Developing skill as a primary investigator is generally attained at the doctoral level of education. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 7 4. Developing nurse researchers at a younger age is a priority for the future in the nursing profession because it should: (Select all that apply.) a. enhance the discipline’s scientific development. b. increase the longevity of research careers. c. receive more research funding for professional organizations. d. promote mentoring opportunities for novice researchers. e. increase nursing’s role in pharmaceutical research. ANS: A, B, D Feedback Correct Developing young researchers increases the number of researchers contributing to the science of the discipline. Introducing nurses to research at a younger age allows them sufficient time to develop in-depth research programs in their careers. Introducing nurses to research at a younger age allows them time and opportunity to be mentored by experienced researchers, as well as to learn to become mentors themselves. Incorrect Younger researchers do not guarantee research monies. Pharmaceutical studies are medical research and are not considered nursing research studies. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 10 STUVIA.COM Chapter 02: Research Questions, Hypotheses, and Clinical Questions LoBiondo-Wood & Haber: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 9th Edition MULTIPLE CHOICE 1. The difference between a research question and a hypothesis is: a. a research question is practice based, and a hypothesis is theory based. b. a hypothesis attempts to answer the question posed by the research problem. c. a research problem defines clinical research and a hypothesis defines basic research. d. there is no difference between a research problem and a hypothesis. ANS: B Feedback A Although a hypothesis is sometimes theory based, sometimes it is not. Similarly, research questions are not always practice based. Sometimes they originate in educational theory that relates to nursing education research, and sometimes they originate in basic, rather than applied, research. B A hypothesis attempts to answer the research question. C Research problems are present in all types of research, and a hypothesis may be present in basic or applied research. D Hypotheses and research questions are not identical. Hypotheses flow from research questions and suggest the ways the questions can be investigated. N PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 24 2. How is a hypothesis related to a theory? a. Hypotheses can be developed in the absence of a theoretical framework. b. Hypotheses must be consistent with an existing theoretical framework. c. A theory can determine the validity of a hypothesis. d. A theory can be used to evaluate the merit of a hypothesis. ANS: B Feedback A A hypothesis is a bridge between a theoretical framework and the real world of empirical testing. Therefore, a theoretical framework is required. B A sound hypothesis is consistent with an existing body of theory and research findings. C When tested, a hypothesis can help determine the validity of a theory’s assumptions—the reverse of option C. D When tested, a hypothesis can help evaluate a theory’s merit—the opposite of option D. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 24 TESTBANKWORLD.ORG 3. A nurse makes these statements. Which one has the greatest potential as an area of nursing research? a. “Most of our hospital’s admissions come in at night.” b. “It is difficult to find personnel willing to work the nightshift.” c. “It seems that most of the patient falls on our unit occur during the nightshift.” d. “The personnel on the nightshift are not attending promptly to the needs of our patients.” ANS: C Feedback A This statement is broad and not specific to patient care. It would need to be defined in much more detail to have potential for nursing research. B This broad statement is important to managers responsible for staffing a health care facility. However, it does not show potential for investigation that would contribute to the body of nursing knowledge. C This statement identifies a specific, important patient problem. Its exploration has potential to contribute to the body of nursing knowledge. D This is a broad subjective observation that does not suggest any approach for investigation or potential for contributing to the body of nursing knowledge. PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 25, Table 2.1 4. The nurse has identified a clinical problem as a potential research question. The next step should be: N a. identify the variables. b. formulate the research hypothesis. c. perform a literature review. d. determine financial resources for the research project. ANS: C Feedback A It is too early to identify variables. They will be confirmed by the literature review. B Although the researcher may have a preliminary hunch about the hypothesis, it cannot be formulated until the research question is formalized after the literature review is completed. C The literature review helps to further define the research question by identifying gaps in the literature, the need for replication of prior research, or the need to extend the knowledge base in a particular research area. It also identifies variables essential to consider in refining the research question. D The financial resources needed for the project cannot be determined until the study’s design and methodology are finalized. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 25, Table 2.1, page 26 TESTBANKWORLD.ORG 5. In a research study, properties of interest that differ in value are: a. variables. b. concepts. c. hypotheses. d. assumptions. ANS: A Feedback A This is the widely accepted and often-cited definition of variables. B A concept is an abstraction that names an object or phenomenon. C A hypothesis is a prediction that helps to answer a research question. D Assumptions are statements accepted as true. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 29 6. A nurse researcher proposes a study of teenage mothers and their experience with postpartum depression. Considerations that would affect the feasibility of the study would be: a. availability of participants. b. direction of the hypotheses. c. gaps in the literature. d. design of the study. ANS: A Feedback A A study’s feasibility is determined by practical considerations, such as availability of subjects, equipment, facilities, and money. B The direction of the hypothesis is irrelevant to a study’s feasibility. C Gaps in the literature provide support for the research study and do not affect its feasibility. D The design of the study is shaped by the research question and is not directly related to the study’s feasibility. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 27 7. The most significant difference between independent and dependent variables is: a. the dependent variable should change in response to manipulation by the independent variable. b. the independent variable should change in response to manipulation by the dependent variable. c. although both the dependent and independent variables are manipulated, only the dependent variable is considered an intervention. d. although both the dependent and independent variables are manipulated, only the independent variable is considered an intervention. ANS: A TESTBANKWORLD.ORG A Dependent variables change in response to manipulation of independent variables in experimental research. B The reverse is accurate. Dependent variables change in response to manipulation of independent variables in experimental research. C The independent variable alone is considered an intervention; the dependent variable is the consequence or presumed effect. D The independent variable alone is considered an intervention; the dependent variable is the consequence or presumed effect. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 29 8. When designing a research study, the nurse should recognize regarding independent and dependent variables a. All research problem statements should contain a dependent and an independent variable. b. There should only be one dependent variable associated with a single independent variable. c. The relationship between the independent and the dependent variable in any study should be causal. d. A given characteristic or situation may be the dependent variable in one study and the independent variable in another. ANS: D Feedback A Some descriptive studies mNay have one variable only, and qualitative studies do not include independent and dependent variables. B Many studies include more than one independent variable and more than one dependent variable. C The relationship between independent and dependent variables is not necessarily causal. An association between variables need not indicate causality. D Depending on the particular study, a specific variable may be the dependent or the independent variable. The causal or associative direction between variables determines the classification of the variables as independent or dependent. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Pages 29-30 9. A nurse’s research question is, “How does maternal employment among health care professionals affect infant health during the first 6 months of life?” In this question, the dependent variable is: a. infant health. b. maternal employment. c. first 6 months of life. d. health care professionals. ANS: A Feedback TESTBANKWORLD.ORG A Infant health is the consequence or presumed effect that changes regarding maternal employment. Thus it is the dependent variable. B Maternal employment is presumed to effect a change in the infant’s behavior (the dependent variable). Thus, maternal employment is the independent variable. C The first 6 months of life refers to the time the subjects (mothers and infants) will be observed in the study. D Health care professionals constitute the population to be studied. PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 29 10. A nurse has defined the research question as, “How does oral nutritional supplementation during dialysis treatments affect the serum albumin levels of adult patients who have chronic kidney disease Stage 5?” In this question, the independent variable is: a. adult patients with chronic kidney disease Stage 5. b. oral nutritional supplementation. c. during dialysis treatments. d. serum albumin levels. ANS: B Feedback A The population being studied is adult patients with chronic kidney disease Stage 5. B Oral nutritional supplementation is the intervention administered to effect a change in the patients’ serNum albumin levels. Thus oral nutritional supplementation is the independent variable. C The time of the intervention is defined as during dialysis treatments. D The study expects to affect the serum albumin levels of patients who receive the intervention. Thus serum albumin levels constitute the dependent variable. PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 29 11. A nurse has defined the research question as, “Is there a relationship between self-esteem and body weight among postmenopausal women?” What type of research-question format (or research design) is implied by this question? a. Correlational non-experimental b. Comparative non-experimental c. Quantitative experimental d. Phenomenological non-experimental ANS: A Feedback A Self-esteem and body weight are variables that are related in an associative way. The word relationship strongly suggests correlational design studies. B A comparative non-experimental study would compare differences between two or more groups. TESTBANKWORLD.ORG C A quantitative experimental study would include an intervention and measure its effect numerically. D A phenomenological design would measure the meaning or impact of a phenomenon; “the lived experience.” PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 30, Table 2.2 12. A nurse has defined the research question as, “What is the lived experience of late-stage pregnancy loss among women older than 35 years?” What type of research-question format (or research design) is implied by this question? a. Correlational non-experimental b. Comparative non-experimental c. Quantitative experimental d. Phenomenological non-experimental ANS: D Feedback A This research question does not indicate an association between variables, which would be studied in a correlational design. B A comparative non-experimental study would compare differences between two or more groups. C A quantitative experimental study would include an intervention and measure its effect numerically. D The question concerns “lived experience,” which implies a grounded-theory study design. N PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 30, Table 2.2 13. Which research question is testable as currently written? a. Should parents addicted to crack cocaine be permitted to raise their children? b. Is the classroom an appropriate place to teach sex education to 10-year-old children? c. Are older adults living in assisted-living facilities satisfied with their level of social interaction? d. Is a positive HIV/AIDS status a sufficient reason for limiting the employment of elementary school teachers? ANS: C Feedback A This question suggests a value statement that is not testable. B This question suggests a value statement that is not testable. C This example implies variables that can be measured and suggests a comparative non-experimental design study. The independent variable is residing in assisted-living facilities, as compared with not residing in assisted-living facilities. The dependent variable is social interaction. D This question suggests a value statement that is not testable. TESTBANKWORLD.ORG PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 29 14. What is the purpose of a hypothesis for any study? a. To identify the dependent and independent variables b. To provide direction for the study by indicating the expected outcomes c. To define the appropriate measures needed to test the research problem d. To provide a means of determining the feasibility of the proposed study ANS: B Feedback A A hypothesis does not define the variables but makes a statement about the relationship between two or more variables. B A hypothesis is a declarative statement about two or more variables that predicts an expected outcome. C A hypothesis does not define the appropriate measures needed to test the research question. The hypothesis does provide direction for the analysis and interpretation of data. D A hypothesis does not determine the feasibility of a research problem. A study’s feasibility is determined by practical considerations such as availability of subjects, equipment, facilities, and money. PTS: 1 DIF: Cognitive Level: Remembering (Knowledge) REF: Page 33 N 15.1 Which hypothesis fails to meet the criteria of testability? 5 a. Proper handwashing prevents the spread of infection. . b. Consistent practice of low-impact aerobic exercise will increase coordination among older adults. c. Patients who used guided imagery during magnetic resonance imaging (MRI) procedures will have reduced perceptions of emotional distress compared with patients who do not use guided imagery during MRI. d. Postoperative patients who receive around-the-clock scheduled analgesics will have lower levels of pain compared with postoperative patients who receive analgesics on an as-needed (PRN) schedule. ANS: A Feedback A This statement does not suggest that there is a predicted outcome as specifically as the other examples. The term proper is value laden and nonspecific. Both proper handwashing and spread of infection require more specific definition. B This hypothesis includes a predicted outcome. C This hypothesis includes a predicted outcome. D This hypothesis includes a predicted outcome. PTS: 1 DIF: Cognitive Level: Analyzing (Analysis) REF: Page 31 TESTBANKWORLD.ORG 16. Which hypothesis is non-directional? a. Hospitals with an infection-control nurse will have fewer instances of sepsis among inpatients than hospitals without an infection-control nurse. b. There will be a greater weight loss among dieting patients who receive a weekly supportive telephone call from a dietitian than among dieting patients who do not receive a weekly supportive phone call. c. There will be a difference in stage of disease for prostate cancer among men who had an abnormal prostate-specific antigen screening compared with men who had an abnormal digital rectal examination screening. d. Children who receive weekly counseling for 1 year after the death of a parent will perform better in school than children who do not receive weekly counseling after the death of a parent. ANS: C Feedback A This hypothesis gives the expected direction (i.e., fewer). B This hypothesis gives the expected direction (i.e., greater). C This hypothesis has no expected direction. It suggests a difference but does not indicate the direction of the difference. D This hypothesis gives the expected direction (i.e., better). PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 36 17. The nurse has defined the hypoNthesis as, “There will be no difference in the number of adverse events among patients discharged 2 days after an abdominal hysterectomy compared with patients discharged 4 days after an abdominal hysterectomy.” This statement is an example of what? a. Directional hypothesis b. Non-directional hypothesis c. Research hypothesis d. Null hypothesis ANS: D Feedback A Because no direction is indicated, this is not a directional hypothesis. B A non-directional hypothesis indicates the existence of a relationship between variables but does not indicate the direction. This hypothesis indicates no relationship between variables. C A research (or scientific) hypothesis is a statement of the expected relationship of the variables. This hypothesis indicates no relationship between variables. D This is a null (or statistical) hypothesis, stating that there is no relationship between the independent (postoperative days) and dependent (adverse events) variables. If in the statistical analysis a significant relationship is found, the null hypothesis would be rejected. PTS: 1 DIF: Cognitive Level: Applying (Application) TESTBANKWORLD.ORG REF: Page 36 18. The nurse notes these statements in a research article: This study explores changes in coping and emotion that occur between the preoperative and the postoperative period. Further, the relationships between coping and emotion preoperatively and postoperatively are evaluated. Finally, the influence of preoperative coping and emotion on postoperative emotion is documented. This section represents which part of a research study? a. Results b. Methods c. Purpose d. Hypothesis ANS: C Feedback A No results were described in the passage. B Although methods are implied, the passage does not include the specific methodology. C The statements describe the aims or goals that the investigator hoped to achieve with the research and thus reflect the purpose of the study. D The passage does not state the hypothesis of the study. PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 32 19. A nurse states the purpose of aNresearch study as, “This study will compare the effect of warm and cold applications on the resolution of intravenous (IV) infiltrations in hospitalized older-adult patients in the early postoperative period.” In this statement, what constitutes the independent variable(s)? a. Postoperative older adult patients b. Early postoperative period c. Warm and cold applications d. Resolution of IV infiltrations ANS: C Feedback A Postoperative older adult patients represent the population to be studied. B Early postoperative period indicates the timing of the intervention. C Warm and cold applications represent the independent variables, which will be manipulated and influence the dependent (outcome) variable resolution of IV infiltrations. D Resolution of IV infiltrations represents the dependent (outcome) variable of the study. PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 29 TESTBANKWORLD.ORG 20. A nurse describes the hypothesis of a research study as, “There is a positive relationship between nurses’ attitudes toward AIDS patients and the number of AIDS patients they have cared for in practice.” This statement is an example of: a. null hypothesis. b. non-directional hypothesis. c. directional hypothesis. d. causal hypothesis. ANS: C Feedback A The statement is not a null hypothesis because a null hypothesis specifies no relationship. B The statement is a directional hypothesis, not a non-directional hypothesis. C Because a positive relationship is specified, the hypothesis is directional. D Because the statement indicates a relationship between variables, the hypothesis indicates an association, rather than a cause-and-effect relationship, between variables. PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 33 21. The nurse has identified a patient situation that may be an area for study. The initial review of the literature helps the investigator to identify what? a. The number of subjects required for the study b. The appropriate statistical tests to analyze the data c. The need to extend knowleNdge in a particular area d. The instruments needed to collect data during the study ANS: C Feedback A The number of subjects needed for a study is part of methodology, determined after the research question and hypotheses are determined. B Statistical tests are part of methodology, determined after the research question and hypotheses are determined. C The initial literature review helps further define the research question by identifying gaps in the literature, the need for replication of prior research, or the need to extend the knowledge base in a particular research area. It also identifies variables essential to consider in refining the research question. D The instruments to be used in the study part of methodology, determined after the research question and hypotheses are determined. PTS: 1 DIF: Cognitive Level: Understanding (Comprehension) REF: Page 27 22. Which hypothesis would be classified as a statistical hypothesis? a. Oxygen inhalation at 2 L/min by nasal catheter will decrease oral temperature measured with an electronic thermometer. b. Oxygen inhalation at 2 L/min by nasal catheter will not affect oral temperature TESTBANKWORLD.ORG measured with an electronic thermometer. c. There will be a greater decrease in anxiety scores in patients receiving informational videos before open heart surgery than in patients who receive standard written information. d. There will be a difference in anxiety scores in patients receiving informational videos before open heart surgery and patients who receive standard written information. ANS: B Feedback A This hypothesis is a directional hypothesis rather than a statistical (null) hypothesis. B A statistical (or null) hypothesis indicates no relationship between variables, as represented in this statement. If in the statistical analysis, a significant relationship is found, the null hypothesis would be rejected. C This hypothesis is a directional hypothesis rather than a statistical (null) hypothesis. D This hypothesis is a nondirectional hypothesis rather than a statistical (null) hypothesis. PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 36 23. Which of these statements is correctly phrased as a clinical question for evidence-based practice? a. What is the best method to Ninsert an enteral feeding tube in an adult patient? b. Are there differences in the characteristics of various brands of enteral feeding tubes? c. In addition to aspiration, what are the most problematic complications of enteral tube feedings? d. What method of determining stomach placement of enteral feeding tubes helps to prevent aspiration in adult patients? ANS: D Feedback A This statement includes an intervention (insertion of an enteral feeding tube) and a population (adult patients) but does not include the other PICO elements. B This statement includes comparison (differences between feeding tubes) but does not include the other PICO elements. C This statement includes only a problem and needs to be further refined to include the PICO elements. D This statement is worded as a clinical question and includes the four PICO elements: population (adult patients), intervention (methods of determining stomach placement), comparison (among methods), and outcome (prevent aspiration). PTS: 1 DIF: Cognitive Level: Applying (Application) REF: Page 39 TESTBANKWORLD.ORG Chapter 03: Gathering and Appraising the Literature Test Bank MULTIPLE CHOICE 1. The review of literature is important to the research process for which of these reasons? a. It guides all steps of the research process. b. It provides a vehicle to disseminate the findings of the study. c. It guides only the conceptualization of the problem statement. d. It identifies only gaps or inconsistencies in the knowledge base. ANS: A Feedback A The review of the literature is important throughout all stages of a research study. B A completed study may be published to disseminate the findings of a study and thus become one citation in a literature review for future studies. However, the literature review does not ensure this. C The review of the literature guides the problem statement as it is defined along with all other parts and stages of a research study. D The review of the literature contributes to consistencies in the literature, locates instruments used to measure variables, identifies experts on topics, etc. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 50 2. The “6S” pyramid hierarchy of preappraised evidence developed by DiCenso, Bayley, & Haynes (2009) provides a means to help nurse consumers of research find preappraised evidence for clinical questions. Using this model, which level of evidence would be highest? a. Summaries such as clinical practice guidelines b. Synopsis of Synthesis such as summaries found in the journal Evidence-Based Nursing c. Syntheses or systematic reviews such as a Cochrane review d. Studies such as synopses of a single study ANS: A Feedback A The highest level of those presented in the question is Summaries, which include clinical practice guidelines and electronic evidence-based textbooks. These summaries about specific conditions are updated regularly. An even higher level of the 6S pyramid is Computerized Decision Support Systems (CDSS), which integrate evidence-based clinical information into an electronic medical record. At present, these systems are not a reality in most institutions and, therefore, they were not included as an option in this question. B Next highest is Synopsis of Synthesis, which provides a preappraised summary of a systematic review that can be found in journals, such as Evidence-Based Nursing. C Third highest is Syntheses or systematic reviews such as a Cochrane review. D Lowest in the hierarchy is Studies, which often refer to synopses of single studies evaluated by a single expert. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 55-57 3. For which of these reasons would a nurse researcher include refereed journals in the literature review? a. The articles are critiqued by a panel of external reviewers. b. The articles selected for publication are related to a specific field of knowledge. c. The journals encourage competition among authors to have their articles published. d. The journals publish only articles that are primary sources of research findings. ANS: A Feedback A The articles are critiqued by a panel of external expert readers. B Articles selected for publication are sources of the latest information about a great variety of fields of knowledge. C There is no overt competition among authors because refereed journals have blinded reviews in most cases. D Refereed journals are often the first source of primary research findings, but they may also include other types of research articles. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 60 4. A research article has undergone a blind review for a peer-reviewed journal. The nurse reading the research article should understand which of the following about this review process? a. The reviewers of the article did not know the identity of the other reviewers. b. The reviewers of the article did not know the identity of the author. c. The criteria used to review the article were not known to the author. d. The criteria used to review the article were determined by the reviewers. ANS: B Feedback A The reviewers of the article may or may not know the identity of the other reviewers. B In a blind review, the manuscript to be reviewed does not include the name of the author. C A standard set of scholarly criteria is used to review the article. The criteria are usually known to the author. D The criteria used to review the article are established by expert reviewers appointed by the publication’s editors. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 60 5. For which of these reasons would a nurse researcher decide to use secondary sources in a review of the literature? a. They provide material written by the person who conducted the study. b. They provide a different way of looking at specific issues or problems. c. They define the relationship of two or more variables affecting an outcome. d. They supplement the body of nursing knowledge in a specific area of practice. ANS: D Feedback A Secondary sources are authored by an individual other than the researcher who conducted the study. B The evidence is distilled by an expert and usually provides a critical evaluation or response to a study, not necessarily a different way of looking at specific issues or problems. C The relationship of two or more variables affecting an outcome defines a hypothesis. D Secondary sources published in refereed journals usually include implications for practice and the work’s contributions to the development of nursing science. DIF: Cognitive Level: Understanding (Comprehension) REF: Table 3-1 6. Which is an example of a primary source in a literature review? a. A video recorded interview of a nurse researcher b. A critique of a nursing research study c. An edited textbook on nursing research d. A review of theoretical frameworks used in nursing research ANS: A Feedback A Primary sources include articles, books, diaries, films, and oral histories of the person who conducted the study or developed the theory. B A critique of a nursing research study is a secondary source. C An edited textbook on nursing research is a secondary source. D A review of theoretical frameworks is a secondary source. DIF: Cognitive Level: Understanding (Comprehension) REF: Table 3-1 7. Which is an example of a secondary source in a literature review? a. An oral history of a nurse researcher b. An investigator’s report of a research study c. A summary and critique of another’s scholarly work d. An autobiography of a developer of a nursing theory ANS: C Feedback A An oral history of a nurse researcher is a primary source. B An investigator’s report of a research study is a primary source. C Secondary sources include materials written by persons other than the person who conducted a research study or developed a particular theory. D An autobiography of a developer of a nursing theory is a primary source. DIF: Cognitive Level: Understanding (Comprehension) REF: Table 3-1 8. Which of these electronic databases is the most relevant and frequently used source for nursing literature? a. MEDLINE b. CINAHL c. Cochrane Collaboration d. National Guideline Clearinghouse ANS: B Feedback A MEDLINE includes some nursing sources, but it is not the most comprehensive database for nursing. B CINAHL is the most relevant and frequently used source for nursing literature, covering nursing and related literature from 1956 to the present. C The Cochrane Collaboration provides access to abstracts from Cochrane Database of Systematic Reviews but is not a nursing literature source. D The National Guideline Clearinghouse provides evidence-based clinical practice guidelines but is not a nursing literature source. DIF: Cognitive Level: Remembering (Knowledge) REF: Page 60 9. When comparing MEDLINE and CINAHL databases, which of these differences will the nurse find? a. The coverage of MEDLINE dates back to 1975, whereas the coverage of CINAHL dates back to 1980. b. MEDLINE’s journal coverage includes more than 10,000 biomedical journals, whereas CINAHL’s coverage includes more than 5000 journals. c. MEDLINE’s database size is more than 21 million records, whereas CINAHL’s database size is more than 3.2 million records. d. MEDLINE has more than 500 Evidence-Based Care Sheets, whereas CINAHL has more than 50 Evidence-Based Care Sheets. ANS: C Feedback A The coverage of MEDLINE dates back to 1947, whereas the coverage of CINAHL dates back to 1937. B MEDLINE’s journal coverage includes more than 5600 biomedical journals, whereas CINAHL’s coverage includes more than 5000 journals. C MEDLINE’s database size is more than 21 million records, whereas CINAHL’s database size is more than 3.2 million records. D CINAHL has more than 130 Evidence-Based Care Sheets, whereas MEDLINE has a Clinical Queries tool to filter for systematic reviews. DIF: Cognitive Level: Understanding (Comprehension) REF: Table 3-3 10. A general timeline for a literature search for an academic paper or project is to go back how far in the literature? a. At least the last 6 months to 2 years b. At least the past 3 to 5 years c. At least the past 6 to 10 years d. At least the past 12 to 15 years ANS: B Feedback A The most recent 6 months to 2 years is an insufficient timeline for an academic paper or project. B The past 3 to 5 years is a sufficient timeline for an academic paper or project because recent literature is relevant and may include classic references in reference lists. C Six to 10 years is probably longer than the timeline needed for the search. D Twelve to 15 years is likely to be much longer than the timeline needed for the search. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 64 11. A nurse is encouraged to use a Boolean operator to more efficiently perform an electronic search of the literature. The nurse should understand that a Boolean operator is what? a. A specialized reference librarian who can assist in searches of electronic medical and nursing databases b. A software program that enables combinations of permissions and restrictions for a database search c. A definition of the relationship between words or groups of words in a literature search such as “and” d. A clinical query that can be performed to focus on a particular clinical issue or practice question ANS: C Feedback A Although reference librarians can be helpful for electronic database searches, they are not Boolean operators. B A Boolean operator is not a software program but refers to variables that define an electronic database search. C A Boolean operator defines the relationships between words or groups of words in the literature search. These include the words, “and,” “or,” and “not.” D A Boolean operator is not a query for a clinical issue or practice question. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 68 12. Which command is an example of a Boolean connection used when ordering an electronic literature search? a. Explode topic b. Limit search to abstracts c. Search from years 2003 to 2013 d. Search diabetes diagnosis and treatment ANS: D Feedback A “Explode topic” is a search strategy, not a Boolean connection. B Limiting the search to abstracts is not a Boolean connection. C Specifying the time limit of the search is not a Boolean connection. D Boolean connections include the terms “and,” “not,” and “or,” which link thesaurus terms and influence the search. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 68 13. Which website is an important source for clinical evidence but limited as a provider of primary documents for literature reviews? a. CINAHL b. MEDLINE c. Cochrane Library d. PsychINFO ANS: C Feedback A CINAHL contains many primary source citations. B MEDLINE contains many primary source citations. C The Cochrane Library is important as a source for clinical evidence but limited as a provider of primary documents for literature reviews. D PsycINFO includes professional and academic literature in psychology. DIF: Cognitive Level: Understanding (Comprehension) REF: Table 3-4 14. What is considered to be essential to a thorough and relevant review of the literature? a. Use of both published and unpublished sources b. Critical evaluation of mainly primary sources c. Liberal use of secondary sources d. Evaluation of both quantitative and qualitative sources ANS: B Feedback A Although both published and unpublished sources may be used, it is the evaluation of primary published sources that is most important. B A thorough and accurate evaluation of mainly primary sources of information is necessary for a thorough and relevant literature review. C Secondary sources may be used, but they should be used sparingly. D Although both quantitative and qualitative sources may be used, it is not necessary to include both in a review of the literature. DIF: Cognitive Level: Understanding (Comprehension) REF: Table 3-1 15. Which objective of a review of the literature is unique to a review for research purposes, rather than a review for evidence-based practice? a. Discover conceptual frameworks used to examine problems b. Generate useful research questions and hypotheses c. Determine what is unknown about a subject, as well as what requires clarification d. Uncover a new practice intervention or gain support for current interventions and policies ANS: B Feedback A Conceptual frameworks are useful for both formal research and evidence-based practice. B For research purposes, the literature review focuses the study by discovering gaps or conflicts in the literature and identifying areas where little research evidence exists. This helps define the research questions and hypotheses. C Both formal research and evidence-based practice are concerned with what is known about a subject, as well as what requires clarification. D Uncovering new practice interventions or gaining support for current practices is primarily in the realm of evidence-based practice. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 50 16. Which of these factors limits the usefulness of the World Wide Web as a source of information for research consumers? a. Downloading from the Web can be a slow process. b. Nontext capabilities reduce the professionalism of presentations. c. There is little quality control over the information on many websites. d. Much of the available information is too technical to be understood by the casual reader. ANS: C Feedback A Downloading is often a rapid process. B This is not an accurate statement about the professionalism of presentations and nontext capabilities. C Many sources are not data based and primary sources. It is not always evident which sources are data based and which are not. D Much information on the Web is comprehensible to the casual reader. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 63 17. When the nurse researcher conducts an electronic literature search, the search yields more than 7000 citations for the topic. The researcher should make which of these interpretations of the finding? a. The search was comprehensive. b. The key words were not sufficiently narrowed. c. The topic does not require additional investigation. d. The topic has broad application across health care disciplines. ANS: B Feedback A The search was too broad and included too many citations to scroll through. B Limiting the focus is necessary using thesaurus terms. C The topic required a more manageable number of retrievals. D The topic is too broad and may or may not apply across various health care disciplines. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 55 18. Why would a nurse researcher choose to use multiple online fee-based databases such as CINAHL and MEDLINE? a. The charges for these services are minimal. b. Databases are updated weekly or monthly. c. An independent professional critique of each work accompanies the full text. d. The service provides translations to English of articles written in other languages. ANS: B Feedback A Libraries pay for database use through subscriptions. B Databases are updated monthly or weekly. C Critiques do not necessarily accompany full texts of all citations. D Translations are not provided; citations may be excluded by specifying the preferred language. DIF: Cognitive Level: Understanding (Comprehension) REF: Page 60 19. A study published in a nursing research journal is titled, “Effects of nocturnal hemodialysis on physiological and psychological parameters of patients with end-stage kidney disease.” The nurse should recognize that this study belongs to which of these types of reference? a. Primary b. Secondary c. Tertiary d. Historical ANS: A Feedback A The example is a research study, a primary source. B This is not a secondary source but a primary source. C The example is a primary source, not a tertiary source. D The example is a primary source of a research study, not a historical study. DIF: Cognitive Level: Understanding (Comprehension) REF: Table 3-1 20. Literature reviews are usually organized according to what? a. The order in which