Galen NSG 4000 Exam 4 | Nursing Practice – Complex Health
(2026) Actual Q&A PDF
1. A nurse is preparing to implement a new evidence-based practice (EBP) guideline on a
medical-surgical unit. Which of the following is a key factor for successful implementation of an
EBP change?
A) Lack of resources and support
B) Resistance to change from staff
C) Strong organizational leadership and a culture that supports change
D) A rigid, top-down approach to change
Correct Answer: Strong organizational leadership and a culture that supports change
Rationale: Successful implementation of EBP requires strong organizational leadership, a culture
that supports change, adequate resources, and staff engagement. Lack of resources, resistance
to change, and rigid approaches are barriers to implementation.
2. A nurse is appraising a research article and notes that the authors used a “cluster
randomized” design. What is a key feature of a cluster randomized trial?
A) Individuals are randomly assigned to groups
B) Groups (e.g., hospitals, schools) are randomly assigned to interventions
C) Participants are not randomly assigned
D) It is a qualitative research design
Correct Answer: Groups (e.g., hospitals, schools) are randomly assigned to interventions
Rationale: In a cluster randomized trial, groups or clusters (e.g., hospitals, schools, communities)
are randomly assigned to the intervention or control group. This design is often used when
individual randomization is not feasible or when the intervention is delivered at the group level.
,3. A nurse is reading a research article that uses a “forest plot” to display the results of a
meta-analysis. What does a forest plot typically display?
A) The results of individual studies and the overall pooled estimate
B) The demographic characteristics of the study participants
C) The study’s funding sources
D) The study’s limitations
Correct Answer: The results of individual studies and the overall pooled estimate
Rationale: A forest plot is a graphical display used in meta-analyses to show the results of
individual studies and the overall pooled estimate. It typically includes point estimates,
confidence intervals, and a summary diamond representing the pooled effect.
4. A nurse is evaluating a research study and notes that the authors report a “number needed to
treat” (NNT) of 5. What is the correct interpretation of this finding?
A) 5 patients must be treated to prevent one additional adverse outcome
B) 5 patients must be treated to cause one additional adverse outcome
C) The treatment is not effective
D) The treatment has a 5% success rate
Correct Answer: 5 patients must be treated to prevent one additional adverse outcome
Rationale: The number needed to treat (NNT) is the number of patients who need to be treated
to prevent one additional adverse outcome. An NNT of 5 means that 5 patients must be treated
to prevent one additional event.
,5. A nurse is appraising a research study and notes that the study has a high risk of “attrition
bias.” What is attrition bias?
A) Bias introduced when participants are lost to follow-up
B) Bias introduced when participants are not randomly assigned
C) Bias introduced when participants are not blinded
D) Bias introduced when the outcome is not measured accurately
Correct Answer: Bias introduced when participants are lost to follow-up
Rationale: Attrition bias occurs when participants drop out of a study, and the reasons for
dropout are related to the intervention or outcome. This can threaten the validity of the study’s
findings.
6. A nurse is reading a research article and notes that the authors used a “survival analysis.”
What is the primary purpose of survival analysis?
A) To analyze the time until an event occurs
B) To analyze the frequency of an event
C) To analyze the severity of an event
D) To analyze the cost of an event
Correct Answer: To analyze the time until an event occurs
Rationale: Survival analysis is a statistical method used to analyze the time until an event of
interest occurs, such as death, relapse, or recovery. It is commonly used in longitudinal studies.
7. A nurse is appraising a research article and notes that the study used a “propensity score”
analysis. What is the primary purpose of propensity score analysis?
A) To control for confounding in observational studies
, B) To increase the sample size
C) To ensure random assignment
D) To reduce the cost of the study
Correct Answer: To control for confounding in observational studies
Rationale: Propensity score analysis is a statistical technique used to control for confounding in
observational studies. It creates a score that represents the probability of receiving the
treatment based on observed covariates, allowing for more accurate comparisons.
8. A nurse is reading a research article and notes that the authors used a “repeated measures”
design. What is a key feature of a repeated measures design?
A) Participants are measured at multiple time points
B) Participants are measured at a single time point
C) Participants are randomly assigned to groups
D) Participants are followed over a short period
Correct Answer: Participants are measured at multiple time points
Rationale: A repeated measures design involves measuring the same participants at multiple
time points. This allows researchers to track changes over time and reduces the variability
associated with between-subject differences.
9. A nurse is appraising a research article and finds that the study used a “factorial” design.
What is a key feature of a factorial design?
A) It tests the effect of a single intervention
B) It tests the effect of multiple interventions and their interactions
C) It uses a single group of participants
(2026) Actual Q&A PDF
1. A nurse is preparing to implement a new evidence-based practice (EBP) guideline on a
medical-surgical unit. Which of the following is a key factor for successful implementation of an
EBP change?
A) Lack of resources and support
B) Resistance to change from staff
C) Strong organizational leadership and a culture that supports change
D) A rigid, top-down approach to change
Correct Answer: Strong organizational leadership and a culture that supports change
Rationale: Successful implementation of EBP requires strong organizational leadership, a culture
that supports change, adequate resources, and staff engagement. Lack of resources, resistance
to change, and rigid approaches are barriers to implementation.
2. A nurse is appraising a research article and notes that the authors used a “cluster
randomized” design. What is a key feature of a cluster randomized trial?
A) Individuals are randomly assigned to groups
B) Groups (e.g., hospitals, schools) are randomly assigned to interventions
C) Participants are not randomly assigned
D) It is a qualitative research design
Correct Answer: Groups (e.g., hospitals, schools) are randomly assigned to interventions
Rationale: In a cluster randomized trial, groups or clusters (e.g., hospitals, schools, communities)
are randomly assigned to the intervention or control group. This design is often used when
individual randomization is not feasible or when the intervention is delivered at the group level.
,3. A nurse is reading a research article that uses a “forest plot” to display the results of a
meta-analysis. What does a forest plot typically display?
A) The results of individual studies and the overall pooled estimate
B) The demographic characteristics of the study participants
C) The study’s funding sources
D) The study’s limitations
Correct Answer: The results of individual studies and the overall pooled estimate
Rationale: A forest plot is a graphical display used in meta-analyses to show the results of
individual studies and the overall pooled estimate. It typically includes point estimates,
confidence intervals, and a summary diamond representing the pooled effect.
4. A nurse is evaluating a research study and notes that the authors report a “number needed to
treat” (NNT) of 5. What is the correct interpretation of this finding?
A) 5 patients must be treated to prevent one additional adverse outcome
B) 5 patients must be treated to cause one additional adverse outcome
C) The treatment is not effective
D) The treatment has a 5% success rate
Correct Answer: 5 patients must be treated to prevent one additional adverse outcome
Rationale: The number needed to treat (NNT) is the number of patients who need to be treated
to prevent one additional adverse outcome. An NNT of 5 means that 5 patients must be treated
to prevent one additional event.
,5. A nurse is appraising a research study and notes that the study has a high risk of “attrition
bias.” What is attrition bias?
A) Bias introduced when participants are lost to follow-up
B) Bias introduced when participants are not randomly assigned
C) Bias introduced when participants are not blinded
D) Bias introduced when the outcome is not measured accurately
Correct Answer: Bias introduced when participants are lost to follow-up
Rationale: Attrition bias occurs when participants drop out of a study, and the reasons for
dropout are related to the intervention or outcome. This can threaten the validity of the study’s
findings.
6. A nurse is reading a research article and notes that the authors used a “survival analysis.”
What is the primary purpose of survival analysis?
A) To analyze the time until an event occurs
B) To analyze the frequency of an event
C) To analyze the severity of an event
D) To analyze the cost of an event
Correct Answer: To analyze the time until an event occurs
Rationale: Survival analysis is a statistical method used to analyze the time until an event of
interest occurs, such as death, relapse, or recovery. It is commonly used in longitudinal studies.
7. A nurse is appraising a research article and notes that the study used a “propensity score”
analysis. What is the primary purpose of propensity score analysis?
A) To control for confounding in observational studies
, B) To increase the sample size
C) To ensure random assignment
D) To reduce the cost of the study
Correct Answer: To control for confounding in observational studies
Rationale: Propensity score analysis is a statistical technique used to control for confounding in
observational studies. It creates a score that represents the probability of receiving the
treatment based on observed covariates, allowing for more accurate comparisons.
8. A nurse is reading a research article and notes that the authors used a “repeated measures”
design. What is a key feature of a repeated measures design?
A) Participants are measured at multiple time points
B) Participants are measured at a single time point
C) Participants are randomly assigned to groups
D) Participants are followed over a short period
Correct Answer: Participants are measured at multiple time points
Rationale: A repeated measures design involves measuring the same participants at multiple
time points. This allows researchers to track changes over time and reduces the variability
associated with between-subject differences.
9. A nurse is appraising a research article and finds that the study used a “factorial” design.
What is a key feature of a factorial design?
A) It tests the effect of a single intervention
B) It tests the effect of multiple interventions and their interactions
C) It uses a single group of participants
