Understanding Nursing Research: Building an Evidence-Based Practice 6th Edition by Sus TEST BANK by ACADEMIAMILL

TEST BANK FOR UNDERSTANDING NURSING RESEARCH 6TH EDITION BY GROVE

Chapter 01: Introduction to Nursing Research and Evidence-Based Practice Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. Which best describes evidence-based-practice (EBP)? a. A combination of best research evidence, clinical expertise, and the needs and

values of patients. b. A determination of the factors necessary to control patient responses to care. c. The development of population care guidelines applicable to all patients. d. The utilization of quantitative and qualitative studies to enhance patient outcomes. ANS: A Feedback A B

C D

Evidence-based practice evolves from the integration of the best research evidence with clinical expertise and patient needs and values. Studies that attempt to find determinants of patient outcomes are generally experimental or quasi-experimental. They may be used to guide EBP but do not completely define it. EBP is a combination of guidelines and specific patient needs and values. Quantitative and qualitative studies applied to the evaluation of patient outcomes are part of EBP but do not completely define EBP.

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2. The nurse is collecting data about the sleep patterns of breastfed babies as part of a larger

research study. Which research method will the nurse use when collecting data for this study? a. Control b. Description c. Explanation d. Prediction ANS: B Feedback A B C D

Control can be described as the ability to write a prescription to produce the desired outcome. Description involves identifying and understanding the nature of nursing phenomena and the relationships among these phenomena. Explanation clarifies the relationships among phenomena and identifies why certain events occur. Through prediction, the probability of a specific outcome can be estimated in a given situation.

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3. The nurse is participating in a study and is collecting data identifying the number of obese

adults whose parents were also obese or overweight. Which research method is being used in this study? a. Control b. Description c. Explanation d. Prediction ANS: D Feedback A B C D

Control indicates the ability to use a prescribed intervention to produce a desired outcome. Description involves identifying and understanding the nature of nursing phenomena and the relationships among these phenomena. Explanation clarifies the relationships among phenomena and identifies why certain events occur. Through prediction the probability of a specific outcome can be estimated in a given situation. By knowing the percentage of parents of obese adults who were obese, the probability of predicting this may be calculated.

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4. The nurse reviews a study in which adherence to an asthma action plan is compared among

groups of adolescents who received different asthma education. Which research method does this represent? a. Control b. Description c. Explanation d. Prediction ANS: C Feedback A B C D

Control indicates the ability to use a prescribed intervention to produce a desired outcome. Description involves identifying and understanding the nature of nursing phenomena and the relationships among these phenomena. Explanation clarifies the relationships among phenomena and identifies why certain events occur. Through prediction, the probability of a specific outcome can be estimated in a given situation.

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5. A nurse manager is interested in learning which attitudes among staff nurses may indicate

relative risk of needle-stick injuries. To study this, the nurse manager will employ which method of study? a. Control

b. Description c. Explanation d. Prediction ANS: D Feedback A B C D

Control indicates the ability to use a prescribed intervention to produce a desired outcome. Explanation clarifies the relationships among phenomena and identifies why certain events occur. Description involves identifying and understanding the nature of nursing phenomena and the relationships among these phenomena. Through prediction, the probability of a specific outcome can be estimated in a given situation.

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6. Which is the most important result of Florence Nightingale’s data collection and statistical

analysis during the Crimean War? a. Bringing awareness of the rigors of war to the general public. b. Developing a process for statistical analysis and nursing documentation. c. Identifying and defining the role of nurses in modern health care. d. Using clinical research to evaluate the importance of sanitation, clean drinking water, and adequate nutrition. ANS: D Feedback A B C D

This was not the most important result This was not the most important result This was not the most important result Nightingale’s research enabled her to instigate attitudinal, organizational, and social changes, including the military’s approach to the care of the sick and society’s sense of responsibility for testing public water, improving sanitation, and preventing starvation to decrease morbidity and mortality rates.

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7. The nurse participates in data collection in a study in which two different pain management

protocols are used with randomly assigned patients to measure differences in postoperative recovery time. Which method of study is this? a. Control b. Correlation c. Description d. Explanation ANS: A

Feedback A B C D

Control indicates the ability to use a prescribed intervention to produce a desired outcome. Correlation examines the relationships between different phenomena. Description involves identifying and understanding the nature of nursing phenomena and the relationships among these phenomena. Explanation clarifies the relationships among phenomena and identifies why certain events occur.

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8. The development of nursing theories and conceptual models in the late 1960s and 1970s

served to: a. determine the effectiveness of nursing interventions. b. establish the concept of evidence-based practice. c. provide funding for nursing research. d. provide direction for nursing research. ANS: D Feedback A B C D

Outcome studies are used to determine the effectiveness of nursing interventions. The concept of EBP was developed in the 1970s and promoted by the ANCC Magnet Designation program. The NINR seeks to provide funding for nursing research. The theories developed in the 1960s and 1970s helped to direct future nursing research.

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9. Under Ada Sue Hinshaw, the National Institute of Nursing Research (NINR) began to change

its focus to: a. funding nursing rather than medical research. b. evaluating outcomes rather than process studies. c. increasing the status and funding for nursing research. d. supporting the dissemination of nursing research. ANS: C Feedback A

B C

The change in focus from medical to nursing research came about with the first nursing programs. Specialty nursing organizations today and some nursing researchers still conduct medical research for specific studies. Outcomes research emerged in the 1980s and 1990s to document the effectiveness of health care services. Under Ada Sue Hinshaw, the national Center for Nursing Research (NCNR) changed its name to the NINR to increase the status and funding of nursing research.

The NCNR’s purpose was to support the dissemination of nursing research.

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10. An emphasis of the American Nurses Credentialing Center (ANCC) Magnet Hospital

Designation Program for Excellence in Nursing is: a. research and development of clinical practice guidelines. b. putting qualitative research into practice in clinical settings. c. using standard nursing care plans based on outcomes research. d. utilizing evidence-based practice in nursing. ANS: D Feedback A

B C D

Clinical practice guidelines are a more recent phenomenon, using evidence-based research, expert opinion, and patient needs and values to standardize care. Qualitative research was introduced in the late 1970s to gain insight into the phenomena related to nursing. Outcomes research was important in the 1980s to 1990s to document the effectiveness of health care services. ANCC implemented the Magnet Hospital Designation Program for Excellence in Nursing Service in 1990 that emphasized EBP for nursing.

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11. In a position statement in 2006, the American Association of Colleges of Nursing (AACN)

identified a need to: a. acquire clinical knowledge and expertise. b. focus on evidence-based practice. c. fund academic nursing research. d. prepare a workforce of nurse scientists. ANS: D Feedback A B C D

Basic nursing education focuses on clinical knowledge and expertise. Evidence-based practice is a focus of ANCC and the Magnet Designation Program for Excellence in Nursing Service. The NINR focuses on funding for nursing research. The AACN identified the importance of creating a research culture, providing high-quality educational programs to prepare a workforce of nurse scientists, develop a sound research structure, and obtain funding for nursing research.

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12. The lead agency designated to improve health care quality is: a. Agency for Healthcare Research and Quality (AHRQ).

b. American Nurses Credentialing Center (ANCC). c. Quality and Safety Education for Nurses (QSEN). d. National Institute for Nursing Research (NINR). ANS: A Feedback A B C D

AHRQ is a scientific partner with the public and private sectors to improve the quality and safety of patient care. ANCC provides credentialing for advanced practice nurses and for Magnet Designation for Excellence in Nursing Service QSEN is focused on developing the requisite skills, knowledge, and attitude statements for the competencies for prelicensure and graduate education. The National Institute of Nursing Research, originally the National Center for Nursing Research, is a federally funded arm of the National Institutes of Health, providing nursing with federal support for nursing research priorities.

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13. To help fulfill the mission of the National Institute for Nursing Research—to promote and

improve the health of individuals, families, communities, and populations—a study may be conducted which: a. assesses the effectiveness of strategies for weight management in patients with type 2 diabetes. b. compares the attitudes of nurses toward clients with type 1 and type 2 diabetes. c. generates up-to-date nursing diagnoses reflecting the needs of clients with type 2 diabetes. d. reviews hospital nurses’ adherence to glucose-monitoring guidelines for patients with type 2 diabetes. ANS: A Feedback A B C D

A study that assesses the effectiveness of interventions helps to improve the health of patient populations by identifying appropriate strategies. A comparison of attitudes is a descriptive study that does not improve outcomes. A study to generate nursing diagnoses does not directly affect patient outcomes. A study reviewing adherence to guidelines seeks to provide data for quality assurance.

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14. Which best describes the Quality and Safety Education for Nurses (QSEN) competency for

evidence-based practice (EBP)? a. Adhering to published guidelines to provide care for a specific population. b. Empowering clients to choose among effective disease management strategies. c. Relying on expert knowledge to guide care plan development for an individual patient. d. Using evidence gained solely from experimental studies to guide care.

ANS: B Feedback A B C D

Strict adherence to guidelines does not take the patient/family preferences into account. The QSEN competency for EBP is defined as integrating the best evidence with clinical expertise and patient/family preferences. EBP does not rely solely on expert knowledge or experimental studies. Although experimental studies provide the highest level of study data, EBP does not rely soley on experiemental studies..

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15. Through knowledge gained from her phenomenological qualitative study identifying levels of

experience of professional nurses, Patricia Benner would identify which nurse as an expert? a. A hospice nurse who values the unique wishes of each patient when providing palliative care. b. A medical-surgical nurse who organizes care for a group of patients to ensure timely administration of medications. c. A neonatal intensive care nurse who is skilled in inserting peripherally inserted central catheters. d. A pediatric nurse who notes subtle changes and intervenes to prevent respiratory failure. ANS: D Feedback A B C D

The proficient nurse views the patient as a whole and recognizes that each patient responds differently to illness and health. The competent nurse is able to achieve goals and plans and to take conscious actions to organize and provide efficient care. The NIC nurse is also an example of a competent nurse who is skilled in a procedure. The expert nurse has an extensive background of experience and is able to identify and accurately intervene skillfully in a situation. The pediatric nurse in this case recognizes subtle changes and is able to act to prevent serious circumstances.

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16. Which study exemplifies qualitative research? a. A study that evaluates appetite among residents of a long-term care facility and

correlates this data with whether or not residents are rooming together with their spouses. b. A study that defines levels of appetite based on residents’ descriptions of hunger in a long-term care facility. c. A study that observes the interactions of spouses during mealtimes in a long-term care facility.

d. A study that observes the effectiveness of spousal encouragement to eat on the

residents’ quality of appetite in a long-term care facility. ANS: C Feedback A B C D

Correlational studies are quantitative studies. A descriptive study that measures appetite is a quantitative study. Qualitative research involves the study of people as they interact in their sociohistorical settings. A measure of the effectiveness of an intervention is a quasi-experimental quantitative study.

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17. A nurse researcher wants to know how well adolescent mothers can learn to manage their

children’s asthma and develops an initial study to explore and define perceptions of asthma among this population. Which best describes this initial study? a. Correlational research b. Descriptive research c. Phenomenological research d. Outcomes research ANS: B Feedback A B

C D

Correlational research would attempt to make a connection between perceptions of asthma and a specific outcome. Descriptive research explores new areas of research and describes situations as they exist in the world. This initial study aims to describe current perceptions of asthma in a given population. Phenomenological research involves gaining deeper insights into perceptions and values, not simply describing them. Qualitative research does not attempt to define variables.

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18. Which research technique would be used by a nurse researcher who wishes to compare

bonding patterns of neonatal intensive care (NIC) infants to non-NIC infants to test various theories about infant-parent bonding? a. Experimental b. Exploratory c. Grounded-theory d. Quasi-experimental ANS: C Feedback A

Experimental and quasi-experimental techniques determine the effectiveness of

B C D

particular outcomes. Exploratory research is performed to describe a problem or issue. Grounded-theory research is performed to formulate, test, and refine a theory about a particular phenomenon. Phenomenological research involves gaining deeper insights into perceptions and values.

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19. What type of study design would be used to evaluate patient satisfaction in an outpatient

clinic? a. Exploratory-descriptive research b. Outcomes research c. Qualitative research d. Phenomenological research ANS: B Feedback A B C D

Exploratory-descriptive research is performed to address an issue or problems by describing the problem in detail. Outcomes research is designed to evaluate patient responses to interventions as well as satisfaction with care. Qualitative research is observational and involves describing patients in a particular setting. Phenomenological research involves gaining deeper insights into perceptions and values.

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20. The nurse researcher wishes to review a body of qualitative studies about women’s attitudes

toward health care in order to develop an overall interpretation of these findings. Which type of review will the nurse researcher use? a. Meta-analysis b. Meta-synthesis c. Mixed-methods systematic review d. Systematic review ANS: B Feedback A B C D

Meta-analyses are used to evaluate quantitative studies. A meta-synthesis is used to evaluate qualitative studies. A mixed methods systematic review is used to evaluate a variety of study designs. A systematic review is a structured, comprehensive synthesis of the research literature to determine the best research evidence available to address a health care question.

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21. Which type of evaluation of research yields the most precise estimates of treatment effects

when describing results? a. Meta-analysis b. Meta-synthesis c. Mixed-methods systematic review d. Systematic review ANS: A Feedback A

A meta-analysis is conducted to statistically combine or pool the results from previous quantitative studies into a single statistical analysis that provides one of the highest levels of evidence about an intervention’s effectiveness. Meta-synthesis is defined as the systematic compiling and integration of qualitative study results to expand understanding and develop a unique interpretation of study findings in a selected area. Mixed-methods systematic reviews might include a variety of study designs, such as qualitative research and quasi-experimental, correlational, and/or descriptive studies. A systematic review is a structured, comprehensive synthesis of the research literature to determine the best research evidence available to address a health care question.

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22. The nurse serves on a committee to develop a clinical protocol to guide dressing changes for

methicillin-resistant Staphylococcus aureus (MRSA) abscesses. Which is the most important type of evidence to consider when formulating this protocol? a. Assertions from a panel of infectious disease physicians about existing protocols to treat this organism. b. A statistical review of experimental studies comparing various dressing change protocols and patient outcomes. c. A systematic review of all nursing and medical literature about the incidence of MRSA infection and various dressing change protocols. d. Studies identifying the correlations between variables such as dressing types and subsequent infection rates. ANS: B Feedback A B C

Expert panel opinions are useful, but do not provide statistically significant evidence about interventions and results. A statistical review of experimental studies is a meta-analysis and is the strongest level of evidence. A literature review is an initial step in developing a protocol or designing a study.

Correlational studies are not as powerful as experimental studies.

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23. What role will a new nurse graduate who has a BSN expect to play in research? a. Appraising studies and implementing evidence-based guidelines and protocols. b. Developing, evaluating, and revising evidence-based guidelines and protocols. c. None, since the BSN affords limited education on the research process. d. Synthesizing findings and leading health care teams to make evidence-based

changes. ANS: A Feedback A B

The BSN prepares nurses to read and critically appraise research studies and to assist with implementation of evidence-based guidelines and protocols. Nurses with a Master of Science in Nursing (MSN) may revise or develop protocols and identify and critically appraise the quality of evidence-based studies. Nurses with a MSN are provided the educational preparation to critically appraise and synthesize findings from studies to revise or develop protocols, algorithms, or policies for use in practice (see Figure 1-4). They also have the ability to identify and critically appraise the quality of evidence-based guidelines developed by national organizations. Advanced practice nurses and nurse administrators have the ability to lead health care teams in making essential changes in nursing practice and in the health care system based on current research evidence. DPNs may lead health care teams to make evidence-based changes in practice.

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24. A job description for a nurse position in a teaching hospital includes “coordinating research

teams to facilitate studies to generate knowledge about nursing actions.” Which type of advanced nursing degree would be required for this position? a. Doctorate of Nursing Practice (DNP) b. Doctorate in Nursing (PhD) c. Master of Science in Nursing (MSN) d. Post-Doctorate in Nursing ANS: B Feedback A B

DNP-prepared nurses translate nursing research into practice. PhD-prepared nurses can critique, implement, plan, and develop new or revised guidelines, as well as generate and replicate knowledge via conduction of research. MSN-prepared nurses identify problems requiring research and may conduct studies, but usually in collaboration with other nurse scientists.

The difference between PhD and post-PhD is unclear—in this situation you are one and the same

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MULTIPLE RESPONSE 1. Which are components of Evidence-Based Practice (EBP)? (Choose all that apply.) a. Best research evidence b. Expert opinion consensus c. Patient needs and values d. Safe, cost-effective care ANS: A, C, D Feedback Correct

Incorrect

Best research evidence is used to formulate EBP. Patient needs and values are used to develop EBP. Safe, cost-effective care is a component of EBP. Expert opinion consensus is not a part of EBP.

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2. A nurse with a Bachelor of Science in Nursing (BSN) is prepared to do which of the

following? (Choose all that apply.) a. Appraise and summarize research findings b. Assist with the implementation of evidence-based guidelines c. Conduct independent nursing studies d. Expand the body of nursing knowledge through independent research ANS: A, B Feedback Correct

Incorrect

The BSN-prepared nurse is capable of appraising and summarizing research findings. The BSN-prepared nurse assists with the implementation of evidence-based guidelines. The BSN-prepared nurse does not conduct independent nursing studies. The BSN-prepared nurse does not expand the body of nursing knowledge through independent research.

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3. Which of the following is a research question for an experimental study? (Choose all that

apply.) a. What is it like to live with asthma? b. Do children who have an updated asthma action plan have fewer missed school days caused by asthma?

c. Which asthma triggers influence poor attitudes about chronic disease? d. Which bronchodilator medication has fewer side effects? ANS: B, D Feedback Correct

Incorrect

Determining which interventions reduce asthma sick days is a controlled, quantitative, experimental study design. A study about the effects of a medication is an experimental study. Asking what it is like to live with asthma will generate qualitative data. A study determining relationships between asthma triggers and attitudes about disease is a correlational study.

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Chapter 02: Introduction to the Quantitative Research Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. A researcher conducts a study which outlines the daily habits of women who are overweight.

This study represents what type of research? a. Correlational b. Descriptive c. Experimental d. Quasi-experimental ANS: B Feedback A B C D

Correlational research investigates the relationship between or among variables. Descriptive research is the exploration of phenomena in real-life situations. Experimental research is an objective, systematic, highly controlled investigation for the purpose of predicting and controlling phenomena. The purpose of quasi-experimental research is to examine causal relationships or determine the effect of one variable on another. Thus, these studies involve implementing a treatment or intervention and examining the effects of this intervention using selected methods of measurement.

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2. The researcher wants to learn whether there is a relationship between parental education and

emergency room use among children who have asthma. Which type of research study will this researcher use? a. Basic b. Correlational c. Historical

d. Phenomenological ANS: B Feedback A B C D

Basic research is scientific investigation that involves the pursuit of “knowledge for knowledge’s sake.” Correlational research investigates the relationship between or among variables. Historical research is a type of qualitative research. Phenomenological research is a type of qualitative research.

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3. The nurse evaluates a research study that examines the relationship between computer and

television screen time and obesity. A correlational analysis reveals a correlation of +0.95. What can the nurse conclude about the relationship between these two variables? a. An increase in screen time causes obesity. b. An increase in obesity leads to increased screen time. c. Screen time and obesity vary in opposite directions. d. Screen time and obesity vary together. ANS: D Feedback A B C D

Variables that vary in opposite directions will have a negative correlation. Descriptive research is the exploration of phenomena in real-life situations. Correlational studies do not indicate cause, so an increase in screen time or an increase in obesity does not cause or lead to an increase in the other. A positive correlation between variables indicates that the variables vary together.

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4. In which type of research does the researcher seek to examine causal relationships among

variables without being able to manipulate the variables? a. Descriptive b. Correlational c. Experimental d. Quasi-experimental ANS: D Feedback A B C D

Descriptive research is the exploration of phenomena in real-life situations. Correlational research investigates the relationship between or among variables but does not attribute cause. Experimental design is considered the most powerful quantitative design because of the rigorous control of variables. Quasi-experimental studies have less control than experimental studies, but they

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5. The nurse participates in data collection for a clinical drug trial in which subjects are

randomly assigned to either a treatment or a placebo group to measure the effects of the drug on a specific outcome. This is which type of study? a. Correlational b. Descriptive c. Experimental d. Quasi-experimental ANS: C Feedback A B C D

Correlational research investigates the relationship between or among variables but does not attribute cause. Descriptive research is the exploration of phenomena in real-life situations. Experimental design involves control of variables and random assignment of subjects so that effects of variables on specific outcomes can be measured. Quasi-experimental studies have less control than experimental studies, but they do exhibit some degree of control.

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6. A researcher studies the effect of asthma action plans on frequency of emergency department

visits for asthma-related symptoms. The study would be described as: a. applied research. b. basic research. c. descriptive research. d. phenomenological research. ANS: A Feedback A B C D

Applied research involves research that is directly applicable to clinical practice. Basic research is scientific investigation that involves the pursuit of “knowledge for knowledge’s sake.” Descriptive research is the exploration of phenomena in real-life situations. Phenomenological research would not investigate this type of research question. Phenomenological research asks “what is the lived experience of the person in this situation?”

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7. Basic research seeks to: a. directly influence clinical practice. b. generate knowledge for knowledge’s sake.

c. predict or control outcomes of variables. d. validate or test theoretical frameworks. ANS: B Feedback A B

C D

Applied research is used to solve problems, make decisions, or predict or control outcomes in real-life practice situations. Basic research is more likely to be found in a laboratory setting and generates knowledge for knowledge’s sake. It may be used as the foundation for other research. Experimental research is conducted in order to be able to predict or control outcomes Grounded theory research is used to validate theoretical frameworks.

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8. When developing a study, a researcher establishes rules for measurement of independent and

dependent variables in order to minimize the possibility of error. This is an example of: a. control. b. manipulation. c. precision. d. rigor. ANS: A Feedback A

B C D

Control involves the imposing of rules by the researcher to decrease the possibility of error and thus increase the probability that the study’s findings are an accurate reflection of reality. Manipulation is when the researcher makes changes in the treatment received by the subjects. Precision encompasses accuracy, detail, and order and is evident in the concise statement of the research purpose. Rigor is the discipline, attention to detail, and precision necessary when striving for excellence in research.

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9. In which type of research study does the researcher have the most control? a. Correlational b. Descriptive c. Experimental d. Quasi-experimental ANS: C Feedback A

Correlational research investigates the relationship between or among variables

B C D

but does not attribute cause. Descriptive research is the exploration of phenomena in real-life situations. Experimental design involves control of variables and random assignment of subjects so that effects of variables on specific outcomes can be measured. Quasi-experimental studies have less control than experimental studies, but they do exhibit some degree of control.

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which data collection takes place in the homes of mothers with premature newborns after discharge home from the NIC. This would be an example of which type of research setting? a. Highly controlled, field b. Highly controlled, laboratory c. Natural, field d. Partially controlled, laboratory ANS: C Feedback A

B C

There are three common settings for conducting research: natural, partially controlled, and highly controlled. A highly-controlled setting would involve experimental control of an independent variable, which this study does not do. This is a field study, with data collection occurring in patients’ homes and not in a laboratory. The setting describes where the research and data collection occur. A natural setting, or field setting, is an uncontrolled, real-life situation or environment, such as the home. In a natural setting, there is relatively little control over the setting and the variables associated with the setting. There are three common settings for conducting research: natural, partially controlled, and highly controlled. A natural setting, or field setting, is an uncontrolled, real-life situation or environment. This is a field study, with data collection occurring in patients’ homes and not in a laboratory

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11. When conducting a research study using a convenience sample of all first grade students from

two classrooms in a nearby school, the nurse researcher may increase the sample control by: a. assigning one classroom to the experimental group and the other classroom to the control group. b. exposing all subjects to the treatment variable and then comparing the outcome data to pretreatment data. c. randomly assigning students from both classrooms to either the experimental group or the control group. d. using all of these subjects as treatment subjects and comparing outcomes to a group of subjects from a similar study. ANS: C

Feedback A B C

Assigning one classroom to one group and the other classroom to the other group is less effective than random sampling. Pre- and post-treatment comparison may be used when random assignment is not possible. Randomly assigning subjects to either a treatment group or a control group improves sample control and decreases bias. Even when convenience sampling is used, subjects may be randomly assigned to groups. Comparing a treatment group to a group in another study does not control the treatment variables because of variations between two studies.

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12. A nurse is assisting with data collection for a study measuring the effects of a sleep aid

medication on oxygen saturations. Subjects will sleep in a darkened room in a sleep lab while participating. Which type of research setting is this? a. Field b. Highly controlled c. Natural d. Partially controlled ANS: B Feedback A B

C D

Field settings are uncontrolled, real-life situations or environments. A highly controlled setting is one in which the influence of extraneous variables is greatly reduced. Examples of such a setting would include laboratories, research or experimental centers, and test units in hospitals. Natural settings are uncontrolled, real-life situations or environments. Partially controlled settings are environments that the researcher has manipulated or modified in some way.

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13. A nurse researcher explains the relationships between research processes and the nursing

process to a group of graduate-level nursing students. Which statement by a nursing student indicates the need for further teaching? a. “Nursing research leads to evidence-based nursing practice guidelines.” b. “Nursing research has a broader focus than the nursing process.” c. “The nursing process helps to identify potential nursing research problems.” d. “The nursing process requires rigorous application of research methods.” ANS: D Feedback A B

Nursing research may be used to develop evidence-based nursing practice guidelines. Nursing research has a broader focus than the nursing process and is generally

C D

population based rather than individual based. The nursing process can help to identify nursing research problems. The nursing process may be based on research, but does not require the rigorous application of research methods.

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14. Research subjects in a study of body image after mastectomy will complete a questionnaire

about body image after surgery. Which assumption would the researcher likely make when conducting this study? a. All mastectomy patients are likely to be negatively affected by the surgery. b. Body image and appearance are important to survivors of breast cancer. c. Subjects will be able to describe a personal awareness of body image. d. Subjects will complete every item on the questionnaire. ANS: C Feedback A

The researcher does not indicate that negative effects of mastectomy are an assumption of the study. The results of the study may indicate whether this is true or not. The researcher does not indicate that the importance of body image an appearance is an assumption of the study. The results of the study may indicate whether this is true or not. Assumptions are statements taken for granted or considered true, even though they have not been scientifically tested. The researcher will assume that subjects have an awareness of this concept. The researcher does not indicate that this is an assumption of the study. It is undoubtedly hoped for to get complete data.

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15. Statements that will be scientifically tested as part of a research study are called: a. assumptions. b. hypotheses. c. limitations. d. variables. ANS: B Feedback A B C D

Assumptions are statements that are taken for granted or considered true, even though they have not been scientifically tested. Hypotheses are the researcher’s best guess as to the outcome of the study. Limitations are factors in the study that cannot be controlled or manipulated, but might have an influence on the outcome. Variables are the factors influencing the hypotheses that the researcher wants to investigate.

PTS: 1 REF: pp. 42-44

DIF: Cognitive level: Remembering (Knowledge)

16. A study that analyzes the effect of exercise on diabetes control among Native-American

children with type II diabetes would most credibly be generalizable to which population? a. African-Americans with type II diabetes b. Native-American children with type I diabetes c. Children with type II diabetes d. All people with type II diabetes ANS: B Feedback A B

C D

The population that the sample represents does not include all African-Americans with type II diabetes. Generalization is the extension of the implications of the research findings from the sample to a larger population. The population represented in the study is Native-American children, so the results of this study may be generalized to this population. The population that the sample represents does not include all children with type II diabetes. The population that the sample represents does not include all patients with type II diabetes.

PTS: 1 REF: p. 46

DIF: Cognitive level: Understanding (Comprehension)

17. To evaluate data collection methodology prior to conducting a large-scale study, a researcher

might carry out a smaller-scale study. This smaller-scale study is known as a/an: a. abstract. b. exploratory design. c. pilot study. d. proposal. ANS: C Feedback A B C D

The abstract is a synopsis of the study found at the beginning of a research report. Exploratory design is used when the total situation is unclear. A pilot study is frequently defined as a smaller version of a proposed study conducted to refine the methodology. A proposal is a formal request to conduct a study; it can be submitted to obtain funds or get feedback on the study’s methodology.

PTS: 1 REF: p. 45

DIF: Cognitive level: Understanding (Comprehension)

18. The nurse researcher is developing a study to examine the effects of asthma education on

missed school days among grade school children. When defining the research problem in the research proposal, the nurse will discuss: a. the proposed methodologies for data collection. b. statistics about the number of school days missed by children with asthma. c. the costs and types of various medications to treat asthma symptoms. d. the need for future studies to examine asthma care for this population. ANS: B Feedback A B C D

The discussion about proposed methodologies is part of the study design. When describing the research problem, the researcher identifies an area of concern for a particular population. The costs and types of medications would be included in background information, but this discussion does not identify the research problem. The discussion about the need for further studies is part of the discussion and summary.

PTS: 1 REF: p. 41

DIF: Cognitive level: Applying (Application)

19. Which portion of a research report would the nurse initially read to get an overview of the

study? a. Abstract b. Conclusion c. Framework d. Methodology ANS: A Feedback A

B C D

The research report usually begins with an abstract: a clear, concise summary of a study, including the research problem and purpose, methodology, and conclusions. The reader can gain an understanding of the study by reading the abstract. Conclusions are presented at the end of the report and describe the findings based on the data collection and data analysis. The framework is present later in the study report and tells about the foundation of the study. The methodology is in the middle part of the report and describes the study methods, tools, data collection, and analysis.

PTS: 1 REF: p. 51

DIF: Cognitive level: Applying (Application)

20. The section of a research report that describes the purpose of a research study will include: a. what relationships among key variables will be examined. b. which various theories provide context for the research problem. c. what is currently understood about the research problem. d. why the research is necessary to help close a gap in knowledge.

ANS: A Feedback A B C D

The research purpose is a statement generated from the research problem identifying the specific focus of goal of the study. The theoretical framework identifies how theories provide context for the research question. The literature review identifies what is currently known about the research problem. The research problem is a statement about why the research is necessary to close gaps in knowledge.

PTS: 1 REF: p. 41

DIF: Cognitive level: Analyzing (Analysis)

21. A researcher conducts a review of relevant literature prior to developing a research study in

order to: a. avoid duplication of research ideas. b. determine which theoretical framework is best adapted to the research problem. c. determine which type of study would be most cost-effective. d. identify what is known and unknown about a particular problem. ANS: D Feedback A

B C D

The literature review identifies what is known and may describe past studies, but is not necessarily performed to avoid duplication of research ideas since many studies are replicated in order to confirm results. The literature review does not evaluate the theoretical framework. The literature review does not determine cost-effectiveness of a study. The literature review is conducted in order to identify what is already known about a research problem and to document why a research study needs to be conducted.

PTS: 1 REF: pp. 41-42

DIF: Cognitive level: Applying (Application)

22. In a qualitative study to describe stages of grief, the researcher asks parents who have lost a

child to cancer to describe their experiences with grief at specific time intervals after their children’s deaths. Which assumption will the researcher make? a. Study subjects have knowledge about theoretical concepts about grief. b. Study subjects understand the concept of grief. c. Subjects will be able to articulate their feelings coherently. d. Subjects will be available for data collection at specific time intervals. ANS: B Feedback A

Subjects who know what grief is do not necessarily have an understanding of theoretical concepts about grief.

B C

A researcher may make an assumption that study subjects will understand the concept of grief. Although it is desired that subjects will be able to articulate their feelings or be available at specific intervals, there is no assumption that they will be able to do so. Subjects may not always be available at specific intervals.

PTS: 1 REF: pp. 42-43

DIF: Cognitive level: Understanding (Comprehension)

23. How is theory tested in quantitative research? a. Assumptions about the theoretical framework are evaluated. b. Concepts become more clearly defined as they are tested. c. Relationships among concepts are tested. d. The entire theory is proven or disproven. ANS: C Feedback A B C D

Assumptions are statements that are taken for granted and are not tested in research. Concepts are defined prior to initiating research. In quantitative research, relational statements between two or more concepts are tested, not the entire theory. Quantitative studies do not prove or disprove an entire theory, just relationships among key concepts.

PTS: 1 REF: pp. 42-43

DIF: Cognitive level: Applying (Application)

24. An operational definition of a variable or concept ensures that the variable or concept will be: a. given theoretical meaning. b. linked to other variables or concepts. c. measured or manipulated. d. understood in context of a theoretical framework. ANS: C Feedback A B C D

A conceptual definition of a concept gives that concept theoretical meaning. The research question links concepts and variables to other concepts and variables. An operational definition of a concept allows the concept to be measured or manipulated. The operational definition does not necessarily give meaning to a concept in the context of a theoretical framework.

PTS: 1 REF: p. 44

DIF: Cognitive level: Analyzing (Analysis)

25. In a research proposal, when describing a research design, the researcher would include:

a. b. c. d.

discussion of a theoretical framework. evaluation of the researcher’s expertise. methods for measurement of variables. purpose of the study.

ANS: C Feedback A B C D

The theoretical framework is discussed in the theory section. The evaluation of the researcher’s expertise is part of the discussion. In the research design, the researcher will describe how variables are measured along with sampling procedures and plans for data collection and analysis. The purpose of the study is discussed in the introduction and purpose section.

PTS: 1 REF: p. 45

DIF: Cognitive level: Analyzing (Analysis)

26. Prior to initiating a large-scale research study, the researcher conducts a small-scale study

using similar subjects, methods, instruments, measurements, and analysis. This is done in order to: a. define the conceptual framework of the study. b. determine the quality of the study components. c. link study variables to one another. d. provide a study design. ANS: B Feedback A B C D

The pilot is not performed to define the conceptual framework of the study. A pilot study is performed on a smaller scale in order to determine the quality of the study components before the study is conducted on a larger scale. The pilot does not necessarily link study variables to one another and is not the purpose of performing a pilot study. The pilot study tests components of the study design, which has already been determined.

PTS: 1 REF: p. 45

DIF: Cognitive level: Analyzing (Analysis)

27. The methodology portion of the research report is used to: a. describe the study design. b. discuss the implications of the study. c. provide a theoretical framework for the study. d. summarize the purpose, methods, and results. ANS: A Feedback A B

In the methodology section, the researcher describes the study design including sampling methods, measurement of variables, data collection, and data analysis. The implications of the study are explored in the discussion section.

C D

The theoretical framework is discussed in the introduction. The summary is discussed in the conclusion.

PTS: 1 REF: p. 45

DIF: Cognitive level: Understanding (Comprehension)

28. When the researcher describes the population of a study, the research consumer understands

that this represents: a. all members of the population at large. b. all people who meet inclusion criteria for the study. c. members of the study group and the control group. d. subjects selected for the study based on sampling techniques. ANS: B Feedback A B C D

Not all members of the population at large meet inclusion criteria and those who do not are not considered part of the population being studied. The population is all people who meet inclusion criteria for the study whether they are sampled and included or not. Members of the study and control group are the sample of the population selected for participation in the study. Subjects selected for the study are a representative sample of the population.

PTS: 1 REF: p. 46

DIF: Cognitive level: Applying (Application)

29. When a researcher describes an instrument as being valid this indicates that the instrument: a. accurately measures a variable. b. consistently measures variables across studies. c. has been described as high quality by other researchers. d. has been routinely used in other, similar studies. ANS: A Feedback A B C D

When an instrument is valid, it is considered to be accurate. Reliability of an instrument means that it is consistent across studies. Quality of the instrument is not defined by validity measures. Frequency of use of the instrument is not defined by validity measures.

PTS: 1 REF: pp. 46-47

DIF: Cognitive level: Analyzing (Analysis)

30. When noting the limitations of a research study, the nurse might make which observation? a. Abstract concepts were defined using concrete, consistent terms. b. Findings could not be generalized to a population not included in the study. c. The researcher included a discussion of the links between the study’s variables. d. The subjects were randomly assigned to control and experimental groups. ANS: B

Feedback A B C D

The definition of concepts does not address the limitations of a study. Limitations are restrictions in a study methodology or framework that may decrease the credibility and generalizability of the findings. The theoretical framework contains a discussion about the links between study variables. Random assignment to control or experimental groups increases the likelihood that the study’s findings may be generalized to a larger population.

PTS: 1 REF: pp. 47-48

DIF: Cognitive level: Analyzing (Analysis)

31. The purpose of a study abstract is to: a. describe the reason for conducting the study. b. outline the theoretical framework that defines the study. c. summarize a study concisely and capture the reader’s attention. d. summarize previous research about the study’s topic. ANS: C Feedback A B C D

The research purpose describes the reason for conducting the study. The theoretical framework clarifies links among variables. An abstract is a clear, concise summary of a study which, researchers hope, will capture the reader’s attention. The literature review summarizes previous research.

PTS: 1 REF: p. 51

DIF: Cognitive level: Understanding (Comprehension)

32. In a study about concussion recovery in high school football players, which statement would

be part of the introduction? a. “The Functional Independence Measure was used to measure postconcussion symptoms.” b. “The purpose of this study was to determine average length of recovery time after a first concussion.” c. “The results of this study showed an average recovery time of 6 weeks among football players.” d. “The study included a convenience sample of high school football players in a five-county area.” ANS: B Feedback A B C D

The methods section contains descriptions of the tools used as well as the sampling methods. The introduction section contains a statement about the study purpose. The conclusion section includes statements about the results of the tests performed. The methods section contains descriptions of the tools used as well as the

sampling methods. PTS: 1 REF: p. 52

DIF: Cognitive level: Analyzing (Analysis)

33. If a nurse wishes to critically appraise a study’s sampling criteria and measurement tools, the

nurse will read which part of the study report? a. Abstract b. Introduction c. Methods d. Results ANS: C Feedback A B C D

The abstract contains a concise description of the entire study. The introduction section contains a statement about the study purpose. The methods section contains descriptions of the tools used as well as the sampling methods. The results section includes statements about the results of the tests performed.

PTS: 1 REF: p. 53

DIF: Cognitive level: Applying (Application)

34. To learn whether there is a statistically significant difference between the control group and

the experimental group in a study, the nurse would review which section of the research report? a. Introduction b. Methods c. Purpose d. Results ANS: D Feedback A B C D

The introduction section contains a statement about the study purpose. The methods section contains descriptions of the tools used as well as the sampling methods. The purpose section contains a discussion of the reason for conducting the study. The results section includes statements about the results of the tests performed and includes statements about the statistical significance of the differences among the variables.

PTS: 1 REF: p. 53

DIF: Cognitive level: Applying (Application)

35. To help determine the relevance of a study to practice, it is recommended that the reviewer

read which two sections of the study initially? a. Abstract, discussion b. Conclusions, references c. Literature review, purpose

d. Methods, results ANS: A Feedback A B C D

Scanning the abstract or introduction and then the discussion will give an overview of the study’s findings. The conclusions and references may be read partly or in full after skimming the abstract and discussion. The literature review and purpose may be read partly or in full after skimming the abstract and discussion. The methods and results may be read partly or in full after skimming the abstract and discussion.

PTS: 1 REF: pp. 54-55

DIF: Cognitive level: Applying (Application)

36. The author of a research report describes the research problem in order to: a. conceptualize the research project. b. guide the development of the study methods. c. determine the goals and focus of the study. d. identify gaps in knowledge. ANS: D Feedback A B C D

The theoretical framework serves to conceptualize the research project. The methodology section outlines the development of study methods. The research purpose identifies the goals and focus of the study. The research problem statement identifies gaps in current knowledge about the subject.

PTS: 1 REF: pp. 52-53

DIF: Cognitive level: Applying (Application)

MULTIPLE RESPONSE 1. Which of the following are true statements about quantitative research? (Choose all that

apply.) a. Correlational research involves the use of statistics to determine relationships among variables. b. Experimental research is the only type of quantitative research that is valid. c. Quasi-experimental research is a useful option when controlled conditions are not possible. d. Statistical tests are employed with quantitative research studies. ANS: A, C, D Feedback Correct

Correlational research involves statistical analysis of variables using correlational statistics.

Incorrect

Quasi-experimental research is a useful option when controlled conditions are not possible. Statistical tests are employed with quantitative research studies. Experiments are only one form of quantitative research.

PTS: 1 REF: p. 33

DIF: Cognitive level: Understanding (Comprehension)

2. What study design involves no intervention on the part of the researcher? (Choose all that

apply.) a. Correlational b. Descriptive c. Experimental d. Quasi-experimental ANS: A, B Feedback Correct Incorrect

A correlational study does not involve interventions by the researcher. A descriptive study does not involve interventions by the researcher. An experimental study involves a highly controlled intervention. A quasi-experimental study involves a controlled intervention.

PTS: 1 REF: pp. 36-37

DIF: Cognitive level: Analyzing (Analysis)

3. The nurse researcher submits a proposal for an initial study to evaluate the effects of regular

moderate exercise on asthma control scores in adolescents with asthma. To achieve increased control in the initial study, the researcher will do which of the following? (Select all that apply.) a. Ask subjects to keep track of time spent exercising in a journal. b. Have subjects exercise on treadmills in the clinic three times weekly. c. Choose subjects classified as having moderate intermittent asthma symptoms. d. Limit participants to adolescent males who have asthma. ANS: B, C, D Feedback Correct

Incorrect

PTS: 1 REF: p. 37

To control variables, the researcher should have subjects participate in the action in as controlled a setting as possible. Having participants exercise in the clinic allows for better control and evaluation of the degree of exercise. Limiting subjects to those who have similar symptoms will help limit extraneous variables that might be attributed to differences in asthma severity or any differences attributed to gender. Asking subjects to record unsupervised exercise limits the degree of control of this variable. DIF: Cognitive level: Analyzing (Analysis)

4. The nurse participates in data collection in a study comparing the effect of two antilipidemia

medications on total cholesterol in patients with hyperlipidemia. Which are extraneous variables to consider in such a study? (Select all that apply.) a. Differences between the antilipidemia medications. b. Family history of hyperlipidemia. c. Individual patients’ weights. d. Other serum lipid values. ANS: B, C, D Feedback Correct

Incorrect

One variable that can affect the study outcome is family history of hyperlipidemia in study participants. Patients who are obese may have different outcomes related to this variable than the reactions of those who are not obese. Other serum lipid values, such as high-density lipoproteins or low-density lipoproteins, can affect total cholesterol. The differences between the two medications are controlled in this study and are not extraneous variables.

PTS: 1 REF: p. 37

DIF: Cognitive level: Applying (Application)

Chapter 03: Introduction to the Qualitative Research Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. What role does qualitative research play in evidence-based practice (EBP)? a. Because it does not involve random-controlled trials (RCTs), it does not contribute

directly to EBP. b. It offers a systematic approach for yielding insights into human experience and

behavior. c. It provides a way to measure and evaluate quality outcomes that affect patient care. d. It provides the basis for most EBP guidelines and patient care protocols. ANS: B Feedback A B

C D

Many insights gained through qualitative studies are used to develop theories on which RCTs may be based. Qualitative research offers a systematic approach for collecting data about and evaluating human perception and experience that cannot be achieved through experimental research. Qualitative research is not concerned solely with outcomes research, which looks at the effects of nursing interventions on patient care outcomes. RCTs are the basis for most EBP guidelines and protocols

PTS: 1 REF: p. 67

DIF: Cognitive level: Understanding (Comprehension)

2. A researcher identifies a socioeconomic group of people to study. After developing a rapport

with key members of the group, getting information about group members from the key members, and spending time working among group members, the researcher develops theories about the group based on this experience. Which type of qualitative research does this represent? a. Ethnographic b. Grounded theory c. Historical d. Phenomenological ANS: A Feedback A

C D

Ethnographic research was developed by anthropologists as a mechanism for studying cultures and involves immersion in the group in order to make observations and get information. Grounded theory research is an inductive technique that emerged from the discipline of sociology. Ethnographic research was developed by anthropologists as a mechanism for studying cultures. Historical research examines events of the past. Ethnographic research was developed by anthropologists as a mechanism for studying cultures. Phenomenological research describes experiences as they are lived. Ethnographic research was developed by anthropologists as a mechanism for studying cultures.

PTS: 1 REF: pp. 74-75

DIF: Cognitive level: Applying (Application)

3. What is true about phenomena in qualitative research? a. Human behavior is generally the result of the direct influence of independent

variables. b. Knowledge gained by qualitative research is concrete and derived from statistical data. c. Multiple realities are possible based on meanings created by individuals and groups. d. Time and context have very little influence on individual or group perspectives. ANS: C Feedback A B C

Human behavior is complex and not just the result of the influence of independent variables. Knowledge gained in qualitative research is less concrete than that gained through quantitative research. The understanding of phenomena in qualitative research is not the same as in quantitative research. In qualitative research, multiple realities, based on individual and group meanings, may be derived from research data. Phenomena in qualitative research are considered unique to the individual and in the time and the context that they occur.

PTS: 1 REF: p. 67

DIF: Cognitive level: Understanding (Comprehension)

4. A researcher conducts a qualitative study and learns that individuals have a variety of

reactions to an event. What can the researcher conclude from this finding? a. The findings are interesting, but are not useful for theory development. b. The reactions described in this study may be generalized to a larger population. c. The study has little significance since there is no well-defined single outcome. d. The variety of reactions is expected since perception varies with individuals. ANS: D Feedback A B C D

Findings in qualitative studies are often used to guide initial theory development whose constructs are later tested through experimental studies. Reactions in qualitative studies do not have statistical significance and cannot be generalized to a larger population. Even without a well-defined outcome, the results do have significance and contribute to the larger body of scientific knowledge. Because meaning is subjective, there can be multiple realities in qualitative research, which seeks to learn how individuals and groups respond to experiences.

PTS: 1 REF: p. 67

DIF: Cognitive level: Applying (Application)

5. A researcher develops a study to examine various phenomena that contribute to theory

development. This is an example of which type of research? a. Ethnographic research b. Grounded theory research c. Historical research d. Phenomenological research ANS: B Feedback A B C D

Ethnographers observe and document interactions within a culture. Grounded theory develops theory directly from the research data. Historical research examines events of the past. Phenomenological research attempts to capture the “lived experience” of study participants.

PTS: 1 REF: p. 67| p. 70

DIF: Cognitive level: Applying (Application)

6. A researcher conducts a study to examine the feelings of cancer patients at various points

during their disease, including at diagnosis, when beginning chemotherapy, and during remission. Which type of study will the researcher use for this study? a. Ethnographic b. Grounded Theory

c. Historical d. Phenomenological ANS: D Feedback A B C D

PTS: 1 DIF: Cognitive level: Applying (Application) REF: p. 67| pp. 69-70 7. What is true about scientific rigor in qualitative nursing research? a. Studies are rigorous only when results are quantifiable. b. Study findings are considered trustworthy when rigor is applied. c. Scientific rigor is not applicable with qualitative studies. d. Scientific rigor is only used with random-controlled trials. ANS: B Feedback A B C D

Rigor can be applied to qualitative research. Rigor is valued because the findings of rigorous studies are seen as being more credible and of greater worth. Rigor can be applied to both qualitative and quantitative research. Rigor is used with qualitative research.

PTS: 1 REF: p. 68

DIF: Cognitive level: Remembering (Knowledge)

8. When designing a study, which has the greatest influence as a researcher decides which type

of qualitative study design to use? a. Funding and resources b. Literature review c. Population d. Research question ANS: D Feedback A B C D

Funding and resources influence the size of the population and the types of measures that may be employed. The literature review and the population do not influence the study design directly. The literature review and the population do not influence the study design directly. Deciding which qualitative approach to use depends on the research question and the purpose of the study.

PTS: 1 REF: p. 68

DIF: Cognitive level: Understanding (Comprehension)

9. A researcher wishes to learn about the experiences that women have when breastfeeding their

infants in the workplace. Which type of study design will the researcher employ? a. Ethnographic b. Exploratory-descriptive c. Grounded theory d. Historical ANS: B Feedback A B C D

Ethnographers observe and document interactions within a culture. Exploratory-descriptive studies are used when researchers are exploring a new topic or describing a situation. Grounded theory develops theory directly from the research data. Historical research examines events of the past.

PTS: 1 REF: pp. 76-77

DIF: Cognitive level: Applying (Application)

10. A researcher who bases phenomenological research on Husserl’s philosophy will: a. incorporate personal biases into conclusions and discussion of the research. b. interpret subjects’ experiences according to the researcher’s own biases. c. place personal biases aside when considering and reporting research findings. d. use personal biases to look for hidden meanings in research data. ANS: C Feedback A B C

This is not an accurate statement. This is not an accurate statement. According to Husserl, to capture the “lived experience” of study participants, the researcher must set aside personal biases to describe the phenomena in a naïve way. Heidegger describes ways that personal biases are incorporated into qualitative research. This is not an accurate statement.

PTS: 1 REF: pp. 69-70

DIF: Cognitive level: Understanding (Comprehension)

11. What is a key element of hermeneutics in research? a. Analysis of documents and interviews to identify themes and subthemes in data b. Bracketing of the researcher’s own perceptions for the duration of the study c. Description of phenomena without interpretation by the researcher d. Focusing solely on phenomena themselves without consideration of biases ANS: A

Feedback A

C D

Hermeneutics is a type of interpretive phenomenological research method that involves textual analysis and identification of themes and subthemes present in interviews and published documents in light of the study’s research questions. Husserl suggested that the researcher must bracket personal biases in order to examine the research data. Husserl differs from Heidigger in this regard.Heidigger argued that it is impossible to set aside beliefs and biases. Heidigger’s approach is interpretive and is part of hermeneutics. Heidigger believed that researchers cannot set aside their biases.

PTS: 1 REF: pp. 69-70

DIF: Cognitive level: Analyzing (Analysis)

12. When performing an external criticism of the documents used in historical research, the

reviewer must determine whether the documents are: a. genuine or fraudulent. b. interesting or dull. c. well known or obscure. d. written by authors who are still living. ANS: A Feedback A B C D

External criticism determines the validity of source material. Whether or not the document is interesting has little to do with the importance of the document. As long as the document is genuine and of interest to the study, whether it is well known or not is irrelevant. Although it might be useful to know whether or not the writers of the document are living, this does not relate to external criticism.

PTS: 1 REF: pp. 78-79

DIF: Cognitive level: Applying (Application)

13. What is true about grounded theory research? a. It is a method used to quantify theoretical constructs in theory development. b. It is used to further research in areas where much concrete data is already known. c. Study designs use a theoretical basis to develop the research questions. d. Theory is developed from the data collected during the research. ANS: D Feedback A B C D

Experimental studies are used to quantify theoretical constructs to test theories. Grounded theory research is preliminary and is often used when little is known about a subject. Theory is developed from the research findings of grounded theory research. Grounded theory develops theory directly from the research data.

PTS: 1

DIF: Cognitive level: Understanding (Comprehension)

REF: p. 70 14. A researcher wishes to understand how inner-city Somali immigrants adapt health care

practices into their experiences with the U.S. health care system. Which type of study approach will the researcher use? a. Descriptive-qualitative b. Ethnographic c. Grounded theory d. Phenomenological ANS: B Feedback A B C D

Exploratory-descriptive studies are used when researchers are exploring a new topic or describing a situation. Ethnographic research involves observation and documentation of interactions within a culture. Grounded theory develops theory directly from the research data. Phenomenological research attempts to capture the “lived experience” of study participants.

PTS: 1 REF: pp. 70-71

DIF: Cognitive level: Applying (Application)

15. Which is an example of an etic approach in an ethnographic study? a. A longitudinal study examining individual immigrants’ attitudes about health care b. A study about African tribal women and their feelings about HIV prevention c. A study comparing various ethnic groups’ folk health practices d. A study of differences between BSN- and AND-prepared nurses’ attitudes about

health care ANS: C Feedback A B C D

A study of immigrants’ attitudes about health care is a phenomenological study. A study examining a particular cultural group is an ethnographic study. The etic approach involves studying behavior from outside the culture and examining similarities and differences across cultures. A study of attitudes about health care is a phenomenological study.

PTS: 1 REF: p. 74

DIF: Cognitive level: Applying (Application)

16. Which qualitative study will call for an exploratory-descriptive study approach? a. An evaluation of clinical outcomes of standard nursing interventions b. An examination of the effects of a treatment on various ethnic groups c. A review of data in order to evaluate theoretical constructs d. A study on a topic about which little is known or understood ANS: D

Feedback A B C D

Outcomes research is concerned with clinical outcomes of standard interventions. Comparing the effects of a treatment on two groups of subjects is a quasi-experimental design. Theory testing uses data to evaluate theoretical constructs. Exploratory-descriptive studies are used when researchers are exploring a new topic or describing a situation.

PTS: 1 REF: pp. 77-78

DIF: Cognitive level: Analyzing (Analysis)

17. A researcher utilizes an emic approach in a research study in order to: a. gather data about lived experiences of individuals. b. trying to understand behaviors from within a culture. c. examine individual human behavior according to personal biases. d. use techniques such as bracketing and intuiting. ANS: B Feedback A

B C

Phenomenological research attempts to capture the “lived experience” of study participants. The emic approach involves studying behaviors from within a culture. The emic approach involves studying behaviors from within a culture. The etic perspective studies behaviors from outside the culture and examines similarities and differences across cultures. (The emic approach involves studying behaviors from within a culture.) The ethnographic approach looks at groups, not individual behaviors. Bracketing and intuiting are techniques used rather than the focus of a study. The emic approach involves studying behaviors from within a culture.

PTS: 1 REF: p. 74

DIF: Cognitive level: Understanding (Comprehension)

18. The goal of grounded theory research is to: a. develop theories and hypotheses based on research findings. b. establish an ethnographic perspective on subjects. c. provide validity checks for constructs. d. test theoretical constructs and hypotheses. ANS: A Feedback A B C D

Theory developed from grounded theory research is “grounded” in the data from which it was derived. An ethnographic perception of research is part of an ethnographic perspective. Validity checks for constructs are not the concern of grounded theory research. Theory testing uses data to evaluate theoretical constructs.

PTS: 1

DIF: Cognitive level: Understanding (Comprehension)

REF: p. 74 19. A researcher wishes to examine the experiences and feelings of siblings of children who have

cancer in order to gain information about this population. Which type of qualitative study method will the researcher use? a. Ethnographic b. Exploratory-descriptive c. Grounded theory d. Historical ANS: B Feedback A B C D

Ethnographic research involves observation and documentation of interactions within a culture. Exploratory-descriptive studies are used when researchers are exploring a new topic or describing a situation. Grounded theory develops theory directly from the research data. Historical research uses historical documents to describe events.

PTS: 1 REF: pp. 77-78

DIF: Cognitive level: Applying (Application)

20. When conducting historical research about the experiences of women refugees from the

Sudan, the researcher interviews women who served as nurses among this population. These nurses represent: a. control group subjects. b. experimental group subjects. c. primary data sources. d. secondary data sources. ANS: D Feedback A B C

Control and experimental group subjects are used in experimental, quantitative, and not in qualitative studies. Control and experimental group subjects are used in experimental, quantitative, and not in qualitative studies. Primary data sources are those gathered directly from the study subjects and can either be from direct interviews or from diaries or other documents written by the subjects. A secondary data source can be a person who lived at the same time or who had contact with the subjects of the study. Nurses who cared for Sudanese woman immigrants would be secondary sources for this population.

PTS: 1 REF: pp. 78-79

DIF: Cognitive level: Applying (Application)

21. When conducting research about the experiences of early advanced practice nurses, the

researcher may consult which possible secondary source? a. A textbook history of early advanced practice nurses

b. Currently practicing advanced practice nurses c. Former patients of early advanced practice nurses d. The scope of practice guidelines for advanced practice nursing ANS: C Feedback A B C D

A textbook history may itself use primary and secondary data sources. Currently practicing APRNs rely on primary and secondary sources for their information, but are not themselves sources of historical information. A secondary data source can be a person who lived at the same time or who had contact with the subjects of the study. The scope of practice guidelines may use historical information, but it is not a historical document.

PTS: 1 REF: pp. 78-79

DIF: Cognitive level: Applying (Application)

22. What are subjects in qualitative research studies usually called? a. Experimental subjects b. Participants c. Primary sources d. Secondary sources ANS: B Feedback A B C D

Experimental subjects are subjects who are part of experimental studies. Subjects in qualitative studies are referred to as participants because the researcher and the participants cooperatively carry out the study. Primary sources are subjects in historical studies who actually lived the experiences being described. Secondary sources are people who knew or worked closely with primary sources in historical research.

PTS: 1 REF: pp. 81-82

DIF: Cognitive level: Remembering (Knowledge)

23. How are subjects selected for qualitative research studies? a. As volunteers through advertising for subjects b. Based on knowledge or experience c. By random sampling methods d. Through convenience sampling ANS: B Feedback A B C

Subjects tend to be recruited and do not necessarily volunteer. Subjects in qualitative research studies are selected based on their knowledge or experience or for their views related to the study. Random sampling techniques are not generally used in qualitative research.

Convenience samples are used when random sampling techniques are not possible and generally in qualitative research. Subjects in qualitative research are selected based on knowledge or experience.

PTS: 1 REF: p. 82

DIF: Cognitive level: Understanding (Comprehension)

24. What is the researcher-participant relationship in qualitative research? a. Attaching personal meanings of the researcher to subjects’ responses b. Controlling subjects’ responses by stating the aims of the study c. Creating empathetic and honest relationships with study subjects d. Keeping a distance to avoid skewing research findings ANS: C Feedback A B C

It is necessary for the researcher to be open to the perceptions of the participants. The researcher tries to avoid controlling the subjects’ responses. In qualitative research, the researcher creates a respectful relationship with each participant that includes being honest and open about the study’s purpose and methods. The researcher does not maintain a detached distance as with quantitative studies, but must become closely involved in the subject’s experience in order to interpret it.

PTS: 1 REF: p. 82

DIF: Cognitive level: Analyzing (Analysis)

25. What type of data collection method is most common in qualitative research? a. Distribution and review of questionnaires from subjects b. Interviews with and observation of subjects c. Participation and immersion in the lives of subjects d. Review of historical documents and literature about subjects ANS: B Feedback A B

C D

Questionnaires are used occasionally, but are often used in quantitative research as well. Because the data in most qualitative studies are the participant’s thoughts, ideas, and perceptions, data collection is most often done by interviewing and observing participants. Ethnographic research is a less common type of qualitative research and involves participation and immersion in the lives of subjects. Historical research is a type of qualitative research that involves review of historical documents and literature.

PTS: 1 REF: p. 83

DIF: Cognitive level: Understanding (Comprehension)

26. During a qualitative research study, a researcher asks subjects a fixed set of questions to

which the participants respond freely. This is an example of a(n): a. open-ended interview. b. semi-structured interview. c. structured interview. d. unstructured interview. ANS: B Feedback A B C D

An open-ended interview is unstructured and, while the researcher defines the focus of the interview, there may be no fixed sequence of questions. A semi-structured interview involves a fixed set of questions with no fixed responses. A structured interview involves a fixed set of questions with a fixed set of answers. An unstructured interview may not have fixed questions or answers.

PTS: 1 REF: pp. 83-84

DIF: Cognitive level: Applying (Application)

27. What may characterize questions asked by the researcher during an exploratory-descriptive

study? a. A focus on participants’ biographical information b. Using structured individual questions c. One main question with –follow-up questions d. Open-ended questions with probes to follow up ANS: B Feedback A B C

Ethnographic researchers will focus on biographical data. In an exploratory-descriptive study, the researcher may ask more structured questions to achieve the purpose of the study. Interviews in a phenomenology study may have one main question with follow-up questions used as needed to elicit the participant’s perspective on the phenomenon. Phenomenological research interviews begin with open-ended questions followed up with more probing questions to elicit participant’s perspectives.

PTS: 1 REF: pp. 83-84

DIF: Cognitive level: Applying (Application)

28. A researcher investigates how nurses in a rural hospital regard the importance of asthma

education using an ethnographic approach. Why was this approach appropriate? a. To find out what it was like for nurses to provide this education b. To explore the theoretical basis of asthma education c. To improve understanding of how these nurses define asthma education d. To look at the history of asthma education to shed light on current practice ANS: C

Feedback A B C

A study to learn what it is like to do something would be best learned through an exploratory study. Grounded theory research explores the theoretical basis for interventions. The ethnographic approach looks at phenomena within a certain culture, in this case the hospital, and seeks to describe how that culture deals with the subject of interest. Historical research studies the history of an intervention.

PTS: 1 REF: p. 74

DIF: Cognitive level: Analyzing (Analysis)

29. When appraising a study in which data was collected by interview, the reviewer will assess

for: a. b. c. d.

adequate length of time for each interview. evidence that prompts were not used to encourage responses. use of clinical setting for conducting interviews. utilization of payment for participation of subjects.

ANS: A Feedback A

B C D

An important aspect of reviewing interview methods is to assess the length of time the researcher allowed for each interview to determine whether subjects had adequate time to respond. Prompts may be used in interviews. It is better if interviews are conducted in a natural, and not a clinical setting. Subjects will ideally be volunteers, recruited for their knowledge and experience.

PTS: 1 REF: p. 83

DIF: Cognitive level: Applying (Application)

30. A researcher may choose to use a focus group instead of one-to-one interviews in order to: a. encourage free expression of views of the participants. b. increase conformity and consistency of participants’ responses. c. reduce the time needed to collect data. d. allow more time for lengthy and complete responses. ANS: A Feedback A

B C D

One of the assumptions underlying the use of focus groups is that group dynamics can help people to express and clarify their views in ways that are less likely to occur in a one-to-one setting. The goal of a focus group is not to increase conformity, but this may sometimes occur if participants go along with the group. This type of data collection often takes more time that with one-on-one interviews. Focus groups often do not allow for lengthy responses by individuals.

PTS: 1 REF: p. 85

DIF: Cognitive level: Applying (Application)

31. When gathering data for a study using observational methods, it is important for the data

collector to: a. be observant of all that is done and said and unsaid. b. direct subjects by setting the stage through structured questions. c. record those actions and words that are related to the focus of the study. d. participate directly with subjects in order to better understand them. ANS: A Feedback A B C D

During observational experiences, the researcher should be observant and attempt to record what is said as well as unsaid and to record all that is done. The observer should not try to direct the actions of the participants. Unexpected events occurring during routine activities may be significant and are carefully noted. Ethnographic research involves immersion and participation.

PTS: 1 REF: p. 86

DIF: Cognitive level: Analyzing (Analysis)

32. To maximize collection of pertinent information when conducting an observational study, the

researcher records field notes: a. after the observation has concluded. b. during or immediately after the observation. c. prior to beginning the observation. d. when writing the research discussion. ANS: B Feedback A B

C D

This is not an accurate statement. In studies that use observation, notes taken during or shortly after observations (field notes) are best recorded while the information is easily recalled. It may be necessary to avoid taking notes during the observation so that the recorder does not miss observing something important. This is not an accurate statement. This is not an accurate statement.

PTS: 1 REF: p. 86

DIF: Cognitive level: Understanding (Comprehension)

33. Which is true about data analysis in a qualitative study? a. It has very little structure. b. It is unnecessary in qualitative studies. c. It requires less time than with quantitative analysis. d. It should be consistent with the philosophical method of the study. ANS: D

Feedback A B C D

Data analysis is as rigorous as with quantitative studies. Data analysis is as rigorous as with quantitative studies and as important. Data analysis may take more time in qualitative studies because “dwelling with the data” requires considerable reading and reflection of the data. Data analysis in qualitative studies should be consistent with the philosophical method of the study.

PTS: 1 REF: p. 89

DIF: Cognitive level: Understanding (Comprehension)

34. A researcher classifies words and phrases that occur in data collected in a qualitative study.

This process is called: a. coding the data. b. describing the data. c. dwelling with the data. d. interpreting the data. ANS: A Feedback A B C D

Coding the data is the process of reading the data, breaking text down into subparts, and labeling that part of the text. Describing the data requires less analysis of the data than coding. Dwelling with the data involves spending time mulling over the data to read and reflect on its meaning. During interpretation, the researcher places the findings in a larger context and may link different themes or factors in the findings to each other.

PTS: 1 REF: p. 89

DIF: Cognitive level: Understanding (Comprehension)

35. Which type of research uses a less formal method of reporting data? a. Ethnographic b. Grounded theory c. Historical d. Phenomenological ANS: C Feedback A

C D

Reports of ethnographic research follow the traditional style. Historical research reports do not follow the traditional formalized style that is characteristic of much research. Reports of grounded theory research follow the traditional style. Historical research reports do not follow the traditional formalized style that is characteristic of much research. Historical research reports do not follow the traditional formalized style that is characteristic of much research. Reports of phenomenological research follow the traditional style. Historical

research reports do not follow the traditional formalized style that is characteristic of much research. PTS: 1 REF: p. 78

DIF: Cognitive level: Remembering (Knowledge)

36. A researcher describes phrases and terms discovered in a qualitative study and describes and

links these with various themes. This is an example of: a. coding the data. b. describing the data. c. dwelling with the data. d. interpreting the data. ANS: D Feedback A B C D

Coding the data is the process of reading the data, breaking text down into subparts, and labeling that part of the text. Describing the data involves stating the findings in meaningful terms. Dwelling with the data involves spending time mulling over the data to read and reflect on its meaning. In qualitative research, data interpretation involves placing things discovered into categories that are linked with themes in order to identify meaning.

PTS: 1 REF: p. 89

DIF: Cognitive level: Understanding (Comprehension)

37. While reviewing transcripts of interviews conducted for a qualitative study, the researcher

appraises the data for congruence with the philosophical perspective of the study. This is an example of: a. perspective. b. reliability. c. rigor. d. validity. ANS: C Feedback A B C D

The perspective identifies the initial intent of the study. Reliability is used to evaluate measurement methods in quantitative research. Rigor in qualitative research requires critically appraising the study for congruence with the philosophical perspective. Validity is used to evaluate measurement methods in quantitative research.

PTS: 1 REF: p. 90

DIF: Cognitive level: Understanding (Comprehension)

38. What is the purpose of qualitative research? a. To allow researchers to interject their own values into studies b. To describe data that cannot be measured or quantified c. To describe experiences and insight from the subject’s perspective

d. To establish causal relationships among subjective data ANS: C Feedback A B C D

Qualitative research often involves the interaction of the researcher’s and the subject’s perspectives and values, but that is not the purpose. Measureable data may be included in qualitative research. Qualitative research seeks to study the experiences of subjects and to gain insights from their perspective and not that of the researcher. Qualitative research seeks to identify meaning and context and not cause and effect.

PTS: 1 REF: p. 90

DIF: Cognitive level: Understanding (Comprehension)

39. How are findings from qualitative studies used to add to the body of nursing knowledge? a. Findings are useful only for describing study subjects. b. Findings may be generalized to a wide variety of population groups. c. Findings provide a broad overview from which meaning is derived. d. Findings reveal meanings that can be used to develop theory. ANS: D Feedback A B C D

Although they describe the particular situation, they have relevance in theory development. Findings are particular to the situation being observed and do not provide a broad overview. Findings are particular to the situation being observed and do not provide a broad overview. The findings from a qualitative study lead to an understanding of a phenomenon in a particular situation and are not generalized, but provide an initial picture or theory.

PTS: 1 REF: p. 67

DIF: Cognitive level: Analyzing (Analysis)

40. A researcher uses film footage to collect data in which type of research? a. Ethnographic b. Grounded theory c. Historical d. Phenomenological ANS: C Feedback A

Ethnographers observe and document interactions within a culture. Historians may observe film, videotapes, photographs, or artistic representations of historical events. Grounded theory develops theory directly from the research data. Historians may

C D

observe film, videotapes, photographs, or artistic representations of historical events. Historians may observe film, videotapes, photographs, or artistic representations of historical events. Phenomenological research attempts to capture the “lived experience” of study participants. Historians may observe film, videotapes, photographs, or artistic representations of historical events.

PTS: 1 REF: p. 67|p. 78

DIF: Cognitive level: Understanding (Comprehension)

41. Which is true about rigor in qualitative research? a. Data should be interpreted according to the initial expectations of the researcher. b. Findings of the study should be generalizable to a larger population. c. Studies are evaluated based on design detail and thoroughness of evaluation. d. There is no method for judging rigor in qualitative research. ANS: C Feedback A B C D

The meaning of the data should be interpreted with an open mind, even if the meaning is not what was initially anticipated. The findings of a qualitative study cannot be generalized but may be applied in other contexts or with other subjects. Rigor in qualitative studies is assessed based on the degree of detail in study design, the care taken in data collection, and the thoroughness of data analysis. Rigor is valued in all research as a means to ensure the credibility and worth of studies.

PTS: 1 REF: p. 68

DIF: Cognitive level: Analyzing (Analysis)

42. Which is true about phenomenological research? a. It is a method that views the person and the environment as integrated. b. It seeks to quantify human behavior and experience. c. It disregards the meaning of lived experiences. d. It is a single approach that uses quantitative research methods. ANS: A Feedback A B C D

Phenomenological research views the person as integrated with the environment. Phenomenological research does not seek to quantify human behavior and experience Phenomenological research seeks to find and interpret the meaning of lived experiences. There are several philosophical approaches to phenomenological research.

PTS: 1 REF: p. 69

DIF: Cognitive level: Analyzing (Analysis)

Chapter 04: Examining Ethics in Nursing Research Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. The purpose of an institutional review board (IRB) in a university or clinical agency is to: a. approve funding for studies based on ethical standards. b. critically appraise ethical aspects of published studies. c. define ethical standards for the institution. d. protect the human rights of subjects in proposed studies. ANS: D Feedback A B C D

IRBs do not approve funding for studies based on ethical standards. IRBs review ethical aspects of studies prior to the conduction of the study, not after they are published. IRBs do not define ethical standards. Institutional review boards (IRBs) are organized to examine the ethical aspects of studies before they are conducted.

PTS: 1 REF: pp. 94-95

DIF: Cognitive level: Analyzing (Analysis)

2. An important initial focus of the Declaration of Helsinki, developed in 1964, was to: a. differentiate therapeutic from nontherapeutic research. b. define the concept of informed consent of research subjects. c. prevent the use of placebos during clinical drug trials. d. prohibit nontherapeutic research to protect subjects from harm. ANS: A Feedback A B C

The Declaration of Helsinki was adopted in 1964 and its major focus was to differentiate between therapeutic research and nontherapeutic research. The Nuremberg code helped to define the concept of informed consent of subjects. The Declaration of Helsinki did not prevent the use of placebos, but declared that researchers must provide subjects in the placebo group with access to proven diagnostic and therapeutic procedures after the study. The Declaration of Helsinki did not prohibit nontherapeutic research, but developed guidelines to address issues with this type of research.

PTS: 1 REF: p. 96

DIF: Cognitive level: Analyzing (Analysis)

3. The Tuskegee Syphilis Study violated several ethical principles in which way? a. Coercion of subjects to participate in the study in exchange for treatment b. Failing to inform subjects about the purpose and procedures in the study c. Failing to inform in the Centers for Disease Control about the results of the study

d. Not informing the subjects’ physicians that they were in the study ANS: B Feedback A B

C D

Subjects were not coerced by the promise of treatment, which was not offered, even when the benefits were known. In the Tuskegee Syphilis Study, subjects were not informed about the purpose and procedures of the study; some were not even informed that they were subjects. The CDC was informed about the results and decided the study could continue. In the Jewish Chronic Disease Study, subjects’ physicians were not informed.

PTS: 1 REF: p. 97

DIF: Cognitive level: Understanding (Comprehension)

4. After the Department of Health, Education, and Welfare (DHEW) regulations were published

in 1973, all research using human subjects was required to: a. avoid using subjects who were ill, mentally impaired, or dying. b. obtain informed consent from all subjects prior to enrollment in a study. c. review only studies in which risk of harm to subjects is especially high. d. undergo full institutional review to examine risks and benefits to subjects. ANS: D Feedback A B C D

The DHEW regulations do not prohibit using subjects who are ill, mentally impaired, or dying, but provided protections for such subjects. The US Code of Federal Regulations requires informed consent of human subjects. DHEW regulations require institutional review of all human subjects, not just those with especially high risk. The Department of Health, Education, and Welfare regulations were published in 1973, providing for the protection of human research subjects and requiring full institutional review of all studies involving human subjects.

PTS: 1 REF: p. 98

DIF: Cognitive level: Understanding (Comprehension)

5. The ethical principles of respect for persons, beneficence, and justice are considered essential

elements in research involving human subjects. In which document are these principles identified? a. Declaration of Helsinki b. Department of Health, Education, and Welfare regulations c. National Commission for the Protection of Human Subjects in the Belmont Report d. Nuremberg Code ANS: C Feedback A

A major focus of the Declaration of Helsinki was the differentiation of

B C

therapeutic research from nontherapeutic research. The Department of Health, Education, and Welfare regulations were published in 1973 providing for the protection of human research subjects. The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was formed in the United States in 1978. This commission developed ethical research guidelines based on the ethical principles of respect for persons, beneficence, and justice and made recommendations to the U.S. Department of Health and Human Services (DHHS) in the Belmont Report. The development of the Nuremberg Code in 1949 addressed the mistreatment of human subjects.

PTS: 1

DIF: Cognitive level: Knowledge

REF: pp. 98-99

6. Which ethical principle protects human subjects from harm? a. Beneficence b. Ethics c. Justice d. Respect for persons ANS: A Feedback A B C D

The ethical principle of beneficence encourages the researcher to do good and to “do no harm.” Ethics is not a specific ethical principle. The principle of justice addresses the fair treatment of human subjects. The principle of respect for persons indicates that human subjects should be treated as autonomous agents with rights to self-determination.

PTS: 1 REF: pp. 98-99

DIF: Cognitive level: Understanding (Comprehension)

7. When conducting research to study medical devices for human use, the nurse researcher must

comply with the Department of Health and Human Services human subjects regulations as well as regulations put forth by the: a. American Nurses Association b. Code of Federal Regulations c. Food and Drug Administration d. Presidential Commission for the Study of Bioethics ANS: C Feedback A B C

The ANA, CFR, and the Presidential Commission do not have specific regulations governing research of medical devices. The ANA, CFR, and the Presidential Commission do not have specific regulations governing research of medical devices. The FDA and the DHHS regulations govern most of the biomedical and behavioral research conducted in the United States. Drugs, medical devices,

biological products, human dietary supplements, and electronic devices are all regulated by these two entities. The ANA, CFR, and the Presidential Commission do not have specific regulations governing research of medical devices.

PTS: 1 REF: pp. 99-100

DIF: Cognitive level: Understanding (Comprehension)

8. To safeguard the right to self-determination among research subjects, the researcher will

ensure that subjects: a. are afforded anonymity to the researcher and the reader. b. are allowed to choose whether to be in a control or a study group. c. may choose whether or not to participate in a study. d. receive a large monetary reward for participating in the study. ANS: C Feedback A B C D

The right to anonymity means that subjects cannot be identified. Subjects are generally randomly assigned to groups. Self-determination refers to individuals’ rights to knowingly become a subject in the study or not, and to do so of their own free will. Subjects who are given large rewards for participation may be coerced.

PTS: 1 REF: p.101

DIF: Cognitive level: Applying (Application)

9. The greatest risk to a person confined to an institution who is a research subject is: a. diminished autonomy. b. discomfort. c. lack of information. d. lack of privacy. ANS: A Feedback A B C D

Persons who are vulnerable because of legal or mental incompetence, terminal illness, or confinement to an institution have diminished autonomy. They are not necessarily at higher risk for discomfort, lack of information, or lack of privacy than are other subjects. They are not necessarily at higher risk for discomfort, lack of information, or lack of privacy than are other subjects. They are not necessarily at higher risk for discomfort, lack of information, or lack of privacy than are other subjects.

PTS: 1 REF: pp. 99-100

DIF: Cognitive level: Understanding (Comprehension)

10. A researcher will have greater success gaining approval for a research study involving

pregnant women if which provision is put into place? a. Care is taken to maintain strict confidentiality of subjects.

b. Consent is given by the pregnant women’s significant others. c. Subjects may experience therapeutic effects from the intervention. d. Subjects receive financial rewards for participation in the study. ANS: C Feedback A B C

Confidentiality and consent must be maintained in all research involving human subjects and do not influence approval for subjects with diminished capacity. Confidentiality and consent must be maintained in all research involving human subjects and do not influence approval for subjects with diminished capacity. Pregnant women are considered to have legal and/or mental diminishment of autonomy. Research involving such subjects is generally more acceptable if the research is therapeutic. Financial rewards may be a form of coercion.

PTS: 1 DIF: Cognitive level: Applying (Application) REF: pp. 101-102 |p. 104 11. When a researcher indicates that assent for participation was gained in a study involving 10

year-old children, this indicates which has occurred? a. The children gave informed consent to participate in the study. b. The children have agreed to be subjects in the study. c. The parents granted approval for their children to participate. d. The parents do not need to give consent because the children gave consent. ANS: B Feedback A B C D

Assent is not informed consent, which must be given by a child’s parent or legal guardian. Assent is gained from children who are subjects and represents their agreement to participate. Assent does not represent approval by the parents. Assent is given in conjunction with informed consent by the parent or legal guardian and is not sufficient by itself to allow a minor to participate in a study.

PTS: 1 REF: p. 102

DIF: Cognitive level: Applying (Application)

12. A researcher wishes to study the effects of antiseizure medications on adult subjects who have

severe cognitive impairments. Which statement is true about using these subjects in research? a. Assent must be gained from the subjects and is sufficient for participation. b. A legally authorized guardian must give informed consent. c. These adults cannot be used as subjects for this study. d. The subjects’ physicians must give consent for participation in the study. ANS: B Feedback A

Assent must be gained if possible, but is not sufficient for participation in a

C D

study. Persons with mental illness or a cognitive impairment are incapable of giving informed consent. A researcher must gain approval from a legally authorized representative or guardian along with gaining assent from the participant. Adults with mental impairments may be used in studies as long as their rights are protected and proper consent is obtained. Physicians are not legally authorized representatives.

PTS: 1 REF: p. 104

DIF: Cognitive level: Applying (Application)

13. A researcher makes every effort to ensure that subjects may benefit from a research

intervention while taking measures to minimize potential harm. This is an example of protecting a research subject’s right to: a. anonymity and confidentiality. b. fair treatment. c. protection from discomfort and harm. d. self-determination. ANS: C Feedback A

B C

Complete anonymity exists if the subject’s identity cannot be linked, even by the researcher, with his or her individual responses. Confidentiality is the safe management of private information shared by a subject. The researcher must refrain from sharing that information without the authorization of the subject. Research findings need to be reported so that a subject or group of subjects cannot be identified. The right to fair treatment suggests that people should be treated fairly and should receive what they are due or owed. The right to protection from discomfort and harm from a study is based on the ethical principle of beneficence, which states that one should do good and, above all, do no harm. Self-determination refers to individuals’ rights to knowingly become a subject in the study or not and to do so of their own free will.

PTS: 1 REF: pp. 100-101

DIF: Cognitive level: Understanding (Comprehension)

14. When obtaining informed consent from study subjects, the researcher will ensure that subjects

freely choose whether or not to participate and will provide subjects: a. general knowledge and overview of the study. b. information about the study methods and design. c. reports about the study results and conclusions. d. the right to choose whether to be in the control versus the study group. ANS: A Feedback A

Informed consent includes disclosure to the subject of essential study

C D

information, comprehension of this information by the subject, competence of the subject to give consent, and voluntary consent of the subject to participate in the study. Information on the study design is given only as it applies to what will happen to the subject. The correct answer is “general knowledge and comprehension of the study.” Informed consent includes disclosure to the subject of essential study information, comprehension of this information by the subject, competence of the subject to give consent, and voluntary consent of the subject to participate in the study. It is not necessary to provide reports about the study results and conclusions as part of gaining informed consent. Subjects are generally randomly assigned to control versus study groups and choice of placement is not a part of informed consent.

PTS: 1 REF: pp. 100-101

DIF: Cognitive level: Understanding (Comprehension)

15. A special concern when conducting research using terminally ill cancer patients as subjects is: a. an inability to randomly assign subjects to study groups. b. an increased risk of harm with decreased benefits. c. difficulty enlisting subjects for participation in the study. d. poor control of extraneous variables. ANS: B Feedback A B C D

Subjects may still be randomly assigned to control versus study groups. Participating in research may carry increased risks with minimal or no benefits for terminally ill subjects. Terminally ill patients may be more likely to be willing to participate in research. There is no difference when controlling extraneous variables in studies involving terminally ill patients.

PTS: 1 REF: p. 104

DIF: Cognitive level: Understanding (Comprehension)

16. Which subject groups may feel especially coerced to participate in research studies? a. Children b. Institutionalized patients c. Pregnant women d. Terminally ill patients ANS: B Feedback A B

Children, pregnant women, and terminally ill patients are allowed to give assent or consent freely for participation in research. Persons confined to institutions may feel coerced to participate in research because they fear harm or because they feel that they may receive special

C D

benefits for participation. Children, pregnant women, and terminally ill patients are allowed to give assent or consent freely for participation in research. Children, pregnant women, and terminally ill patients are allowed to give assent or consent freely for participation in research.

PTS: 1 REF: p. 104

DIF: Cognitive level: Knowing (Knowledge)

17. If a health care provider discloses information about a patient to a researcher for a study, the

provider and the researcher must have a(n): a. agreement about the study’s purpose. b. data use agreement. c. limited data set. d. written study proposal. ANS: B Feedback A B C

Agreement about the study’s purpose is not necessary for sharing information. A data use agreement limits how data may be used and how it will be protected and must be in place for a provider to disclose data to a researcher. A limited data set describes the type of data that may be disclosed without an individual subject’s authorization or an IRB waiver; in order to disclose this limited data set, a data use agreement must be in place. The written study proposal does not confer the right to disclose patient data to a researcher.

PTS: 1 REF: p. 106

DIF: Cognitive level: Applying (Application)

18. In a study about pregnant women’s use of tobacco, the researcher is able to link individual

subjects’ identities to their responses on a questionnaire, but does not share this information with others. This is an example of: a. anonymity. b. breach of confidentiality. c. confidentiality. d. privacy. ANS: C Feedback A B C D

Anonymity exists when the subject’s identity cannot be linked, even by the researcher, with individual responses. A breach of confidentiality occurs when a researcher allows an unauthorized person to gain access to the raw data of a study. Confidentiality is the researcher’s safe management of information or data shared by a subject to ensure the data are kept private. Privacy is a larger concept encompassing anonymity and confidentiality.

PTS: 1 REF: pp. 106-107

DIF: Cognitive level: Applying (Application)

19. A researcher using a small sample of an easily distinguishable group of subjects wishes to use

extensive quotes in the research report. This researcher risks: a. a loss of study validity. b. breaching confidentiality. c. losing objectivity. d. reduction of benefits to subjects. ANS: B Feedback A B C D

Study validity is related to the proper use of study tools and measurements. Breach of confidentiality is of special concern in qualitative studies that have few study participants and involve the reporting of long quotes. Objectivity is the ability of the researcher to avoid interpreting results in a biased manner. Benefits to subjects are not necessarily compromised in small studies using quotations.

PTS: 1 REF: pp. 106-107

DIF: Cognitive level: Applying (Application)

20. A subject’s right to fair selection and treatment in a study is related to which ethical principle? a. Beneficence b. Justice c. Privacy d. Respect for persons ANS: B Feedback A B

C D

The principle of beneficence requires that subjects are protected from harm. The right to fair selection and treatment of subjects is based on the ethical principle of justice, requiring people to be treated fairly and to receive what they are owed. The principle of privacy requires that anonymity and confidentiality are protected. The principle of respect for persons requires that human subjects should be treated as autonomous agents with rights to self-determination.

PTS: 1 REF: pp. 107-108

DIF: Cognitive level: Understanding (Comprehension)

21. Which unethical study in previous history involved withholding a treatment from subjects in

order to study the effects of a disease progression on subjects? a. The Jewish Chronic Disease Hospital Study b. The Nazi Medical Experiments c. The Tuskegee Syphilis Study d. The Willowbrook Study

ANS: C Feedback A

B C

In the Jewish Chronic Disease Hospital Study, subjects were injected with a suspension containing live cancer cells and did not know they were taking part in a study or that the injections contained these live cancer cells. In the Nazi Medical Experiments, an array of atrocious unethical medical experiments were conducted on prisoners of war. In the Tuskegee Syphilis Study, penicillin was deliberately withheld from the research subjects and their families, in order to study the effects of the natural progression of syphilis. In the Willowbrook Study, mentally retarded children were infected with the hepatitis virus and new patients were not admitted to this institution unless their parents consented for their children to participate in this study.

PTS: 1 REF: p. 97

DIF: Cognitive level: Understanding (Comprehension)

22. A researcher conducts a study to evaluate the frequency of intimate partner violence among

females treated for sexually transmitted diseases (STDs). When collecting data, which action may be problematic when protecting subjects’ rights? a. Allowing subjects to decline participation in the study b. Approaching all patients who meet eligibility requirements c. Identifying subjects with numbers instead of names d. Instructing subjects to complete every item on the questionnaire ANS: D Feedback A B C D

Autonomy is protected when subjects are informed that participation is voluntary. Approaching all subjects who meet eligibility requirements removes the possibility of bias. Using numbers instead of names helps to protect privacy. Subjects who are told that they must complete every item on a questionnaire risk losing their right to autonomy.

PTS: 1 REF: p. 101

DIF: Cognitive level: Analyzing (Analysis)

23. A researcher gives healthy adult subjects a handout explaining the nature of a study and then

obtains written consent from those who choose to participate. Which statement is true about this process? a. Subjects have given informed consent for participation in the study. b. Subjects have not given voluntary consent for participation in the study. c. The researcher has failed to determine comprehension of the study by participants. d. The researcher has not disclosed information about the study to the participants. ANS: C

Feedback A

B C D

Informed consent implies not only that the researcher has imparted information to the subjects, but also that the prospective subjects have comprehended the information. The researcher needs to discuss the information with the subjects and ask them to restate the information to assess their understanding. The subjects have voluntarily consented to participate. These subjects have been given written information, but have not stated their understanding, so informed consent has not been obtained. The researcher disclosed information to the subjects about the study.

PTS: 1 REF: p. 112

DIF: Cognitive level: Analyzing (Analysis)

24. Which situation may allow waiving the need to obtain written consent for participation in a

research study? a. The researcher is conducting an informal study about heart disease. b. The researcher is using questionnaires to collect data about suicide risk. c. The subjects do not want documentation linking them to the study. d. The subjects desire complete anonymity in the study. ANS: C Feedback A B C

Informal studies and those using questionnaires about potentially harmful subjects do not meet the requirements for waiving of consent. Informal studies and those using questionnaires about potentially harmful subjects do not meet the requirements for waiving of consent. Subjects who do not want documentation linking them to the research who have received information and demonstrated comprehension of the information may have consent waived if they desire. Anonymity can be maintained even with signed consent.

PTS: 1 REF: p. 114

DIF: Cognitive level: Applying (Application)

25. Which federal agency was established to manage investigations of misconduct in research? a. Department of Health, Education, and Welfare (DHEW) b. Department of Health and Human Services (DHHS) c. Food and Drug Administration (FDA) d. Office of Research Integrity (ORI) ANS: D Feedback A B C D

This is not a correct statement. This is not a correct statement. This is not a correct statement. The Office of Research Integrity was developed by the federal government in 1989 to supervise the implementation of the rules and regulations related to research misconduct and to manage any investigations of misconduct.

PTS: 1 REF: p. 122

DIF: Cognitive level: Understanding (Comprehension)

26. A researcher makes an honest error when tabulating and analyzing research findings.

According to the Office of Research Integrity, this constitutes: a. fabrication. b. falsification. c. misrepresentation. d. no misconduct. ANS: D Feedback A B

C D

Fabrication refers to making up results and recording or reporting them. Falsification is manipulating research materials, equipment, or processes, or changing or omitting data or results so that the research is not accurately represented. Misrepresentation refers to presenting data inaccurately. A researcher making an honest error is not guilty of misconduct.

PTS: 1 REF: p. 122

DIF: Cognitive level: Understanding (Comprehension)

27. Which is an example of falsification in research? a. Citing work by another researcher and claiming it as one’s own. b. Making up statistics about the incidence of reactions to an intervention. c. Omitting data about a subject that disproves the researcher’s hypothesis. d. Using data gained without the consent of the research subjects. ANS: C Feedback A B C

Plagiarism is citing another’s research and claiming it as one’s own. Fabrication involves making up results and reporting them. Falsification is manipulating research materials, equipment, or processes, or changing or omitting data or results so that the research is not accurately represented. Lack of informed consent occurs when the researcher fails to gain consent from study subjects.

PTS: 1 REF: p. 122

DIF: Cognitive level: Applying (Application)

28. A researcher combines data from another researcher’s study along with data from the reported

study in graphs without noting the source of the data. This is an example of: a. an honest error. b. fabrication. c. falsification. d. plagiarism.

ANS: D Feedback A B C

An honest error would occur if the researcher was unaware that the data belonged to someone else. Fabrication involves making up results and reporting them. Falsification is manipulating research materials, equipment, or processes, or changing or omitting data or results so that the research is not accurately represented. Plagiarism is citing another’s research and claiming it as one’s own.

PTS: 1 REF: p. 122

DIF: Cognitive level: Applying (Application)

MULTIPLE RESPONSE 1. Which patient information requires deidentifying in order to maintain privacy? (Select all that

apply) a. E-mail addresses b. Full-face photographs c. State of residence d. Medical record numbers ANS: A, B, D Feedback Correct

Incorrect

E-mail addresses, full-face photographs, and medical record numbers may all be used to identify patients and must be de-identified in study reports to prevent linking study results to individuals. E-mail addresses, full-face photographs, and medical record numbers may all be used to identify patients and must be de-identified in study reports to prevent linking study results to individuals. E-mail addresses, full-face photographs, and medical record numbers may all be used to identify patients and must be de-identified in study reports to prevent linking study results to individuals. The state of residence is not necessarily an identifier, but any geographic division smaller than a state is.

PTS: 1 REF: p. 106

DIF: Cognitive level: Understanding (Comprehension)

2. According to the HIPAA privacy rules, which are covered entities that may use and disclose a

limited data set to researchers for study? (Select all that apply) a. Health plans b. Health care providers c. Institutional Review Boards d. Researchers ANS: A, B Feedback

Correct

Incorrect

Health care providers, health plans, and health care clearinghouses are covered entities. Health care providers, health plans, and health care clearinghouses are covered entities. This is not a correct statement. This is not a correct statement.

PTS: 1 REF: p. 106

DIF: Cognitive level: Remembering (Knowledge)

3. Which of the following represent some degree of risk of causing discomfort or harm to

subjects in a study? (Select all that apply) a. Asking parents of children in a clinic waiting room to complete a patient satisfaction questionnaire. b. Assessing the number of males and females enrolled in nursing schools using enrollment data. c. Interviewing nursing home residents about their memories of the Great Depression. d. Using pathology reports from a hospital lab to gain data about the percentage of new patients who have anemia. ANS: A, C, D Feedback Correct

Incorrect

Asking parents to complete a questionnaire increases the risk of temporary discomfort associated with filling out the form. Interviewing nursing home residents increases the risk of discomfort because it may invoke bad memories. Using pathology reports does not confer benefits to the subjects and may run the risk of invasion of privacy. Asking parents to complete a questionnaire increases the risk of temporary discomfort associated with filling out the form. Interviewing nursing home residents increases the risk of discomfort because it may invoke bad memories. Using pathology reports does not confer benefits to the subjects and may run the risk of invasion of privacy. Asking parents to complete a questionnaire increases the risk of temporary discomfort associated with filling out the form. Interviewing nursing home residents increases the risk of discomfort because it may invoke bad memories. Using pathology reports does not confer benefits to the subjects and may run the risk of invasion of privacy. Assessing the numbers of males and females does not increase risk or cause discomfort.

PTS: 1 REF: p. 108

DIF: Cognitive level: Analyzing (Analysis)

4. A researcher wants to study whether showing a video about car safety increases the likelihood

of car seat use among a group of first-time parents. When obtaining informed consent, the researcher must include: (Select all that apply) a. an assurance of anonymity. b. a statement of the research purpose.

c. consent to incomplete disclosure. d. voluntary participation. ANS: A, C, D Feedback Correct

Incorrect

Anonymity and voluntary participation must be assured in all research involving human subjects. In this study, parents who know ahead of time that the purpose is to see whether car seat use is increased may increase their use of car seats whether or not they view the video. Anonymity and voluntary participation must be assured in all research involving human subjects. In this study, parents who know ahead of time that the purpose is to see whether car seat use is increased may increase their use of car seats whether or not they view the video. Anonymity and voluntary participation must be assured in all research involving human subjects. In this study, parents who know ahead of time that the purpose is to see whether car seat use is increased may increase their use of car seats whether or not they view the video. In some cases, a statement of the research purpose can influence the results and a consent to incomplete disclosure may be obtained instead.

PTS: 1 REF: p. 111

DIF: Cognitive level: Analyzing (Analysis)

5. A researcher has submitted a proposal to an Institutional Review Board (IRB) to evaluate the

effects of a new drug on newborn infants. In this case, members of the IRB should include: (Select all that apply) a. an ethicist. b. a hospital pharmacist. c. a neonatologist. d. a pharmaceutical representative. ANS: A, B, C Feedback Correct

When selecting an IRB, there must be at least five members of varying backgrounds to promote a complete, scholarly, and fair review of research. When vulnerable subjects such as newborns are part of a study, at least one member must have knowledge and experience in working with these subjects. A neonatologist and a hospital pharmacist would both be included in this case. All IRBs must have an ethicist, lawyer, or minister whose primary concern is nonscientific. When selecting an IRB, there must be at least five members of varying backgrounds to promote a complete, scholarly, and fair review of research. When vulnerable subjects such as newborns are part of a study, at least one member must have knowledge and experience in working with these subjects. A neonatologist and a hospital pharmacist would both be included in this case. All IRBs must have an ethicist, lawyer, or minister whose primary concern is nonscientific. When selecting an IRB, there must be at least five members of varying backgrounds to promote a complete, scholarly, and fair review of research.

Incorrect

When vulnerable subjects such as newborns are part of a study, at least one member must have knowledge and experience in working with these subjects. A neonatologist and a hospital pharmacist would both be included in this case. All IRBs must have an ethicist, lawyer, or minister whose primary concern is nonscientific. A pharmaceutical representative would have a conflict of interest in promoting the drug.

PTS: 1 REF: p. 117

DIF: Cognitive level: Applying (Application)

6. A nurse researcher who wishes to use animals in a research study must include which

elements in an animal use protocol? (Select all that apply) a. Animal living conditions and veterinary care b. Assurances that animals will be kept alive c. Justification for the use of animals over humans d. Procedures to minimize pain and distress ANS: A, C, D Feedback Correct

Incorrect

Elements of animal use protocols should include descriptions of animal living conditions and veterinary care, justifications for the use of animals, and procedures that will minimize pain and distress. Researches need to identify methods of euthanasia and do not need assurances that animals will be kept alive. Elements of animal use protocols should include descriptions of animal living conditions and veterinary care, justifications for the use of animals, and procedures that will minimize pain and distress. Elements of animal use protocols should include descriptions of animal living conditions and veterinary care, justifications for the use of animals, and procedures that will minimize pain and distress.

PTS: 1 REF: pp. 123-124

DIF: Cognitive level: Analyzing (Analysis)

Chapter 05: Research Problems, Purposes, and Hypotheses Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. The most important initial step when developing a research study is to: a. develop the problem statement. b. explore the background for the research problem. c. identify the research problem. d. state the research purpose. ANS: C Feedback

A B C D

The problem statement is written after the research problem has been identified. The background for the research problem is written to identify what is known about the research problem. The problem provides the basis for developing the research purpose and identifies gaps in knowledge needed for nursing practice. The research purpose derives from the research problem and identifies specific goals for the study.

PTS: 1 REF: p. 131

DIF: Cognitive level: Applying (Application)

2. A nursing researcher determines that there is little information about the use of

complementary practices in treating obesity. This represents the research: a. design. b. problem. c. purpose. d. significance. ANS: B Feedback A B C D

The research design is the type of study that will be conducted to study the research problem. The problem provides the basis for developing the research purpose and identifies gaps in knowledge needed for nursing practice. The research purpose derives from the research problem and identifies specific goals for the study. The problem statement is written after the research problem has been identified. The significance for the research identifies how important the knowledge is to the discipline.

PTS: 1 REF: pp. 131-132

DIF: Cognitive level: Applying (Application)

3. When writing a proposal for a research study, the researcher includes a problem statement that

serves to: a. define the specific focus of a study. b. describe what is known about the research problem. c. identify a gap in knowledge needed for practice. d. indicate the importance of the problem to nursing. ANS: C Feedback A B C

The research purpose derives from the research problem and identifies specific goals for the study. The problem background identifies what is already known about the topic. The problem statement is written after the research problem has been identified. The problem provides the basis for developing the research purpose and identifies gaps in knowledge needed for nursing practice.

The significance for the research identifies how important the knowledge is to the discipline.

PTS: 1 REF: pp. 131-132

DIF: Cognitive level: Applying (Application)

4. In a research proposal, the researcher states that the proposed study will explore children’s

feelings about chemotherapy side effects. This statement describes the: a. problem background. b. problem significance. c. research problem. d. research purpose. ANS: D Feedback A B C D

The problem background identifies what is already known about the topic. The problem statement is written after the research problem has been identified. The significance of the research identifies how important the knowledge is to the discipline. The problem provides the basis for developing the research purpose and identifies gaps in knowledge needed for nursing practice. The research purpose derives from the research problem and identifies specific goals for the study.

PTS: 1 REF: pp. 131-132

DIF: Cognitive level: Applying (Application)

5. Which is included in a statement of a research study purpose? a. A description of gaps in knowledge about the research problem. b. A discussion of the significance of the research problem. c. A review of what is known about the research problem. d. A statement about how the research problem will be studied. ANS: D Feedback A B C D

The problem provides the basis for developing the research purpose and identifies gaps in knowledge needed for nursing practice. The significance for the research identifies how important the knowledge is to the discipline. The problem background identifies what is already known about the topic. The problem statement is written after the research problem has been identified. The research purpose derives from the research problem and identifies specific goals for the study.

PTS: 1 REF: pp. 131-132

DIF: Cognitive level: Applying (Application)

6. The statement in the introduction of a research study report—“while children who have higher

asthma control scores tend to have fewer emergency department visits for asthma exacerbations, it is unclear how nursing interventions can impact these scores”—represents the: a. problem background. b. problem significance. c. research problem. d. research purpose. ANS: B Feedback A B C D

The problem background identifies what is already known about the topic. The problem statement is written after the research problem has been identified. The significance for the research identifies how important the knowledge is to the discipline and to health care and the health of individuals and families. The problem provides the basis for developing the research purpose and identifies gaps in knowledge needed for nursing practice. The research purpose derives from the research problem and identifies specific goals for the study.

PTS: 1 REF: pp. 131-132

DIF: Cognitive level: Analyzing (Analysis)

7. The statements in the introductory paragraphs of a research report that cite results of previous

studies about a research problem represent the: a. problem background. b. problem significance. c. problem statement. d. research purpose. ANS: A Feedback A B C D

PTS: 1 REF: p. 132

DIF: Cognitive level: Analyzing (Analysis)

8. Which statement is a research purpose for a correlational study? a. “This study will compare the effects of an oral antidiabetic medication to effects of

a placebo on glucose control in groups of randomly assigned subjects.” b. “This study will examine whether pre-appointment telephone reminders increase

show rate among patients in an ambulatory well-patient clinic.”

c. “This study will use direct observation to identify methods parents use to

discipline children in public places.” d. “This study will use questionnaires and school transcripts to examine the

relationship of dietary habits to grades among school-age children.” ANS: D Feedback A B C

A study looking at the effects of an experimental intervention on randomly assigned subjects to affect a specific outcome is an experimental study. A study to look at the effects of an intervention on an outcome is a quasi-experimental study. A study to observe and describe behaviors without examining relationships among variables and without manipulation of the variables by researchers is a descriptive study. Correlational research is conducted to examine whether there is a positive or negative relationship among variables without attributing cause and effect.

PTS: 1 REF: p. 134

DIF: Cognitive level: Applying (Application)

9. The nurse researcher states that a research purpose is to measure the effects of bar code

medication administration on medication errors. This is a study purpose for which type of research? a. Correlational b. Grounded theory c. Outcomes d. Quasi-experimental ANS: C Feedback A B C D

Correlational research is conducted to determine whether there are relationships among variables. Grounded theory research is designed to determine how theory explains phenomena being studied. Outcomes studies are conducted to examine the end results of care. Quasi-experimental research requires some manipulation of variables and comparison of groups.

PTS: 1 REF: p. 140

DIF: Cognitive level: Analyzing (Analysis)

10. Which statement in a study about preoperative education and postoperative recovery times

represents a research question? a. “What are the types of preoperative education materials that may be used?” b. “What are the constructs that facilitate adult learning among patients?” c. “What preoperative teaching will shorten postoperative recovery time?” d. “What is already known about preoperative teaching and postoperative recovery?” ANS: C

Feedback A B C

The characteristic of a variable is given in the operational definition. The theoretical framework identifies constructs and theories about the research study. A research question focuses on description of variables or concepts, examination of relationships among variables, and determination of differences between two or more groups regarding selected variables. The background about what is already known about the topic for conducting is described in the literature review.

PTS: 1 REF: p. 147

DIF: Cognitive level: Analyzing (Analysis)

11. What type of hypothesis is the following?

“Children with cystic fibrosis who use a cough assist device will experience less anxiety about their disease and have fewer inpatient hospital admissions per year.” a. Complex, directional b. Complex, null c. Simple, associative d. Simple, nondirectional ANS: A Feedback A

B C D

A complex hypothesis predicts the relationship among three or more variables. In this example, the variables are cough assist devices (independent), hospital admissions (dependent), and anxiety (dependent). A directional hypothesis states the nature of the interaction between two or more variables. In this example, the direction is indicated by the prediction “experience less anxiety.” A complex hypothesis is correct, but the null hypothesis predicts no difference. This study has more than two variables (not simple) and indicates a direction and not just an association. A simple hypothesis has only two variables (this study has more than two), and there is a direction predicted (experiencing less anxiety and having fewer inpatient hospital admissions).

PTS: 1 REF: pp. 149-150

DIF: Cognitive level: Analyzing (Analysis)

12. A statement about the significance of a study describes the: a. influence of results on nursing practice. b. relationship among study variables. c. study design and methods. d. validity of the study measurement tools. ANS: A Feedback A

The statement about the significance of the study identifies its importance to the body of knowledge and to nursing practice.

B C D

The research purpose and research question identify proposed relationships among study variables. The study design and methods describe the type of study, sampling techniques, and tools used to evaluate data. The validity of measurement tools is determined by whether the tools measure what they claim to measure.

PTS: 1 REF: pp. 140-141

DIF: Cognitive level: Understanding (Comprehension)

13. A reviewer assesses a potential researcher’s credentials and experience, the availability of

funding and resources, and ethical considerations of a potential study. This represents evaluation of a study’s: a. expertise. b. feasibility. c. purpose. d. significance. ANS: B Feedback A B

C D

Expertise refers to the researcher’s qualifications, credentials, and experience. The feasibility of a study is determined by examining the researcher’s qualifications, the funding and resources available to conduct the study, the availability of subjects, facilities, and equipment, and ethical considerations. The study purpose identifies the focus and goals of the study. The significance identifies the importance of the study to the body of knowledge and to practice.

PTS: 1 REF: pp. 143-144

DIF: Cognitive level: Understanding (Comprehension)

14. Identify the independent variable in the following hypothesis:

“Mothers of infants born with spina bifida who participate in support groups report higher levels of confidence when caring for their infants than do mothers who do not participate in support groups.” a. Confidence in caring for their infants b. Infants with spina bifida c. Mothers of infants with spina bifida d. Support group participation ANS: D Feedback A B

Infants with spina bifida is part of the criteria for inclusion in the study. The level of confidence in caring for their infants is the dependent variable. It is measured as a response to whether or not the mothers received the “treatment” of using a support group. The mothers of infants with spina bifida are criteria for inclusion as subjects in the study and are not variables.

An independent variable is a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. In this example, use of support groups is the “treatment” that is being used to manipulate levels of confidence in caring for their infants.

PTS: 1 REF: pp. 153-154

DIF: Cognitive level: Analyzing (Analysis)

15. In a research proposal, the author describes what is already known about the research topic.

This would be included in the discussion of the study’s: a. background. b. feasibility. c. purpose. d. significance. ANS: A Feedback A B

C D

The background section describes research about the problem performed to date. In the section about a study’s feasibility, the researcher’s expertise, funding resources, availability of subjects and settings, and ethical considerations are examined. The research purpose identifies specific goals and the focus of the study. The study’s significance discusses the importance of the study to the discipline.

PTS: 1 REF: pp. 143-144

DIF: Cognitive level: Applying (Application)

16. Which component of a research study is exemplified in the statement, “This study identifies

various themes associated with parenting children who have chronic disease?” a. Aim or objective b. Hypothesis c. Research methodology d. Research problem ANS: A Feedback A

B C D

A research objective or aim is a clear, concise, declarative statement that is expressed in the present tense and which focuses on one or two variables, indicating whether they are to be identified or described. The hypothesis is a formal statement about an expected relationship between two or more variables. The research methodology identifies sampling and measurement techniques. The research problem identifies gaps in knowledge.

PTS: 1 REF: pp. 145-146

DIF: Cognitive level: Applying (Application)

17. The statement, “Do patients who receive care in a Patient-Centered Medical Home have fewer

emergency department visits than those who do not?” is an example of a research:

a. b. c. d.

aim. hypothesis. method. question.

ANS: D Feedback A

B C D

The research objective or aim is a clear, concise, declarative statement that is expressed in the present tense and which focuses on one or two variables, indicating whether they are to be identified or described. The hypothesis is a formal statement about an expected relationship between two or more variables. The research methodology identifies sampling and measurement techniques. A research question is a concise interrogative statement that is worded in the present tense, includes one or more variables, and guides the implementation of studies by asking whether or not there is a relationship between the variables.

PTS: 1 REF: pp. 147-148

DIF: Cognitive level: Applying (Application)

18. All of the following aspects of a research proposal are part of the research hypothesis except: a. methodology. b. outcomes. c. population. d. variables. ANS: A Feedback A B

The methodology is not described in the research hypothesis statement. The hypothesis is a formal statement about an expected relationship between two or more variables. It will mention the expected outcomes, the population being studied, and the specific variables. The hypothesis is a formal statement about an expected relationship between two or more variables. It will mention the expected outcomes, the population being studied, and the specific variables. The hypothesis is a formal statement about an expected relationship between two or more variables. It will mention the expected outcomes, the population being studied, and the specific variables.

PTS: 1 REF: pp. 149-150

DIF: Cognitive level: Understanding (Comprehension)

19. In a study comparing the effects of complementary therapies on pain scores and narcotic

analgesic use in homeless women and women who own homes, which of the following is a demographic variable? a. Complementary therapies b. Homeless women c. Narcotic analgesic use d. Pain scores

ANS: B Feedback A B C D

Complementary therapy is the independent variable. Demographic variables are characteristics or attributes of subjects that are collected to describe the sample. Narcotic analgesic use and pain scores are dependent variables. Pain scores are a dependent variable.

PTS: 1 REF: p. 157

DIF: Cognitive level: Applying (Application)

20. The statement, “In this study, elevated blood glucose is a value greater than 110 mg/dL,” is an

example of a(n): a. associative hypothesis. b. conceptual definition. c. operational definition. d. problem statement. ANS: C Feedback A

B C

A hypothesis indicates the researcher’s educated guess at what the outcome of the research will be. An associative hypothesis describes a predicted relationship that the researcher develops between the established variables being studied. This statement is an operational definition, not a hypothesis. A conceptual definition is the theoretical meaning of a variable. An operational definition is derived from a set of procedures or progressive acts that a researcher performs to receive sensory impressions that indicate the existence or degree of existence of a variable. An operational definition is developed so that a variable can be measured or manipulated in a concrete situation. In this example, pain is the sensory impression being measured on a numerical scale. The problem statement indicates the gap in knowledge needed for practice and provides a basis for the study.

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DIF: Cognitive level: Applying (Application)

21. Which is true about a causal hypothesis? a. It describes the effects of independent variables on dependent variables. b. It predicts a negative or positive interaction between variables. c. It proposes positive or negative relationships among variables. d. It states that a relationship exists between variables without indicating direction. ANS: A Feedback A

A causal hypothesis proposes a cause-and-effect interaction between two or more variables.

B C D

An associative hypothesis states that a relationship exists among variables. A correlational hypothesis proposes negative or positive interactions between variables. A causal hypothesis indicates direction.

PTS: 1 REF: pp. 149-150

DIF: Cognitive level: Understanding (Comprehension)

22. Which is an example of a directional, correlational hypothesis? a. “Increasing hours spent in study groups is associated with an increase in GPA

among nursing students.” b. “Increased use of study groups will result in an increase in GPA among nursing

students.” c. “Nursing students who use study groups are among groups of students who have

higher GPAs.” d. “Studying in study groups is related to GPA levels in nursing students.” ANS: A Feedback A

B C D

A directional hypothesis states whether a positive or negative interaction will occur between variables. A correlational hypothesis indicates an association without attributing cause. Stating that increased use of study groups will result in increased GPA makes this statement a cause-and-effect hypothesis. The third and fourth statements are nondirectional because they do not state whether or not there is a positive or negative interaction. The third and fourth statements are nondirectional because they do not state whether or not there is a positive or negative interaction.

PTS: 1 REF: pp. 149-151

DIF: Cognitive level: Applying (Application)

23. The statistical (null) hypothesis in a research study states that there is: a. a causal relationship between variables. b. a statistically significant relationship between variables. c. an implied relationship between variables. d. no relationship between variables. ANS: D Feedback A B C D

Any hypothesis stating a statistically significant relationship, an implied relationship, or a causal relationship among variables is a research hypothesis. Any hypothesis stating a statistically significant relationship, an implied relationship, or a causal relationship among variables is a research hypothesis. Any hypothesis stating a statistically significant relationship, an implied relationship, or a causal relationship among variables is a research hypothesis. The null hypothesis is the converse of the research hypothesis and states that there is no relationship among variables.

PTS: 1 REF: pp. 150-151

DIF: Cognitive level: Remembering (Knowledge)

24. Which is an important feature of a testable hypothesis? a. It may differ from the variables and population identified in the research purpose. b. Methods of sampling, measurement, and data analysis are included in the

hypothesis statement. c. Relationships among the study variables must be causative. d. Variables in a testable hypothesis are measurable or able to be manipulated. ANS: D Feedback A B C D

Variables stated in a research hypothesis are those identified in the research purpose. The testable hypothesis does not identify methodological points to avoid limiting the hypothesis to those methods. Relationships in a testable hypothesis may be associative or correlational. A testable hypothesis is one that clearly predicts the relationships among variables and contains variables that are measurable or able to be manipulated in a study.

PTS: 1 REF: p. 152

DIF: Cognitive level: Understanding (Comprehension)

25. Which statement differentiates research variables from research concepts? a. Concepts are more abstract than variables. b. Concepts are usually studied in quantitative research. c. Variables are less subject to manipulation and measurement. d. Variables cannot be concisely defined or clearly described. ANS: A Feedback A B C D

Concepts are more abstract than variables and are usually studied in qualitative research. Concepts are more abstract than variables and are usually studied in qualitative research. Variables are qualities, properties, or characteristics of persons, things, or situations that can be manipulated, and measured. Variables are qualities, properties, or characteristics of persons, things, or situations that change or vary and can be concisely defined, and described.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: pp. 153-154| p. 156 26. A researcher wishes to study the effects of a low-fat diet on self-esteem, weight, and energy

levels among obese women over age 40. Which is the independent variable in this study? a. Low-fat diet b. Obesity

c. Self-esteem, weight, and energy levels d. Women over 40 ANS: A Feedback A B C D

The independent variable in a study is the variable that can be manipulated to determine whether a specific outcome or result is achieved. Obesity and women over 40 are demographic variables. Self-esteem, weight, and energy levels are dependent variables, based on the presence or absence of the independent variable. Obesity and women over 40 are demographic variables.

PTS: 1 REF: p. 153

DIF: Cognitive level: Applying (Application)

27. Which is true about a dependent variable in a research study? It is: a. manipulated by the researcher to test the research hypothesis. b. the cause of changes in other variables in a research study. c. the experimental variable in a research study. d. the outcome the researcher wishes to predict. ANS: D Feedback A B C D

Changes in the dependent variable are presumed to be caused by the independent variables. The independent variable is manipulated by the researcher and is presumed to cause changes in the dependent variable. The independent variable is also referred to as the experimental variable. The dependent variable is the outcome that the researcher wishes to predict or explain.

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DIF: Cognitive level: Understanding (Comprehension)

28. Which type of variable is used in a descriptive study? a. Dependent variable b. Independent variable c. Research variable d. Treatment variable ANS: C Feedback A B C

The dependent variable is the outcome that the researcher wishes to predict or explain. The independent variable is manipulated by the researcher and is presumed to cause changes in the dependent variable. Research variables are the qualities, properties, or characteristics identified in a descriptive or correlational study.

The independent variable is sometimes called the treatment variable.

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29. During a study to measure the effects of violent video games on aggressive behavior, the

researchers learned that a portion of the subjects lived in homes with one or more alcoholic parents. In this study, the presence of an alcoholic parent is a(n): a. confounding variable. b. dependent variable. c. independent variable. d. unrecognized variable. ANS: A Feedback A

B C D

A confounding variable is an extraneous variable that is not recognized until the study is in process or is recognized before beginning the study, but cannot be controlled. The dependent variable is the outcome that the researcher wishes to predict or explain. The independent variable is manipulated by the researcher and is presumed to cause changes in the dependent variable. An unrecognized variable is a type of extraneous variable that is not noted during the study, but may or may not influence the outcome.

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30. To reduce or eliminate the influence of environmental variables on study results, the

researcher may: a. completely describe all environmental settings encountered in the study. b. discuss these variables in the study results. c. use a research unit in a hospital or laboratory. d. use a qualitative study design to conduct the study. ANS: C Feedback A B C

Describing the environmental variables or discussing them in the study results does not eliminate the influence of the environment on the study outcomes. Describing the environmental variables or discussing them in the study results does not eliminate the influence of the environment on the study outcomes. Environmental variables are a type of extraneous variable present in the setting in which the study is conducted. In order to control for environment, the researcher will use a laboratory setting or a research unit in a hospital. Using a qualitative study design noes not eliminate the influence of the environment on study outcomes.

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DIF: Cognitive level: Applying (Application)

31. Which is an example of a conceptual definition of a dependent variable in a study evaluating

the effects of home nursing on coping among patients with chronic illness? a. “Coping is a set of actions and strategies used by individuals to reduce the stressors associated with chronic disease management.” b. “Coping skills were measured using a five-point Likert scale with higher scores indicating higher coping skills.” c. “Home nursing can include registered nurse and nursing assistant management of treatments provided at home.” d. “Home nursing was measured in the number of hours per week and the number of hours per day of in-home care.” ANS: A Feedback A B C D

A conceptual definition provides the theoretical meaning of a variable. The dependent variable in this study is “coping.” Operational definitions describe the actions the researcher will take to identify the characteristics of the variable. “Home nursing” is the independent variable in this study. “Home nursing” is the independent variable in this study.

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DIF: Cognitive level: Analyzing (Analysis)

32. Which is true about an operational variable in quantitative research? a. It is developed so that the degree of its existence can be measured. b. It is often derived from a theoretical definition of a related concept. c. It is specific to the time and setting of the research study. d. It provides the theoretical meaning of a variable. ANS: A Feedback A

B C D

An operational definition is derived from a set of procedures or progressive acts that a researcher performs to receive sensory impressions that indicate the existence or degree of existence of a variable. The conceptual definition is derived from the theoretical definition of a related concept. Operational definitions need to be independent of time and setting. The conceptual definition provides theoretical meaning for a variable.

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DIF: Cognitive level: Analyzing (Analysis)

33. In a qualitative study, which is true about the definition of research concepts? a. They are measureable variables that help illustrate theoretical concepts. b. They are often defined or described as a result of the study. c. They are written to provide a concise measure of theoretical concepts. d. They must be clearly described to proceed with the study.

ANS: B Feedback A B C D

Unlike variables in a quantitative study, they usually are not easily measured. In many qualitative studies, the focus of the study is to define or describe the concept. They are developed as the study unfolds and do not have to be clearly described in order to proceed with the study. They are developed as the study unfolds and do not have to be clearly described in order to proceed with the study.

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34. Which type of variable is used in a summary of sample characteristics? a. Demographic variables b. Dependent variables c. Independent variables d. Research variables ANS: A Feedback A B C D

Demographic variables are attributes of subjects that are collected to describe the sample. Dependent variables are variables that change as a result of manipulation of the independent variable. Independent variables are variables that are manipulated to observe effects on dependent variables. Research variables are variables used in qualitative studies.

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DIF: Cognitive level: Applying (Application)

35. Which is true about a statement of the research purpose? a. It describes the background for the subject of the research study. b. It includes a discussion of the significance of the study. c. It includes the research problem statement. d. It provides a concise description of the study’s focus. ANS: D Feedback A B C D

The review of the literature provides background for the subject of a research study. The study’s significance is a part of the overall purpose of the study. The research problem statement is a separate statement and includes a discussion of the study’s significance. The research purpose is a concise, clear statement of the specific goal of focus of the study.

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DIF: Cognitive level: Remembering (Knowledge)

36. An examination of the researcher’s plan for using measurement tools to examine relationships

among variables helps determine the: a. research hypothesis. b. research objectives. c. study feasibility. d. study purpose. ANS: A Feedback A B C

The research hypothesis is determined through the research question and is a statement about the relationship among the research variables. The research objectives are identified in the research purpose. The study feasibility is determined by the researcher’s expertise, the available funding, measurement tools and sample population availability, and ethical considerations. The study purpose is a statement identifying what will be measured in a particular study.

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DIF: Cognitive level: Understanding (Comprehension)

37. Which is true about a research hypothesis? a. It defines the various research variables and describes how they will be measured. b. It explains the relationship of the research purpose to theory development. c. It includes the research problem, purpose, and research questions. d. It links the research problem statement to the study design and data analysis. ANS: D Feedback A B C D

The problem statement can link the research purpose to theory development. The introduction contains the research problem, purpose, and research questions. The research purpose links the problem statement to the study design and data analysis. The research hypothesis is the formal statement of the expected relationship between two or more variables in a specified population.

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DIF: Cognitive level: Understanding (Comprehension)

38. In a research proposal, a statement about expected relationships among variables is the: a. conceptual definition. b. operational definition. c. research hypothesis. d. research problem. ANS: C

Feedback A B

C D

The conceptual definition is derived from the theoretical definition of a related concept and provides theoretical meaning for a variable. An operational definition is derived from a set of procedures or progressive acts that a researcher performs to receive sensory impressions that indicate the existence or degree of existence of a variable. The research hypothesis is the formal statement of the expected relationship between two or more variables in a specified population. The research problem identifies gaps in knowledge.

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DIF: Cognitive level: Applying (Application)

39. Which type of variable is manipulated by the researcher? a. Demographic b. Dependent c. Independent d. Research ANS: C Feedback A B C D

Demographic variables are attributes of members of a sample population. The dependent variable is the outcome variable and is the variable researchers wish to predict based on manipulation of the independent variable. The independent, or experimental variable, is manipulated by the researcher in order to observe possible effects on the dependent variable. A research variable is used in qualitative studies.

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DIF: Cognitive level: Remembering (Knowledge)

40. In a study of adolescent children using a group of high school football players and junior-high

school cyclists, researchers compared the length of recovery from concussion between those wearing brand X helmets and those wearing brand Y helmets. In this study “high school football players” represent which type of variable? a. Demographic b. Dependent c. Independent d. Research ANS: A Feedback A B C D

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DIF: Cognitive level: Applying (Application)

Chapter 06: Understanding and Critically Appraising the Literature Review Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. One reason for conducting a review of the literature other than for purposes of developing a

research study is to: a. determine the expertise of researchers in the field of study. b. identify current theoretical frameworks. c. implement evidence-based practice guidelines. d. work in a Magnet-certified hospital setting. ANS: C Feedback A

Evaluation of the expertise of researchers and identification of theoretical frameworks are part of literature reviews but are not the reason for conducting them. Evaluation of the expertise of researchers and identification of theoretical frameworks are part of literature reviews but are not the reason for conducting them. Although a literature reviews are commonly associated with development of research studies, they are also conducted when developing projects to establish evidence-based-practice (EBP). Nurses in Magnet hospitals often participate in EBP projects and will conduct literature reviews for these, but not solely to be able to work in these institutions.

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2. What is the purpose of a limited research review? a. To allow the reader to become familiar with the research problem b. To develop an initial pilot study prior to a more in-depth study c. To direct the planning and execution of a study d. To identify studies published after a study is performed ANS: D Feedback A B C D

A full literature review allows the reader to become familiar with the research problem and is performed prior to a pilot or a full study. The full literature review directs the planning and execution of the study. The full literature review directs the planning and execution of the study. A limited research review is often conducted after an initial literature review in order to describe any studies performed after the study has been performed. The results of both the original literature review and the limited literature review are

included in the report. PTS: 1 REF: p. 163

DIF: Cognitive level: Understanding (Comprehension)

3. A reviewer reading a proposal for a qualitative research study notes that the author has not

included a literature review. The reviewer understands that a literature review may have been omitted in this case because: a. it is not necessary to conduct a literature review for qualitative research. b. qualitative research is conducted to study areas where there is no previous knowledge. c. some researchers feel that previous studies may bias data collection in qualitative studies. d. the researcher was not adequately prepared to conduct this research study. ANS: C Feedback A B C D

A literature review can be helpful in qualitative research and should be performed if possible. This is true of some but not all qualitative methods (for example grounded theory); however, it is not true of all qualitative designs. Many times literature reviews are omitted from qualitative research to avoid causing expectations that might bias findings, data collection, and data analysis. At times, there is little or no previous research on the topic, but not always. Omission of a literature review in qualitative research does not indicate that the researcher is ill-prepared.

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DIF: Cognitive level: Applying (Application)

4. Which type of study is least likely to include a review of the literature prior to initiating the

study? a. Grounded theory b. Phenomenological c. Qualitative d. Quantitative ANS: B Feedback A

B C D

Grounded theory researchers may have a limited review of relevant studies in order to make the researcher aware of what studies have been conducted and that a research problem exists. Phenomenological researchers are most likely to delay literature review until after a study is completed in order to avoid bias. Qualitative and quantitative research will involve literature reviews, although these may be less substantial in qualitative studies. Qualitative and quantitative research will involve literature reviews, although these may be less substantial in qualitative studies.

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DIF: Cognitive level: Remembering (Knowledge)

5. What is the main purpose of a literature review in grounded theory research? a. To explain, extend, and support the framework used for the study b. To identify gaps in current knowledge about the research topic c. To place research findings in context of what is already known. d. To support the need to study the selected research topic ANS: A Feedback A

B C D

In grounded theory research, the researcher uses the literature review primarily to explain, support, and extend the framework used in the study, and not to direct data collection or study methods. It is usually completed at the end of the analysis rather than before the proposal development The literature review in quantitative studies is designed to identify gaps in knowledge. Phenomenological literature reviews are conducted to place research findings in the context of what is already known. Because the literature review for grounded theory research is generally conducted at the end of the analysis, it is not used to support the need for studying the topic, but to summarize what is known.

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6. Why might Wikipedia be a questionable reference for a study citation? a. It does not contain factual information. b. It does not provide ideas for other resources. c. It is an online resource.. d. It is an open, editable format. ANS: D Feedback A B C D

Wikipedia may contain factual information, but this is not reliable. Wikipedia may provide ideas for other resources. Wikipedia is an online resource, but that fact does not exclude it from being used. Wikipedia is an open, editable format; the information may not always be accurate because it is not peer reviewed and scientifically based.

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7. Which source of information is rarely cited in academic publications? a. Conference proceedings b. Dissertation or thesis c. Encyclopedia

d. Textbooks ANS: C Feedback A B C

Conference proceedings, dissertations or theses, and textbooks may all be cited. Conference proceedings, dissertations or theses, and textbooks may all be cited. Encyclopedias tend to provide background information and some information leading to other resources, but generally not scholarly or primary source information. Conference proceedings, dissertations or theses, and textbooks may all be cited.

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8. When determining the reliability of a website resource in a literature review, it is important to

determine: a. accessibility of the website information. b. costs of retrieving website information. c. sponsorship of website information. d. whether website information is also published conventionally. ANS: C Feedback A B C

Accessibility, cost, and conventional publication of website information are not determinants of reliability of website information. Accessibility, cost, and conventional publication of website information are not determinants of reliability of website information. Not all websites are valid and appropriate for citation in a literature review. Those that are sponsored by companies that sell certain products under study may not be appropriate resources because their information may be biased. Accessibility, cost, and conventional publication of website information are not determinants of reliability of website information.

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DIF: Cognitive level: Applying (Application)

9. A review of empirical literature will yield information obtained from: a. concept analyses. b. descriptions of models and frameworks. c. research studies. d. theories. ANS: C Feedback A B

Theoretical literature includes concept analyses, models, theories, and conceptual frameworks. Theoretical literature includes concept analyses, models, theories, and conceptual frameworks.

C D

Empirical literature refers to knowledge derived from research and is based on data from research. Theoretical literature includes concept analyses, models, theories, and conceptual frameworks.

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DIF: Cognitive level: Remembering (Knowledge)

10. What is an important limitation of secondary sources in literature reviews? a. The authors do not have high levels of expertise. b. They are usually not peer-reviewed sources. c. They do not contain unique or original information. d. They may contain misinterpreted information. ANS: D Feedback A B C D

Authors of secondary sources have similar levels of expertise as those of primary sources. Secondary sources may contain original information as authors synthesize and analyze findings from primary sources. Secondary sources are usually peer reviewed. A secondary source summarizes or quotes content from primary sources. Because authors of secondary sources paraphrase the works of researchers and theorists and interpret what the primary author wrote, this information may be misinterpreted.

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11. When reviewing articles in a peer-reviewed publication, the reader is assured that the articles

are: a. b. c. d.

landmark studies. primary sources. seminal studies. trustworthy sources.

ANS: D Feedback A

Landmark studies, primary sources, and seminal studies are included in peer-reviewed literature, but may also appear in literature that is not peer reviewed. Landmark studies, primary sources, and seminal studies are included in peer-reviewed literature, but may also appear in literature that is not peer reviewed. Landmark studies, primary sources, and seminal studies are included in peer-reviewed literature, but may also appear in literature that is not peer reviewed. Research reports detailing study events, including results and analysis of

findings included in refereed professional journals, are considered one of the most credible types of evidence and are typically considered one of the most useful sources for researchers as they conduct a literature review for a current study. Articles found in refereed journals have been evaluated in an anonymous process by unbiased reviewers and received favorable review, not only for the integrity of the research itself, but because the topic of interest has been deemed significant to the profession. PTS: 1 REF: p. 166

DIF: Cognitive level: Understanding (Comprehension)

12. For a study to be considered current, it should be published within the last: a. year. b. 2 years. c. 5 years. d. 10 years. ANS: C Feedback A B C D

This is not a correct statement. This is not a correct statement. Current sources are those published within 5 years before publication of the manuscript. This is not a correct statement.

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DIF: Cognitive level: Remembering (Knowledge)

13. Some studies cited in a literature review may be decades old. The researcher may decide to

use studies from this far back because these studies: a. are groundbreaking or landmark studies. b. are particularly well-written studies. c. are peer-reviewed, relevant studies. d. are still considered current studies. ANS: A Feedback A

B C D

Studies that are groundbreaking or landmark studies are those that were significant to the development of knowledge on the topic being reviewed. In this case, it is appropriate to cite these studies, even if they are very old. Well-written, peer reviewed studies that are not current are generally not used in a literature review. Well-written, peer reviewed studies that are not current are generally not used in a literature review. Studies that are decades old, however well-written and relevant, are not current studies, but are used for historical or seminal context.

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14. A researcher conducts a study using dependent and independent variables used in a previous

study but uses a different population of subjects. What type of study is this? a. Landmark b. Pilot c. Replication d. Seminal ANS: C Feedback A B C

A landmark study is one that generates knowledge that influences a discipline and sometimes society as a whole. Landmark studies are often replicated. A pilot study is a study using a small sample size to develop the study methods and tools and is later replicated on a larger scale. A replication study is a reproduction or repetition of a study that a researcher conducts to determine whether the findings of the original study can be consistently found in different settings with different subjects. A seminal study is the first study on a particular topic that signals a new way of thinking about the topic. These studies are often replicated.

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DIF: Cognitive level: Applying (Application)

15. A nurse appraising a research article should perform which action in order to critically

evaluate the literature review? a. Locate and review sources and abstracts listed in the research article b. Note the number of data-based and theoretical sources cited in the reference list c. Perform a meta-analysis or meta-synthesis on the cited references d. Search the literature to determine whether other relevant sources exist ANS: B Feedback A B

Locating and reviewing all abstracts would be too time consuming and may not be possible. Because it would be very time consuming to search the literature and determine whether the listed sources are relevant, the reviewer should review the reference list and determine the focus of the sources, the number of data-based and theoretical sources cited, and where and when the sources were published. Meta-analysis and meta-synthesis are not done when critically appraising a literature review. These techniques are used to perform an in-depth analysis of studies already cited in the literature. It is not necessary at this point to search the literature to determine other relevant sources.

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DIF: Cognitive level: Applying (Application)

16. When appraising a literature review, one aspect of determining the breadth of the review is: a. whether the review provides direction for the proposed study.

b. the number and percentages of sources from the past 5 to 10 years. c. whether landmark or seminal studies have been used. d. the disciplines of the study authors and journals cited in the review. ANS: D Feedback A B

An assessment of whether the literature review provides direction for the study does not specifically evaluate the breadth of the literature review. The currency of the literature review is evaluated by noting the number of sources more than 5 to 10 years old as well as whether landmark or seminal studies are cited. The currency of the literature review is evaluated by noting the number of sources more than 5 to 10 years old as well as whether landmark or seminal studies are cited. When assessing the breadth of a literature review, the reviewer should identify the disciplines of the authors cited and the journals in which they published their studies.

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DIF: Cognitive level: Applying (Application)

17. An initial step when preparing to conduct a literature review is to: a. choose the types of sources to use. b. clarify the purpose of the review. c. determine how many articles to review. d. select electronic data bases and keywords. ANS: B Feedback A B C

The types of sources and the number of articles to review depend on the purpose of the review. Because the approach will vary according to the purpose of the review, the first step in conducting a literature review is to identify the purpose of the review. Once the purpose of the review is established and the author has an idea about the type and number of sources, the electronic databases and keywords are selected. Once the purpose of the review is established and the author has an idea about the type and number of sources, the electronic databases and keywords are selected.

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DIF: Cognitive level: Applying (Application)

18. When conducting a literature review for a thesis or dissertation and deciding how far back in

the available literature to search, what will the student do? a. Ask the instructor to specify necessary publication years for articles cited. b. Base the decision on the number of articles necessary for the assigned task. c. Locate any seminal or landmark studies on the topic of research. d. Look for sources no older than 10 years prior.

ANS: C Feedback A

C D

The breadth and currency of the literature review should be based on the topic and the purpose of the research and not on an assigned number or a particular number of years. The breadth and currency of the literature review should be based on the topic and the purpose of the research and not on an assigned number or a particular number of years. When beginning a thesis or dissertation, the graduate student should look for seminal or landmark studies as a place to begin a literature review. The breadth and currency of the literature review should be based on the topic and the purpose of the research and not on an assigned number or a particular number of years.

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19. When developing evidence-based-practice guidelines, if a researcher wishes to identify

studies that evaluate a specific intervention in quantitative research, the literature review should include: a. grounded theory research. b. only current research from the last 5 years. c. replication studies and meta-analyses. d. seminal and landmark studies about the topic. ANS: C Feedback A B

Grounded theory research is performed to test theory. While current research is desired, researchers may review older studies, particularly if they are seminal or landmark studies, although these are not necessary for this type of literature review. To synthesize evidence related to a practice problem and to evaluate a specific intervention in quantitative research, replication studies, meta-analyses, and meta-syntheses are used. While current research is desired, researchers may review older studies, particularly if they are seminal or landmark studies, although these are not necessary for this type of literature review.

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20. In the following APA-formatted reference, what is indicated by the italicized words?

Maxwell, S. E., & Delaney, H. D. (2004). Designing experiments and analyzing data: A model comparison perspective (2nd ed.). Mahway, NJ: Lawrence Erlbaum Associates. a. Abstract information b. Article title c. Book title d. Publishing company

ANS: C Feedback A B C D

The abstract information is not included in a reference citation. An article title is italicized if the citation is from a journal. When citing a book, the title is italicized. The publishing company information is listed last.

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21. A step just prior to beginning a literature search using an electronic database is to: a. decide how many articles are needed. b. determine the type of study. c. identify keywords for the search. d. perform a Google search. ANS: C Feedback A B C D

The number of articles needed for a literature review depends on the content of the articles and will not be known ahead of time. The study type is not typically determined just prior to an electronic search. To narrow the number of articles in a search and refine the search to more relevant articles, identifying keywords is necessary. A Google search may or may not be helpful for leading a researcher to other articles, but it is not a scientific database.

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DIF: Cognitive level: Applying (Application)

22. When conducting a literature search, which electronic product would a nurse researcher use to

track and store reference information? a. Cumulative Index of Nursing and Health Literature (CINAHL) b. EndNotes or Ref Works c. Google Scholar d. Science Direct ANS: B Feedback A B

C D

CINAHL is an electronic database used to search literature. EndNotes is reference management software that helps to track and store information on all search fields and allows the researcher to file this information with comments about each reference. Google Scholar is an electronic search engine. Science Direct is an electronic search engine.

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23. After a literature search has yielded a list of articles, an efficient way to identify relevant

studies during a literature search is to review: a. an electronic database search history. b. only experimental studies. c. reference lists in other studies. d. study abstracts. ANS: D Feedback A B C D

The electronic database search history lists only articles searched for but does not yield information about whether or not they are relevant. Experimental studies are not always relevant to a particular study, and other types of studies may be relevant. Reference lists in other studies may give information about other articles to review, but do not give information about the content of these articles. The abstract provides pertinent information about the article in a condensed, easy to peruse format so that the researcher can determine whether the article is pertinent to the topic.

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24. Once relevant studies have been identified, the researcher’s next step is to: a. determine the expertise of each study’s authors. b. obtain full-text copies of each of these articles. c. review the study design and methodology of each article. d. write the literature review based on abstract information. ANS: B Feedback A B

C D

During the literature review, the researcher will examine the authors’ expertise and will review the study design and methodology. Although the abstract information helps to determine a study’s relevance, it is essential to read the full-text article to conduct a literature review. Once relevant studies are found, the researcher must obtain either electronic or print full-text articles. During the literature review, the researcher will examine the authors’ expertise and will review the study design and methodology. The literature review cannot be written based on abstract information only.

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DIF: Cognitive level: Applying (Application)

25. When initially reading the relevant literature for comprehension, the researcher will: a. critically appraise the studies. b. highlight the main points of the studies. c. make decisions about paraphrasing quotes. d. review the abstract only.

ANS: B Feedback A B

C D

Critical appraisal involves making value judgments about the validity or credibility of the study content. Comprehending a source begins by reading and focusing on understanding the main points of the article and can be achieved by highlighting the main points of the article. Deciding what to paraphrase occurs later, just before writing the review. Reviewing the abstract helps the researcher determine which articles are relevant but does not help with comprehension.

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DIF: Cognitive level: Applying (Application)

26. A researcher performs a critical appraisal of a group of studies measuring the effects of a

home care education program on confidence levels of caregivers of elderly family members. The critical appraisal will include: a. determining the theoretical frameworks used for defining confidence. b. identifying sampling and inclusion criteria used in the studies. c. making value judgments about the credibility and validity of concepts. d. recording quotations relevant to the concept of confidence. ANS: C Feedback A

C D

While identifying theoretical frameworks, identifying sampling techniques and inclusion criteria, and recording pertinent quotations are important, they are not part of the critical appraisal of studies. While identifying theoretical frameworks, identifying sampling techniques and inclusion criteria, and recording pertinent quotations are important, they are not part of the critical appraisal of studies. To critically appraise an article, relevant content is identified and value judgments are made about the validity and credibility of key concepts. While identifying theoretical frameworks, identifying sampling techniques and inclusion criteria, and recording pertinent quotations are important, they are not part of the critical appraisal of studies.

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DIF: Cognitive level: Understanding (Comprehension)

27. To analyze a body of literature in a literature review the reviewer will: a. describe the findings of each study in the literature review. b. list the studies and itemize the findings of each one. c. make value judgments about the credibility of each study. d. synthesize and summarize findings from various studies. ANS: D Feedback

A B C D

It is not enough to merely describe the findings or to list the information in each one. It is not enough to merely describe the findings or to list the information in each one. Making value judgments is part of the appraisal process. Analysis requires synthesis and summarization of findings of the studies listed and an ability to manipulate the information by the reviewer.

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DIF: Cognitive level: Understanding (Comprehension)

28. Which is most important in a critical appraisal of a body of literature? a. Counting the available resources to determine whether more information is

necessary. b. Examining the quality and content of the resources to determine the credibility and

validity of each. c. Reviewing the reference lists in each study to find other relevant studies and

landmark studies. d. Searching the literature thoroughly using appropriate keywords to ensure that all

relevant literature is included. ANS: B Feedback A

The literature search is important and must be thorough, but the critical appraisal depends on an evaluation of the quality and not the quantity of the available resources. Critiquing the literature review of a published study involves examining the quality of the content and sources presented. This is more important than achieving an accurate count of available resources. Reviewing the reference lists may be useful for determining whether other relevant studies exist, but it is not the most important aspect of a critical appraisal, which is an evaluation of the quality of studies available. Searching the literature thoroughly using appropriate keywords to ensure that all relevant literature is included. may be useful for determining whether other relevant studies exist, but it is not the most important aspect of a critical appraisal, which is an evaluation of the quality of studies available

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29. In a literature review, the author identifies themes present in articles under review and

describes connections among these themes. This is an example of: a. analysis. b. appraisal. c. synthesis. d. theorizing. ANS: C Feedback

A B C D

Analysis requires manipulation of what is found, literally making it the author’s own. Appraisal involves identifying relevant content and determining the credibility or validity of the information. Synthesis of sources involves thinking deeply about what has been found and identifying the main themes of the information. Theorizing is part of developing the research question.

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30. A researcher reviews several articles about coping skills among parents of children with

chronic illness and notes that half of the studies involved single-parent families. The researcher decides to examine whether coping skills differ in single-parent versus dual-parent households. The researcher is engaging in: a. analyzing. b. appraising. c. evaluating. d. synthesizing. ANS: D Feedback A B C D

Analysis requires manipulation of what is found, literally making it the author’s own. Appraisal involves identifying relevant content and determining the credibility or validity of the information. Evaluation involves reviewing the literature content and determining its relevance to the topic. Synthesis of sources involves thinking deeply about what has been found and identifying the main themes of the information. In this case, the reviewer has discovered a variable that may affect the outcome of the studies.

PTS: 1 REF: pp. 182-183

DIF: Cognitive level: Analyzing (Analysis)

31. When developing the outline for a literature review, the researcher’s first step is to: a. describe the focus or purpose of the review in the discussion section. b. include a statement about what is known in the literature. c. make notes about which sources to site in each section. d. use a standardized format to outline subsections in the discussion section. ANS: C Feedback A B C

The introduction section includes the focus or purpose of the literature review. The conclusion contains the statement about what is known in the literature. An initial outline is the first step in writing the literature review and begins with determining the major sections for the paper and identifying the sources that will be used in each one.

The discussion section format will vary based on the topic.

PTS: 1 REF: pp. 183-184

DIF: Cognitive level: Applying (Application)

32. The concluding sentence of each paragraph in a literature review: a. describes relevant studies that support the theme of the paragraph. b. identifies the main themes of the paragraph. c. provides evidence to support the topic of the paragraph. d. transitions to the ideas expressed in the following paragraph. ANS: D Feedback A B C D

The opening sentence identifies the main themes of the paragraph. The sentences between the opening sentence and the concluding sentence describe relevant studies and provide evidence to support the paragraph topic. The sentences between the opening sentence and the concluding sentence describe relevant studies and provide evidence to support the paragraph topic. The concluding sentence in a paragraph in the literature review should transition to the ideas expressed in the following paragraph.

PTS: 1 REF: pp. 183-184

DIF: Cognitive level: Applying (Application)

33. When citing sources in a literature review, it is best if the author: a. paraphrases other authors’ ideas. b. points out any defects in other authors’ work. c. synthesizes the work of a group of authors. d. uses direct quotations as much as possible. ANS: A Feedback A

C D

When citing the work of other authors, the author of a literature review should paraphrase their words whenever possible—clearly, and in the reviewer’s own words. It is important, in an analysis of the literature, to identify defects in other authors’ works, but this should be done with respect and without being highly critical. Synthesis of others’ work is an important part of the literature review as well and involves paraphrasing and analysis. Direct quotations should be avoided unless the author states something in a unique way.

PTS: 1 REF: pp. 183-184

DIF: Cognitive level: Understanding (Comprehension)

34. An author uses an electronic source in portable document format (PDF). Which is true about

citing this source in a literature review? a. It is necessary to provide the URL used to retrieve the article electronically.

b. It is not treated differently than a print version of the article. c. The original print article must be located. d. The page numbers will not be available for citation. ANS: B Feedback A B C D

Providing the URL for such an article is not helpful in this case. When retrieving a PDF document, the source is cited as if a copy of the print version of the article had been used. It is not necessary to locate the original print article when a PDF article is used. A PDF article is the same as a print article and will have page numbers for citation.

PTS: 1 REF: p. 184

DIF: Cognitive level: Applying (Application)

Chapter 07: Understanding Theory and Research Frameworks Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. Which is true about a study framework? a. It guides nurses in clinical practice. b. It explains a portion of a theory. c. It is one of the major ideas of a theory. d. It is the underlying methodology used in research. ANS: B Feedback A B C D

The knowledge gained from testing theories is used to guide nursing practice. A study framework is a brief explanation of a theory or those portions of a theory that are to be tested in a study. Concepts are the major ideas contained in a theory. The framework is not the methodology, which consists of sampling techniques, tools, and measures used to gather and analyze data.

PTS: 1 REF: p. 190

DIF: Cognitive level: Understanding (Comprehension)

2. Which statement is true about theory and qualitative studies? a. Qualitative studies rely on conceptual frameworks and not on theory. b. Qualitative studies are not based on theory. c. Qualitative studies may be used to create theory. d. Qualitative studies use theory in the same way as quantitative studies. ANS: C

Feedback A B C D

Qualitative studies do not rely on conceptual frameworks. Qualitative studies may be based on theory. Qualitative studies may be based on a theory or may be designed to create a theory. Quantitative studies are designed to test the components of a theory, while qualitative studies may merely be based on or seek to create a theory.

PTS: 1 REF: p. 190

DIF: Cognitive level: Understanding (Comprehension)

3. A researcher is studying how anxiety affects coping with chronic disease and theorizes that

measures to reduce anxiety will improve subjects’ ability to cope with day-to-day demands of self-care. In this example, anxiety and coping are: a. assumptions. b. concepts. c. philosophies. d. theories. ANS: B Feedback A B

Assumptions are statements in a philosophy or theory that are taken for granted or considered to be true. Concepts are terms that abstractly describe and name an object, idea, experience, or phenomenon and are defined in specific ways to present the ideas relevant to a theory. Philosophies are rational intellectual explorations of truths or principles and describe viewpoints on what reality is and which ethical ideas should guide practice. Theories are sets of concepts that present a view of a phenomenon.

PTS: 1 REF: pp. 190-191

DIF: Cognitive level: Applying (Application)

4. When reviewing various theoretical frameworks, the nurse researcher identifies several

viewpoints about how nurses should engage with terminally ill patients. These viewpoints represent: a. abstract ideas. b. assumptions. c. concrete ideas. d. philosophies. ANS: D Feedback A B C

An abstract idea focuses on a general view of a phenomenon. Assumptions are statements in a philosophy or theory that are taken for granted or considered to be true. A concrete idea focuses on a particular instance.

A philosophy is an idea that explores truths or principles and describes which ethical ideas should guide practice.

PTS: 1 REF: pp. 190-191

DIF: Cognitive level: Applying (Application)

5. A nurse researcher develops a study to assist patients with type 2 diabetes mellitus to lose

weight by altering eating patterns. The researcher states, “Patients with type 2 diabetes mellitus desire to control weight to gain better glycemic control.” This statement is a(n): a. assumption. b. concept. c. philosophy. d. theory. ANS: A Feedback A B

PTS: 1 REF: pp. 190-191

DIF: Cognitive level: Applying (Application)

6. A nurse researcher will measure the effects of infant and parent bonding on infant weight gain

in the first 6 months of life. The nurse will evaluate the number of times each day that the parent holds the infant. This measure is an example of a(n): a. abstract idea. b. concept. c. concrete idea. d. phenomenon. ANS: C Feedback A B C D

An abstract idea is a general view of a phenomenon, such as parent/infant bonding. A concept is a term that abstractly describes a phenomenon. Concrete ideas refer to realities or actual instances, focusing on the particular and not the general. A phenomenon is the appearance or aspect of reality as it is experienced.

PTS: 1 REF: pp. 191-192

DIF: Cognitive level: Applying (Application)

7. The nurse researcher plans to evaluate self-care and its effects on disease prevention. The

nurse identifies various health promotion activities—such as proper diet, exercise, and hours of sleep per night—as components of self-care. In this example, “self-care” is a: a. concept. b. construct. c. theory. d. variable. ANS: A Feedback A B C D

A concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all. A construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts. Theories are sets of concepts that present a view of a phenomenon. A variable is more specific than a concept and is variable and measurable.

PTS: 1 REF: pp. 191-192

DIF: Cognitive level: Applying (Application)

8. The nurse researcher plans to evaluate self-care and its effects on disease prevention. The

nurse identifies various health promotion activities—such as proper diet, exercise, and hours of sleep per night—as components of self-care. In this example, “health promotion” is a: a. concept. b. construct. c. theory. d. variable. ANS: B Feedback A B C D

PTS: 1 REF: pp. 191-192

DIF: Cognitive level: Applying (Application)

9. The nurse researcher plans to evaluate self-care and its effects on disease prevention. The

nurse identifies various health promotion activities—such as proper diet, exercise, and hours of sleep per night—as components of self-care. In this example, “hours of sleep” is a: a. concept. b. construct. c. theory. d. variable. ANS: D

Feedback A B C D

A construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts. A concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all. Theories are sets of concepts that present a view of a phenomenon. A variable is more specific than a concept and is variable and measurable.

PTS: 1 REF: pp. 191-193

DIF: Cognitive level: Applying (Application)

10. The nurse researcher plans to evaluate self-care and its effects on disease prevention. The

nurse identifies various health promotion activities—such as proper diet, exercise, and hours of sleep per night—as components of self-care. In this example, “effects of self-care on disease prevention” is a: a. concept. b. construct. c. theory. d. variable. ANS: C Feedback A B C D

A concept is more abstract than a variable and represents the name for an object or phenomenon of interest. A concept is the most abstract element of all. A construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts. Theories are sets of concepts that present a view of a phenomenon. A conceptual map includes all of the major concepts in a theory or framework. A variable is more specific than a concept and is variable and measurable.

PTS: 1 REF: pp. 191-192

DIF: Cognitive level: Applying (Application)

11. Which is an important characteristic of a variable? a. It is broad and encompasses several ideas. b. It is constant from one instance to another. c. It is less specific than a concept. d. It is measurable and changeable. ANS: D Feedback A B C D

Variables are narrow in their definition. Variables vary from one instance to another. Variables are more specific than are concepts. A variable is more specific than a concept and is variable and measurable.

PTS: 1 REF: p. 191

DIF: Cognitive level: Understanding (Comprehension)

12. Which is true about a conceptual definition in a research study? a. It defines how a concept can be manipulated in a study. b. It describes how a concept may be measured in a study. c. It is comprehensive and includes associative meanings. d. It is more specific than a dictionary definition. ANS: C Feedback A B C D

The operational definition describes how the concept may be manipulated in a study. The operational definition describes how the concept may be measured in a study. A conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have. A conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have.

PTS: 1 REF: p. 192

DIF: Cognitive level: Understanding (Comprehension)

13. In a study about childhood obesity, the researcher discusses the concept of overweight in

terms of weight for height measures, body mass index (BMI), body image, self-esteem, and social norms. When discussing body image, self-esteem, and social norms, the researcher is describing the: a. conceptual definition. b. dependent variable. c. independent variable. d. operational definition. ANS: A Feedback A B C D

A conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have. The dependent variable is a measurable variable that is hypothesized to change as a result of manipulation or difference in the independent variable. The independent variable is a measurable variable that is manipulated by the researcher to observe possible changes in the dependent variable. The operational definition describes how the concept may be measured or manipulated in a study.

PTS: 1 REF: p. 192

DIF: Cognitive level: Analyzing (Analysis)

14. In a study about childhood obesity, the researcher discusses the concept of overweight in

terms of weight for height measures, body mass index (BMI), body image, self-esteem, and social norms. The researcher states that a BMI > the 95th percentile represents overweight. This statement is a(n): a. conceptual definition.

b. dependent variable. c. independent variable. d. operational definition. ANS: D Feedback A B C D

A conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have. The dependent variable is a measurable variable that is hypothesized to change as a result of manipulation or change in the independent variable. The independent variable is a measurable variable that is manipulated by the researcher to observe possible changes in the dependent variable. The operational definition describes how the concept may be measured or manipulated in a study.

PTS: 1 REF: p. 192

DIF: Cognitive level: Analyzing (Analysis)

15. A researcher discusses how endorphins released during aerobic exercise cause a heightened

sense of well-being in subjects. This discussion is a: a. conceptual definition. b. operational definition. c. relational statement. d. theoretical framework. ANS: C Feedback A B C D

A conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have. The operational definition describes how the concept may be measured or manipulated in a study. A relational statement clarifies the type of relationship that exists between concepts. A theoretical framework describes abstract concepts and phenomena and is used to guide nurses in clinical practice.

PTS: 1 REF: p. 193

DIF: Cognitive level: Analyzing (Analysis)

16. When a researcher analyzes data obtained from study variables for possible significant

relationships among these variables, the researcher is testing the: a. abstract ideas. b. conceptual definitions. c. relationship statements. d. study assumptions. ANS: C Feedback

A B

C D

An abstract idea focuses on a general view of a phenomenon. A conceptual definition is more comprehensive than a denotative or dictionary definition and includes associated meanings the word may have. It does not identify relationships. A relational statement clarifies the type of relationship that exists between concepts. Assumptions are statements in a philosophy or theory that are taken for granted or considered to be true.

PTS: 1 REF: p. 193

DIF: Cognitive level: Analyzing (Analysis)

17. Which statement is true about the hypothesis in a research study? a. It clearly identifies concepts. b. It is written at a higher level of abstraction than a general proposition. c. It is not testable. d. It makes a statement about specific relationships among variables. ANS: D Feedback A B C D

The hypothesis does not define concepts. The hypothesis is written at a lower level of abstraction than a framework or proposition. Hypotheses are written to be tested in a study and make predictions about the relationships among variables. Hypotheses are written to be tested in a study and make predictions about the relationships among variables.

PTS: 1 REF: p. 193

DIF: Cognitive level: Understanding (Comprehension)

18. Which nursing theorist developed a grand nursing theory? a. Brennaman b. Orem c. Pender d. Swanson ANS: B Feedback A B C D

Brennaman developed mid-level nursing theories. Orem’s theory is a grand nursing theory. Pender developed mid-level nursing theories. Swanson developed mid-level nursing theories.

PTS: 1 REF: p. 194

DIF: Cognitive level: Remembering (Knowledge)

19. A nurse researcher discusses a theory about the stigma of chronic illness in children and

describes aspects of chronic illness including aesthetic qualities, causes of the condition, and concealability of the disease as dimensions of this stigma. In this case, “aesthetic qualities, causes of the condition, and concealability of the disease” are: a. concepts. b. constructs. c. theories. d. variables. ANS: B Feedback A B C D

PTS: 1 REF: p. 194

DIF: Cognitive level: Analyzing (Analysis)

20. The level of theory often derived from evidence-based guidelines is: a. grand theory. b. grounded theory. c. mid-range theory. d. practice theory. ANS: D Feedback A B C D

A grand theory is an abstract nursing theory. Grounded theory is theory derived from the analysis of data. A mid-range theory is narrower in scope than a grand theory. A specific type of mid-range theory is a prescriptive, or practice theory. These are often derived from evidence-based guidelines and are specific to situations.

PTS: 1 REF: p. 195

DIF: Cognitive level: Understanding (Comprehension)

21. In the introduction to a study, the researcher explains why self-esteem is expected to affect

obesity. The explanation of this relationship represents which aspect of the study? a. Concept b. Construct c. Framework d. Theory ANS: C Feedback A

A concept is more abstract than a variable and represents the name for an object

B C D

or phenomenon of interest. A concept is the most abstract element of all. A construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts. A framework is an abstract, logical structure of meaning identifying how one variable is expected to affect another. Theories are sets of concepts that present a view of a phenomenon.

PTS: 1 REF: p. 198

DIF: Cognitive level: Applying (Application)

22. Which will the researcher use to display the concepts and relationships in a theoretical

framework? a. Construct b. Graph c. Model d. Theory ANS: C Feedback A B C D

A construct is a concept that has been created for the study. A construct is a broader category or idea that may encompass several concepts. A graph may be used in a model to depict variables. A model is a diagram or map that graphically displays concepts and relationships in a theory. Theories are sets of concepts that present a view of a phenomenon.

PTS: 1 REF: p. 198

DIF: Cognitive level: Understanding (Comprehension)

Chapter 08: Clarifying Quantitative Research Designs Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 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 Feedback A

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. Correlational and descriptive designs are nonexperimental studies that focus on examining variables as they naturally occur and not on the implementation of a

C D

treatment by the researcher. Quasi-experimental and experimental studies are designed to examine causality between a researcher-implemented treatment and a study outcome. 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.

PTS: 1

DIF: Cognitive level: Comprehension

REF: p. 212

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 Feedback A B

C D

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. Longitudinal design refers to data collection from the same subjects at different points in time.

PTS: 1

DIF: Cognitive level: Application

REF: p. 212

3. A nurse researcher wishes to identify rates of pertussis infection in children less than one 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 Feedback 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. 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.

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DIF: Cognitive level: Applying

REF: p. 212

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 Feedback A B

C D

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. Descriptive designs may be used to develop theories and identify problems with current practice. 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.

PTS: 1

DIF: Cognitive level: Understanding

REF: pp. 212-213

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 Feedback A

B C

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.

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DIF: Cognitive level: Applying

REF: p. 216

6. 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. In order 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 Feedback A B C D

Correlational studies do not involve manipulation of a variable. In correlational designs, a large range in the variable scores is necessary to determine the existence of a relationship. 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.

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REF: p. 217

7. 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 Feedback A B C

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. Using this design facilitates the identification of many interrelationships in a situation. 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.

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REF: pp. 218-220

8. 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 Feedback A B C D

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. A predictive correlational design is used to predict the value of one variable based on the values obtained for another variable or variables.

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DIF: Cognitive level: Comprehension

REF: p. 220

9. 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 Feedback A B C D

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. The model testing design requires all concepts relevant to the model be measured and the relationships among these concepts examined. A predictive correlational design is used to predict the value of one variable based on the values obtained for another variable or variables.

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REF: p. 221

10. 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 Feedback A B C

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. 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. Limiting the study to patients of a certain age only controls for one extraneous variable.

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DIF: Cognitive level: Analyzing

REF: p. 223

11. 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 Feedback A

B C D

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.

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DIF: Cognitive level: Understanding

REF: p. 223

12. 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 Feedback A B

C D

Bias refers to interference by the researcher that influences the outcome of a study. 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. Reliability and validity are related to consistency and trustworthiness of measurement tools. Reliability and validity are related to consistency and trustworthiness of measurement tools.

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REF: p. 224

13. 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 Feedback A B C D

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. This can be threatened by anything interfering with consistent implementation of a variable, including inadequate training of individuals who implement the intervention.

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DIF: Cognitive level: Analyzing

REF: pp. 224-225

14. 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 Feedback A B C D

PTS: 1

DIF: Cognitive level: Analyzing

REF: p. 225

15. 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 Feedback A B

C D

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. 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. If not all nurses received cue-based education, the intervention implementation will be unreliable.

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DIF: Cognitive level: Analyzing

REF: p. 225

16. 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 as a whole. This is a threat to: a. construct validity. b. external validity. c. internal validity. d. statistical conclusion validity. ANS: B Feedback A B C D

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DIF: Cognitive level: Analyzing

REF: p. 225

17. 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 in order 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 Feedback A B C D

Mono-operation bias occurs when only one measure is used to evaluate an outcome. 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. 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.

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DIF: Cognitive level: Analysis

REF: pp. 225-226

18. 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 Feedback A B C

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. 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. Precision of measurement refers to whether or not the tools yield the same readings or findings from one test to another.

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REF: p. 226

19. 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 Feedback A B C D

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. Double-blind data collection, random assignment of subjects, and reliability of test measures are important to improve control and reduce bias. One way to reduce the effect of extraneous variables is to train a small number of staff to administer the intervention to improve consistency.

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REF: p. 225

20. 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. b. c. d.

construct validity. external validity. internal validity. statistical conclusion validity.

ANS: C Feedback A B C D

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REF: p. 226

21. 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 Feedback A B C D

Consistent application of the intervention and improved precision of measurements help minimize threats to statistical conclusion validity. 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. 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.

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REF: pp. 224-225

22. 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 Feedback A B

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. Construct validity depends on adequate definition and measurement of

C D

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.

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REF: p. 225

23. 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 Feedback A B C D

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

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REF: p. 225|p. 228

24. 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 Feedback A B C D

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REF: p. 225

25. In order 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 Feedback A B

C D

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.

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REF: p. 225

26. In order 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 Feedback A B C D

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. To improve determinations of causality, the independent variable should be administered consistently to all subjects in the treatment group. The independent variable should be precisely defined.

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REF: pp. 229-230

27. 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 Feedback A

An alternative intervention would invite comparison, but if it is new, it would

B C D

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. 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.

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REF: pp. 230-232

28. 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 Feedback A B C D

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. Groups that receive the intervention in either type of study are referred to as experimental or treatment groups.

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REF: pp. 230-232

29. 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 Feedback A B C

Statistical conclusion validity is concerned with whether the conclusions based on statistical analyses are an accurate reflection of the real world.

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REF: pp. 232-233

30. 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 Feedback A

B C D

Experimental designs involve manipulation independent variables, but without random assignment of subjects to groups, which can weaken the study by increasing the potential for bias. Pre-test/Post-test 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. 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.

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REF: p. 232|p. 237|p. 238|p. 241

31. 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 Feedback A B C D

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.

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REF: p. 241

Chapter 09: Examining Populations and Samples in Research Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE

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 Feedback A

C D

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.

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REF: p. 249

2. A researcher wishes to evaluate the management of chemotherapy side effects in children with

acute lymphocytic leukemia (ALL). Children with ALL are an example of which of the following? a. Accessible population b. Element of the population c. Sample population d. Target population ANS: D Feedback A B C D

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

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REF: p. 249

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 Feedback A

B C

The accessible population is that portion of the entire population that the researcher can actually use, which, in this case, would be the 250 patients at this medical center. 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. The target population is the entire set of individuals who meet the sampling criteria.

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REF: p. 249

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 Feedback A B C

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. The target population is the entire set of individuals who meet the sampling criteria.

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REF: p. 250

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 Feedback 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

B C D

population. A general population is the population as a whole, 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.

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REF: p. 250

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 Feedback A

B C

Inclusion criteria, eligibility criteria, and sampling criteria are those characteristics that the subject or element must possess to be part of the target population. 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. Inclusion criteria, eligibility criteria, and sampling criteria are those characteristics that the subject or element must possess to be part of the target population.

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REF: p. 251

7. The benefit to using a sample that utilizesnarrow sampling criteria is that there is increased: a. control of extraneous variables. b. generalizability. c. heterogenicity. d. range of values and scores. ANS: A Feedback A B C D

A sample that is narrowly defined is more homogeneous and has greater control of extraneous variables. The more narrow 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.

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REF: p. 251

8. A researcher uses a sample whose members have characteristics similar to 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 Feedback A

Knowing a sample is a cluster sample tells how it was created but does not define a representative sample. Representativeness means that the sample, accessible population, and target population are alike in as many ways as possible. Knowing a sample is a purposive sample tells how it was created but does not define a representative sample. Representativeness means that the sample, accessible population, and target population are alike in as many ways as possible. Knowing a sample is a random sample tells how it was created but does not define a representative sample. Representativeness means that the sample, accessible population, and target population are alike in as many ways as possible. Representativeness means that the sample, accessible population, and target populations are alike in as many ways as possible.

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REF: p. 251

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 Feedback A B C D

The acceptance rate is the percentage of subjects who meet eligibility requirements who consent to participate. The sample attrition rate is the percentage of subjects who withdraw from a study after the study has begun. 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.

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REF: p. 253

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 Feedback 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 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. 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.

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REF: pp. 252-254

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 Feedback A B C D

Cluster, convenience, and systematic sampling increase the risk that the sample population has attributes that differ from the general population. Cluster, convenience, and systematic sampling increase the risk that the sample population has attributes that differ from the general population. 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.

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REF: pp. 252-254

12. A researcher wishes to identify all school-age children who have type 2 diabetes mellitus in a

local community in order 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 Feedback A B C D

The ACA does not address the sharing of patient information. COBRA is concerned with health care coverage after termination of coverage. HIPAA contains guidelines about sharing patient information and may serve as a barrier to obtaining names of potential subjects. IRBs govern the use of human subjects in research.

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REF: p. 254

13. A researcher enters a list of subject 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 Feedback A

Cluster sampling occurs when the researcher selects subjects from groups of subjects within the larger population, as with groups from specific regions or cities. 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. 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.

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REF: p. 259

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 Feedback

A B C

Using only married subjects makes the results ungeneralizable to unmarried subjects. Randomly assigning subjects without stratification does not make the groups representative. 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. Having equal numbers from each group is possible as long as subjects are randomly assigned and not selected.

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REF: p. 260

15. When using stratified random sampling, the researcher is able to: 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 Feedback A B C D

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. 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.

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REF: p. 260

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 Feedback 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.

C D

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.

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REF: p. 261

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 Feedback A

B C D

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.

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REF: p. 262

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 Feedback A B C

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. Representativeness of the sample is a concern in convenience sampling, and generalizability is therefore limited.

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REF: p. 264

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 Feedback A B C D

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

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REF: p. 262

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 Feedback A B C D

Cluster sampling is a type of random sampling and is much stronger than convenience sampling. There is little opportunity to control for bias in a convenience sample. 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.

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REF: p. 264

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 Feedback A

In convenience sampling, the researcher uses subjects as they are available until the desired sample size is reached.

B C D

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.

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REF: p. 264

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. In order 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 Feedback A

B C D

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. Quota sampling involves convenience sampling but adds techniques to ensure that certain subject types are represented. 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.

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REF: p. 265

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 .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 Feedback A B

Quota sampling and stratified random sampling do not necessarily affect a study’s power. The minimum acceptable level of power for a study is 0.8 and 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. 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.

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REF: pp. 266-268

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 Feedback A B

Quota and cluster sampling techniques help to increase the representativeness of the sample but do not affect the significance of the measurement findings. 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. 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.

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REF: p. 268

25. 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 Feedback A B C

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. 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. Simple random sampling would not work well because the researcher is looking for a specific subgroup of the general population.

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REF: p. 271

26. 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 Feedback A B C D

Network sampling takes advantage of social networks and the fact that friends tend to have characteristics in common. With purposive sampling, the researcher consciously selects certain participants to include in the study and may or may not include all typical subject types. 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.

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REF: p. 270

27. 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 Feedback A B C D

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.

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REF: pp. 274-275

28. 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 Feedback A B C D

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. 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.

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REF: pp. 274-275

29. 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 Feedback A

B C D

Information gained in a qualitative study must be in depth and of high quality in order 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.

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REF: pp. 274-275

30. 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 Feedback A

B C D

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. Simple random sampling is when every member of the population has an equal chance of selection for the sample. In a stratified sample, knowledge about characteristics of the population is used to create a sample that is representative of the larger population.

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DIF: Cognitive level: Applying

REF: p. 259

31. 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 Feedback A B

C D

Grounded theory research is concerned with development of theories. 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. 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.

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DIF: Cognitive level: Applying

REF: pp. 274-275

32. 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 Feedback A

In cluster sampling, a researcher develops a sampling frame that includes a list

C D

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. Stratified random sampling is used when certain characteristics of the group are identified and then proportionately included in the randomly chosen sample. Systematic sampling is selecting every kth individual from a listing of the population.

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DIF: Cognitive level: Applying

REF: p. 260

33. In order 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 Feedback A B C D

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. 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. 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. 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.

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DIF: Cognitive level: Analyzing

REF: p. 274

34. Which type of setting is most commonly used in qualitative research? a. Controlled b. Multiple c. Natural d. Partially controlled ANS: C Feedback A B C

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. 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.

PTS: 1

DIF: Cognitive level: Understanding

REF: p. 277

35. 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 Feedback A

B C D

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. A natural, or field, setting occurs naturally, without control by the researcher. 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.

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REF: p. 277

36. 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 Feedback A B C D

A nursing home unit and an intensive care unit allow for partial control. 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 school-based clinic allows for the least control. A nursing home unit and an intensive care unit allow for partial control.

PTS: 1

DIF: Cognitive level: Understanding

REF: p. 278

37. 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

Feedback A B C D

Part of sampling theory is defining sample types, but this is not the goal of sampling theory. 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 developing methods for collecting data, but this is not the goal of sampling theory. Sampling theory does not provide frameworks for data analysis.

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REF: p. 278

38. 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 Feedback A B

C D

Case studies are, by definition, composed of a very small sample, possibly even just one individual. 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. 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.

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DIF: Cognitive level: Remembering

REF: p. 267

39. In qualitative research, the sampling plan is developed in order 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 Feedback A B

C D

Decreasing systematic bias and reducing sampling error are the goals of sampling in quantitative research. 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. The cultural elements of the study are unrelated to sample size. Decreasing systematic bias and reducing sampling error are the goals of

sampling in quantitative research. PTS: 1

DIF: Cognitive level: Remembering

REF: p. 278

40. Which is a type of probability sampling? a. Cluster b. Convenience c. Network d. Quota ANS: A Feedback A B C D

Cluster sampling is a type of probability sampling. Convenience, network, and quota sampling are all types of nonprobability sampling. Convenience, network, and quota sampling are all types of nonprobability sampling. Convenience, network, and quota sampling are all types of nonprobability sampling.

PTS: 1

DIF: Cognitive level: Remembering

REF: p. 278

41. Which is a type of nonprobability sampling? a. Purposeful b. Simple random c. Stratified random d. Systematic ANS: A Feedback A B C D

Purposeful sampling is a type of nonprobability sampling. Simple random, stratified random, and systematic sampling are all types of probability sampling. Simple random, stratified random, and systematic sampling are all types of probability sampling. Simple random, stratified random, and systematic sampling are all types of probability sampling.

PTS: 1

DIF: Cognitive level: Remembering

REF: p. 278

42. 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 Feedback

A B C D

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.

PTS: 1

DIF: Cognitive level: Understanding

REF: p. 264

43. 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 Feedback A

B C

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. 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. 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.

PTS: 1

DIF: Cognitive level: Understanding

REF: p. 278

Chapter 10: Clarifying Measurement and Data Collection in Quantitative Research Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 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 Feedback A

Direct measurement allows for measures of concrete factors, such as a person’s

B C

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.

PTS: 1 REF: p. 283

DIF: Cognitive level: Applying (Application)

2. Which can be measured using direct measurement? a. Anxiety level b. Blood pressure c. Diagnosis d. Feelings ANS: B Feedback A B C

Indirect measurement involves measuring abstract concepts such as anxiety or feelings. Direct measurement allows for measures of concrete factors, such as a person’s height, weight, or blood pressure. 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.

PTS: 1 REF: p. 283

DIF: Cognitive level: Applying (Application)

3. 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 Feedback A B

C D

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.

PTS: 1 REF: p. 284

DIF: Cognitive level: Applying (Application)

4. 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 Feedback A B

C D

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.

PTS: 1 REF: pp. 284-285

DIF: Cognitive level: Applying (Application)

5. 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 Feedback A B

C D

spaced intervals, and a continuum of values. PTS: 1 REF: pp. 284-285

DIF: Cognitive level: Applying (Application)

6. 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 Feedback A B

C D

PTS: 1 REF: pp. 284-285

DIF: Cognitive level: Applying (Application)

7. 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 Feedback A B C D

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.

PTS: 1 REF: p. 286

DIF: Cognitive level: Analyzing (Analysis)

8. 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 Feedback A B C D

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. 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.

PTS: 1 REF: p. 286

DIF: Cognitive level: Analyzing (Analysis)

9. 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 Feedback A B C D

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. 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.

PTS: 1 REF: pp. 286-287

DIF: Cognitive level: Analyzing (Analysis)

10. A researcher performs a series of pilot studies to evaluate whether a measurement tool

produces consistent results. This is an evaluation of: a. accuracy. b. precision.

c. reliability. d. validity. ANS: C Feedback A B C D

Accuracy and precision are part of the evaluation of physiological measurement tools. Accuracy and precision are part of the evaluation of physiological measurement tools. Reliability is concerned with the consistency of a measurement method. Validity is concerned with how well the instrument reflects the abstract concept being examined.

PTS: 1 REF: p. 287

DIF: Cognitive level: Understanding (Comprehension)

11. A researcher studying children identifies the following age groups:

Birth to age 12 months 12 months to 3 years 3 years to 5 years 5 years to 12 years 12 years to 18 years These categories are not: a. empirical. b. equal. c. exclusive. d. exhaustive. ANS: C Feedback A B C D

Empirical is a term implying some objective reality. The nonequal divisions would only relate to the level of measurement and not pose a problem. Exclusive means a datum must fit into only one of the categories. In this example, someone age 5 can fit into two categories. The example gives age ranges that exhaust all possibilities for ages of children.

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DIF: Cognitive level: Understanding (Comprehension)

12. A researcher evaluates a measurement tool by administering the tool to a group of subjects

every 2 weeks for 8 weeks. This is a measure of the tool’s: a. alternate forms reliability. b. internal consistency reliability. c. interrater reliability. d. test-retest reliability. ANS: D

Feedback A B C D

Alternate forms reliability seeks to determine whether two forms of an instrument measure the same attributes. Internal consistency reliability addresses the correlation of each question to other questions within the scale. Interrater reliability measures whether two or more observers measure the same attributes. Test-retest reliability measures whether the same attribute is consistent from one testing time to another.

PTS: 1 REF: p. 288

DIF: Cognitive level: Applying (Application)

13. A nursing professor administers three versions of a final exam to a class of students and

compares the exams for reliability. This is a measure of: a. homogeneity. b. interrater reliability c. equivalence. d. test-retest reliability. ANS: C Feedback A B C D

Homogeneity, or internal consistency reliability, addresses the correlation of each question to other questions within the scale. Interrater reliability measures whether two or more observers measure the same attributes. Alternate forms reliability, or stability, seeks to determine whether two forms of an instrument measure the same attributes. Test-retest reliability measures whether the same attribute is consistent from one testing time to another.

PTS: 1 REF: p. 288

DIF: Cognitive level: Applying (Application)

14. In a pilot study to help train a group of data collectors who will evaluate children’s pain using

a FACES rating scale, the researcher examines the reliability of the scores of each data collector. This is an example of which type of reliability measure? a. Alternate forms reliability b. Internal consistency reliability c. Interrater reliability d. Test-retest reliability ANS: C Feedback A B C

attributes. Test-retest reliability measures whether the same attribute is consistent from one testing time to another.

PTS: 1 REF: pp. 288-289

DIF: Cognitive level: Applying (Application)

15. A researcher notes a reliability score of 0.75 between two observers in a clinical drug trial

evaluating whether the drug decreases anxiety. This score means that: a. there is 25% random error. b. there is 75% random error. c. this is an acceptable measure of reliability. d. this measurement tool is not reliable. ANS: B Feedback A B C

The interrater reliability value represents reliability. A 0.75 measure indicates 75% reliability and 25% random error. The interrater reliability value represents reliability. A 0.75 measure indicates 75% reliability and 25% random error. Generally, interrater reliability is best at 0.90, and any value less than 0.80 should generate serious concern about the reliability of the data or the data gatherer. This is a measure of interrater reliability and may not necessarily reflect on the reliability of the tool.

PTS: 1 REF: pp. 288-289

DIF: Cognitive level: Analyzing (Analysis)

16. A researcher evaluates scores of a paper and pencil instrument with dichotomous variables

using the Kuder-Richardson formula. This is a test of: a. alternate forms reliability. b. internal consistency reliability. c. interrater reliability. d. test-retest reliability. ANS: B Feedback A B C D

PTS: 1 REF: pp. 288-289

DIF: Cognitive level: Understanding (Comprehension)

17. Which statement is true about validity? a. Validity evaluates an instrument for a specific group or purpose. b. Validity occurs when an instrument is valid across situations. c. Validity measures are absolute. d. Validity measures are independent of reliability. ANS: A Feedback A

B C D

Validity will vary from one sample to another and one situation to another, so validity testing evaluates the use of an instrument for a specific group or purpose. Validity measures are not all-or-nothing but occur on a continuum. Validity measures are not all-or-nothing but occur on a continuum. Without reliability, a tool cannot be valid.

PTS: 1 REF: pp. 290-291

DIF: Cognitive level: Analyzing (Analysis)

18. A researcher evaluates whether a tool addresses the major elements of the construct being

studied. This helps to ensure: a. content validity. b. equivalence. c. internal consistency. d. readability level. ANS: A Feedback A B C D

Content validity measures the extent to which the measurement method includes all the major elements relevant to the construct being measured. Equivalence and internal consistency are both measures of reliability. Equivalence and internal consistency are both measures of reliability. Readability focuses on the study participants’ ability to read and comprehend the content of an instrument.

PTS: 1 REF: pp. 290-291

DIF: Cognitive level: Applying (Application)

19. A researcher tests a measurement tool’s validity by administering it to a group of subjects who

don’t have health insurance and a group who have health insurance to examine attitudes about access to health care. The researcher is looking for evidence of validity from: a. contrasting groups. b. convergence. c. divergence. d. readability. ANS: A Feedback

A B

C D

Evidence of validity from contrasting groups can be tested by identifying groups that are expected or known to have contrasting scores on an instrument. Evidence of validity from convergence is determined when a relatively new instrument is compared with an existing instrument that measures the same construct. Evidence of validity from divergence is determined by asking subjects to complete tools that measure opposite concepts. Readability level focuses on the subjects’ ability to read and comprehend the content of an instrument.

PTS: 1 REF: pp. 290-291

DIF: Cognitive level: Analyzing (Analysis)

20. A researcher develops a new instrument to measure coping skills and conducts a pilot study to

compare the new tool with an existing tool that measures this concept. This is an example of evidence of validity from: a. contrasting groups. b. convergence. c. divergence. d. readability. ANS: B Feedback A B

C D

PTS: 1 REF: pp. 290-291

DIF: Cognitive level: Analyzing (Analysis)

21. A researcher administers two instruments known to measure opposite concepts and performs

correlational analyses on the results. The original measure has a negative correlation of ?7?0.6 with the new measure. This indicates: a. both measures are valid. b. neither measure is valid. c. only the first measure is valid. d. only the second measure is valid. ANS: A Feedback A

If a divergent measure is negatively correlated with an opposite scale, the validity for each of the instruments is strengthened.

B C D

A divergent measure that is negatively correlated with an opposite scale strengthens the validity of both measures and does not negate their validity. A divergent measure that is negatively correlated with an opposite scale strengthens the validity of both measures. A divergent measure that is negatively correlated with an opposite scale strengthens the validity of both measures.

PTS: 1 REF: pp. 290-291

DIF: Cognitive level: Analyzing (Analysis)

22. A researcher administers a scale measuring self-confidence and one measuring self-doubt to a

group of subjects and performs a correlational analysis of the results. This is a test of validity from: a. contrasting groups. b. convergence. c. divergence. d. readability. ANS: C Feedback A B

C D

PTS: 1 REF: pp. 290-291

DIF: Cognitive level: Analyzing (Analysis)

23. A researcher evaluating the weight of subjects who are obese ensures that the scales used are

maintained and calibrated according to the manufacturer’s recommendations. This is to ensure: a. accuracy. b. convergence. c. precision. d. validity. ANS: C Feedback A B

Accuracy is comparable to validity, addressing the extent to which the instrument measures what it is supposed to measure. Evidence of validity from convergence is determined when a relatively new instrument is compared with an existing instrument that measures the same construct.

Precision is the degree of consistency or reproducibility of measurements made with physiologic instruments and is comparable to reliability in psychosocial measures. Validity addresses the extent to which the instrument measures what it is supposed to measure.

PTS: 1 REF: p. 292

DIF: Cognitive level: Understanding (Comprehension)

24. When documenting reports that previous research has demonstrated the accuracy of a

physiologic measure, the researcher is addressing the measure’s: a. equivalence. b. homogeneity. c. reliability. d. validity. ANS: D Feedback A B C D

Equivalence focuses on consistency between two or more observers measuring the same event. Homogeneity examines the extent to which all items in an instrument consistently measure the construct of interest. Reliability is concerned with the consistency of a measurement method. Validity refers to the fact that the instrument measures what it says it will measure. Accuracy is comparable to validity, addressing the extent to which the instrument measures what it is supposed to measure.

PTS: 1 REF: p. 292

DIF: Cognitive level: Analyzing (Analysis)

25. In a study evaluating pulse oximetry measures in infants, a researcher notes that the pulse

oximeter probes are attached to infants’ feet in different ways. This represents which type of measurement error? a. Environmental b. Equipment c. Subject d. User ANS: D Feedback A

B C D

Environmental error includes things such as temperature, barometric pressure, or static electricity that might affect how well the equipment works or how the subject responds. Equipment error may be related to calibration or the stability of the equipment. Subject error occurs if the subject alters the equipment or the equipment alters the subject. User errors are caused by the person using the equipment and can include variations by the same user, different users, or changes in supplies used to

operate the equipment. PTS: 1 REF: p. 292

DIF: Cognitive level: Analyzing (Analysis)

26. In a study measuring oxygen saturation levels in infants, the researcher notes that data

collectors record low saturation levels that occur when the heart rate is erratic and the infants are irritable and actively moving around. This will likely result in which type of measurement error? a. Environmental b. Equipment c. Interpretation d. User ANS: C Feedback A

User errors are caused by the person using the equipment and can include variations by the same user, different users, or changes in supplies used to operate the equipment. Environmental error includes things such as temperature, barometric pressure, or static electricity that might affect how well the equipment works or how the subject responds. Interpretation error occurs when signals transmitted from the equipment can result in misinterpretation, such as low saturation levels that occur when the equipment is not getting an accurate reading. Equipment error may be related to calibration or the stability of the equipment.

PTS: 1 REF: p. 292

DIF: Cognitive level: Analyzing (Analysis)

27. An instrument that detects the presence of streptococcal antibodies is negative. Before

reporting the absence of disease, the researcher must determine whether this result might be a: a. false negative. b. false positive. c. gold standard. d. true positive. ANS: A Feedback A

B C D

A false negative may indicate that a disease is not present when it actually is. If a test report is negative, the researcher must ensure that the test does not have a high likelihood of false negative results. A false positive means that a disease may not be present when the test result is positive. The gold standard is the most accurate means of currently diagnosing a particular disease and serves as the basis for comparison for other tests. A true positive means that a positive test result means that the result indicates a positive diagnosis.

PTS: 1 REF: p. 295

DIF: Cognitive level: Applying (Application)

28. Which is true about a test that is highly sensitive for detecting a disease? a. There is a high probability of having a false negative result. b. There is a high probability of having a false positive result. c. There is a low probability of having a false negative result. d. There is a low probability of having a false positive result. ANS: C Feedback A B C D

Tests that are highly specific have a low percentage of false positives. Tests that are highly sensitive have a low percentage of false positives A test that is highly sensitive is very good at identifying the presence of disease and has a low percentage of false negatives. Tests that are highly specific have a low percentage of false positives.

PTS: 1 REF: p. 296

DIF: Cognitive level: Understanding (Comprehension)

29. Which is true about a test that is highly specific? a. It is good at identifying patients who do not have a disease. b. It is good at identifying patients who have a disease. c. It results in an increased number of false negatives. d. It results in an increased number of false positives. ANS: A Feedback A B C D

A test that is highly sensitive is very good at identifying patients who do not have a disease. A test that is highly sensitive is very good at identifying the presence of disease. Tests that are highly specific have a low percentage of false negatives Tests that are highly specific have a low percentage of false positives.

PTS: 1 REF: p. 296

DIF: Cognitive level: Understanding (Comprehension)

30. A researcher reports that a measure is highly sensitive when diagnosing patients. The reviewer

understands that this test: a. has a low percentage of false negatives. b. has a low percentage of false positives. c. has a high percentage of false negatives. d. has a high percentage of false positives. ANS: A Feedback A B

Tests that are highly sensitive have a low percentage of false negatives. A test that is highly specific has a low percentage of false positives.

C D

A test that is highly specific has a low percentage of false positives. A test that is highly specific has a low percentage of false positives.

PTS: 1 REF: pp. 296-297

DIF: Cognitive level: Understanding (Comprehension)

31. A screening test has a specificity of 92%. This means that there is a(n): a. 92% chance of a true positive. b. 92% chance of a false positive. c. 8% chance of a false positive. d. 8% chance of a true positive. ANS: C Feedback A B C

A 92% specificity rating indicates a 92% chance that the test is negative and the patient does not have the disease. A 92% specificity rating indicates a 92% chance that the test is negative and the patient does not have the disease. A test with a specificity rating of 92% is very good at identifying patients who do not have a disease. If the test is very specific, there is a low chance of false positives. In this case the chance of a false positive is 8%. A 92% specificity rating indicates a 92% chance that the test is negative and the patient does not have the disease.

PTS: 1 REF: pp. 296-297

DIF: Cognitive level: Applying (Application)

32. Which is important when using observational measurement in order to produce reliable data? a. Data collectors will record observations in their own words. b. Each subject should have different observers to record responses. c. Observations will be spontaneously recorded as they occur. d. Researchers will develop checklists of notable behaviors for observers to use. ANS: D Feedback A B C D

Data collectors must be trained to observe specific behaviors and in how to describe and code those behaviors. Increasing the number of data collectors increases the risk for error. Unstructured observation allows for spontaneous recording of observations but is less reliable than structured observation. Checklists of behaviors help to indicate whether or not specific behaviors occur and help to structure observations.

PTS: 1 REF: p. 300

DIF: Cognitive level: Applying (Application)

33. A researcher uses a checklist of questions to ask participants while collecting data for a study.

This represents which type of data collection? a. Structured interview

b. Structured questionnaire c. Unstructured interview d. Unstructured questionnaire ANS: A Feedback A B C D

A structured interview occurs when the data collector uses a checklist or list of specific questions while interviewing the subject. A structured questionnaire is a tool that the subject completes that uses a checklist or list of specific questions. An unstructured interview occurs when the data collector does not use a checklist or list of specific questions while interviewing the subject. An unstructured questionnaire is a tool that the subject completes that does not use a checklist or list of specific questions.

PTS: 1 REF: pp. 302-303

DIF: Cognitive level: Applying (Application)

34. Which statement is true about using a questionnaire to collect data? a. Questions are presented consistently with less chance for bias than with an

interview. b. Questionnaires are generally more expensive than interviewing techniques. c. Subjects usually give more in-depth answers when responding to questionnaires. d. The response rate is generally higher than when using interviews to collect data. ANS: A Feedback A

B C D

Questionnaires contain the same questions, so there is increased consistency and less interviewer bias than with interviews, in which the questions may vary and there may be interviewer bias. Questionnaires are less costly to administer than interviews. Subjects tend to give answers that are not as in depth as those they give when being interviewed. Questionnaires generally have a lower response rate than interviews.

PTS: 1 REF: pp. 304-305

DIF: Cognitive level: Understanding (Comprehension)

35. Which type of scale is most commonly used in a survey of patient satisfaction? a. Likert scale b. Numeric rating scale c. Rating scale d. Visual analog scale ANS: A Feedback A

The Likert scale is designed to determine the opinions or attitudes of study subjects and is the most commonly used of the various scales.

B C D

A numeric rating scale is used to measure the degree of a concept on a continuum, such as pain on a scale from 1 to 10. A rating scale is similar to a numeric rating scale. A visual analog scale measures the strength, magnitude, or intensity of subjective feelings, sensations, or attitudes along a continuum and may be used to assess patient satisfaction, but it is not the most commonly used type of scale.

PTS: 1 REF: pp. 306-308

DIF: Cognitive level: Understanding (Comprehension)

36. A researcher wishes to evaluate the reliability of a visual analog pain scale in a group of

postoperative patients. The best way to do this is to compare results: a. to results of the test when given to another set of subjects. b. to results from the same subjects using the FACES rating scale. c. to results from a previous measure with a different visual analog scale. d. to results from a group of subjects who have minimal or no pain. ANS: A Feedback A

B C D

Reliability of a visual analog scale is best determined by the test-retest method, so the researcher should administer the test to two sets of subjects and compare the results. Comparing results using two different instruments does not determine reliability of the first measure. Comparing results from a previous measure using another version of the scale is a measure of alternate forms reliability. Changing the population does not allow for a test of the reliability of the measurement tool.

PTS: 1 REF: pp. 306-308

DIF: Cognitive level: Analyzing (Analysis)

37. Which generally is an advantage of using primary data in a research study? a. It allows researchers to conduct more longitudinal studies. b. It has greater specificity to the study purpose. c. It puts less burden on study participants. d. It reduces the cost of data collection. ANS: B Feedback A B C D

Secondary data are collected by other researchers and then stored and can contribute to longitudinal studies. Primary data are collected for a particular study and are specific to that study. Primary data collection puts more of a burden on study participants. Primary data collection is more costly than secondary data collection.

PTS: 1 REF: p. 311

DIF: Cognitive level: Understanding (Comprehension)

38. What type of information is typically found in an administrative database? a. Data collected for a specific research study b. Demographic information about a population c. Journal accounts of subjects’ responses to surveys d. Statistical results of experimental studies ANS: B Feedback A B

C D

Data collected for a specific study are primary data. Administrative data are collected within clinical agencies and government entities and include demographic, organizational, clinical, and geographical information. Journal accounts and statistical results of experimental studies may be primary or secondary data. Journal accounts and statistical results of experimental studies may be primary or secondary data.

PTS: 1 REF: pp. 311-312

DIF: Cognitive level: Understanding (Comprehension)

39. Which data represent the lowest form of measurement? a. Levels of anxiety on a scale from mild to severe b. Race and ethnicity classification c. Temperature of subjects after an intervention d. Weight, height, and body mass index ANS: B Feedback A B C D

Levels of anxiety represent ordinal data. Race and ethnicity represent nominal data, which are considered the lowest form of measurement. Temperature represents interval data. Weight, height, and BMI represent ratio data.

PTS: 1 REF: p. 313

DIF: Cognitive level: Remembering (Knowledge)

40. Which is true about using data from an existing database? a. It allows larger sampling and complex analyses. b. The burden on participants is higher than when primary data collection is used. c. The researcher is able to draw upon data that are specific to a particular study. d. Research reports do not have to describe data collection procedures. ANS: A Feedback A

Using data from existing databases allows for larger sampling at less cost. Researchers can review data from across situations and time periods, allowing for more complex analyses of data.

B C D

The burden on participants is lower. The researcher must draw on data from other studies. Data collection procedures must be described with any data used.

PTS: 1 REF: p. 311

DIF: Cognitive level: Understanding (Comprehension)

41. In a study involving multiple data collectors, the researcher helps to ensure consistency in data

collection by: a. describing the study participant recruitment process in the research summary. b. detailing the training process of the data collectors in the research report. c. discarding data that includes even minor deviations in data collection methods. d. minimizing the influence of intervening forces on the study findings. ANS: B Feedback A B C D

Describing the recruitment process is important but does not contribute to consistency in data collection. To address consistency, the researcher must detail how data collectors are trained and how interrater reliability is achieved in the study report. If deviations in data collection methods occur, they should be discussed, but the results should not be discarded. Minimizing the influence of intervening forces helps to control the study design.

PTS: 1 REF: p. 311

DIF: Cognitive level: Understanding (Comprehension)

Chapter 11: Understanding Statistics in Research Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. Which situation will involve the use of inferential statistics? a. A comparison of independent variables in a quasi-experimental study b. A discussion about demographic data c. An analysis of demographic variables of the target population d. An examination of the differences between control and experimental group scores ANS: D Feedback A B C D

Descriptive statistics are used as summary statistics to organize data and are used to describe the sample or key variables. Descriptive statistics are used as summary statistics to organize data and are used to describe the sample or key variables. Descriptive statistics are used as summary statistics to organize data and are used to describe the sample or key variables. Inferential statistics are designed to address objectives, questions, and

hypotheses in studies to allow inference form the study sample to the target population. These statistics are used to identify relationships, examine predictions, and determine group differences. PTS: 1 REF: p. 320

DIF: Cognitive level: Analyzing (Analysis)

2. A reviewer reads a research report and notes that the number of subjects in the original sample

is larger than the number in the final analysis. Besides attrition of subjects, this discrepancy is likely because: a. data from the control group are not included in the analysis. b. essential data is missing from subjects no longer included. c. subjects producing outlying data have been excluded from the results. d. the final analysis usually discusses data from the experimental group only. ANS: B Feedback A B

C D

The analysis discusses data from both the experimental and the control groups. If enough data are missing for certain variables, researchers may have to exclude analyses using these variables and may sometimes have to exclude some subjects from data analysis. Outlying data are not excluded from study results; such data must be discussed. A final analysis will discuss data from both the experimental and control group.

PTS: 1 REF: p. 320

DIF: Cognitive level: Applying (Application)

3. A researcher notes that 2 subjects in an experimental group had scores similar to those in the

control group, while the other 20 experimental group subjects had scores far different from those in the control group. The researcher would consider the scores for the two subjects as: a. control group findings. b. outlier scores. c. unexpected findings. d. ungrouped participants. ANS: B Feedback A B C D

Subjects who receive the experimental group intervention remain part of the experimental group regardless of their scores. Subjects with extreme values that seem unlike the rest of the sample are called outliers. Unexpected findings can occur with or without outliers. Subjects can be grouped into categories or not; the process may highlight outliers, but would not define them.

PTS: 1 REF: p. 323

DIF: Cognitive level: Applying (Application)

4. It is important to know the demographic variables among study subjects in order to:

a. b. c. d.

calculate central tendency and standard deviation of study scores. ensure that control and experimental subjects are different. ensure that outcomes are not caused by independent variables. understand how well the sample represents the target population.

ANS: D Feedback A B

Demographic variables are not used to calculate central tendency and standard deviation of study results. Researchers evaluate demographic variables in experimental studies to ensure that the groups are similar so that outcomes can be related to the independent variables and not to population differences. Researchers evaluate demographic variables in experimental studies to ensure that the groups are similar so that outcomes can be related to the independent variables and not to population differences. One goal of analyzing demographic variables in a study to make sure that the sample population is representative of the target population so that findings may be generalized to the larger population.

PTS: 1 REF: p. 320

DIF: Cognitive level: Applying (Application)

5. A researcher evaluates the internal consistency (reliability) a newly developed scale used in a

pilot study and notes a Cronbach alpha coefficient of space 0.72. The researcher will: a. compare the measure with scores from another group of subjects. b. test the scale for validity prior to using it in another study. c. try another measure with better reliability in another pilot study. d. use the scale in the larger study and continue to monitor coefficient results. ANS: D Feedback A B C D

It is not necessary, at this point, to compare the measure with scores from another group of subjects. It is not necessary to test the scale for validity prior to using it again. This scale should be used and does not need to be discarded for another scale. A Cronbach alpha score of 0.80 to 0.90 indicates that the measure is sufficiently reliable to use in a study, although a value of 0.70 is considered acceptable. The researcher should use the scale with the larger group and monitor this value.

PTS: 1 REF: p. 323

DIF: Cognitive level: Applying (Application)

6. An appropriate level of significance for nursing research is either: a. 0.5 or 0.1. b. 0.03 or 0.003. c. 0.05 or 0.01. d. 0.005 or 0.001. ANS: C

Feedback A

C D

0.5 or 0.1 values are too high. The level of significance selected for most nursing studies is 0.05. In some studies, the more rigorous level of significance of 0.01 may be chosen. 0.03 or 0.003 values are not generally accepted levels of significance. The level of significance selected for most nursing studies is 0.05. In some studies, the more rigorous level of significance of 0.01 may be chosen. The level of significance selected for most nursing studies is 0.05. In some studies, the more rigorous level of significance of 0.01 may be chosen. 0.005 or 0.001 values would be too rigorous. The level of significance selected for most nursing studies is 0.05. In some studies, the more rigorous level of significance of 0.01 may be chosen.

PTS: 1 REF: p. 325

DIF: Cognitive level: Remembering (Knowledge)

7. To measure test-retest reliability of an instrument, a researcher may use the: a. Cronbach alpha coefficient. b. Fischer’s exact test. c. Kuder-Richardson score. d. Pearson’s correlation statistic. ANS: D Feedback A B C D

Cronbach’s alpha coefficient is used to determine reliability in a single study. Fischer’s exact test measures statistical significance, usually in small samples. The Kuder-Richardson score measures internal reliability. The t-test, or Pearson’s correlation statistics, may be used to determine test-retest reliability.

PTS: 1 REF: p. 325

DIF: Cognitive level: Understanding (Comprehension)

8. Which describes an outlier? a. A data point with a value outside what is predicted by other data points b. Any data point far from the median point, but still within 2 standard deviations

from the mean. c. A study result that is directly attributable to randomness. d. A study score from a subject lost to attrition after the study begins. ANS: A Feedback A B C D

Outliers are subjects or data points with extreme values that seem unlike the rest of the study sample. Outliers may be within or outside standard deviations. Outliers are not directly attributable to randomness. Outliers are data collected from subjects in the study.

PTS: 1 REF: p. 325

DIF: Cognitive level: Understanding (Comprehension)

9. What is the purpose of using exploratory analysis in a research report? a. To compare control and experimental groups b. To develop testable hypotheses c. To examine and describe data d. To identify theoretical constructs ANS: C Feedback A B C D

Statistical analysis is used to compare control and experimental groups. Statistical analysis is used to develop testable hypotheses. Exploratory analysis is used to examine all of the data descriptively and to identify variation among data and whether outliers exist. Theoretical constructs are discussed in the theoretical framework.

PTS: 1 REF: p. 323

DIF: Cognitive level: Understanding (Comprehension)

10. An important goal of inferential statistical analysis is to: a. analyze and describe data collected during a study. b. determine whether theoretical constructs are valid. c. generalize results from the study to the target population. d. measure the reliability and validity of measurement tools. ANS: C Feedback A B C D

Descriptive data analysis is performed to analyze and describe data collected during a study. Inferential statistics are not performed to determine the validity of theoretical constructs. Inferential statistical analysis is performed for the purpose of generalizing findings from the study sample to appropriate accessible and target populations. Other analyses are conducted to examine the reliability and validity of measurement tools.

PTS: 1 REF: p. 323

DIF: Cognitive level: Analyzing (Analysis)

11. After a clinical drug trial to measure the effects of atorvastatin administration on low-density

lipoprotein levels, which of the following conclusion statements is acceptable in the research report? a. Findings of clinical drug tests suggest that atorvastatin works to reduce low-density lipoprotein levels in study subjects. b. Results of this clinical drug trial demonstrate that atorvastatin works to reduce low-density lipoprotein levels in all adults over age 65. c. The negative correlation between atorvastatin administration and low-density lipoprotein levels indicates that atorvastatin causes a decrease in LDL levels.

d. The study proved that atorvastatin decreases low-density lipoprotein levels. ANS: A Feedback A B C D

Researchers can never prove things using inferential reasoning; they can never be certain their reasoning is correct. Findings can never be applied to all humans. Correlation does not equate with causation. The study cannot prove that something is the case; it can only support the likelihood.

PTS: 1 REF: p. 323

DIF: Cognitive level: Analyzing (Analysis)

12. In a discussion that includes the analysis of data collected during a pilot study, the researcher

discusses the relationships and differences in data sets and makes predictions based on this analysis. The researcher will use which process? a. descriptive analysis b. inferential analysis c. reliability testing d. validity testing ANS: B Feedback A B C D

Descriptive analysis is used to examine all of the data descriptively and to identify variation among data and whether outliers exist. Inferential analysis techniques focus on relationships and differences in data, along with predictions based on the data. Reliability and validity testing are measures used to evaluate whether measurement tools are effective. Reliability and validity testing are measures used to evaluate whether measurement tools are effective.

PTS: 1 REF: p. 323

DIF: Cognitive level: Understanding (Comprehension)

13. A nurse conducts a study to evaluate the likelihood that single adolescent mothers will

breastfeed their newborn infants if they are given materials about the benefits of breastfeeding. The results show a p value of 0.18. The nurse may conclude that: a. the value is too low to be able to draw meaningful conclusions. b. there is an 18% probability that this population will breastfeed their infants. c. there is an 18% probability that this population will not breastfeed their infants. d. there is an 82% probability that this population will breastfeed their infants ANS: B Feedback A B

The p value does not have a required range of value to be considered relevant. The p value expresses the probability that an event will occur. In this case, the p

value is 0.18, or 18%, and the researcher can predict this probability based on study results. The p value expresses the probability that an event will occur. In this case, the p value is 0.18, meaning that there is an 18% chance that adolescent mothers will breastfeed their infants. The p value expresses the probability that an event will occur. In this case, the p value is 0.18, meaning that there is an 18% chance that adolescent mothers will breastfeed their infants.

PTS: 1 REF: p. 324

DIF: Cognitive level: Analyzing (Analysis)

14. Which of the following is not one of the components of power analysis? a. Effect size b. Error type c. Power d. Sample size ANS: B Feedback A B C D

Cohen identified four parameters of a power analysis: the level of significance, sample size, power, and effect size. Error type is not a component of power analysis. Cohen identified four parameters of a power analysis: the level of significance, sample size, power, and effect size. Cohen identified four parameters of a power analysis: the level of significance, sample size, power, and effect size.

PTS: 1 REF: p. 329

DIF: Cognitive level: Remembering (Knowledge)

15. In statistical analysis of data, the alpha value is used to: a. describe the degree of generalizability of the findings. b. determine the risk of a Type I error. c. reveal whether the p value meets criteria for statistical significance. d. speculate on the frequency distribution of study values. ANS: C Feedback A B C

The alpha value does not address generalizability of findings. The p value is used to calculate the probability of a Type I error. The alpha, or the level of statistical significance, is the probability level at which the results of statistical analysis are judged to indicate a statistically significant difference between the groups. The normal curve provides information on the frequency distribution of study values.

PTS: 1 REF: p. 325

DIF: Cognitive level: Analyzing (Analysis)

16. A researcher studies the effects of a nursing intervention on a desired patient outcome and

discovers a statistically significant difference between groups receiving the intervention and those not receiving the intervention. The researcher concludes that the intervention is effective. This researcher has made a: a. generalization. b. statistical inference. c. Type I error. d. Type II error. ANS: B Feedback A B C D

Generalizations are made when information gained from a specific instance is generalized to the general population. A statistical inference is made from the study findings obtained from a specific sample and applied to the target population. A Type I error occurs when a researcher incorrectly states that something is significant when it is not. A Type II error occurs when a researcher declares the null hypothesis to be true when it is not.

PTS: 1 REF: p. 326

DIF: Cognitive level: Understanding (Comprehension)

17. When comparing a study with a level of significance of 0.05 with a study having a level of

significance of 0.01, the researcher knows that the study with the level of significance of 0.05 is more likely to have a: a. correct null hypothesis. b. generalizable finding. c. Type I error. d. Type II error. ANS: C Feedback A B C D

A Type I error carries a greater risk of rejecting a null hypothesis when it is true, but does not increase the likelihood of a correct null hypothesis. The Type I error does not affect the generalizeability of the findings. There is a greater risk of a Type I error with a 0.05 level of significance than with a 0.01 level of significance. There is a greater risk of a Type II error with a 0.01 level of significance than with a 0.05 level of significance.

PTS: 1 REF: p. 326

DIF: Cognitive level: Understanding (Comprehension)

18. When a researcher concludes that study findings are applicable to the total population, this is

an example of: a. generalization. b. inference.

c. probability. d. significance. ANS: A Feedback A B C D

Generalizations are made when information gained from a specific instance is generalized to the general population. A statistical inference is made from the study findings obtained from a specific sample and applied to the target population. Probability refers to the likelihood that a variable falls at a certain point in the range of data scores. Significance is a value indicating the chance that values are from different groups when the value of one group is not within the range of values of another group.

PTS: 1 REF: p. 326

DIF: Cognitive level: Applying (Application)

19. In research, the probability that any data score will be within a certain range of a mean value

is calculated based on the theory of: a. frequency. b. inference. c. levels of significance. d. the normal curve. ANS: D Feedback A B C

Frequency refers to the number of times a specific value occurs. A statistical inference is made from the study findings obtained from a specific sample and applied to the target population. Levels of significance is a value indicating the chance that values are from different groups when the value of one group is not within the range of values of another group. A normal curve is a theoretical frequency distribution of all possible values in a population, with a 95% probability that any value from that population will fall within 2 standard deviations of the mean.

PTS: 1 REF: p. 326

DIF: Cognitive level: Analyzing (Analysis)

20. A researcher plans to apply a one-tailed test of significance when analyzing data from a study.

Which is true about using this test? a. The researcher will be unable to predict whether differences are greater than or less than the mean value. b. This is a nondirectional hypothesis, so values will not have a tendency to vary in a specific direction. c. This may increase the possibility of a Type I error when evaluating the significance of the findings. d. This will decrease the possibility of a Type II error when drawing conclusions

about the data. ANS: D Feedback A B C D

A one-tailed hypothesis increases a study’s power and improves the ability to predict outcomes. A one-tailed test is a unidirectional hypothesis, with values tending to vary in a specific direction. A one-tailed test does not increase the chance of a Type I error. A one-tailed hypothesis means that the data tend to vary in a certain direction. One-tailed statistical tests are uniformly more powerful than two-tailed tests and decrease the possibility of a Type II error.

PTS: 1 REF: p. 327

DIF: Cognitive level: Analyzing (Analysis)

21. In a study to examine motivational techniques to help adolescent smokers to quit smoking, the

null hypothesis states that the intervention will have no effect on this population. The researcher establishes a level of significance of 0.01. When analyzing the data, the researcher concludes that there is a significant difference between subjects receiving the intervention and those who do not. In this study, a Type I error means there is a: a. 1% chance that the conclusion is wrong. b. 1% chance that the conclusion is correct. c. 99% chance that the conclusion is wrong. d. 99% chance that the null hypothesis is correct. ANS: A Feedback A

B C D

Type I error occurs when the null hypothesis is rejected when it is actually correct. A significance of 0.01 indicates a 1% chance that the null hypothesis is correct when it is rejected. There is a 99% chance, in this study, that the conclusion is correct and the null hypothesis is incorrect. There is a 99% chance, in this study, that the conclusion is correct and the null hypothesis is incorrect. There is a 99% chance, in this study, that the conclusion is correct and the null hypothesis is incorrect.

PTS: 1 REF: p. 328

DIF: Cognitive level: Analyzing (Analysis)

22. A researcher develops a study to examine the effects of Keep Yourself Safe Screening

(KYSS) on the incidence of intimate partner violence (IPV). The study level of significance is 0.05. The null hypothesis, that KYSS will have no effect on IPV, is found to be true. When reviewing the study for Type II errors, the reviewer understands that: a. a level of significance of 0.01 would decrease the risk of a Type II error. b. the level of significance does not affect the chance of a Type II error. c. there is a 5% chance that the null hypothesis is false. d. there is a 5% chance that the null hypothesis is true.

ANS: C Feedback A B

The risk of a Type II error increases when the level of significance is less. A level of significance of 0.05 indicates a 5% chance of a Type II error that occurs when the null hypothesis regarded as true but is actually false but does not affect the likelihood that the null hypothesis is true or false. A Type II error occurs when the null hypothesis is regarded as true but is actually false. A level of significance of 0.05 indicates a 5% chance of a type II error. A level of significance of 0.05 indicates a 5% chance of a Type II error that occurs when the null hypothesis regarded as true but is actually false but does not affect the likelihood that the null hypothesis is true or false.

PTS: 1 REF: p. 328

DIF: Cognitive level: Analyzing (Analysis)

23. In a data set that has a normal distribution what percent of scores will be within two standard

deviations above or below the mean? a. 34 b. 68 c. 95 d. 99 ANS: C Feedback A B C D

This is not a correct statement. This is not a correct statement. In the normal curve, 95% of the scores will be within two standard deviations above or below the mean. This is not a correct statement.

PTS: 1 REF: p. 326

DIF: Cognitive level: Remembering (Knowledge)

24. A researcher conducts a power analysis for a study in which there was no difference between

control and experimental group scores and identifies a power level of 0.75 and a level of significance of 0.05. What will this researcher do? a. Alter measurement methods to detect larger changes in scores b. Conclude that the null hypothesis is true c. Consider repeating the study using a larger sample d. Lower the level of significance to 0.01. ANS: C Feedback A

Because the level of power is too low, the researcher cannot draw valid conclusions about the data. Measurement methods that measure large changes decrease the effect size, which decreases the power.

C D

The level of significance does not indicate whether the null hypothesis is true or false, merely the probability of making an error in judging whether it is true or false. The minimum acceptable power level is 0.80. To improve this, a larger sample size may be necessary. Lowering the level of significance lowers the power.

PTS: 1 REF: p. 329

DIF: Cognitive level: Applying (Application)

25. The concept of degrees of freedom refers to: a. the level of significance for a study. b. the standard deviation from the mean among data. c. the variability of a given score based on other scores. d. whether statistical analysis is one- or two-tailed. ANS: C Feedback A B C D

Degrees of freedom do not directly affect the level of significance, standard deviation, or tailedness. Degrees of freedom do not directly affect the level of significance, standard deviation, or tailedness. Degrees of freedom involve the freedom of a score value to vary given the other existing scores. Degrees of freedom do not directly affect the level of significance, standard deviation, or tailedness.

PTS: 1 REF: p. 329

DIF: Cognitive level: Understanding (Comprehension)

26. The median scores of two groups participating in a study are exactly the same for a particular

variable. This suggests that the: a. average score is the same for both groups. b. the middle score is the same for both groups. c. the most frequent score is the same for both groups d. groups are very much alike in relation to the variable. ANS: A Feedback A

B C D

The median is a measure of central tendency and indicates the middle score of a group, but does not indicate the variability of the scores around the mean. A measure of dispersion is required to demonstrate the distribution of scores. The same median score does not mean the average score, or the mean, is the same. The same median score does not mean that the most frequent, or mode, is the same. The same median does not equate to sameness in other ways.

PTS: 1 REF: p. 326

DIF: Cognitive level: Applying (Application)

27. Assuming a normal distribution, what range of numbers would include two thirds of the

scores if they ranged from 50 to 99, M = 75, and SD = 5? Between: a. 55 and 95 b. 65 and 85 c. 68 and 82 d. 70 and 80 ANS: D Feedback A B C D

This is not a correct statement. This is not a correct statement. This is not a correct statement. In the normal curve, 68% of scores will be within one standard deviation above or below the mean. In the example, two thirds of scores (66%) fall between 70 and 80. The mean = 75 and the SD = 5 for this sample. It follows that scores will fall between one standard deviation below (75 – 5 = 70) and one standard deviation above the mean (75 + 5 = 80).

PTS: 1 REF: p. 326

DIF: Cognitive level: Applying (Application)

28. A researcher collects scores measuring weight among school-age children who are in an

obesity prevention program and notes that several students are morbidly obese with the majority of students falling within or below the 85th percentile for weight. The scores from the morbidly obese children will affect which measure of central tendency the most? a. Mean b. Median c. Mode d. All of the above are affected equally. ANS: A Feedback A B C D

The mode and median are not as affected by outliers as is the mean. This is not a correct statement. This is not a correct statement. This is not a correct statement.

PTS: 1 REF: p. 326

DIF: Cognitive level: Applying (Application)

29. A researcher will present demographic data about ethnicity, gender, and diagnoses about a

study population using which method? a. Continuous frequency distribution b. Grouped frequency distribution c. Percentage frequency distribution d. Ungrouped frequency distribution

ANS: D Feedback A B C

Continuous data are presented using grouped data tables. Ungrouped frequency distribution tables are used to present categorical data, such as demographic data, when categories are discrete. A percentage distribution indicates the percentage of subjects who fall into a category and is often used when comparing scores from findings with other data samples. Ungrouped frequency distribution tables are used to present categorical data, such as demographic data, when categories are discrete.

PTS: 1 REF: p. 330

DIF: Cognitive level: Applying (Application)

30. A researcher wishes to present data identifying pain scores for a group of subjects using a

grouped frequency distribution table. Which is true about using this method? a. Each group must have equivalent ranges in scores. b. Ranges may overlap from one group to the next. c. Some data may not fit into any group. d. There should be no more than five groups of scores. ANS: A Feedback A B C D

In grouped frequency distribution tables, each group of scores must have equivalent ranges. Ranges should be discrete without overlapping so that each datum will fit into only one group. The ranges must be exhaustive so that all data will fit into a group. There should be at least 5 and no more than 20 groups.

PTS: 1 REF: p. 330

DIF: Cognitive level: Applying (Application)

31. When a data set has a normal distribution curve, which statement is true about the data? a. The mean is the lowest value. b. The median is the highest value. c. The mode is the central value. d. The mode, median, and mean are equal values. ANS: D Feedback A B C D

This is not a correct statement. This is not a correct statement. This is not a correct statement. In a normal distribution curve, the mode, median, and mean are equal.

PTS: 1

DIF: Cognitive level: Remembering (Knowledge)

REF: p. 331 32. Which describes the mode of a data set? a. The appropriate measure of central tendency for interval data b. The appropriate measure of central tendency for ordinal data c. The exact center of scores for nominal data d. The score value occurring with greatest frequency ANS: D Feedback A B C D

The mode is the appropriate measure of central tendency for nominal data, not for interval or ordinal data. The mode is the appropriate measure of central tendency for nominal data, not for interval or ordinal data. The mode represents the score that occurs with greatest frequency in a data set. The mode represents the score that occurs with greatest frequency in a data set.

PTS: 1 REF: p. 331

DIF: Cognitive level: Understanding (Comprehension)

33. A researcher studying subjects who have pulmonary disease presents a data set to describe the

different conditions the subjects experience and reports the following data. Which number represents the mode for this data set? Asthma 4 COPD 6 Chronic bronchitis 4 Pulmonary hypertension 7 a. 4.0 b. 5.25 c. 6.5 d. 7.0 ANS: A Feedback A B C D

The mode is the number that occurs most frequently in a data set. In this case, there are two groups of 4, so 4 is the mode. This is not a correct statement. This is not a correct statement. This is not a correct statement.

PTS: 1 REF: p. 331

DIF: Cognitive level: Applying (Application)

34. A researcher collects the following scores on a set of ranked data. Which is the median score?

a. 2 b. 5 c. 6 d. 7 e. 10

f. 15 g. 18 h. 21 a. 7 b. 10 c. 8.5 d. 10.5 ANS: C Feedback A B C

This is not a correct statement. This is not a correct statement. The median score is the midpoint score in a data set. In an even number of scores, the midpoint is calculated by averaging the two central scores. In this case, 7 + 10 = 17/2 = 8.5. This is not a correct statement.

PTS: 1 REF: p. 331

DIF: Cognitive level: Applying (Application)

35. What is the mean value in the following set of scores?

a. 128 b. 128 c. 130 d. 135 e. 144 a. 128 b. 130 c. 133 d. 132.8 ANS: C Feedback A B C D

128 is the mode. 130 is the median. The mean is the average of the scores, or the sum of all scores divided by the number of scores. The mean is the average of the scores, or the sum of all scores divided by the number of scores.

PTS: 1 REF: p. 331

DIF: Cognitive level: Applying (Application)

36. A researcher conducts a study and calculates a mean value of 100 in a set of scores ranging

from 90 to 300. Which other measure will the researcher report when describing central tendency in this data set? a. Median b. Mode c. Range

d. Variance ANS: A Feedback A

B C D

The median value is not affected by extreme scores and should also be reported. The mean is most affected by outliers in a study. In this case, the mean value is very close to values at one end of the scale and not toward the center, indicating that a normal curve is not present. The mode will describe the most frequent score. The range and variability will be reported, but do not describe central tendency. The range and variability will be reported, but do not describe central tendency.

PTS: 1 REF: p. 331

DIF: Cognitive level: Analyzing (Analysis)

37. Which is true about a sample that is heterogeneous? a. It has a wide variation in scores. b. Scores will be clustered around the mean. c. The measure of range will be small. d. The standard deviation cannot be calculated. ANS: A Feedback A B C D

Heterogeneous samples have a wide variation in scores. Such samples will have a wide standard deviation, with scores that can be far from the mean score. Such samples will have a wide standard deviation, with scores that can be far from the mean score. Such samples will have a wide standard deviation, with scores that can be far from the mean score.

PTS: 1 REF: p. 331

DIF: Cognitive level: Applying (Application)

38. A researcher is analyzing the following data set. Which value represents the range?

a. 43 b. 46 c. 46 d. 57 e. 67 f. 69 g. 78 a. 35 b. 46 c. 57 d. 58 ANS: A

Feedback A B C D

The range represents the difference between the lowest and the highest scores. 46 is the mode, or the most frequently recorded value. 57 is the median, or the data point in the middle of all the data when they are placed in order. 58 is the mean, or the average number of all the data.

PTS: 1 REF: p. 333

DIF: Cognitive level: Applying (Application)

39. Which is true about the measure of a data set’s range? a. It is an average score. b. It is calculated using central scores. c. It is determined only for interval level data. d. It is sensitive to outliers in a data set. ANS: D Feedback A

C D

The range represents the difference between the lowest score and the highest score and is sensitive to any outliers that may occur far from the scores clustered in the middle. The range represents the difference between the lowest score and the highest score and is sensitive to any outliers that may occur far from the scores clustered in the middle. It is determined using any type of data, not just interval-level data. The range represents the difference between the lowest score and the highest score and is sensitive to any outliers that may occur far from the scores clustered in the middle.

PTS: 1 REF: p. 333

DIF: Cognitive level: Understanding (Comprehension)

40. Which is true about the variance for scores in a data set? a. A larger variance value usually indicates a smaller dispersion of scores. b. It can be calculated for nominal scores. c. The calculated score has no absolute value. d. The variance indicates the range of scores. ANS: C Feedback A B C D

A larger variance value usually indicates a greater dispersion of values. Variance can only be calculated for nominal and ratio level of measurement. The calculated variance value has no absolute value and can be compared only with data obtained using similar measures. The variance indicates the spread or dispersion of the scores, not the range.

PTS: 1 REF: p. 333

DIF: Cognitive level: Remembering (Knowledge)

41. A researcher has calculated a variance of 9 for a data set. What is this data set’s standard

deviation? a. 1 b. 3 c. 4 d. 5 ANS: B Feedback A B C D

This is not a correct statement. The variance is the standard deviation squared. The square root of 9 is 3. This is not a correct statement. This is not a correct statement.

PTS: 1 REF: p. 333

DIF: Cognitive level: Applying (Application)

42. A data set is found to approximate a normal curve and has a mean of 72.5 and a standard

deviation of 10.8. In which range of numbers will 99% of the scores fall? a. 35.8 – 112.6 b. 44.6 – 100.4 c. 51.3 – 93.7 d. 61.7 – 83.3 ANS: B Feedback A B C D

These numbers have a greater range than 2.58 standard deviations of the mean, so would include more than 99% of the scores. In a normal curve, 99% of the scores fall within 2.58 standard deviations of the mean, or 27.87 in each direction. 72.5 – 27.87 = 44.6; 72.5 + 27.87 = 100.4. 95% of the scores will fall between 2 standard deviations of the mean, or 21.17 each direction, making this range 51.3 – 93.7. 68% of scores will fall within one standard deviation, with a range of 61.7 – 83.3.

PTS: 1 REF: p. 334

DIF: Cognitive level: Analyzing (Analysis)

43. Based on study data, a researcher predicts that a population mean will fall within a specific

range of data. This is called the: a. confidence interval. b. range. c. standard deviation. d. validity measure. ANS: A Feedback A

The confidence interval is the probability of including the value of the

B C D

population within an interval estimate. The range is the full range of all data, from the smallest to the highest number. Standard deviations define the variability of data. Validity is a measure of the extent to which the measure represents the real word data.

PTS: 1 REF: p. 334

DIF: Cognitive level: Applying (Application)

44. A researcher analyzes scores from two studies in which patients’ temperatures were measured

after antipyretic medications are given. One study measures temperatures in centigrade and the other in Fahrenheit. The researcher will: a. calculate standard deviation measures for each study using their scale values. b. compile all data regardless of scale and calculate measures of central tendency. c. determine a Z-score and then calculate measures of central tendency. d. realize that studies using different measures cannot be compared. ANS: C Feedback A B C

Standard deviation measures are used to assess the range of scores within a data set, but are not useful when analyzing data from two data sets. Compiling all data regardless of scale will not allow accurate comparison and analysis of the data. When study results use different scales to report data, it is necessary to standardize the scores into a more general meaning. This standardized score is a Z-score. Comparing data from studies with different scales of measurement does not yield meaningful data.

PTS: 1 REF: p. 335

DIF: Cognitive level: Applying (Application)

45. Which is true about a Z-score? a. It identifies the confidence interval for a group of data. b. It is a method for calculating variance . c. It is a standardized score used when data measures use different scales. d. It represents the median data point in any set of data. ANS: C Feedback A B C

The Z-score does not identify the confidence interval, variance, or median. The Z-score does not identify the confidence interval, variance, or median. When study results use different scales to report data, it is necessary to standardize the scores into a more general meaning. This standardized score is a Z-score. The Z-score does not identify the confidence interval, variance, or median.

PTS: 1

DIF: Cognitive level: Remembering (Knowledge)

REF: p. 335 46. A researcher presents data to examine the relationship between income and weight and uses a

scatterplot to display the results. The researcher places income level intervals along the vertical line in the graph. The reviewer knows that: a. data about income represent the independent variable b. income data are presented along the X axis. c. the plot will show whether the relationship is negative or positive. d. weight values will occur along the Y axis. ANS: C Feedback A B C D

This is correlational data; neither variable is independent. The Y axis is the vertical axis. A scatterplot may be used illustrate the relationship between variables and will show either a negative or positive relationship. The Y axis is the vertical axis.

PTS: 1 REF: p. 335

DIF: Cognitive level: Analyzing (Analysis)

47. A researcher wishes to display scores representing the relationship between two variables.

Which will the researcher use? a. Grouped data table b. Pie chart c. Scatterplots d. Z-score ANS: C Feedback A B C D

Grouped data tables and pie charts show the frequency of data. Grouped data tables and pie charts show the frequency of data. A scatterplot may be used illustrate the relationship between variables and will show either a negative or positive relationship. The Z-score is a standardized score calculated to compare data when measures use different scales.

PTS: 1 REF: p. 335

DIF: Cognitive level: Applying (Application)

48. Which is true about a correlational analysis technique? a. It is most desirable for small samples with homogeneous scores. b. It is used to determine cause and effect among sets of variables. c. It measures the relationship among variables. d. It usually involves comparing data from two subjects. ANS: C Feedback

A B C D

These techniques are most desirable with large, heterogeneous samples. Correlational analysis does not determine cause and effect. Correlational analysis techniques are used to measure the relationship among variables. Correlational analysis occasionally compares data from two subjects.

PTS: 1 REF: p. 340

DIF: Cognitive level: Understanding (Comprehension)

49. A review of demographic data shows that mothers with higher levels of education have fewer

children. This represents which type of relationship? a. Asymmetrical b. Negative c. Positive d. Symmetrical ANS: B Feedback A B C D

Asymmetry refers to skewdness in the data set. A negative relationship exists when higher scores of one variable are correlated to lower scores of another In a positive relationship, high scores on one variable are correlated to high scores on another variable Symmetrical means that the analysis given no indication of the direction of the relationship

PTS: 1 REF: p. 340

DIF: Cognitive level: Understanding (Comprehension)

50. A review of demographic data shows that mothers with higher levels of education have fewer

children. In this example, the r value is likely to be: a. = 0. b. <0. c. >0. d. not definable. ANS: B Feedback A B

C D

This is not a correct statement. A perfect negative correlation is -1. A perfect positive correlation is +1. Negative correlations are less than zero and positive correlations are greater than zero. This is not a correct statement. This is not a correct statement.

PTS: 1 REF: pp. 340-341

DIF: Cognitive level: Applying (Application)

51. A researcher calculates a Pearson product-moment coefficient of 0.2. The reviewer

understands that this value represents: a. a moderate positive correlation. b. a moderate negative correlation. c. a weak positive correlation. d. a weak negative correlation. ANS: C Feedback A B C

This is not a correct statement. This is not a correct statement. A r value between -0.3 and +0.3 is considered to indicate a weak relationship. A positive number indicates a positive relationship, so this value is a weak positive correlational value. This is not a correct statement.

PTS: 1 REF: pp. 340-343

DIF: Cognitive level: Applying (Application)

52. A researcher correlates self-confidence measures with obesity rates and determines an r value

of 0.8. What can the reviewer conclude when evaluating this research? a. There is a 36% chance that variation in one score is the result of variation in the other score b. There is a 64% chance that variation in one score is the result of variation in the other score c. There is a 64% chance that variation in one score is the result of variation in something other than the other score d. There is a weak correlation between these two variables ANS: B Feedback A B

C D

This is not a correct statement. Explained variance is a score that is r2 which, in this case, is 0.64, or 64%. This means that there is a 64% chance that the variation in one score affects the variation in the other score. This is not a correct statement. This is not a correct statement.

PTS: 1 REF: pp. 340-342

DIF: Cognitive level: Analyzing (Analysis)

53. Clinicians now can calculate a person’s myocardial infarction risk by evaluating several

known risk factors, such as cholesterol levels and diabetes. This is possible because of: a. bivariate correlation analysis b. factor analysis. c. multiple regression analysis. d. simple linear regression analysis. ANS: C

Feedback A B C

Bivariate correlation measures the extent of relationship of two variables. Factor analysis examines interrelationships among large numbers of variables to identify clusters of variables most closely linked. Multiple regression analysis is used to analyze study data that include two or more independent variables in order to predict the value of one variable when the value of the independent variables is known. Simple linear regression analysis is used when one independent variable is used to predict a dependent variable.

PTS: 1 REF: p. 344

DIF: Cognitive level: Analyzing (Analysis)

54. What is true about the chi-square test of independence? a. Chi-square test of independence results are important calculations in most studies. b. In a relatively small sample size, the chi-square test of independence can reduce

the chance of a Type II error. c. The chi-square test of independence is a powerful test used to examine differences

in studies with two subjects. d. The chi-square test of independence is used to determine whether two variables are

related or independent. ANS: D Feedback A

B C

The chi-square test of independence determines whether two variables are independent or related. This test is relatively unimportant in most studies and is not a powerful test. Large sample sizes are necessary to reduce the chance of a Type II error. The chi-square test of independence determines whether two variables are independent or related. This test is relatively unimportant in most studies and is not a powerful test. The chi-square test of independence determines whether two variables are independent or related. This test is relatively unimportant in most studies and is not a powerful test.

PTS: 1 REF: pp. 347-348

DIF: Cognitive level: Understanding (Comprehension)

55. Which circumstance will call for the use of analysis of variance (ANOVA)? a. A researcher wishes to compare differences in means between four groups b. A researcher wishes to compare the difference in variance between two groups c. A researcher wishes to compare the difference in variance among four groups d. A researcher wishes to compare the difference in correlation between two groups. ANS: C Feedback A B

ANOVA does not test differences in means. ANOVA is used to examine differences among three or more groups.

C D

ANOVA is used to examine differences among three or more groups and tests for difference in variance. ANOVA does not examine differences in correlation.

PTS: 1 REF: pp. 351-352

DIF: Cognitive level: Understanding (Comprehension)

56. A researcher conducts an experimental study on patients at different outpatient clinics,

including clinics in inner city, suburban, and rural locations. To help ensure that differences in scores are not related to clinic location, the researcher will apply which technique? a. ANOVA b. ANCOVA c. Bivariate correlation analysis d. Factor analysis ANS: B Feedback A B

C D

ANOVA is used to examine differences among three or more groups and tests for difference in variance. Analysis of covariance, or ANCOVA, is used to examine the effect of a treatment apart from the effect of one or more potentially confounding variables, such as clinic location. Bivariate correlation measures the extent of relationship of two variables. Factor analysis examines interrelationships among large numbers of variables to identify clusters of variables most closely linked.

PTS: 1 REF: p. 353

DIF: Cognitive level: Applying (Application)

57. In a study comparing weight gain between small-for-gestational-age (SGA) infants who were

breastfed and SGA infants who were fed formula, researchers noted increased weight gain in infants who were held more regardless of how they were fed. This finding is an example of a: a. mixed result. b. nonsignificant result. c. serendipitous result. d. significant result. ANS: C Feedback A B C D

Mixed results occur when some but not all predicted relationships are demonstrated. Nonsignificant results are negative results, indicating only that the study failed to find a significant relationship. Serendipitous, or unexpected results, are relationships found between variables that were not hypothesized and not predicted prior to beginning the study. Significant results are results that statistically show a significant difference among variables and which help to build a body of knowledge.

PTS: 1 REF: p. 353

DIF: Cognitive level: Analyzing (Analysis)

Chapter 12: Critical Appraisal of Quantitative and Qualitative Research for Nursing Practice Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. The goal of a critical appraisal should be to: a. determine where faults exist in the study design. b. evaluate whether a proposed study is feasible. c. identify the meaning and credibility of the study. d. review the credentials and expertise of the researcher. ANS: C Feedback A B C

Identifying faults in the study design is part of a critical appraisal but not the end goal. Reviewers conduct feasibility analyses prior to approval of a study. An intellectual critical appraisal involves careful examination of all aspects of a study to judge the strengths, weaknesses, meaning, credibility, and significance of a study. Evaluating the researcher’s credentials is part of a critical appraisal but not the end goal.

PTS: 1 REF: pp. 362-363

DIF: Cognitive level: Analyzing (Analysis)

2. When critically appraising a research study, the reviewer will expect to find: a. identification of new research problems. b. implementation of a perfect research design. c. precise understanding of the real world. d. tools to control outcomes in nursing practice. ANS: A Feedback A B C D

Good scientific inquiry will likely include identification of additional problems. There is no perfect research design. All studies have flaws. Although an improved understanding of the real world is realistic, no study will lead to precise understandings of the real world. Experimental research strives to predict and control outcomes in practice, but each study only leads to improvements in this ability.

PTS: 1 REF: pp. 362-363

DIF: Cognitive level: Understanding (Comprehension)

3. How do practicing nurses participate in critical appraisal of research? a. By adhering to evidence-based practice guidelines and best practices b. By presenting findings from their own outcomes research c. By questioning the quality, credibility, and meaning of studies d. By reading research journals to keep current in knowledge and practice ANS: C Feedback A B C

Using EBP guidelines and best practices are part of research translation but are not part of critical appraisal. Presenting research findings and reading research journals are part of research utilization but are not part of critical appraisal. In order for critical appraisal to occur, nurses need to question the quality of the studies, the credibility of the findings, and the meaning of the findings for practice. Presenting research findings and reading research journals are part of research utilization but are not part of critical appraisal.

PTS: 1 REF: p. 363

DIF: Cognitive level: Applying (Application)

4. What will the reviewer do during the evaluation portion of a critical appraisal of a research

study? a. Assess whether the measurement tools are consistent with the phenomena of interest b. Determine whether the study findings are meaningful and should be implemented in practice c. Discuss the statistical analysis of the study’s findings including demographic and experimental data d. Review the components of the study to gain an overall understanding of the study report ANS: B Feedback A B

C D

Analysis involves identifying incongruence between the phenomenon of interest and the measurement tool. During the evaluation of a critical appraisal, the reviewer determines the credibility and meaning of a study and decides whether the findings are relevant to practice. Reviewing statistical data is part of the methodology review. The reviewer reads through a study for comprehension to gain an overall understanding at the beginning of the critique.

PTS: 1 REF: p. 363

DIF: Cognitive level: Analyzing (Analysis)

5. When reading a research article in a refereed journal, the nurse researcher is assured that the

article: a. describes a study undergoing review.

b. has been previously published. c. is printed in abstract form only. d. is of high quality and standards. ANS: D Feedback A B C D

Articles published in refereed journals have already undergone review. Refereed journals contain new research not previously published. Articles published in refereed journals include abstracts as well as a full report of the study. Journals that are refereed are critically appraised by expert peer reviews and tend to be of high quality.

PTS: 1 REF: p. 364

DIF: Cognitive level: Applying (Application)

6. A reviewer is asked to critically appraise a report to help determine whether funding will be

allocated for a research study. This reviewer will be appraising a research: a. abstract. b. article. c. literature review. d. proposal. ANS: D Feedback A B C D

Abstracts, articles, and literature reviews may all be critically appraised when evaluating research study reports after the research has been conducted. Abstracts, articles, and literature reviews may all be critically appraised when evaluating research study reports after the research has been conducted. Abstracts, articles, and literature reviews may all be critically appraised when evaluating research study reports after the research has been conducted. Critical appraisals of research proposals are conducted to approve student research projects, to permit data collection in institutions, and to select studies for funding.

PTS: 1 REF: p. 364

DIF: Cognitive level: Understanding (Comprehension)

7. What is the goal of an intellectual critical appraisal of a research study? a. To determine whether a study should be replicated b. To identify strengths and weaknesses in a study c. To determine whether a study should be implemented into practice d. To weed out and discard studies that are flawed ANS: B Feedback A

Determining whether a study should be replicated is not the goal of intellectual critical appraisal.

B C D

The purpose of intellectual critical appraisal includes identifying strengths and weaknesses in studies to help determine their credibility and meaning. Determining whether a study should be implemented into practice is not the goal of intellectual critical appraisal. Many studies are flawed, but this does not mean that they are useless and need to be discarded. Flaws must be identified and discussed.

PTS: 1 REF: p. 365

DIF: Cognitive level: Analyzing (Analysis)

8. How are study results utilized to develop evidence for practice? a. Only evidence and data from strong studies are used. b. Only quantitative studies are used to build evidence c. Strong points from multiple studies are used to build evidence. d. Studies must be replicated successfully to be used for evidence. ANS: C Feedback A B C D

Many flawed studies contain strong points that may be used to build evidence. Qualitative and quantitative studies are both used in evidence building. Adding together the strong points from multiple studies slowly builds a solid base of evidence for practice. It is not necessary to replicate every study to use data for evidence.

PTS: 1 REF: p. 365

DIF: Cognitive level: Applying (Application)

9. What are the steps used to evaluate quantitative research studies? a. Assess the study design, evaluate the sampling methods, and review the study

conclusions. b. Determine the study purpose, review the study data, and evaluate the implications

for further research. c. Evaluate the study methods, validate the measurement tools, and determine the

quality of results. d. Identify the steps in the research process, determine the strengths and weaknesses,

and evaluate the credibility and meaning of the findings. ANS: D Feedback A B C D

All of the other tasks listed are part of the process but do not represent the three steps in evaluating quantitative research. All of the other tasks listed are part of the process but do not represent the three steps in evaluating quantitative research. All of the other tasks listed are part of the process but do not represent the three steps in evaluating quantitative research. There are three steps in the quantitative research critical appraisal process: identifying the steps of the research process in studies, determining study strengths and weaknesses, and evaluating the credibility and meaning of the

study findings. PTS: 1 REF: p. 366

DIF: Cognitive level: Understanding (Comprehension)

10. When appraising the introduction section of a research study, what will the reviewer look for? a. Completeness and quality of the study abstract b. Evaluation of a comprehensive review of the literature c. Significance of the research problem to practice d. Study purpose and design ANS: A Feedback A

B C D

During a critical appraisal, the reviewer will review the introduction and evaluate the completeness of the study abstract along with the description of the qualifications of the study authors and the clarity of the article title. The literature review, the significance of the research problem to practice, and the study purpose and design are not part of the introduction. The literature review, the significance of the research problem to practice, and the study purpose and design are not part of the introduction. The literature review, the significance of the research problem to practice, and the study purpose and design are not part of the introduction.

PTS: 1 REF: p. 371

DIF: Cognitive level: Applying (Application)

11. What is important to assess when critically appraising a literature review? a. If previous studies support the research problem b. If textbooks are included in the reference list c. What sources are used to provide study funding d. Whether relevant studies are discussed ANS: D Feedback A B C D

Individual studies do not necessarily support the research problem but are used to show what is known and not known about a subject. Textbooks may be used, but refereed journals with current research are preferred. The sources of funding for studies may be mentioned if relevant to study outcomes. The literature review should evaluate whether relevant studies are discussed, if the sources are current, whether the studies are critically appraised and synthesized and if they are from refereed journals, and if a summary of current knowledge is provided.

PTS: 1 REF: p. 371

DIF: Cognitive level: Analyzing (Analysis)

12. An intellectual critical appraisal differs from other kinds of critiques because it:

a. b. c. d.

focuses solely on the strengths of the study. evaluates the quality and meaning of empirical evidence. judges the researcher’s ability and credentials. regards both the work itself as well as the study author.

ANS: B Feedback A B C D

An intellectual critical appraisal looks at both strengths and weaknesses equally. An intellectual critical appraisal is directed at the study and is used to determine credibility and meaning. An intellectual critical appraisal is directed at the study, not the researcher. An intellectual critical appraisal is directed at the study, not the researcher.

PTS: 1 REF: p. 365

DIF: Cognitive level: Understanding (Comprehension)

13. What will the reviewer assess when critically appraising a study framework? a. How the variables and concepts are evaluated and measured b. What the research hypothesis is and how it was developed c. Whether the literature review is complete d. Whether the study variables link to key concepts ANS: D Feedback A B C D

The methodology is concerned with how variables are evaluated and measured, but not necessarily how they link to the framework and concepts. The research hypothesis is derived from the study purpose. The framework critique is not concerned directly with the literature review. The reviewer of a study should identify key concepts in the study framework and then evaluate whether the key variables that will be measured link to those concepts.

PTS: 1 REF: pp. 371-372

DIF: Cognitive level: Applying (Application)

14. A reviewer is critically appraising a study’s variables. What will the researcher evaluate? a. Conceptual and operational definitions of variables b. Relationships of demographic variables to key concepts in the study framework c. Whether variables and key concepts are linked d. Use of all types of variables, including independent, dependent, and research

variables ANS: A Feedback A B C

When appraising the study variables, the reviewer will note whether variables are conceptually and operationally defined. It is not necessary to relate demographic variables to concepts. The evaluation of the link between variables and key concepts occurs during

appraisal of the study framework. Not all types of variables are included in all study types.

PTS: 1 REF: p. 372

DIF: Cognitive level: Understanding (Comprehension)

15. While critically appraising a study, a reviewer notes that the study includes an intervention.

What will the reviewer assess? a. If the intervention is consistently implemented using a clearly described protocol b. How the intervention is administered to each subject in the study sample c. If the intervention is consistently administered to both experimental and control subjects d. Whether the intervention has been used in prior studies ANS: A Feedback A B C D

When evaluating a study intervention, the reviewer should note whether the intervention is clearly described with a protocol and consistently implemented. The intervention should be administered in the same way to all members of the experimental group only. The intervention should be administered in the same way to all members of the experimental group only. It is not necessary to identify, at this stage of the critique, whether the intervention has been used in previous studies.

PTS: 1 REF: p. 372

DIF: Cognitive level: Applying (Application)

16. In which type of study design would a reviewer expect to find a discussion of extraneous

variables? a. Ethnographic b. Qualitative c. Quasi-experimental d. Phenomenological ANS: C Feedback A

An ethnographic study is not concerned with the effects of one variable on another; therefore extraneous variables that may affect a variable are not usually discussed. A qualitative study is not concerned with the effects of one variable on another; therefore extraneous variables that may affect a variable are not usually discussed. Extraneous variables are of most concern in experimental and quasi-experimental studies in which the researcher seeks to learn the effect of an independent variable on a dependent variable and must rule out the influence of other variables. A phenomenological study is not concerned with the effects of one variable on

another; therefore extraneous variables that may affect a variable are not usually discussed. PTS: 1 REF: p. 372

DIF: Cognitive level: Understanding (Comprehension)

17. A reviewer critically appraising a study about self-care behaviors of adolescents who have

cystic fibrosis evaluates comparisons of this sample to those from studies of young adults with cystic fibrosis. This appraiser is evaluating the: a. credibility and meaning of the study. b. framework and key concepts of the study. c. limitations of the study. d. reliability and validity of the study. ANS: A Feedback A

B C D

When evaluating the credibility and meaning of the study, the reviewer may examine the relationships among the current study compared with those of previous studies. The framework and key concepts are included in the evaluation of the study framework. The review of a study’s limitations occurs when evaluating the study discussion and conclusions. The reliability and validity are included in the evaluation of the study methods and design.

PTS: 1 REF: p. 374

DIF: Cognitive level: Applying (Application)

18. When assessing the conclusions, findings, and implications of a study, the appraiser will: a. determine whether alternate hypotheses are possible. b. ensure that results are not based on past research. c. identify that findings are specific to the sample population. d. refute the study if limitations are identified. ANS: A Feedback A B C D

During this phase of study review, the critical appraiser will evaluate, based on the study results, whether alternate hypotheses are possible. Results should be based on the study but may also build on other study findings as well. The appraiser should determine whether findings may be generalized to the larger population. Limitations should be discussed, but they do not necessarily refute the study.

PTS: 1 REF: p. 374

DIF: Cognitive level: Analyzing (Analysis)

19. A reviewer reads through a study from beginning to end, noting whether the title and abstract

are clear, if relevant terms are defined, and if the introduction, methods, results, and discussion are plainly identified. This represents which part of a critical appraisal? a. Analysis of the study methods b. Comprehension of the study outcomes c. Evaluation of the literature review d. Identification of the steps of the research process ANS: D Feedback A B C D

The other actions occur when evaluating the strengths and weaknesses and the credibility and meaning of the findings. The other actions occur when evaluating the strengths and weaknesses and the credibility and meaning of the findings. The other actions occur when evaluating the strengths and weaknesses and the credibility and meaning of the findings. Reviewing the abstract and reading the study from beginning to end are the first steps of a critical appraisal and are part of identifying the steps in the research process.

PTS: 1 REF: pp. 372-373

DIF: Cognitive level: Analyzing (Analysis)

20. A reviewer conducting a critical appraisal of a research study compares and contrasts study

methods with those that are ideal, representing which step of the research process? a. Analysis b. Comparison c. Comprehension d. Evaluation ANS: B Feedback A B C D

The analysis phase involves a critique of the logical links connecting one study element with another. The comparison phase requires knowledge of what each step of the research process should be like, and then that is compared with the ideal. The comprehension phase requires the reviewer to thoroughly understand the study. The evaluation phase highlights the meaning and significance of the study.

PTS: 1 REF: pp. 372-373

DIF: Cognitive level: Understanding (Comprehension)

21. During an initial review of a study, the reviewer will expect the methods section of the

research report to include: a. a description of the study design and sampling methods. b. the limitations and generalizations of the study. c. tables and figures representing study results. d. the framework and definitions of study variables.

ANS: A Feedback A B C D

The methods section of a study report will contain a description of the study design and the sampling methods used to obtain the study population. The limitations and generalizations of the study will be discussed in the conclusion section. Tables and figures will appear in the results section. The framework and definitions will be included in a discussion of the study framework.

PTS: 1 REF: pp. 372-374

DIF: Cognitive level: Applying (Application)

22. During a critical appraisal of a research study, the reviewer determines that a study about

blood glucose monitoring of patients with type 1 diabetes mellitus has implications for patients with type 2 diabetes. The reviewer will determine this during which phase of the research critique? a. Analysis b. Comparison c. Comprehension d. Evaluation ANS: D Feedback A B C D

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DIF: Cognitive level: Applying (Application)

23. A reviewer conducts a critical appraisal of a study and notes that the study abstract does not

include key results. The reviewer will discuss this in which part of the appraisal? a. Introduction b. Literature review c. Problem d. Purpose ANS: A Feedback A

The abstract is part of the introduction.

B C D

The abstract is not a part of the literature review. The abstract is not included in the discussion of the study problem. The abstract is not included in the discussion of the study purpose.

PTS: 1 REF: p. 374

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24. A reviewer performs a critical appraisal of a study and notes that the researcher conducted a

previous pilot study. The reviewer will: a. discount any findings not congruent with the pilot study. b. ensure that the larger study and pilot study used identical data collection methods. c. ignore the findings of the pilot study because they are not relevant to this study. d. note whether the pilot study findings were used to design the current study. ANS: D Feedback A B C D

Findings in the pilot study may differ from those in the larger study if changes are made based on the pilot. Identical data collection methods may not be used if results from the pilot indicated a need for change. The findings of the pilot study provide information that guides the researcher to change study methods in the subsequent study. When reviewing a study in which a pilot study was performed, the reviewer may note whether findings of the pilot study led to changes in study methods in the subsequent study.

PTS: 1 REF: p. 366

DIF: Cognitive level: Analyzing (Analysis)

25. What is not necessary for a reviewer to include in a critical appraisal when evaluating study

sampling methods? a. Characteristics of the sample b. Eligibility criteria c. Sample attrition d. Study setting ANS: D Feedback A B C D

Sample characteristics are an important part of a critical appraisal when evaluating study methods. Eligibility criteria are an important part of a critical appraisal when evaluating study methods. Sample characteristics are an important part of a critical appraisal when evaluating study methods. When discussing the sampling methods, the reviewer may address characteristics of the sample, eligibility criteria to determine the sample, and sample attrition. The study setting is not part of the discussion about the sample.

PTS: 1 REF: p. 389

DIF: Cognitive level: Understanding (Comprehension)

26. Which is true about the evaluation of study variables in a critical appraisal of a research

study? a. It is not necessary to identify whether the measures are nominal, ordinal, ratio, or interval. b. The reviewer will be concerned only with the reliability of measures in the current study. c. The reviewer will identify the names and authors of the measurement strategies. d. The reviewer will make sure research variables are defined conceptually but not operationally. ANS: C Feedback A B C D

The reviewer will identify the types of measurement scales used. The reviewer will be concerned with the reliability and validity of measures. When discussing study variables, the reviewer will evaluate the measurement strategies, including the names and authors of the various strategies. The reviewer will ensure that variables are defined conceptually and operationally.

PTS: 1 REF: p. 368

DIF: Cognitive level: Understanding (Comprehension)

27. A reviewer critically appraises a study. Which aspect of the review indicates a weakness in the

study? a. The conceptual definitions of variables are consistent with operational definitions. b. The literature review identifies what is known and not known about the problem. c. The researcher identifies and discusses threats to design validity. d. The statement of purpose provides a broad, general focus for the study. ANS: D Feedback A B C D

The conceptual and operational definitions should be consistent, so this is a strength. The literature review should identify what is known and not known, so this is a strength. The researcher should identify and discuss known threats to validity, so this is a strength. The purpose should provide a narrow, clear focus for the study, so this is a study weakness.

PTS: 1 REF: p. 368

DIF: Cognitive level: Analyzing (Analysis)

28. What is the focus of a critical appraisal of qualitative research studies? a. Completeness of the literature review b. Conceptual and operational definition of variables

c. Integrity of study design and methods d. Validity of study measures ANS: C Feedback A B C D

Completeness of the literature review is a component of the critical appraisal but not the focus. Conceptual and operational definition of variables is part of the critical appraisal of quantitative studies. Integrity of study design and methods is a key component of critical appraisal of qualitative research studies. Validity of the study measures is a component of the critical appraisal but is not the focus.

PTS: 1 REF: p. 389

DIF: Cognitive level: Understanding (Comprehension)

29. What are the three steps of critical appraisal of qualitative research? a. Assess the study design, evaluate sampling methods, and review study

conclusions. b. Determine the study purpose, review study data, and evaluate implications for

further research. c. Identify the components of the research process, determine strengths and

weaknesses, and evaluate the trustworthiness of the study. d. Identify the steps in the research process, determine strengths and weaknesses, and evaluate the credibility and meaning of the findings. ANS: C Feedback A

Assessing study design, evaluating sampling methods, and reviewing study conclusions are parts of the critical appraisal of qualitative research, but are not the three main steps. Determining the study purpose, reviewing study data, and evaluating implications for further research are parts of the critical appraisal of qualitative research, but are not the three main steps. Identifying the components of the research process, determining strengths and weaknesses, and evaluating the trustworthiness of the study are the components of critical appraisal of qualitative research studies. Identifying the steps in the research process, determining strengths and weaknesses, and evaluating the credibility and meaning of the findings are parts of the critical appraisal of qualitative research, but are not the three main steps

PTS: 1 REF: p. 389

DIF: Cognitive level: Understanding (Comprehension)

30. What standard may be applied to determine the strengths and weaknesses in a qualitative

research study? a. Consistency of study methods with guidelines of expert researchers b. Determination of the generalizability of the study findings

c. Reliability of scales of measurement used in data collection d. Validity of statistical analyses used in data analysis ANS: A Feedback A

B C D

A critical appraisal may review a qualitative study and note whether study methods follow guidelines set by expert researchers because there are no hard and fast rules for study methods in qualitative research. Study findings are regarded as transferable and not generalizable in qualitative research. Reliability of measurement is part of quantitative research. Validity of statistical analyses is part of quantitative research.

PTS: 1 REF: p. 391

DIF: Cognitive level: Understanding (Comprehension)

31. When critically appraising the dependability of qualitative research, the reviewer evaluates: a. documentation of decisions made during analysis of the findings. b. if interrater reliability has been determined. c. whether measurement tools have internal validity. d. whether statistical analysis has been performed. ANS: A Feedback A

B C D

In qualitative research, statistical processes are not used. The reviewer should evaluate whether the researcher clearly documents how decisions about the data have been made. In qualitative research, statistical processes are not used. In qualitative research, statistical processes are not used. In qualitative research, statistical processes are not used.

PTS: 1 REF: pp. 391-392

DIF: Cognitive level: Understanding (Comprehension)

32. In a critical appraisal, a reviewer conducts an audit of the transcripts of interviews and

determines that the author’s conclusions are correct. This is an example of: a. confirmability. b. credibility. c. dependability. d. trustworthiness. ANS: A Feedback A B C

Confirmability is determined when the reviewer compares transcripts from interviews to the author’s conclusions and agrees with the conclusions. Credibility is the confidence that the results produced in the study reflect the views of the participants. Dependability is documentation of steps taken and decisions made during

analysis. Trustworthiness is an evaluation of the value of qualitative studies.

PTS: 1 REF: pp. 391-392

DIF: Cognitive level: Understanding (Comprehension)

33. When establishing that a researcher has produced a result consistent with the views of the

participants interviewed for a study, the critical appraiser has determined which strength of a qualitative study? a. Confirmability b. Credibility c. Dependability d. Trustworthiness ANS: B Feedback A B C D

PTS: 1 REF: pp. 391-392

DIF: Cognitive level: Understanding (Comprehension)

34. A determination that findings in a qualitative study are applicable to other populations is an

evaluation of a study’s: a. generalizability. b. reliability. c. transferability. d. validity. ANS: C Feedback A B C D

Because statistical analysis is not applied to qualitative research, generalizability cannot be determined. Because statistical analysis is not applied to qualitative research, reliability cannot be determined. In qualitative studies, analysis of results can yield information about the transferability of the findings to others. Because statistical analysis is not applied to qualitative research, validity cannot be determined.

PTS: 1 REF: pp. 391-392

DIF: Cognitive level: Understanding (Comprehension)

35. Once a qualitative study has been evaluated for credibility, transferability, dependability, and

confirmability, the study is considered to be: a. generalizable. b. reliable. c. trustworthy. d. valid. ANS: C Feedback A B C D

Because statistical analysis is not applied to qualitative research, generalizability cannot be determined. Because statistical analysis is not applied to qualitative research, reliability cannot be determined. A critical appraisal of qualitative studies is performed to evaluate trustworthiness, rather than meaning and credibility as with quantitative studies. Because statistical analysis is not applied to qualitative research, validity cannot be determined.

PTS: 1 REF: pp. 391-392

DIF: Cognitive level: Understanding (Comprehension)

36. All nurses need to have expertise in which skill regarding research? a. Critical appraisal b. Interviewing techniques c. Literature review d. Statistical analysis ANS: A Feedback A

B C D

Critical appraisal of research is necessary in order to read and review research studies to consider their application for practice. All nurses should be able to critically appraise research. The other skills are important for nurses engaging in research. The other skills are important for nurses engaging in research. The other skills are important for nurses engaging in research.

PTS: 1 REF: p. 410

DIF: Cognitive level: Understanding (Comprehension)

Chapter 13: Building an Evidence-Based Nursing Practice Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. Which is true about evidence-based practice? a. Evidence-based guidelines are unrelated to accreditation regulations. b. Evidence-based practice is determined only through experimental studies.

c. Most nursing interventions are based on evidence-based principles. d. The use of evidence-based practice results in improved patient outcomes. ANS: D Feedback A B C

The Joint Commission revised their accreditation criteria to emphasize patient care quality achieved through EBP. EBP guidelines are based on all types of research, using the best research knowledge available. Some nursing interventions are evidence based currently, but many require additional research to generate the knowledge essential for making changes in practice. The greatest benefits of EBP are improved outcomes for patients, providers, and health care agencies.

PTS: 1 REF: p. 416

DIF: Cognitive level: Understanding (Comprehension)

2. Which standards were developed to help nursing students develop the skills, knowledge, and

attitudes needed to continuously improve quality and safety? a. EBP b. IRB c. QSEN d. Magnet ANS: C Feedback A B C

EBP is evidence-based practice, which is the basis for developing practice guidelines that are grounded in the best evidence and research. IRBs are institutional review boards, whose purpose is to protect human subjects in research studies. The Quality and Safety Education for Nursing, or QSEN, project was implemented to improve prelicensure nurses’ knowledge, skills, and attitudes necessary to continuously improve quality and safety in health care systems. Magnet criteria are standards for a practice model for hospitals seeking accreditation through the American Nurses Credentialing Center.

PTS: 1 REF: p. 416

DIF: Cognitive level: Understanding (Comprehension)

3. When addressing a health care question to determine best practice, the nurse identifies and

appraises quality research using a structured, comprehensive synthesis of the research literature to determine the best research evidence available. This is an example of a: a. literature review b. meta-analysis. c. meta-synthesis. d. systematic review. ANS: D

Feedback A B C D

A literature review seeks to find all literature about a topic and is not as rigorous or systematic as a systematic review. A meta-analysis is a review of quantitative studies by statistically pooling or combining the results from these studies into a single quantitative analysis. A meta-synthesis is used to pool and combine findings from qualitative studies. A systematic review is a structured, comprehensive synthesis of the research literature to determine the best research evidence available to help determine best practice.

PTS: 1 REF: p. 421

DIF: Cognitive level: Applying (Application)

4. What is the purpose of the PRISMA statement? a. To help researchers develop a clinical question before a review b. To help determine whether studies reviewed should be replicated c. To improve reporting of meta-analyses and systematic reviews d. To outline the abstract when reporting on meta-analyses and other reviews ANS: C Feedback A B C

It is not used to develop a clinical question prior to analyses or to determine whether studies should be replicated. It is not used to develop a clinical question prior to analyses or to determine whether studies should be replicated. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was developed in 2009 to improve the quality of reporting for systematic reviews and meta-analyses and includes 27 items to ensure that this is done. It is not used to outline the abstract when reporting on analyses and other reviews.

PTS: 1 REF: p. 426

DIF: Cognitive level: Understanding (Comprehension)

5. To develop a clinical question when reviewing the effectiveness of nursing interventions, the

nurse will use which format? a. PICOS b. PRISMA c. Study design d. Systematic review ANS: A Feedback A

PICOS (Population, Intervention, Comparison of intervention, Outcomes, and Study design) is the most common format for developing a research question by nurse researchers. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses

C D

(PRISMA) statement was developed in 2009 to improve the quality of reporting for systematic reviews and meta-analyses and includes 27 items to ensure that this is done. The study design is part of PICOS but, by itself, does not determine the study question. The systematic review is conducted to evaluate existing research and is generally performed when the study question is known.

PTS: 1 REF: pp. 422-423

DIF: Cognitive level: Applying (Application)

6. A nurse studies the effects of teaching the MyPlate.gov materials to preschoolers by providing

this education to preschoolers in a single day care center and then following their BMI scores over a 5-year period and comparing their scores to those of children from another day care center. In this study, which element is represented by the O in the PICOS acronym? a. BMI scores b. Five-year follow-up c. MyPlate.gov materials d. Preschoolers ANS: A Feedback A B C D

In PICOS, the O stands for outcomes, which, in this study, are the BMI measures thought to be affected by the intervention. The 5-year follow-up is part of the study design, or S. The MyPlate.gov materials are used for the intervention, or I. The preschoolers are the population, or P.

PTS: 1 REF: p. 423

DIF: Cognitive level: Applying (Application)

7. Which type of research literature would be included in grey literature sources? a. Book chapters b. Dissertations c. Journal articles d. Textbooks ANS: B Feedback A B C D

Book chapters, journal articles, and textbooks are all published sources. Grey literature sources tend to be those that are not published and may include dissertations or theses. Book chapters, journal articles, and textbooks are all published sources. Book chapters, journal articles, and textbooks are all published sources.

PTS: 1 REF: p. 424

DIF: Cognitive level: Remembering (Knowledge)

8. What must a researcher describe to identify that a comprehensive, systematic literature search

was conducted? a. All key search terms and databases used in the search b. A list of grey literature sources used in the review c. The date restrictions applied to the literature search d. The use of literature only from prestigious journals ANS: A Feedback A

The key search terms, different databases searched, and search results need to be recorded in the systematic review and meta-analysis publications in order to indicate that a comprehensive search was performed. A list of grey literature sources and the data restrictions applied are important parts of the discussion about the review but do not indicate how comprehensive the search has been. A list of grey literature sources and the data restrictions applied are important parts of the discussion about the review but do not indicate how comprehensive the search has been. Using literature only from prestigious journals can lead to bias because it may exclude other relevant sources.

PTS: 1 REF: p. 425

DIF: Cognitive level: Applying (Application)

9. What is true about a meta-analysis? a. It helps to determine whether studies should be replicated. b. It identifies and appraises previous research. c. It pools results from previous studies into a single quantitative analysis. d. It replicates previous studies to confirm statistical results. ANS: C Feedback A B

C D

The meta-analysis does not determine which studies need to be replicated. A systematic review is a structured, comprehensive synthesis of the research literature to determine the best research evidence available to help determine best practice. A meta-analysis is a review of quantitative studies by statistically pooling or combining the results from these studies into a single quantitative analysis. A meta-analysis examines previous studies but does not replicate previous studies.

PTS: 1 DIF: Cognitive level: Understanding (Comprehension) REF: p. 428|p. 433 10. Which is true about the literature search criteria for a meta-analysis? a. They include only published works from refereed journals. b. They include the full range of related sources based on the topic. c. They usually are narrowly focused around the research question. d. They use works from a single database in order to remain consistent.

ANS: C Feedback A B C D

The search needs to be rigorous and to include published and unpublished works that are pertinent, using varied databases. The search needs to be rigorous and to include published and unpublished works that are pertinent, using varied databases. The search criteria for a meta-analysis are usually narrowly focused around the research question. The search needs to be rigorous and to include published and unpublished works that are pertinent, using varied databases.

PTS: 1 REF: p. 432

DIF: Cognitive level: Understanding (Comprehension)

11. A study yielding negative results is withheld for publication for several years, contributing to

which type of bias? a. Citation bias b. Location bias c. Outcome-reporting bias d. Time-lag bias ANS: D Feedback A B C D

Citation bias occurs when certain studies are cited more often than others and are more likely to be identified in database searchers. Location biases occur if studies are published in lower-impact journals and indexed in less-searched databases. Outcome-reporting biases occur when study results are not reported accurately and clearly. Time-lag bias occurs when results of some studies are released several years after those from other studies, meaning that the later results cannot be reported.

PTS: 1 REF: p. 433

DIF: Cognitive level: Understanding (Comprehension)

12. In a meta-analysis, the researcher displays a symmetrical funnel plot of the data from a group

of studies. This indicates: a. heterogenicity of study samples. b. limited publication bias. c. methodological bias. d. reporting bias. ANS: B Feedback A B

A symmetrical funnel plot indicates limited publication bias and occurs with homogeneity of study samples. A symmetrical funnel plot indicates limited publication bias and occurs with

C D

homogeneity of study samples. Asymmetry of the funnel plot indicates publication, methodological, and reporting bias. Asymmetry of the funnel plot indicates publication, methodological, and reporting bias.

PTS: 1 REF: pp. 433-434

DIF: Cognitive level: Analyzing (Analysis)

13. What is true about reporting the mean difference between two groups in a meta-analysis? a. It is a measure of differences between nominal data for the two groups. b. It is an estimate of the effect of differences between the two groups of subjects. c. It is not used to examine differences in ratio-level data. d. It is appropriate only when the same scale is used to measure outcomes. ANS: D Feedback A B C D

It is not used to compare nominal data but is useful for ordinal and ratio-level data. It measures differences in outcomes and not subjects. It is not used to compare nominal data but is useful for ordinal and ratio-level data. The mean difference is reported in a meta-analysis to identify the effect of an intervention but is appropriate only if the outcome is measured by the same scale in all the studies.

PTS: 1 REF: p. 435

DIF: Cognitive level: Understanding (Comprehension)

14. In a meta-analysis, a researcher wishes to examine differences in temperatures of subjects in

two groups but notes that one study uses a centigrade scale and the other study uses a Fahrenheit scale. Which statistic will the researcher apply in this case? a. Dichotomous data reporting b. Funnel plot c. Mean difference d. Standardized mean difference ANS: D Feedback A B C

Dichotomous datareporting is used to describe outcome data that are noncontinuous. The funnel plot is used to provide graphic representations of possible effect sizes. The mean difference is reported in a meta-analysis to identify the effect of an intervention but is appropriate only if the outcome is measured by the same scale in all the studies. The standardized mean difference is a summary statistic reported in a meta-analysis when the same outcome is measured by different scales.

PTS: 1 REF: pp. 434-435

DIF: Cognitive level: Applying (Application)

15. Which method will a researcher use to evaluate a group of qualitative studies? a. Meta-analysis b. Meta-synthesis c. Mixed-methods systematic review d. Systematic review ANS: B Feedback A B C D

A meta-analysis is a review of quantitative studies by statistically pooling or combining the results from these studies into a single quantitative analysis. A meta-synthesis is used to pool and combine findings from qualitative studies. A mixed-methods systematic review is used to evaluate a combination of quantitative and qualitative studies. A systematic review is a structured, comprehensive synthesis of the research literature to determine the best research evidence available to help determine best practice.

PTS: 1 REF: pp. 436-437

DIF: Cognitive level: Understanding (Comprehension)

16. A researcher evaluates data from a variety of studies, including those involving qualitative

and quantitative research, and uses findings from qualitative studies to interpret synthesized quantitative studies. This is an example of: a. meta-synthesis. b. mixed-method synthesis. c. multilevel synthesis. d. parallel synthesis. ANS: D Feedback A B C

A meta-synthesis is used to pool and combine findings from qualitative studies. A mixed-methods synthesis review is used to evaluate a combination of quantitative and qualitative studies. A multilevel synthesis involves synthesizing the findings from quantitative studies separately from qualitative studies and integrating the findings in the report. Parallel synthesis involves the separate synthesis of quantitative and qualitative studies, but the findings from the qualitative synthesis are used in interpreting the synthesized quantitative studies.

PTS: 1 REF: pp. 440-441

DIF: Cognitive level: Understanding (Comprehension)

17. Which is the strongest source of research and evidence for developing evidence-based

guidelines?

a. b. c. d.

Meta-analyses of specifically focused research questions Panels of experts sharing their opinions on best practices Quasi-experimental studies Rigorous experimental studies

ANS: A Feedback A

B C D

The strongest source of research evidence is synthesized to develop recommendations for practice and generally comes from meta-analyses. Often consultants, other researchers, and additional expert clinicians are asked to review the guidelines as well. Although panels of experts may be asked to review the guidelines, the use of meta-analyses provides the strongest research evidence. Quasi-experimental studies, along with other studies, are included in meta-analyses to provide the strongest research evidence. Rigorous experimental studies are analyzed together in meta-analyses to provide the strongest research evidence.

PTS: 1 REF: pp. 454-456

DIF: Cognitive level: Understanding (Comprehension)

18. When using the Stetler Model of research utilization, the nurse researcher reviews the risks,

resources, and readiness of staff associated with making changes in practice based on evidence. Which part of the model is this? a. Phase I: Preparation b. Phase II: Validation c. Phase III: Comparative Evaluation d. Phase IV: Translation/Application ANS: C Feedback A B C

In the Preparation phase, the researcher determines the purpose, focus, and potential outcomes of making an evidence-based change in practice. In the Validation phase, the researcher critically appraises the research reports to determine their soundness. In the Comparative Evaluation phase, the researcher substantiates the evidence, evaluates the fit of the health care setting, determines the feasibility of using research findings, and identifies concerns with current practice using the three “Rs” of risks, resources, and readiness. In the Translation/Application phase, the researcher plans for actual use of the research evidence in practice.

PTS: 1 REF: pp. 448-449

DIF: Cognitive level: Applying (Application)

19. Which research discipline seeks to develop practical applications based on research

knowledge? a. Meta-analysis b. Meta-synthesis

c. Rigorous experimental studies d. Translational research ANS: D Feedback A B C D

A meta-analysis is a review of quantitative studies by statistically pooling or combining the results from these studies into a single quantitative analysis. A meta-synthesis is used to pool and combine findings from qualitative studies. Rigorous experimental studies are analyzed together in meta-analyses to provide the strongest research evidence. Translational research is a new type of research to improve the translation of research knowledge into practice.

PTS: 1 REF: p. 461

DIF: Cognitive level: Understanding (Comprehension)

Chapter 14: Outcomes Research Grove: Understanding Nursing Research, 6th Edition MULTIPLE CHOICE 1. The goal of outcomes research is to: a. determine the most cost-effective nursing interventions in patient care. b. examine the end results of patient care from various health interventions. c. help providers make end-of-life decisions about patient care. d. improve patient satisfaction with nursing care. ANS: B Feedback A B C D

Cost-effectiveness is one possible outcome, but other patient outcomes may be more important. Outcomes research focuses on the end results of health care practices and interventions. Outcomes research is not solely about end-of-life care and is not focused on end-of-life decision making. Patient satisfaction is one result but is not the goal of all outcomes research.

PTS: 1 REF: p. 467

DIF: Cognitive level: Understanding (Comprehension)

2. What is the key construct in Donabedian’s theory of outcomes research? a. Efficiency of health care delivery b. Healthy outcomes c. Professional accountability d. Quality of care ANS: D

Feedback A B C D

Efficiency, healthy outcomes, and professional accountability all may be examined during outcomes research, but none of these is the key construct. Efficiency, healthy outcomes, and professional accountability all may be examined during outcomes research, but none of these is the key construct. Efficiency, healthy outcomes, and professional accountability all may be examined during outcomes research, but none of these is the key construct. Quality of care is the overriding construct of Donabedian’s theory of outcomes research.

PTS: 1 REF: pp. 468-469

DIF: Cognitive level: Remembering (Knowledge)

3. Which is an example of a type of nursing service that might be evaluated in outcomes

research? a. Application of wound care products b. Clinical care protocol implementation c. Glucose monitoring for newly diagnosed diabetics d. Using a Braden Scale for skin assessment ANS: B Feedback A B C D

Application of products, monitoring patient status, and using measurement scales are all examples of nursing interventions. Nursing services can include staffing and education of nurses as well as implementation of protocols and standards of care. Application of products, monitoring patient status, and using measurement scales are all examples of nursing interventions. Application of products, monitoring patient status, and using measurement scales are all examples of nursing interventions.

PTS: 1 REF: pp. 468-469

DIF: Cognitive level: Remembering (Knowledge)

4. Which would be an example of an interdependent role for nurses in the Nursing Role and

Effectiveness Model? a. Administering a medication to a patient b. Arranging for home health care services c. Initiating a fall risk protocol d. Performing an admission assessment ANS: B Feedback A B C

Dependent role functions include execution of medical orders and physician-initiated treatments. Interdependent role functions in the Nursing Role Effectiveness Model include communication, case management, and coordination of care. Dependent role functions include execution of medical orders and physician-initiated treatments.

Independent role functions include assessment, diagnosis, and nursing-initiated treatments.

PTS: 1 REF: pp. 469-470

DIF: Cognitive level: Applying (Application)

5. In an outcome study, a researcher demonstrates a link between the number of mothers who

successfully breastfeed their infants and the number of maternal-child nurses who are baccalaureate prepared. This illustrates: a. interdependent nursing role functions. b. nursing-sensitive patient outcomes. c. patient-sensitive outcomes. d. the Nursing Role Effectiveness Model. ANS: B Feedback A B

C D

Interdependent nursing functions are those that include both nurse-initiated and physician-initiated treatments. Outcomes that are nursing sensitive are those that are influenced by nursing care decisions and actions as well as those associated with nursing staffing, education, and assignments. Patient-sensitive outcomes are those that are influenced by different aspects of patients, such as age, gender, or disease process. The Nursing Role Effectiveness Model examines outcomes that are nursing sensitive.

PTS: 1 REF: pp. 471-472

DIF: Cognitive level: Applying (Application)

6. The development of the Uniform Hospital Discharge Data Set and the Universal Minimum

Health Data Set was helped by: a. establishing guidelines for outcomes research. b. identifying the contribution of nursing care to patient outcomes. c. prescribing data elements to be monitored in outcomes research. d. reporting financial and statistical data from hospitals. ANS: C Feedback A B C D

The data sets helped facilitate standards about data elements but did not establish guidelines for outcomes research. The Nursing Role Effectiveness Model helped to identify the contribution of nursing care to patient outcomes. The data sets facilitated consistency in data collection among health care organizations by prescribing the data elements to be gathered. The Canadian Institute for Health Information established a reporting system to report financial and statistical data from hospitals.

PTS: 1 REF: p. 472

DIF: Cognitive level: Understanding (Comprehension)

7. Which government agency supports research to improve the outcomes and quality of health

care? a. AHRQ b. ARRA c. CIHI d. FDA ANS: A Feedback A B

The Agency of Healthcare Research and Quality (AHRQ) supports research designed to improve the outcomes and quality of health care. The American Recovery and Reinvestment Act (ARRA) is not a government agency; funding from this act allowed AHRQ to expand its work in support of comparative effectiveness research. The Canadian Institute for Health Information (CIHI) helped to establish national Canadian standards for collecting and reporting financial and statistical data from health service organizations. The Federal Drug Administration (FDA) regulates the research and distribution of medications.

PTS: 1 REF: p. 472

DIF: Cognitive level: Understanding (Comprehension)

8. Which organization includes nursing-sensitive outcomes measures in its performance

measurement portfolio? a. Agency of Healthcare Research and Quality b. Department of Health and Human Services c. National Guideline Clearinghouse d. National Quality Forum ANS: D Feedback A B C D

The Agency of Healthcare Research and Quality supports research designed to improve the outcomes and quality of health care. The Department of Health and Human Services includes the Agency of Healthcare Research and Design. The National Guideline Clearinghouse is a resource for evidence-based guidelines. The National Quality Forum was created as a national standard-setting organization for health care performance measures and includes nursing-sensitive measures in its portfolio.

PTS: 1 REF: p. 474

DIF: Cognitive level: Remembering (Knowledge)

9. The National Quality Forum was established in 1999 for which purpose? a. To identify and develop nursing-sensitive quality measures b. To support state and health system efforts to implement and evaluate medical

liability reform models c. To allow the AHRQ to expand its work supporting comparative effectiveness

research d. To set standards for health care performance measures ANS: D Feedback A B C D

The NDNQI identifies and develops nursing-sensitive quality measures. The AHRQ supports state and health system efforts to implement and evaluate medical liability reform models. The ARRA allows the AHRQ to expand its work supporting comparative effectiveness research. The National Quality Forum sets standards for health care performance measures.

PTS: 1 REF: p. 474

DIF: Cognitive level: Understanding (Comprehension)

10. To help meet the requirements for Magnet recognition, which organization will a hospital

participate in? a. The American Nurses Association (ANA) b. The Agency of Healthcare Research and Quality (AHRQ) c. The National Database of Nursing Quality Indicators (NDNQI) d. The National Quality Forum (NQF) ANS: C Feedback A B C D

Although the ANA is the organization that oversees the Magnet Recognition Program, hospitals do not join this organization. The AHRQ supports research designed to improve the outcomes and quality of health care. Participation in NDNQI meets requirements for the Magnet Recognition Program. The NQF was created as a national standard-setting organization for health care performance measures.

PTS: 1 REF: pp. 474-475

DIF: Cognitive level: Understanding (Comprehension)

11. Which is one of the indicators used by the National Database of Nursing Quality Indicators

(NDNQI)? a. Assessment, intervention, and reassessment of pediatric pain b. Clinical Laboratory Improvement Amendment (CLIA) standards c. Protocols for monitoring biometric equipment used in hospitals d. The number of hours hospital residents work per week ANS: A Feedback

A B C D

NDNQI identifies and develops nursing-sensitive quality measures. Assessment, intervention, and reassessment of pediatric pain is one of the indicators it uses. CLIA standards are those applied to hospital laboratory personnel and equipment. Biometric equipment standards are not nursing-sensitive measures. Standards about hospital residents are not nursing-sensitive measures.

PTS: 1 REF: pp. 474-475

DIF: Cognitive level: Understanding (Comprehension)

12. Which is an important finding in outcomes research about Advanced Practice Nursing (APN)

practice? a. APNs provide care that is equivalent to that provided by doctors at a fraction of the cost. b. Care by APNs shows equivalent or improved outcomes to that provided by physicians. c. Hospital readmission rates are slightly higher for patients who use APNs for primary care. d. The level of patient satisfaction is greater with APNs regardless of clinical outcomes. ANS: B Feedback A B

C D

Studies are not reported showing equivalent care at reduced cost. There is abundant research demonstrating the safety and effectiveness of APNs. In a search of all random controlled trials comparing APNs to usual care, findings consistently showed that care by APNs resulted in equivalent or improved outcomes. Studies do not show increased readmission rates. Patient satisfaction is high, but so are positive clinical outcomes.

PTS: 1 REF: pp. 476-477

DIF: Cognitive level: Understanding (Comprehension)

13. What is an important aspect of outcomes research as defined by Donabedian? a. Selection of only proximal outcomes in order to streamline outcomes research b. The need for patients or recipients of care to define which outcomes are desirable c. The need to link outcomes with specific nursing processes d. The use of population groups rather than individuals for outcome studies ANS: C Feedback A B C D

Outcomes research involves studies of all outcomes of nursing care. Donabedian does not identify the need to study patient feelings about outcomes or care. In outcomes research, according to Donabedian, there is a need to clearly link identified outcomes with the processes that caused the outcomes. Donabedian does not identify the need to use population groups rather than

individuals for outcome studies. PTS: 1 REF: p. 477

DIF: Cognitive level: Understanding (Comprehension)

14. Which is an example of a distal outcome in outcomes research? a. Glucose monitoring skills in patients receiving diabetic teaching b. Hospital readmission rates in patients admitted for myocardial infarction c. Pain scores before and after pain medication d. Patient perception of tobacco advertising among COPD patients ANS: D Feedback A

Glucose monitoring skills, hospital readmission rates, and pain scores are proximal outcomes because they are related directly to nursing interventions and not to external forces. Glucose monitoring skills, hospital readmission rates, and pain scores are proximal outcomes because they are related directly to nursing interventions and not to external forces. Glucose monitoring skills, hospital readmission rates, and pain scores are proximal outcomes because they are related directly to nursing interventions and not to external forces. A distal outcome is one which is removed from proximity to the care or service received and is more influenced by external (nontreatment) factors. Quality of life is an example of a distal outcome.

PTS: 1 REF: p. 478

DIF: Cognitive level: Applying (Application)

15. In outcomes research, a Magnet-designated hospital is an example of which type of variable? a. Dependent b. Intervention c. Outcome d. Structural ANS: D Feedback A B C D

A dependent variable is one that is affected by manipulation of another variable. An intervention variable is one that is manipulated to examine the effects of this manipulation on a dependent variable. An outcome variable is one that is linked to patient care. Magnet designation indicates certain standards of structure including shared governance, implementation of nursing practice, and autonomy.

PTS: 1 REF: pp. 478-479

DIF: Cognitive level: Understanding (Comprehension)

16. A nurse uses a care map to guide nursing interventions for patients with COPD. This is an

example of using:

a. b. c. d.

evidence-based practice. practice patterns. practice styles. standards of care.

ANS: D Feedback A B C D

Evidence-based practice includes clinical guidelines, critical paths, and standards of care. A practice pattern is a concept representing the variation in what type of care is provided. A practice style represents variation in how care is provided. A standard of care is a norm according to which quality of care is judged and includes guidelines, critical paths, and care maps.

PTS: 1 REF: pp. 480-481

DIF: Cognitive level: Understanding (Comprehension)

17. What is the role of evidence-based practice in outcomes research? a. Evidence-based practice identifies practice standards that can be evaluated using

patient outcomes. b. Evidence-based practice defines practice styles and patterns used in professional

practice. c. The standards used in evidence-based practice clearly identify desired patient

outcomes. d. There is a clear link between evidence-based practice and improved patient

outcomes. ANS: A Feedback A B C D

EBP guidelines contain standards and norms against which patient outcomes can be evaluated. Practice styles and patterns represent variations in what type of care and how care is delivered and are part of clinical guidelines. Very few empirical studies have assessed the impact of EBP on patient outcomes. Very few empirical studies have assessed the impact of EBP on patient outcomes.

PTS: 1 REF: pp. 480-481

DIF: Cognitive level: Understanding (Comprehension)

18. What type of sample is generally used in outcomes studies? a. Small sample b. Heterogeneous sample c. Homogeneous sample d. Volunteer sample ANS: B

Feedback A B C

A small sample would not provide a heterogeneous sample. Because the target population in outcomes studies is often heterogeneous, it is necessary to obtain large, heterogeneous samples. Typical sampling criteria for outcomes research include obtaining a very large, heterogeneous sample in which all patients have the likelihood of being represented. A volunteer sample is generally not encouraged, as it does not allow for the researcher to influence the sample characteristics.

PTS: 1 REF: pp. 481-482

DIF: Cognitive level: Applying (Application)

19. Which type of study design is commonly used in outcomes studies? a. Phenomenological b. Qualitative c. Quasi-experimental d. Random-control trial ANS: C Feedback A B C D

Phenomenological and qualitative studies do not account for effects of variables on patient outcomes. Phenomenological and qualitative studies do not account for effects of variables on patient outcomes. Quasi-experimental studies and observational research designs are most commonly used for outcomes research to provide effectiveness and efficiency. Random controlled trieals also seek to provide evidence about the effects interventions, but, with outcomes studies, the intervention is not limited to medications or clinical procedures..

PTS: 1 REF: pp. 483-484

DIF: Cognitive level: Understanding (Comprehension)

20. A researcher identifies a group of Native American subjects who are at risk for type 2 diabetes

mellitus and follows this group over time to observe actual rates of acquiring this disease. This is an example of a: a. clinical database. b. prospective cohort study. c. qualitative study. d. quasi-experimental study. ANS: B Feedback A B

A clinical database is a collection of data about a group of patients. A prospective cohort study is an epidemiologic study in which the researcher identifies a group of people who are at risk for a condition and follows them over time.

C D

A qualitative study is a nonexperimental study to examine attributes of a group of subjects. A quasi-experimental study is one in which the researcher has less control over independent variables than in a random controlled trial.

PTS: 1 REF: pp. 484-485

DIF: Cognitive level: Applying (Application)

21. A nurse identifies an unusual incidence of acute lymphocytic leukemia (ALL) in school-age

children in a nearby community and conducts a study to examine exposure to a variety of water pollutants from a local industry. This is an example of a: a. phenomenological study. b. qualitative study. c. prospective cohort study. d. retrospective cohort study. ANS: D Feedback A B C

Qualitative and phenomenological studies are nonexperimental studies to examine attributes of groups of subjects. Qualitative and phenomenological studies are nonexperimental studies to examine attributes of groups of subjects. A prospective cohort study is an epidemiologic study in which the researcher identifies a group of people who are at risk for a condition and follows them over time. A retrospective cohort study is an epidemiologic study in which the researcher identifies a group of people who have experienced a particular event and examines possible previous causes for this event.

PTS: 1 REF: pp. 485-486

DIF: Cognitive level: Applying (Application)

22. A researcher wishes to widely disseminate findings of outcomes research in order to influence

practice in a variety of settings. Which methods might this researcher use? a. A series of presentations and publications in professional and public forums b. An oral presentation at an international conference c. Publication in scholarly, peer-reviewed journals d. Writing about this research in a chapter of a nursing textbook ANS: A Feedback A B

Employing a series of presentations and publications in many venues is the only approach that achieves a widespread dissemination of the research findings. An open forum for exchange of ideas is excellent but is not sufficient in the eyes of outcomes researchers. Outcomes researchers consider wide dissemination of the results to providers and consumers necessary to promote change in health care practices. Presenting the findings, even at a prestigious conference, is not sufficient in the

eyes of outcomes researchers. Outcomes researchers consider wide dissemination of the results to providers and consumers necessary to promote change in health care practices. Outcomes researchers consider wide dissemination of the results to providers and consumers necessary to promote change in health care practices.

PTS: 1 REF: pp. 494-495

DIF: Cognitive level: Understanding (Comprehension)