NR 449 Week 2 Comprehensive Examination: 150 Practice MCQs with Rationale.
1. Nursing research is significant to the profession of nursing because it
... [Show More] promotes what?
a. More specifically defined nursing practice responsibilities
b. Decreased liability within the practice of nursing
c. Generation of a specialized body of nursing knowledge for use in nursing practice
d. Expansion of the scope of nursing practice into areas formerly reserved for other
disciplines
Rationale: The correct answer is C. Nursing research generates a specialized scientific knowledge base that empowers the nursing profession to anticipate & meet constantly shifting challenges of health care delivery to multiple populations. It provides a foundation for evidence-based nursing care & quality improvement activities.
2. Which aspect of the scientific investigation of nursing practice is also a fundamental concept of American Nurses Association (ANA)'s Code for Nurses?
a. Professional accountability
b. St&ards of care
c. Legal scope of practice
d. Advanced practice nursing activities
Rationale: The correct answer is A. Scientific investigation promotes accountability, a hallmark of the nursing profession & a fundamental concept of the ANA's Code for Nurses.
3. Nurses who do not conduct research need to underst& the nursing research process for which of these reasons?
a. To identify potential subjects for clinical research studies
b. To assist as accurate data collectors in clinical research studies
c. To teach patients & their families about the usefulness of consenting to
participate in research
d. To be able to evaluate nursing research reports for relevance to their own clinical
practice
Rationale: The correct answer is D. Nurses need to underst& the research process in order to critically read research reports & determine if nursing practice should incorporate the research findings as valid evidence.
4. Which of these actions demonstrates the role of a knowledgeable consumer of nursing research?
a. Designing a nursing research study
b. Analyzing data to determine a study's outcomes
c. Evaluating the credibility of research findings
d. Implementing an intervention found to be effective in one clinical case study
Rationale: The correct answer is C. A consumer of nursing research needs to underst& the research process to determine the merit & relevance of evidence presented in research studies.
5. Members of the nursing staff are to participate in a unit-based clinical research study. Which research-related actions would be expected of a nurse with a baccalaureate nursing degree?
a. Using critical appraisal skills to underst& & assess the steps of the research
process
b. Providing expert nursing consultation about the way in which clinical services are
delivered
c. Developing research methods to monitor & evaluate the quality of nursing
practice in the clinical setting
d. Providing leadership in the application of scientific knowledge to nursing
Practice
Rationale: The correct answer is A. A baccalaureate-prepared nurse should be able to use skills of critical appraisal to both underst& & appraise the steps of the research process.
6. Which statement describes the role of the nurse in research?
a. Nurses must be prepared at the baccalaureate or higher level of education to have any role in nursing research.
b. Nurses with master's or higher levels of education are solely responsible for applying research to clinical practice.
c. The research role of nurses prepared at both the baccalaureate & master's levels of education includes critical appraisal skills.
d. Regardless of the nursing education level, only the nurse with the most comprehensive underst&ing of statistical methods should interpret research findings.
Rationale: The correct answer is C. To use research in evidence-based practice, the nurse must not necessarily be able to conduct research but should be able to underst& & appraise the steps of the research process to read the research literature critically & use it to inform clinical decisions.
7. What is the primary value of evidence-based nursing practice?
a. Implementing the most cost-effective nursing practices when providing patient care
b. Incorporating research findings with clinical expertise when individualizing patient care
c. Separating nursing research as unique from the research of other disciplines
d. Developing new nursing theories to promote the growth of nursing science
Rationale: The correct answer is B. Evidence-based practice allows the nurse to systematically integrate the best available research evidence with individual clinical expertise, as well as the patient's values & preferences, when making clinical decisions.
8. A novice nurse researcher is comparing the processes used in nursing research & evidence-based practice. What differences, if any, exist between the two processes?
a. As scientific processes, they are fundamentally the same & should result in parallel outcomes.
b. Both processes involve testing a question with an appropriate design & specific methodology.
c. In a research study the question is tested with an appropriate design & specific methodology, whereas in evidence-based practice the question is used to search the research literature to find answers.
d. In evidence-based practice, qualitative studies are critically appraised to answer a clinical question, whereas in nursing research, quantitative studies are reviewed to provide a foundation for the study.
Rationale: The correct answer is C. Nursing research includes developing a design for a study, whether quantitative or qualitative, reviewing the literature, & carrying out a specific methodology to find answers to a question. In contrast, evidence-based practice includes a review of completed research studies to identify answers to a clinical question.
9. A nurse is analyzing a research article. Where in the article is the nurse likely to find the research question & study purpose?
a. Introduction
b. Data analysis
c. Findings
d. Data collection
Rationale: The correct answer is A. The research question & study purpose is generally found early in the report: in the abstract, the introduction, or at the end of the literature review or conceptual framework section.
10. The nurse researcher is conducting a research study using subjects who will be interviewed regarding their experience with postpartum depression. For which of these reasons would the researcher selects a qualitative, rather than quantitative, research design?
a. Quantitative research is usually conducted in natural settings using data that are
words rather than numbers.
b. Qualitative research seeks to explain cause-&-effect relationships between
variables.
c. Quantitative research typically uses a convenience sample, seeking to answer a
clinical question about human experience.
d. Qualitative research collects data from a small number of subjects, allowing for
in-depth study of a phenomenon.
Rationale: The correct answer is D. Qualitative research typically collects data from a small number of subjects, thus allowing for in-depth study of a phenomenon while using a subjective approach.
11. The nurse is analyzing a research article. To determine if an integrative review was performed as part of the study, the nurse must underst& that this type of review is what?
a. A summary of research studies on a focused topic that used a specific statistical
methodology
b. A synthesis of the research & theoretical literature on a specific area without a
statistical analysis
c. A synthesis of qualitative articles on a focused topic using a specific qualitative
methodology
d. A summary of articles in an attempt to develop a clinical practice statement or
clinical guidelines
Rationale: The correct answer is B. An integrative review is a synthesis of research or theoretical literature on a specific area that follows specific steps of literature integration without statistical analysis.
12. When assessing the strength of a body of evidence used in a research study for consistency, the nurse should determine what?
a. Extent to which the study's design, implementation, & analysis minimize bias
b. Number of studies that have evaluated the research question, including overall
sample size across studies
c. Degree to which studies with similar & different designs investigated the same
research questions & report similar findings
d. Significance of the findings based on the statistical methods used for data analysis
Rationale: The correct answer is C. Consistency is the degree to which studies that had similar & different designs (but investigate the same research question) reported similar findings.
13. The nurse is analyzing a qualitative research article. In which section of the article is the nurse likely to find a summary of legal-ethical issues considered in the study?
a. Data collection or procedures
b. Findings or results
c. Discussion or implications
d. Abstract or introduction
Rationale: A Legal-ethical issues are typically discussed in the article's data collection or procedures section, usually when discussing the sample.
14. The nurse is analyzing a qualitative research article. In which section of the article should the nurse expect to find a discussion of the research findings?
a. Procedures
b. Methods
c. Sample
d. Results
Rationale: The correct answer is D. The discussion of the findings will be located in the results or discussion section.
15. The nurse is using the critical reading process to analyze a research article. The nurse identifies the main theme of the article & states it in two sentences, using the nurse's own words. The nurse is using a strategy to promote which type of underst&ing?
a. Preliminary
b. Comprehensive
c. Analysis
d. Synthesis
Rationale: The correct answer is B. Strategies for comprehensive underst&ing include restating the main idea or theme of the article in one's own words.
16. The nurse is using the critical reading process to analyze a research article. The nurse is using a list of criteria to determine how well the researcher performed each step of the research process. The nurse is using a strategy to promote which type of underst&ing?
a. Preliminary
b. Comprehensive
c. Analysis
d. Synthesis
Rationale: The correct answer is C. Strategies for analysis underst&ing include using criteria to critique the steps of the research process used in the study.
17. Which of the following is a critical step for the quality improvement process in health care settings?
a. Outlining general long-range goals
b. Identifying current successful practices
c. Testing practice changes slowly & tentatively
d. Adopting a practice change as a new st&ard of care
Rationale: The correct answer is D. The goal of quality improvement activities is to bring about changes in practice that will make a positive difference in patient care. Therefore, adopting a practice change is a critical step in the process.
1. Which statement(s) describe the actions of the baccalaureate nurse graduate as a participant in the nursing research process? (Select all that apply.)
a. Administering care at the bedside according to a research protocol
b. Providing leadership by helping others apply scientific knowledge to practice
c. Sharing with nursing colleagues research findings that are pertinent to practice
d. Designing & conducting nursing research studies
e. Functioning as a primary investigator for a research study
Rationale: The correct answer is A, C. Following a research protocol at the bedside is an activity consistent with the practice of a nurse prepared at the baccalaureate level.
Sharing research evidence with colleagues is an activity consistent with the practice of a nurse prepared at the baccalaureate level.
Which aspects of the nursing research process are common to nurses at all educational levels? (Select all that apply.)
a. Disseminating research findings in research reports
b. Maintaining the protection of patients who are subjects in a study
c. Using one's expertise to develop theoretical explanations for findings
d. Knowing the relationship between research & nursing practice
e. Being a member of a collaborative team that applies research to practice
Rationale: The correct answer is B, D, E. All nurses are responsible for protecting the rights of patients.
All nurses should be aware that research is related to practice.
All nurses can be a part of a clinical team that applies research to practice.
For the baccalaureate nursing student, education in nursing research has which outcomes? (Select all that apply.)
a. Mastering the development of research protocols
b. Gaining a basic underst&ing of the research process
c. Learning how research is related to clinical nursing practice
d. Developing skill as a primary investigator in research
e. Becoming a knowledgeable consumer of nursing research
Rationale: The correct answer is B, C, E. The student should gain an initial underst&ing of the importance of research in nursing practice.
The student should learn how research is related to clinical nursing practice.
The student should learn skills in the critical analysis of research to assist in decisions about applying research findings in nursing practice.
Developing nurse researchers at a younger age is a priority for the future in the nursing profession for which reasons? (Select all that apply.)
a. Enhancing the discipline's scientific development
b. Increasing the longevity of research careers
c. Receiving more research funding for professional organizations
d. Promoting mentoring opportunities for novice researchers
e. Increasing nursing's role in pharmaceutical research
Rationale: The correct answer is A, B, D. Developing young researchers increases the number of researchers contributing to the science of the discipline.
Introducing nurses to research at a younger age allows them sufficient time to develop in-depth research programs in their careers.
Introducing nurses to research at a younger age allows them time & opportunity to be mentored by experienced researchers, as well as to learn to become mentors themselves.
1. What difference, if any, exists between a research question & a hypothesis?
a. A research question is practice based, & a hypothesis is theory based.
b. A hypothesis attempts to answer the question posed by the research problem.
c. A research problem defines clinical research & a hypothesis defines basic research.
d. There is no difference between a research problem & hypothesis.
Rationale: The correct answer is B. A hypothesis attempts to answer the research question.
2. How is a hypothesis related to a theory?
a. Hypotheses can be developed in the absence of a theoretical framework.
b. Hypotheses must be consistent with an existing theoretical framework.
c. A theory can determine the validity of a hypothesis.
d. A theory can be used to evaluate the merit of a hypothesis.
Rationale: The correct answer is B. A sound hypothesis is consistent with an existing body of theory & research findings.
3. A nurse makes these statements. Which one has the greatest potential as an area of nursing research?
a. "Most of our hospital's admissions come in at night."
b. "It is difficult to find personnel willing to work the night shift."
c. "It seems that most of the patient falls on our unit occur during the night shift."
d. "The personnel on the night shift are not attending promptly to the needs of our patients."
Rationale: C This statement identifies a specific, important patient problem. Its exploration has potential to contribute to the body of nursing knowledge.
4. The nurse has identified a clinical problem as a potential research question. Which of these steps should the nurse take next?
a. Identify the variables
b. Formulate the research hypothesis
c. Perform a literature review
d. Determine financial resources for the research project
Rationale: The correct answer is C. The literature review helps to further define the research question by identifying gaps in the literature, the need for replication of prior research, or the need to extend the knowledge base in a particular research area. It also identifies variables essential to consider in refining the research question.
5. In a research study, what are the properties of interest that differ in value?
a. The study's variables
b. The study's concepts
c. The study's hypotheses
d. The study's assumptions
Rationale: A This is the widely accepted & often-cited definition of variables.
6. A nurse researcher proposes a study of teenage mothers & their experience with postpartum depression. Which of these considerations would affect the feasibility of the study?
a. Availability of participants
b. Direction of the hypotheses
c. Gaps in the literature
d. Design of the study
Rationale: The correct answer is A. A study's feasibility is determined by practical considerations, such as availability of subjects, equipment, facilities, & money.
7. What is the key difference between independent & dependent variables?
a. The dependent variable should change in response to manipulation by the independent variable.
b. The independent variable should change in response to manipulation by the dependent variable.
c. Although both the dependent & independent variables are manipulated, only the dependent variable is considered an intervention.
d. Although both the dependent & independent variables are manipulated, only the independent variable is considered an intervention.
Rationale: A Dependent variables change in response to manipulation of independent variables in experimental research.
8. When designing a research study, the nurse should have which of these underst&ings about independent & dependent variables?
a. All research problem statements should contain a dependent & an independent variable.
b. There should only be one dependent variable associated with a single independent variable.
c. The relationship between independent & dependent variable in any study should be causal.
d. A given characteristic or situation may be the dependent variable in one study & the independent variable in another.
Rationale: The correct answer is D. Depending on the particular study, a specific variable may be the dependent or the independent variable. The causal or associative direction between variables determines the classification of the variables as independent or dependent.
9. A nurse's research question is, "How does maternal employment among health care professionals affect infant health during the first 6 months of life?" In this question, what is the dependent variable?
a. Infant health
b. Maternal employment
c. First 6 months of life
d. Health care professionals
Rationale: The correct answer is A. Infant health is the consequence or presumed effect that changes regarding maternal employment. Thus it is the dependent variable.
10. A nurse has defined the research question as, "How does oral nutritional supplementation during dialysis treatments affect the serum albumin levels of adult patients who have chronic kidney disease Stage 5?" In this question, what is the independent variable?
a. Adult patients with chronic kidney disease Stage 5
b. Oral nutritional supplementation
c. During dialysis treatments
d. Serum albumin levels
Rationale: The correct answer is B Oral nutritional supplementation is the intervention administered to effect a change in the patients' serum albumin levels. Thus oral nutritional supplementation is the independent variable.
11. A nurse has defined the research question as, "Is there a relationship between self-esteem & body weight among postmenopausal women?" What type of research-question format (or research design) is implied by this question?
a. Correlational nonexperimental
b. Comparative non experimental
c. Quantitative experimental
d. Grounded theory nonexperimental
Rationale: The correct answer is A. Self-esteem & body weight are variables that are related in an associative way. The word, relationship, strongly suggests correlational design studies.
12. A nurse has defined the research question as, "What is the lived experience of late-stage pregnancy loss among women older than 35 years?" What type of research-question format (or research design) is implied by this question?
a. Correlational non experimental
b. Comparative non experimental
c. Quantitative experimental
d. Grounded theory nonexperimental
Rationale: The correct answer is D. The question concerns "lived experience," which implies a grounded-theory study design.
13. Which research question is testable as currently written?
a. Should parents addicted to crack cocaine be permitted to raise their children?
b. Is the classroom an appropriate place to teach sex education to 10-year-old children?
c. Are older adults living in assisted-living facilities satisfied with their level of social interaction?
d. Is a positive HIV/AIDS status a sufficient reason for limiting the employment of elementary school teachers?
Rationale: The correct answer is C. This example implies variables that can be measured & suggests a comparative nonexperimental design study. The independent variable is residing in assisted-living facilities, as compared with not residing in assisted-living facilities. The dependent variable is social interaction.
14. What is the purpose of a hypothesis for any study?
a. To identify the dependent & independent variables
b. To provide direction for the study by indicating the expected outcomes
c. To define the appropriate measures needed to test the research problem
d. To provide a means of determining the feasibility of the proposed study
Rationale: The correct answer is B. A hypothesis is a declarative statement about two or more variables that predicts an expected outcome.
15. Which hypothesis fails to meet the criteria of testability?
a. Proper h& washing prevents the spread of infection.
b. Consistent practice of low-impact aerobic exercise will increase coordination among older adults.
c. Patients who used guided imagery during magnetic resonance imaging (MRI) procedures will have reduced perceptions of emotional distress compared with patients who do not use guided imagery during MRI.
d. Postoperative patients who receive around-the-clock scheduled analgesics will have lower levels of pain compared with postoperative patients who receive analgesics on an as-needed (PRN) schedule.
Rationale: The correct answer is A. This statement does not suggest that there is a predicted outcome as specifically as the other examples. The term proper is value laden & nonspecific. Both proper h&washing & spread of infection require more specific definition.
16. Which hypothesis is nondirectional?
a. Hospitals with an infection-control nurse will have fewer instances of sepsis among inpatients than hospitals without an infection-control nurse.
b. There will be a greater weight loss among dieting patients who receive a weekly supportive telephone call from a dietitian than among dieting patients who do not receive a weekly supportive phone call.
c. There will be a difference in stage of disease for prostate cancer among men who had an abnormal prostate-specific antigen screening compared with men who had an abnormal digital rectal examination screening.
d. Children who receive weekly counseling for 1 year after the death of a parent will perform better in school than children who do not receive weekly counseling after the death of a parent.
Rationale: The correct answer is C. This hypothesis has no expected direction. It suggests a difference but does not indicate the direction of the difference.
17. The nurse has defined the hypothesis as, "There will be no difference in the number of adverse events among patients discharged two days after an abdominal hysterectomy compared with patients discharged 4 days after an abdominal hysterectomy." This statement is an example of what?
a. Directional hypothesis
b. Nondirectional hypothesis
c. Research hypothesis
d. Null hypothesis
Rationale: The correct answer is D. This is a null (or statistical) hypothesis, stating that there is no relationship between the independent (postoperative days) & dependent (adverse events) variables. If in the statistical analysis a significant relationship is found, the null hypothesis would be rejected.
18. The nurse notes these statements in a research article:
This study explores changes in coping & emotion that occur between the preoperative & the postoperative period. Further, the relationships between coping & emotion preoperatively & postoperatively are evaluated. Finally, the influence of preoperative coping & emotion on postoperative emotion is documented.
This section represents which part of a research study?
a. Results
b. Methods
c. Purpose
d. Hypothesis
Rationale: The correct answer is C. The statements describe the aims or goals that the investigator hoped to achieve with the research & thus reflect the purpose of the study.
19. A nurse states the purpose of a research study as, "This study will compare the effect of warm & cold applications on the resolution of intravenous (IV) infiltrations in hospitalized older-adult patients in the early postoperative period." In this statement, what constitutes the independent variable(s)?
a. Postoperative older adult patients
b. Early postoperative period
c. Warm & cold applications
d. Resolution of IV infiltrations
Rationale: The correct answer is C. Warm & cold applications represent the independent variables, which will be manipulated & influence the dependent (outcome) variable resolution of IV infiltrations.
20. A nurse describes the hypothesis of a research study as, "There is a positive relationship between nurses' attitudes toward AIDS patients & the number of AIDS patients they have cared for in practice." This statement is an example of what?
a. Null hypothesis
b. Nondirectional hypothesis
c. Directional hypothesis
d. Causal hypothesis
Rationale: The correct answer is C. Because a positive relationship is specified, the hypothesis is directional.
21. The nurse has identified a patient situation that may be an area for study. The initial review of the literature helps the investigator to identify what?
a. The number of subjects required for the study
b. The appropriate statistical tests to analyze the data
c. The need to extend knowledge in a particular area
d. The instruments needed to collect data during the study
Rationale: The correct answer is C. The initial literature review helps further define the research question by identifying gaps in the literature, the need for replication of prior research, or the need to extend the knowledge base in a particular research area. It also identifies variables essential to consider in refining the research question.
22. Which hypothesis would be classified as a statistical hypothesis?
a. Oxygen inhalation at 2 L/min by nasal catheter will decrease oral temperature measured with an electronic thermometer.
b. Oxygen inhalation at 2 L/min by nasal catheter will not affect oral temperature measured with an electronic thermometer.
c. There will be a greater decrease in anxiety scores in patients receiving informational videos before open heart surgery than in patients who receive st&ard written information.
d. There will be a difference in anxiety scores in patients receiving informational videos before open heart surgery & patients who receive st&ard written information.
Rationale: The correct answer is B. A statistical (or null) hypothesis indicates no relationship between variables, as represented in this statement. If in the statistical analysis, a significant relationship is found, the null hypothesis would be rejected.
23. Which of these statements is correctly phrased as a clinical question for evidence-based practice?
a. What is the best method to insert an enteral feeding tube in an adult patient?
b. Are there differences in the characteristics of various br&s of enteral feeding tubes?
c. In addition to aspiration, what are the most problematic complications of enteral tube feedings?
d. What method of determining stomach placement of enteral feeding tubes helps to prevent aspiration in adult patients?
Rationale: The correct answer is D. This statement is worded as a clinical question & includes the four PICO elements: population (adult patients), intervention (methods of determining stomach placement), comparison (among methods), & outcome (prevent aspiration).
1. The review of literature is important to the research process for which of these reasons?
a. It guides all steps of the research process.
b. It provides a vehicle to disseminate the findings of the study.
c. It guides only the conceptualization of the problem statement.
d. It identifies only gaps or inconsistencies in the knowledge base.
Rationale: The correct answer is A. The review of the literature is important throughout all stages of a research study.
2. The "6S" pyramid hierarchy of preappraised evidence developed by DiCenso, Bayley, & Haynes (2009) provides a means to help nurse consumers of research find pre appraised evidence for clinical questions. Using this model, which level of evidence would be highest?
a. Summaries such as clinical practice guidelines
b. Synopsis of Synthesis such as summaries found in the journal Evidence-Based Nursing
c. Synthesis of systematic reviews such as a Cochrane review
d. Studies such as synopses of a single study
Rationale: The correct answer is A. The highest level of those presented in the question is Summaries, which include clinical practice guidelines & electronic evidence-based textbooks. These summaries about specific conditions are updated regularly. An even higher level of the 6S pyramid is Computerized Decision Support Systems (CDSS), which integrate evidence-based clinical information into an electronic medical record. At present, these systems are not a reality in most institutions &, therefore, they were not included as an option in this question.
3. For which of these reasons would a nurse researcher include refereed journals in the literature review?
a. The articles are critiqued by a panel of external reviewers.
b. The articles selected for publication are related to a specific field of knowledge.
c. The journals encourage competition among authors to have their articles published.
d. The journals publish only articles that are primary sources of research findings.
Rationale: The correct answer is A. The articles are critiqued by a panel of external expert readers.
4. A research article has undergone a blind review for a peer-reviewed journal. The nurse reading the research article should underst& which of the following about this review process?
a. The reviewers of the article did not know the identity of the other reviewers.
b. The reviewers of the article did not know the identity of the author.
c. The criteria used to review the article were not known to the author.
d. The criteria used to review the article were determined by the reviewers.
Rationale: The correct answer is B. In a blind review, the manuscript to be reviewed does not include the name of the author.
5. For which of these reasons would a nurse researcher decided to use secondary sources in a review of the literature?
a. They provide material written by the person who conducted the study.
b. They provide a different way of looking at specific issues or problems.
c. They define the relationship of two or more variables affecting an outcome.
d. They supplement the body of nursing knowledge in a specific area of practice.
Rationale: The correct answer is D. Secondary sources published in refereed journals usually include implications for practice & the work's contributions to the development of nursing science.
6. Which is an example of a primary source in a literature review?
a. A video recorded interview of a nurse researcher
b. A critique of a nursing research study
c. An edited textbook on nursing research
d. A review of theoretical frameworks used in nursing research
Rationale: The correct answer is A. Primary sources include articles, books, diaries, films, & oral histories of the person who conducted the study or developed the theory.
7. Which is an example of a secondary source in a literature review?
a. An oral history of a nurse researcher
b. An investigator's report of a research study
c. A summary & critique of another's scholarly work
d. An autobiography of a developer of a nursing theory [Show Less]