LoBiondo-Wood: Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice, 7th Edition

Chapter 01: Integrating the Processes of Research and Evidence-Based Practice

Test Bank

MULTIPLE CHOICE

1.	How is nursing research significant to the profession of nursing?
a.	It allows nursing responsibility to be more specifically defined.	
b.	It allows liability within the practice of nursing to be decreased.	
c.	It allows a specialized body of knowledge to be generated for use in health care delivery.	
d.	It allows the scope of nursing practice to be expanded into areas formerly reserved for other disciplines.	

ANS:	C
Correct C: Theory-based nursing research provides a foundation for evidence-based nursing care. Nursing research generates a specialized scientific knowledge base that empowers the nursing profession to anticipate and meet constantly shifting challenges of health care delivery to multiple populations.

Incorrect A: Research aids in documenting accountability of nurses, but professional guidelines already exist regarding responsibility. Each state has a Nurse Practice Act that defines scope of practice.
Incorrect B: Liability is a legal concept. Research does not change a nurse’s liability.
Incorrect D: Although research can document nursing accountability, each state’s Nurse Practice Act would define the scope of nursing practice for that state.

DIF:	Cognitive Level: Knowledge	REF:	Page 7

2.	Which aspect of scientific investigation of nursing practice is a fundamental concept of American Nurses Association (ANA)’s Code for Nurses (2002)?
a.	Accountability	
b.	Patient advocacy	
c.	Ethical behavior	
d.	Specialized practice	

ANS:	A
Correct A: Scientific investigation promotes accountability, a hallmark of the nursing profession and a fundamental concept of the ANA (2002) Code for Nurses.

Incorrect B: Patient advocacy is an expected nursing behavior but is not the main concept of the ANA (2002) Code for Nurses.
Incorrect C: Ethical behavior is an expected nursing behavior but is not the main concept of the ANA (2002) Code for Nurses.
Incorrect D: The ANA code applies to general nursing practice.

DIF:	Cognitive Level: Knowledge	REF:	Page 7

3.	Why do nurses who do not conduct research need to understand the nursing research process?
a.	To identify potential subjects for clinical research studies	
b.	To assist as accurate data collectors in clinical research studies	
c.	To teach patients and families the usefulness of consenting to participate in research	
d.	To be able to evaluate nursing research reports for relevance to their own clinical practice	

ANS:	D
Correct D: Nurses should be able to understand the research process by reading research reports and deciding whether they should modify their practice based on research evidence.

Incorrect A: Nurses who do not conduct research would not influence subject identification.
Incorrect B: Nurses who do not conduct research would not influence data collection.
Incorrect C: Nurses who do not conduct research would not influence subject recruitment.

DIF:	Cognitive Level: Comprehension	REF:	Page 7

4.	Which action demonstrates the role of a knowledgeable consumer of nursing research?
a.	Designing a research study	
b.	Analyzing data to determine outcomes	
c.	Evaluating the credibility of the research findings	
d.	Implementing an intervention found to be effective in one clinical study	

ANS:	C
Correct C: A consumer of nursing research needs to understand the research process to determine the merit and relevance of evidence for research studies.

Incorrect A: A consumer uses and applies research to practice but is not responsible for designing a study.
Incorrect B: A consumer does not conduct data analysis of a study; the study’s primary investigator analyzes data.
Incorrect D: A consumer can apply research findings to practice but does not have to implement research protocols.

DIF:	Cognitive Level: Comprehension	REF:	Page 11

5.	In designating the research functions of the nursing staff, which function would be expected of a nurse with a baccalaureate nursing degree?
a.	Use skills of critical appraisal to understand and appraise the steps of the research process	
b.	Provide expert consulting about the way in which clinical services are delivered	
c.	Develop methods to monitor the quality of nursing practice in the clinical setting	
d.	Provide leadership in applying scientific knowledge in nursing practice	

ANS:	A
Correct A: A baccalaureate-prepared nurse should be able to use skills of critical appraisal to both understand and appraise the steps of the research process.

Incorrect B: Bachelor of science in nursing (BSN)-level nurses are at the bedside implementing protocols, whereas expert consulting is reserved for master of science in nursing (MSN)-level or PhD-level nurses.
Incorrect C: Developing methods is reserved for nurses with advanced education.
Incorrect D: Providing leadership is reserved for nurses with advanced education.

DIF:	Cognitive Level: Comprehension	REF:	Page 7

6.	Which statement regarding the role of the nurse in research is true?
a.	Nurses must be prepared at the baccalaureate level or higher to have any role in nursing research.	
b.	Master’s-prepared nurses (MSN, MN, or MS degrees) are primarily responsible for using the findings of nursing research in clinical practice.	
c.	The research role of both the baccalaureate- and master’s-prepared nurse calls for skills of critical appraisal.	
d.	Regardless of nursing education, the only nurse who should interpret research findings is the one who has the most comprehensive understanding of statistical analysis methods.	

ANS:	C
Correct C: To use research (evidence-based practice), the nurse must not necessarily be able to conduct research but should be able to understand and appraise the steps of the research process to read the research literature critically and use it to inform clinical decisions.

Incorrect A: Having a role in nursing research or implementing findings is not limited to BSN and MSN nurses only.
Incorrect B: MSN-prepared nurses can provide leadership to supervise how research findings are applied in the clinical area. All levels of nurses can apply research findings to practice.
Incorrect D: Data analysis is usually conducted by an MSN- or PhD-level nurse.

DIF:	Cognitive Level: Comprehension	REF:	Page 7

7.	What action or strategy limits rather than promotes the depth of nursing research?
a.	Addressing physiologic and psychological responses to actual or potential health problems	
b.	Employing qualitative methods and quantitative methods in the same study	
c.	Developing programs of research that build on prior investigations	
d.	Using singular measures to assess phenomena	

ANS:	D
Correct D: Using a single measure will not allow a researcher to examine the complexity of human phenomena.

Incorrect A: Addressing the physical and psychological aspects of a phenomenon provides depth to research outcomes.
Incorrect B: Multiple-method studies can provide greater depth of understanding of a phenomenon.
Incorrect C: Building on prior research allows for deeper exploration of human phenomena.

DIF:	Cognitive Level: Comprehension	REF:	Page 8

8.	What is the overall value of developing evidence-based nursing practice?
a.	Implementation of the most cost-effective nursing practice patterns	
b.	Allowing the nurse to use the best available evidence, individual clinical expertise, and the patient’s values and preferences in making clinical decisions	
c.	Separation of nursing research from the research of other disciplines	
d.	Development of new nursing theories	

ANS:	B
Correct B: Evidence-based practice allows you to systematically use the best available evidence with the integration of individual clinical expertise as well as the patient’s values and preferences in making clinical decisions.

Incorrect A: Implementation of more cost-effective nursing interventions can occur based on evidence, but it is not the overall value of developing evidence-based nursing practice.
Incorrect C: Developing a unique body of nursing knowledge is important, but it is not the overall value of developing evidence-based nursing practice. Also, nurse researchers should be able to collaborate with other researchers in other disciplines.
Incorrect D: Developing nursing theory is important, but evidence-based nursing is focused on the more concrete aspects of clinical practice.

DIF:	Cognitive Level: Comprehension	REF:	Page 16

9.	How can a novice nurse researcher recognize the difference in the research process and the evidence-based practice process?
a.	As scientifically based processes, they are fundamentally the same and should result in congruent outcomes.	
b.	Both processes result in testing a question with an appropriate design and specific
methodology.	
c.	In a research study, the question is tested with an appropriate design and specific
methodology, whereas the evidence-based practice process uses the question to search the literature for completed studies that can answer the clinical question.	
d.	Both processes use a question to spearhead a search for completed studies that can be critically appraised in an attempt to answer the posed clinical question.	

ANS:	C
Correct C: This is the fundamental difference between the research process and the evidence-based practice process.

Incorrect A: The research process and the evidence-based practice process, though similar, have fundamental differences as well.
Incorrect B: This definition applies to the research process, not the evidence-based practice process.
Incorrect D: This definition applies to the evidence-based practice process.

DIF:	Cognitive Level: Comprehension	REF:	Page 7

10.	The nurse researcher is analyzing a research article. Where can the researcher expect to find the research question and study purpose noted?
a.	Introduction	
b.	Data analysis	
c.	Findings	
d.	Data collection	

ANS:	A
Correct A: The research question and study purpose can be expected to be found in the abstract or in the introduction.

Incorrect B: The research question and study purpose are not typically noted in the data analysis section of the research article.
Incorrect C: The research question and study purpose are not typically noted in the findings section of the research article.
Incorrect D: The research question and study purpose are not typically noted in the data collection section of the research article.

DIF:	Cognitive Level: Knowledge	REF:	Page 9

11.	The nurse researcher is conducting a research study using a dozen subjects who were interviewed regarding their experience with postpartum depression. The researcher opts for a qualitative research design. What would be the most accurate rationale for the researcher choosing this type of design?
a.	Quantitative research is usually conducted in natural settings using data that are words rather than numbers.	
b.	Qualitative research seeks to explain cause-and-effect relationships between variables.	
c.	Quantitative research seeks to answer a question about a human experience.	
d.	Qualitative research collects data from a small number of subjects, allowing for in-depth study of a phenomenon.	
ANS:	D
Correct 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.

Incorrect A: Qualitative research is usually conducted in natural settings using data that are words rather than numbers.
Incorrect B: Quantitative research seeks to explain cause-and-effect relationships between variables.
Incorrect C: Qualitative research seeks to answer a question about a human experience.

DIF:	Cognitive Level: Knowledge	REF:	Page 8

12.	The nurse researcher is analyzing a research article that includes a study of breast cancer patients and the cutting-edge treatments that they are considering including in their treatment regimens. How can the researcher determine whether an integrative review was performed as part of the study?
a.	An integrative review summarizes articles on a focus topic using a specific method.	
b.	An integrative review is a synthesis of the literature on a specific area without statistical analysis.	
c.	An integrative review is a synthesis of qualitative articles on a topic using specific qualitative methodology.	
d.	An integrative review synthesizes articles in an attempt to develop a clinical practice statement.	

ANS:	B
Correct B: An integrative review is a synthesis of the literature on a specific area that follows specific steps of literature integration without statistical analysis.

Incorrect A: Meta-analysis summarizes articles on a focus topic using a specific methodology.
Incorrect C: Meta-synthesis is a synthesis of qualitative articles on a focused topic using specific qualitative methodology.
Incorrect D: Clinical guidelines are practice statements designed to assist clinicians about health care decisions for specific conditions or situations.

DIF:	Cognitive Level: Knowledge	REF:	Page 9

13.	The nurse researcher is attempting to grade the strength of a body of evidence used in a research study. How can the researcher grade the evidence for consistency?
a.	Consistency is the extent to which the study’s design, implementation, and analysis minimize bias.	
b.	Consistency is the number of studies that have evaluated the research question, including overall sample size across studies.	
c.	Consistency is the degree to which studies that have similar and different designs (but investigate the same research question) report similar findings.	
d.	Consistency is the strength of the findings from the data analyses.	

ANS:	C
Correct C: Consistency is the degree to which studies that have similar and different designs (but investigate the same research question) report similar findings.

Incorrect A: Quality is the extent to which the study’s design, implementation, and analysis minimize bias.
Incorrect B: Quantity is the number of studies that have evaluated the research question, including overall sample size across studies.
Incorrect D: Quantity is the strength of the findings from the data analyses.

DIF:	Cognitive Level: Knowledge	REF:	Page 17

14.	The nurse researcher is analyzing a qualitative research article. Where should the researcher expect to find a discussion of legal-ethical issues located in the journal article?
a.	Data collection or procedure sections	
b.	Results of findings	
c.	Discussion and implications	
d.	Abstract or introduction	

ANS:	A
Correct A: Legal-ethical issues will typically be discussed in the journal article’s data collection or procedures sections.

Incorrect B: The research results will typically be found in the results or findings sections.
Incorrect C: Recommendations are typically found in the discussion and implications sections.
Incorrect D: The research question and study purpose are typically found in the abstract or introduction.

DIF:	Cognitive Level: Knowledge	REF:	Page 9

15.	The nurse researcher is analyzing a quantitative research article. Where should the researcher expect to find a discussion of the findings of the research?
a.	In “procedure” or “data analysis”	
b.	In “methods” or “instruments”	
c.	In “sample” or “subjects”	
d.	In “results” or “discussion”	

ANS:	D
Correct D: A discussion of the findings will be located in the section labeled as “results” or “discussion.”

Incorrect A: Data analysis is typically included in the section labeled as “data analysis” or “procedure.”
Incorrect B: Instruments, validity, and reliability are included in the “methods” or “instruments” sections.
Incorrect C: The sample as well as legal-ethical issues are included in the section labeled as “sample” or “subjects.”

DIF:	Cognitive Level: Knowledge	REF:	Page 10

16.	The nurse researcher is attempting to use the critical reading process as she analyzes a research article. The nurse identifies the main theme of the article and states it in her own words in two sentences. Which critical reading process strategy is the researcher using?
a.	Strategy for preliminary understanding	
b.	Strategy for comprehensive understanding	
c.	Strategy for analysis understanding	
d.	Strategy for synthesis understanding	

ANS:	B
Correct B: Stating the theme of the article in your own words is a strategy for comprehensive understanding as part of the critical reading process.

Incorrect A: Stating the theme of the article in your own words is not a strategy for preliminary understanding as part of the critical reading process.
Incorrect C: Stating the theme of the article in your own words is not a strategy for analysis understanding as part of the critical reading process.
Incorrect D: Stating the theme of the article in your own words is not a strategy for synthesis understanding as part of the critical reading process.

DIF:	Cognitive Level: Knowledge	REF:	Page 12

MULTIPLE RESPONSE

1.	Select the answers that most accurately describe the responsibilities 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 research findings with colleagues that are pertinent to practice	
d.	Designing and conducting research protocols	
e.	Functioning as a primary investigator for a research study	

ANS:	A, C
Correct A: Following a research protocol at the bedside is consistent with the educational level of a BSN graduate.
Correct C: Sharing research evidence with colleagues is an activity consistent with the educational level of a BSN graduate.

Incorrect B: Leadership related to scientific investigation is more appropriate for an MSN graduate.
Incorrect D: Designing research is more appropriate for a PhD graduate.
Incorrect E: Functioning as a primary investigator is a role of the PhD graduate.

DIF:	Cognitive Level: Comprehension	REF:	Page 7

2.	Which aspects of the nursing research process are common to all educational levels of nurses? (Select all that apply.)
a.	Disseminating research findings in research reports	
b.	Maintaining protection of human subjects	
c.	Using expertise to develop theoretical explanations for findings	
d.	Being aware of the relationship between research and nursing practice	
e.	Being a collaborative member of a team that applies research to practice	

ANS:	B, D, E
Correct B: All nurses are accountable for protecting the rights of patients.
Correct D: All nurses should be aware that research is related to practice.
Correct E: All nurses can be a part of a clinical team that applies research to practice.

Incorrect A: Disseminating research in scientific reports is an activity reserved for nurses with an MSN or PhD.
Incorrect C: Developing theoretical explanations for findings is an activity reserved for nurses with an MSN or PhD.

DIF:	Cognitive Level: Comprehension	REF:	Page 7.

3.	For the baccalaureate-level nursing student, education in nursing research links theory and practice together by (select all that apply):
a.	Teaching the student to master development of research protocols	
b.	Providing the student with a basic understanding of the research process	
c.	Exposing the student to being a participant in the research process	
d.	Helping a student develop skills as a primary investigator in research	
e.	Helping the student become an intelligent consumer of research	

ANS:	B, C, E
Correct B: The BSN student should gain an initial understanding of the importance of research in nursing practice.
Correct C: BSN students should learn that they can function as participants in the research process.
Correct E: BSN students should also understand the research process at a level that allows them to decide if research evidence should be applied to their nursing practice.

Incorrect A: Mastery of research protocol development does not occur at the BSN level.
Incorrect D: Developing skills as a primary investigator is a skill that is developed in advanced levels of nursing education.

DIF:	Cognitive Level: Comprehension	REF:	Page 7

4.	Developing nurse researchers at a younger age is a priority for the future in the nursing profession. The benefits of developing younger researchers include (select all that apply):
a.	Enhancing the discipline’s scientific development	
b.	Increasing the longevity of research careers	
c.	Bringing more research monies to professional organizations	
d.	Promoting mentoring opportunities for new researchers	
e.	Increasing nursing participation in pharmaceutical studies	

ANS:	A, B, D
Correct A: Developing young researchers increases the body of researchers contributing to the science of the discipline.
Correct B: Introducing nurses to research at a younger age allows them to develop a wider body of scientific knowledge in their careers as researchers.
Correct D: Introducing nurses to research at a younger age also allows researchers to be mentored by experienced researchers.

Incorrect C: Younger researchers do not guarantee research monies.
Incorrect E: Pharmaceutical studies are medical research and are not considered nursing research studies.

DIF:	Cognitive Level: Comprehension	REF:	Page 6