Adult-Gerontology CNS Test Evidence-Based Practice and Research 1 — Questions and Answers
Question 1: What represents the highest level of evidence in the evidence hierarchy for clinical practice decisions?
- Expert opinion
- Systematic reviews and meta-analyses of RCTs (Correct answer)
- Single randomized controlled trial
- Prospective cohort study
Correct answer: Systematic reviews and meta-analyses of RCTs
Systematic reviews and meta-analyses of multiple RCTs represent the highest evidence level as they pool data from the best-designed studies.
Question 2: Which statistical measure best conveys the clinical significance of a treatment effect in practice?
- P-value
- Number needed to treat (NNT) (Correct answer)
- Standard deviation
- Relative risk
Correct answer: Number needed to treat (NNT)
NNT conveys how many patients must be treated to prevent one additional adverse outcome, making it clinically meaningful and actionable.
Question 3: A CNS wants to implement a practice change based on new evidence. Which model is most commonly used for EBP implementation in hospital settings?
- Donabedian Model
- Iowa Model of Evidence-Based Practice (Correct answer)
- Roy Adaptation Model
- Orem's Self-Care Model
Correct answer: Iowa Model of Evidence-Based Practice
The Iowa Model provides a step-by-step framework specifically designed for implementing evidence-based practice changes in clinical settings.
Question 4: Which research design is best for determining causality between an intervention and a patient outcome?
- Case-control study
- Randomized controlled trial (Correct answer)
- Cross-sectional study
- Qualitative phenomenological study
Correct answer: Randomized controlled trial
RCTs with random assignment minimize confounding bias and allow for causal inference between interventions and outcomes.
Question 5: A CNS critically appraises a study reporting p = 0.03. What does this mean?
- The treatment works in 3% of patients
- There is a 3% probability the result occurred by chance (Correct answer)
- The study had a 3% measurement error rate
- The effect size is 0.03
Correct answer: There is a 3% probability the result occurred by chance
A p-value of 0.03 means there is a 3% probability that the observed result occurred by chance if the null hypothesis were true.
Question 6: Which quality improvement tool is used to visually identify root causes of a clinical problem?
- PDSA cycle
- Fishbone (Ishikawa) diagram (Correct answer)
- SWOT analysis
- Lean process map
Correct answer: Fishbone (Ishikawa) diagram
The Fishbone diagram visually maps potential causes of a problem across categories such as people, process, equipment, and environment.
Adult-Gerontology CNS Test Evidence-Based Practice and Research 1
What represents the highest level of evidence in the evidence hierarchy for clinical practice decisions?