Adult-Gerontology Primary Care Nurse Practitioner Exam Research & Evidence-Based Practice 2 — Questions and Answers
Question 1: A nurse practitioner wants to determine whether a new diabetes education intervention reduces HbA1c in older adults. Which study design provides the strongest evidence for causality?
- Cross-sectional survey
- Randomized controlled trial (Correct answer)
- Case-control study
- Retrospective cohort study
Correct answer: Randomized controlled trial
A randomized controlled trial (RCT) is the gold standard for establishing causality because random assignment controls for confounding variables.
Question 2: When critically appraising a systematic review, which tool is most appropriate to assess its methodological quality?
- CONSORT checklist
- STROBE statement
- AMSTAR-2 tool (Correct answer)
- CASP cohort checklist
Correct answer: AMSTAR-2 tool
AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews) is specifically designed to evaluate the quality of systematic reviews and meta-analyses.
Question 3: A 78-year-old patient asks about a medication shown to reduce fall risk by 30% in a clinical trial. Which additional statistic would best help the NP communicate the clinical significance to the patient?
- P-value
- Confidence interval width
- Number needed to treat (NNT) (Correct answer)
- Standard deviation
Correct answer: Number needed to treat (NNT)
The NNT tells patients how many people must be treated for one person to benefit, making abstract statistics clinically meaningful.
Question 4: An NP reviews a study on hypertension management in adults over 65. The study reports a p-value of 0.04. What is the most accurate interpretation?
- There is a 4% chance the treatment is ineffective
- There is a 96% probability the null hypothesis is true
- There is a 4% probability of obtaining results this extreme if the null hypothesis is true (Correct answer)
- The treatment has a 96% success rate
Correct answer: There is a 4% probability of obtaining results this extreme if the null hypothesis is true
A p-value represents the probability of observing results as extreme as those found, assuming the null hypothesis is true.
Question 5: Which type of bias occurs when participants in a longitudinal study on cognitive decline in older adults who are lost to follow-up are systematically different from those who remain?
- Recall bias
- Attrition bias (Correct answer)
- Hawthorne effect
- Confirmation bias
Correct answer: Attrition bias
Attrition bias occurs when individuals who drop out of a study differ systematically from those who complete it, skewing results.
Question 6: An NP is implementing evidence-based screening for depression in geriatric patients. According to the USPSTF grading system, a Grade B recommendation means:
- Evidence is insufficient to assess benefits and harms
- There is high certainty of moderate net benefit (Correct answer)
- There is moderate certainty of substantial net benefit
- There is at least moderate certainty that net benefit is small
Correct answer: There is high certainty of moderate net benefit
USPSTF Grade B indicates high certainty of moderate net benefit or moderate certainty of moderate-to-substantial net benefit.
Question 7: A qualitative study exploring older adults' experiences with chronic pain management would most appropriately use which data collection method?
- Structured questionnaire with Likert scales
- In-depth semi-structured interviews (Correct answer)
- Randomized crossover design
- Retrospective chart review
Correct answer: In-depth semi-structured interviews
Semi-structured interviews allow participants to describe their experiences in depth while maintaining focus on the research question.
Adult-Gerontology Primary Care Nurse Practitioner Exam Research & Evidence-Based Practice 2
A nurse practitioner wants to determine whether a new diabetes education intervention reduces HbA1c in older adults.
Which study design provides the strongest evidence for causality?