Clinical Nurse Leader Exam Evidence-Based Practice & Research 1 — Questions and Answers
Question 1: In the hierarchy of evidence, which study design provides the strongest evidence for clinical decision-making?
- Systematic review and meta-analysis of randomized controlled trials (Correct answer)
- Single randomized controlled trial
- Cohort study
- Expert opinion and case series
Correct answer: Systematic review and meta-analysis of randomized controlled trials
Systematic reviews and meta-analyses synthesize multiple RCTs, providing the highest level of evidence for clinical practice recommendations.
Question 2: A CNL wants to implement a practice change based on a research article. Before implementing, the CNL should FIRST:
- Critically appraise the evidence for quality, validity, and applicability to the patient population (Correct answer)
- Share the article with all unit nurses immediately
- Request administrative approval for the change
- Survey patients to determine if they want the change
Correct answer: Critically appraise the evidence for quality, validity, and applicability to the patient population
Critical appraisal of evidence quality and applicability to the specific patient population must precede any practice change based on research.
Question 3: Which clinical question format helps CNLs structure focused, answerable questions for evidence searches?
- PICO (Population, Intervention, Comparison, Outcome) (Correct answer)
- SOAP (Subjective, Objective, Assessment, Plan)
- SBAR (Situation, Background, Assessment, Recommendation)
- SMART (Specific, Measurable, Achievable, Relevant, Time-bound)
Correct answer: PICO (Population, Intervention, Comparison, Outcome)
The PICO framework structures clinical questions in a way that facilitates efficient, targeted database searches for relevant evidence.
Question 4: A CNL is searching PubMed for evidence on pain management. Which filter would return the HIGHEST level of evidence?
- Systematic Reviews filter (Correct answer)
- Randomized Controlled Trials filter
- Clinical Trial filter
- Case Reports filter
Correct answer: Systematic Reviews filter
Filtering for systematic reviews returns the highest level of evidence, as these synthesize findings across multiple RCTs.
Question 5: Which type of research generates numerical data and seeks to establish relationships, causation, or prevalence across populations?
- Quantitative research (Correct answer)
- Qualitative research
- Mixed-methods research
- Ethnographic research
Correct answer: Quantitative research
Quantitative research uses numerical data and statistical analysis to identify patterns, relationships, and causation across populations.
Question 6: A CNL wants to understand nurses' lived experiences of moral distress. Which research approach is MOST appropriate?
- Qualitative phenomenological study (Correct answer)
- Randomized controlled trial
- Cross-sectional survey
- Retrospective chart review
Correct answer: Qualitative phenomenological study
Phenomenological qualitative research is designed to explore the lived experiences and meanings individuals assign to their experiences, making it ideal for studying moral distress.
Clinical Nurse Leader Exam Evidence-Based Practice & Research 1
In the hierarchy of evidence, which study design provides the strongest evidence for clinical decision-making?