Clinical Nurse Specialist Research & Evidence-Based Practice 3 — Questions and Answers
Question 1: A CNS identifies a gap between current practice and best evidence for pressure injury prevention. Which EBP model emphasizes transforming evidence into practice through organizational readiness and knowledge transformation?
- Knowledge-to-Action (KTA) Framework (Correct answer)
- Iowa Model
- ACE Star Model
- Stetler Model
Correct answer: Knowledge-to-Action (KTA) Framework
The Knowledge-to-Action (KTA) Framework specifically addresses both knowledge creation and the action cycle needed to translate research into organizational practice change.
Question 2: Which type of reliability refers to the consistency of a measurement tool when used by two different raters at the same time?
- Inter-rater reliability (Correct answer)
- Test-retest reliability
- Internal consistency
- Parallel-forms reliability
Correct answer: Inter-rater reliability
Inter-rater reliability measures the degree of agreement between two or more independent raters using the same instrument simultaneously.
Question 3: A CNS wants to determine if a new pain screening tool accurately identifies patients with moderate-to-severe pain. Which measurement property is PRIMARILY being evaluated?
- Criterion validity (Correct answer)
- Content validity
- Construct validity
- Face validity
Correct answer: Criterion validity
Criterion validity assesses how well a new tool's scores correlate with an established gold-standard measure of the same construct.
Question 4: A CNS reviews a meta-analysis reporting a pooled odds ratio of 0.65 (95% CI: 0.50–0.84) for a nursing intervention reducing falls. What does an OR of 0.65 indicate?
- The intervention reduces the odds of falling by 35% (Correct answer)
- The intervention increases fall risk by 65%
- There is no significant effect on falls
- The control group had 65% fewer falls
Correct answer: The intervention reduces the odds of falling by 35%
An OR of 0.65 means the odds of falling in the intervention group are 35% lower than in the control group (1 − 0.65 = 0.35).
Question 5: When implementing EBP, the CNS encounters staff who are skeptical about changing a long-standing protocol. Which strategy is MOST effective for addressing this resistance?
- Engage opinion leaders to champion the change (Correct answer)
- Mandate compliance through administration
- Implement the change without informing staff first
- Delay the change indefinitely
Correct answer: Engage opinion leaders to champion the change
Engaging respected clinical opinion leaders to champion evidence-based changes is one of the most effective strategies for overcoming resistance and facilitating adoption.
Question 6: A CNS designing a study randomly assigns participants to treatment or control groups but does not blind assessors to group assignment. Which bias is MOST likely introduced?
- Detection (ascertainment) bias (Correct answer)
- Selection bias
- Performance bias
- Attrition bias
Correct answer: Detection (ascertainment) bias
When outcome assessors know the group assignment, their measurement or interpretation of outcomes may be systematically skewed, introducing detection bias.
Question 7: Which level of evidence is assigned to expert opinion and consensus statements in most evidence hierarchies?
- Lowest level (e.g., Level V or VII depending on the framework) (Correct answer)
- Highest level
- Same level as randomized controlled trials
- Same level as cohort studies
Correct answer: Lowest level (e.g., Level V or VII depending on the framework)
Expert opinion and consensus statements represent the lowest level of evidence because they are not based on empirical research and are most susceptible to bias.
Clinical Nurse Specialist Research & Evidence-Based Practice 3
A CNS identifies a gap between current practice and best evidence for pressure injury prevention.
Which EBP model emphasizes transforming evidence into practice through organizational readiness and knowledge transformation?