Clinical Nurse Specialist Research & Evidence-Based Practice 4 — Questions and Answers
Question 1: A CNS is conducting a quality improvement project to reduce catheter-associated urinary tract infections. How does this QI project DIFFER from research?
- QI aims to improve local processes and does not require IRB approval when it doesn't generate generalizable knowledge (Correct answer)
- QI requires a control group and randomization
- QI must be published to be valid
- QI and research are subject to the same regulatory requirements
Correct answer: QI aims to improve local processes and does not require IRB approval when it doesn't generate generalizable knowledge
QI projects focus on improving specific organizational processes and typically do not require IRB approval when they are not intended to generate generalizable scientific knowledge.
Question 2: Which statistical test is MOST appropriate when a CNS wants to compare mean pain scores among three different patient groups?
- One-way ANOVA (Correct answer)
- Independent t-test
- Chi-square test
- Pearson correlation
Correct answer: One-way ANOVA
One-way ANOVA compares means across three or more independent groups, making it the appropriate test for this scenario.
Question 3: A CNS evaluates a diagnostic test with 90% sensitivity and 85% specificity. A patient tests negative. Which conclusion is BEST supported?
- A true negative is highly likely because high sensitivity means few false negatives (Correct answer)
- A true positive is highly likely
- Specificity alone determines the predictive value
- The test result is not clinically useful
Correct answer: A true negative is highly likely because high sensitivity means few false negatives
High sensitivity (90%) means the test rarely misses true cases, so a negative result strongly suggests the patient truly does not have the condition.
Question 4: In a grounded theory study conducted by a CNS researcher, data collection and analysis occur simultaneously. What is this process called?
- Constant comparative analysis (Correct answer)
- Content analysis
- Thematic coding
- Triangulation
Correct answer: Constant comparative analysis
Constant comparative analysis is the hallmark method of grounded theory, where incoming data are continuously compared with previously collected data to develop and refine theory.
Question 5: A CNS reviewing a study finds that 30% of participants dropped out before the study ended, and dropouts were sicker than completers. Which bias does this MOST likely introduce?
- Attrition bias (Correct answer)
- Selection bias
- Recall bias
- Confirmation bias
Correct answer: Attrition bias
When participants who drop out differ systematically from those who complete the study, attrition (withdrawal) bias is introduced, threatening internal validity.
Question 6: Which element of the PICO format represents the comparison group in a clinical question?
- C — Comparison or Control (Correct answer)
- P — Population
- I — Intervention
- O — Outcome
Correct answer: C — Comparison or Control
In the PICO framework, C stands for Comparison or Control, representing the alternative treatment, placebo, or standard care being compared to the intervention.
Question 7: A CNS performs a power analysis before launching a study. What is the PRIMARY purpose of this analysis?
- To determine the minimum sample size needed to detect a clinically meaningful effect (Correct answer)
- To calculate the p-value before data collection
- To assess the reliability of the measurement instrument
- To determine the number of variables to include
Correct answer: To determine the minimum sample size needed to detect a clinically meaningful effect
Power analysis calculates the sample size required to detect a specified effect size with a given probability (power), reducing the risk of Type II error.
Clinical Nurse Specialist Research & Evidence-Based Practice 4
A CNS is conducting a quality improvement project to reduce catheter-associated urinary tract infections.
How does this QI project DIFFER from research?