Clinical Nurse Specialist Research & Evidence-Based Practice 5 — Questions and Answers
Question 1: A CNS discovers that a landmark RCT supporting a unit protocol was funded entirely by the manufacturer of the intervention device. Which threat to evidence quality should PRIMARILY be considered?
- Potential industry funding bias affecting outcome reporting (Correct answer)
- Lack of external validity
- Inadequate blinding of participants
- Insufficient follow-up duration
Correct answer: Potential industry funding bias affecting outcome reporting
Industry-funded research is associated with a higher likelihood of reporting favorable outcomes for the sponsor's product, representing a significant conflict of interest and funding bias.
Question 2: Which qualitative data collection method would a CNS MOST appropriately use to explore how multidisciplinary team members perceive barriers to EBP implementation?
- Focus group interviews (Correct answer)
- Structured observation
- Cross-sectional survey
- Retrospective chart review
Correct answer: Focus group interviews
Focus groups facilitate rich, interactive discussion among multiple participants simultaneously, making them ideal for exploring shared and contrasting perceptions within a team.
Question 3: A CNS calculates the number needed to treat (NNT) from a study. The absolute risk reduction (ARR) is 0.10. What is the NNT?
- 10 (Correct answer)
- 0.10
- 100
- 1
Correct answer: 10
NNT = 1 / ARR = 1 / 0.10 = 10, meaning 10 patients must receive the intervention for one additional patient to benefit.
Question 4: A CNS uses the Delphi technique to build expert consensus on a new clinical practice guideline. Which feature is MOST characteristic of the Delphi method?
- Multiple rounds of anonymous expert questionnaires with controlled feedback between rounds (Correct answer)
- A single face-to-face expert panel discussion
- Random assignment of experts to opinion groups
- Blinding experts to all prior research evidence
Correct answer: Multiple rounds of anonymous expert questionnaires with controlled feedback between rounds
The Delphi technique uses iterative anonymous questionnaire rounds with summarized group feedback between rounds to achieve structured consensus without groupthink.
Question 5: When appraising a qualitative study, which criterion is the EQUIVALENT of internal validity in quantitative research?
- Credibility (Correct answer)
- Transferability
- Dependability
- Confirmability
Correct answer: Credibility
Credibility in qualitative research parallels internal validity, reflecting confidence that findings accurately represent participants' experiences and the phenomenon studied.
Question 6: A CNS notices that nurses on the day shift document fall prevention measures significantly more often than night-shift nurses, though both shifts report similar fall rates. Which type of bias MOST likely explains this discrepancy?
- Performance bias
- Surveillance bias (Correct answer)
- Recall bias
- Hawthorne effect
Correct answer: Surveillance bias
Surveillance bias occurs when one group receives more intense monitoring or documentation scrutiny, leading to differential detection or recording of events rather than true differences in practice.
Question 7: Which action BEST demonstrates a CNS translating research evidence into sustainable clinical practice change?
- Embedding the evidence-based intervention into unit policies, staff orientation, and competency validation (Correct answer)
- Sharing a journal article at a single staff meeting
- Conducting a one-time audit of current practice
- Posting a research summary in the break room
Correct answer: Embedding the evidence-based intervention into unit policies, staff orientation, and competency validation
Sustainability of EBP change requires institutionalizing the intervention through policy revision, onboarding education, and ongoing competency checks so the change persists beyond initial implementation.
Clinical Nurse Specialist Research & Evidence-Based Practice 5
A CNS discovers that a landmark RCT supporting a unit protocol was funded entirely by the manufacturer of the intervention device.
Which threat to evidence quality should PRIMARILY be considered?