Nurse Executive Test Research & Evidence-Based Practice 3 — Questions and Answers
Question 1: A nurse executive wants to measure inter-rater reliability for a newly developed nursing assessment tool. Which statistic is MOST appropriate?
- Pearson correlation coefficient
- Cohen's kappa (Correct answer)
- Cronbach's alpha
- Intraclass correlation coefficient (ICC) for continuous data only
Correct answer: Cohen's kappa
Cohen's kappa is the standard statistic for measuring inter-rater agreement on categorical data, accounting for agreement due to chance.
Question 2: Which EBP model explicitly incorporates organizational context and facilitation as key drivers of successful implementation alongside evidence?
- Iowa Model
- PARIHS (Promoting Action on Research Implementation in Health Services) (Correct answer)
- Stetler Model
- ACE Star Model
Correct answer: PARIHS (Promoting Action on Research Implementation in Health Services)
The PARIHS framework positions successful implementation as a function of evidence, context, and facilitation working together.
Question 3: A nurse executive is assessing the validity of a diagnostic screening tool used on the unit. A test with high sensitivity will have:
- Few false positives
- Few false negatives (Correct answer)
- High positive predictive value in all populations
- High specificity
Correct answer: Few false negatives
High sensitivity means the test correctly identifies most true cases, resulting in few false negatives.
Question 4: When translating research findings into practice, the final step in the Iowa Model of Evidence-Based Practice is to:
- Select a topic based on priority
- Critique and synthesize the evidence
- Pilot the change and evaluate outcomes
- Disseminate results and consider adoption broadly (Correct answer)
Correct answer: Disseminate results and consider adoption broadly
After piloting and evaluating, the Iowa Model concludes with disseminating results and deciding whether to adopt the change organization-wide.
Question 5: In a cohort study examining catheter-associated UTI rates, researchers follow two groups of patients — those exposed to a new catheter care bundle and those receiving standard care — over 6 months. This design is BEST described as:
- Case-control study
- Cross-sectional study
- Prospective cohort study (Correct answer)
- Retrospective chart review
Correct answer: Prospective cohort study
Following defined groups forward in time from exposure to outcome describes a prospective cohort design.
Question 6: A nurse executive is evaluating a research report and finds a p-value of 0.03. Which statement BEST interprets this finding?
- There is a 3% probability that the intervention caused the outcome
- There is a 97% probability that the null hypothesis is true
- If the null hypothesis were true, there is a 3% chance of observing results this extreme or more extreme by chance (Correct answer)
- The intervention has a clinically meaningful effect
Correct answer: If the null hypothesis were true, there is a 3% chance of observing results this extreme or more extreme by chance
A p-value represents the probability of obtaining results as extreme as observed, assuming the null hypothesis is true — not the probability that the hypothesis is correct.
Question 7: Which level of evidence ranks HIGHEST on most evidence hierarchies used in nursing EBP?
- Expert consensus opinion
- Well-designed randomized controlled trial
- Systematic review with meta-analysis of RCTs (Correct answer)
- Descriptive correlational study
Correct answer: Systematic review with meta-analysis of RCTs
Systematic reviews with meta-analysis of multiple well-designed RCTs represent the highest level of evidence because they synthesize the strongest study designs.
Nurse Executive Test Research & Evidence-Based Practice 3
A nurse executive wants to measure inter-rater reliability for a newly developed nursing assessment tool.
Which statistic is MOST appropriate?