Orthopaedic Nurse Test Research & Evidence-Based Practice 4 — Questions and Answers
Question 1: A nurse is implementing EBP for post-operative orthopaedic pain management. Which Iowa Model step follows the identification of a clinical problem?
- Pilot the change in practice
- Form a team and review the literature (Correct answer)
- Evaluate outcomes after implementation
- Disseminate findings
Correct answer: Form a team and review the literature
After identifying a clinical problem in the Iowa Model, the next step is to assemble a team and conduct a thorough literature review.
Question 2: An orthopaedic researcher uses stratified randomization to ensure equal distribution of age groups between study arms. The primary purpose is to:
- Increase the sample size
- Reduce selection bias and confounding (Correct answer)
- Blind participants to group assignment
- Eliminate the need for statistical analysis
Correct answer: Reduce selection bias and confounding
Stratified randomization ensures that important variables like age are evenly distributed across groups, reducing confounding.
Question 3: In an orthopaedic cohort study, participants who had knee replacement surgery are followed for 2 years for complications. The exposure in this study is:
- The 2-year follow-up period
- Knee replacement surgery (Correct answer)
- Post-operative complications
- The researcher's intervention
Correct answer: Knee replacement surgery
In a cohort study, the exposure is the factor under investigation—in this case, knee replacement surgery.
Question 4: A nurse reviews an article where participants were not told whether they received real or sham ultrasound therapy for bone healing. This describes which type of blinding?
- Double-blind
- Open-label
- Single-blind (Correct answer)
- Triple-blind
Correct answer: Single-blind
Single-blind means only the participants are unaware of their group assignment, while researchers know the allocation.
Question 5: Which outcome measure would be most appropriate for an EBP project focused on patient-centered outcomes after total hip arthroplasty?
- Surgeon operative time
- Patient-reported outcome measure (PROM) such as the Harris Hip Score (Correct answer)
- Number of X-rays taken
- Staff overtime hours
Correct answer: Patient-reported outcome measure (PROM) such as the Harris Hip Score
PROMs like the Harris Hip Score capture the patient's own assessment of function and pain, making them ideal for patient-centered outcomes.
Question 6: A nurse reads a case-control study investigating risk factors for surgical site infection (SSI) after spinal fusion. Cases are patients with SSI and controls are those without. The measure of association reported is:
- Relative risk
- Odds ratio (Correct answer)
- Hazard ratio
- Number needed to harm
Correct answer: Odds ratio
Case-control studies report odds ratios because they cannot directly calculate incidence rates from retrospective data.
Question 7: During a research ethics review for an orthopaedic study, the principle of justice requires:
- Protecting participants from all possible risks
- Fair and equitable selection of research participants (Correct answer)
- Ensuring informed consent is obtained
- Maintaining participant confidentiality
Correct answer: Fair and equitable selection of research participants
Justice in research ethics requires that the benefits and burdens of participation are distributed equitably across populations.
Orthopaedic Nurse Test Research & Evidence-Based Practice 4
A nurse is implementing EBP for post-operative orthopaedic pain management.
Which Iowa Model step follows the identification of a clinical problem?