Orthopaedic Nurse Test Research & Evidence-Based Practice 5 — Questions and Answers
Question 1: An orthopaedic nurse reviews two studies on early mobilization after hip fracture. Study A has a small sample and wide confidence intervals; Study B has a large sample and narrow confidence intervals. Which study provides more precise estimates?
- Study A, because smaller studies are less biased
- Study B, because larger samples yield narrower confidence intervals (Correct answer)
- Both equally, as p-values determine precision
- Study A, because fewer confounders are present
Correct answer: Study B, because larger samples yield narrower confidence intervals
Larger sample sizes produce narrower confidence intervals, indicating more precise and reliable estimates of effect.
Question 2: A nurse implementing EBP notices that staff resist adopting a new evidence-based wound dressing protocol. The most effective strategy to overcome this barrier is to:
- Mandate immediate compliance with no discussion
- Engage frontline staff in reviewing evidence and adapting the protocol (Correct answer)
- Wait until staff voluntarily adopt the change
- Eliminate the old protocol from written policy only
Correct answer: Engage frontline staff in reviewing evidence and adapting the protocol
Engaging frontline nurses in reviewing the evidence and co-developing the protocol increases ownership and reduces resistance to change.
Question 3: Which statistical test is most appropriate for comparing mean pain scores between three groups of orthopaedic patients receiving different analgesic regimens?
- Chi-square test
- Paired t-test
- One-way ANOVA (Correct answer)
- Pearson correlation
Correct answer: One-way ANOVA
One-way ANOVA is used to compare means across three or more independent groups.
Question 4: In a study on physical therapy after ACL repair, the research team uses intention-to-treat (ITT) analysis. This means:
- Only patients who completed all sessions are analyzed
- All randomized participants are analyzed in their assigned group regardless of protocol adherence (Correct answer)
- Patients are analyzed only if they had no complications
- Analysis includes only the per-protocol completers
Correct answer: All randomized participants are analyzed in their assigned group regardless of protocol adherence
ITT analysis includes all randomized participants in their originally assigned groups, preserving the integrity of randomization.
Question 5: A meta-analysis on postoperative orthopaedic infection rates uses a forest plot. The diamond at the bottom of the plot represents:
- The largest study in the analysis
- The overall pooled effect estimate across all studies (Correct answer)
- Studies with the highest risk of bias
- The confidence interval of a single study
Correct answer: The overall pooled effect estimate across all studies
The diamond in a forest plot represents the combined pooled effect estimate and its confidence interval across all included studies.
Question 6: When evaluating an EBP change on pressure injury prevention in orthopaedic patients, the PDSA cycle stands for:
- Plan, Document, Study, Audit
- Plan, Do, Study, Act (Correct answer)
- Prepare, Design, Survey, Assess
- Pilot, Deploy, Sustain, Adapt
Correct answer: Plan, Do, Study, Act
The PDSA (Plan-Do-Study-Act) cycle is a quality improvement framework used to test and implement EBP changes iteratively.
Question 7: An orthopaedic nurse evaluating research on surgical positioning identifies a study where participants were assigned to groups based on their hospital admission date. This is an example of:
- Random allocation
- Quasi-experimental design (Correct answer)
- Randomized crossover design
- Blinded assignment
Correct answer: Quasi-experimental design
Quasi-experimental designs lack true randomization, often using convenience or sequential methods like admission date for group assignment.
Orthopaedic Nurse Test Research & Evidence-Based Practice 5
An orthopaedic nurse reviews two studies on early mobilization after hip fracture.
Study A has a small sample and wide confidence intervals; Study B has a large sample and narrow confidence intervals.
Which study provides more precise estimates?