NP Research & Evidence-Based Practice 3 — Questions and Answers
Question 1: A clinical practice guideline recommends a treatment with a Grade 1B strength of recommendation. What does this mean?
- Strong recommendation based on moderate-quality evidence (Correct answer)
- Weak recommendation based on high-quality evidence
- Strong recommendation based on high-quality evidence
- Weak recommendation based on low-quality evidence
Correct answer: Strong recommendation based on moderate-quality evidence
In GRADE terminology, Grade 1 means strong recommendation (benefits clearly outweigh risks) and Grade B indicates moderate-quality evidence.
Question 2: Which study design is most appropriate for examining the prevalence of type 2 diabetes in rural communities?
- Cross-sectional study (Correct answer)
- Case-control study
- Randomized controlled trial
- Cohort study
Correct answer: Cross-sectional study
Cross-sectional studies measure the prevalence of a condition in a defined population at a single point in time.
Question 3: An NP calculates the number needed to treat (NNT) as 20. How should this be communicated to a patient?
- 20 patients must be treated for one additional patient to benefit from the treatment (Correct answer)
- The treatment is 20% effective at preventing the outcome
- 20% of patients will experience side effects
- The treatment reduces risk by 20 percentage points
Correct answer: 20 patients must be treated for one additional patient to benefit from the treatment
NNT represents the number of patients who must receive the treatment for one additional patient to experience a benefit compared to the control.
Question 4: When appraising a diagnostic test study, which statistical measure best describes a test's ability to rule OUT a disease when negative?
- High sensitivity (Correct answer)
- High specificity
- High positive predictive value
- High likelihood ratio positive
Correct answer: High sensitivity
A highly sensitive test has few false negatives; a negative result on a highly sensitive test effectively rules out the disease (SnNout mnemonic).
Question 5: Which element of an informed consent process is most critical for research participants?
- Voluntary participation with the right to withdraw without penalty (Correct answer)
- Understanding all possible study outcomes before enrollment
- Signing the consent form in the presence of two witnesses
- Completing a competency assessment prior to enrollment
Correct answer: Voluntary participation with the right to withdraw without penalty
Voluntariness and the right to withdraw without penalty or loss of benefits are foundational ethical requirements for research participation.
Question 6: An NP reads a study with p=0.03. Which statement best describes what this means?
- There is a 3% probability of observing results this extreme if the null hypothesis is true (Correct answer)
- There is a 97% probability that the treatment is effective
- The result has a 3% chance of being a false positive
- The effect size is clinically significant at the 3% level
Correct answer: There is a 3% probability of observing results this extreme if the null hypothesis is true
The p-value represents the probability of obtaining results at least as extreme as observed, assuming the null hypothesis is true.
Question 7: In translating evidence into practice, the Iowa Model of Evidence-Based Practice recommends which initial step?
- Identifying a practice trigger or clinical problem (Correct answer)
- Forming a multidisciplinary team
- Conducting a systematic literature search
- Piloting the practice change on a small unit
Correct answer: Identifying a practice trigger or clinical problem
The Iowa Model begins with identifying a problem-focused or knowledge-focused trigger that prompts the need for practice change.
NP Research & Evidence-Based Practice 3
A clinical practice guideline recommends a treatment with a Grade 1B strength of recommendation.
What does this mean?