NP Research & Evidence-Based Practice 5 — Questions and Answers
Question 1: A nurse practitioner is conducting a chart review study with de-identified data. Which statement about HIPAA compliance is most accurate?
- De-identified data is not considered protected health information under HIPAA (Correct answer)
- IRB approval is not required when data is de-identified
- De-identification requires removal of only the patient's name and date of birth
- HIPAA does not apply to retrospective chart reviews
Correct answer: De-identified data is not considered protected health information under HIPAA
Under HIPAA, properly de-identified data (18 identifiers removed under Safe Harbor or statistical expert method) is no longer considered PHI.
Question 2: Which measure of central tendency is most appropriate when reporting outcomes from a skewed distribution such as length of hospital stay?
- Median (Correct answer)
- Mean
- Mode
- Standard deviation
Correct answer: Median
The median is preferred for skewed distributions because it is not influenced by extreme outliers that distort the mean.
Question 3: An NP is applying evidence from a study conducted in tertiary academic medical centers to patients in a rural primary care setting. Which concept is most relevant?
- External validity or generalizability (Correct answer)
- Internal validity
- Construct validity
- Statistical validity
Correct answer: External validity or generalizability
External validity (generalizability) refers to how well study findings apply to populations, settings, and contexts beyond those studied.
Question 4: In a Delphi method study, what is the primary purpose of multiple iterative rounds with expert panelists?
- To achieve consensus among experts through structured feedback (Correct answer)
- To test an intervention across multiple sites simultaneously
- To reduce observer bias in qualitative data collection
- To increase the statistical power of expert opinion
Correct answer: To achieve consensus among experts through structured feedback
The Delphi method uses sequential questionnaire rounds with anonymized group feedback to move experts toward consensus on complex issues.
Question 5: A clinical trial is terminated early due to overwhelming evidence of benefit in the treatment group. This is an example of which concept?
- Stopping for efficacy based on interim analysis (Correct answer)
- Type I error inflation due to multiple comparisons
- Regression to the mean affecting outcomes
- Publication bias favoring positive results
Correct answer: Stopping for efficacy based on interim analysis
Interim analyses with pre-specified stopping rules allow early termination for efficacy when treatment benefit is established before the planned end of the study.
Question 6: When a systematic review uses a PRISMA flow diagram, what information does it primarily convey?
- The process of study identification, screening, eligibility, and inclusion (Correct answer)
- The statistical methods used to pool study results
- The quality ratings assigned to each included study
- The funding sources and potential conflicts of interest
Correct answer: The process of study identification, screening, eligibility, and inclusion
The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram transparently documents the study selection process from database searches to final inclusion.
Question 7: An NP wants to implement evidence-based fall prevention protocols but faces resistance from nursing staff who believe current practice is adequate. According to Rogers' Diffusion of Innovations theory, these nurses are best classified as:
- Late majority
- Early majority
- Laggards (Correct answer)
- Early adopters
Correct answer: Laggards
Laggards are resistant to change, skeptical of innovation, and tend to adopt only when traditional alternatives are no longer available.
NP Research & Evidence-Based Practice 5
A nurse practitioner is conducting a chart review study with de-identified data.
Which statement about HIPAA compliance is most accurate?