Test Bank for Understanding Nursing Research: Building an Evidence-Based Practice 7th Editio

Test Bank for Understanding Nursing Research:

Building an Evidence-Based Practice 7th Edition

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Chapter 08: Clarifying Quantitative Research Designs
Grove: Understanding Nursing Research, 7th Edition

MULTIPLE CHOICE

1. Which type of research design focuses on implementation of a treatment by the researcher?

a. Correlational
b. Descriptive
c. Experimental
d. Longitudinal
ANS: C
Experimental and quasi-experimental studies are designed to examine causality between a
researcher-implemented treatment and a study outcome. Correlational and descriptive designs
are nonexperimental studies that focus on examining variables as they naturally occur and not
on the implementation of a treatment by the researcher. Longitudinal design refers to data
collection from the same subjects at different points in time and may or may not be used with
experimental or nonexperimental studies.

DIF: Cognitive level: Comprehension

2. A researcher administers a written test to evaluate knowledge of insulin administration and

glucose monitoring to a group of subjects at annual intervals over the next decade. This is an
example of which type of study design?
a. Correlational
b. Cross-sectional
c. Descriptive
d. Longitudinal
ANS: D
Longitudinal design refers to data collection from the same subjects at different points in time.
Correlational studies seek to examine relationships among variables without manipulation of a
treatment by the researcher. Cross-sectional designs examine a group of subjects
simultaneously in various stages of development, illness severity, or recovery to identify
changes in a phenomenon across stages. A descriptive study is used to examine variables as
they occur naturally without manipulation of variables.

DIF: Cognitive level: Applying

3. A nurse researcher wishes to identify rates of pertussis infection in children less than 1 year of
age and then again at 6 years of age to examine the relationship of immunization status on
infection rates in this population. This is an example of which type of study design?
a. Correlational, longitudinal
b. Correlational, cross-sectional
c. Descriptive, longitudinal
d. Descriptive, cross-sectional
ANS: A
 A correlational study design looks at predictive relationships between variables. A
longitudinal study design refers to data collection from the same subjects at different points in
time. Cross-sectional designs examine a group of subjects simultaneously in various stages of
development, illness severity, or recovery to identify changes in a phenomenon across stages.
A descriptive study is used to examine variables as they occur naturally without manipulation.

DIF: Cognitive level: Applying

4. Which statement is true about a descriptive study design?

a. It is not possible to operationally define variables in this type of study.
b. Sample selection and size cannot be controlled in descriptive studies.
c. This type of design is used to identify problems occurring in practice.
d. Variables may be manipulated to avoid bias in this type of study.
ANS: C
Descriptive designs may be used to develop theories and identify problems with current
practice. Descriptive designs may involve operational definitions of variables, but variables
are not manipulated in descriptive studies. Protection against bias in a descriptive design is
achieved through conceptual and operational definition of variables, sample selection and
size, valid and reliable instruments, and data collection procedures that partially control the
environment.

DIF: Cognitive level: Understanding

5. A nurse conducts a study to see whether there are differences in the number of books Latino
parents and the number of books African-American parents read to their toddlers each week.
Which type of study will this researcher utilize?
a. Comparative descriptive
b. Correlational
c. Cross-sectional
d. Longitudinal
ANS: A
A comparative descriptive design is used to describe variables and to examine differences in
variables in two or more groups that occur naturally in a setting that may have been formed
using gender, age, or socioeconomic status. A correlational study design looks at predictive
relationships between variables. Cross-sectional designs examine a group of subjects
simultaneously in various stages of development, illness severity, or recovery to identify
changes in a phenomenon across stages. Longitudinal design refers to data collection from the
same subjects at different points in time.

DIF: Cognitive level: Applying

6. A nurse researcher monitors women with breast cancer for depression before and throughout
their chemotherapy treatment. This is an example of which type of study design?
a. Cross-sectional
b. Longitudinal
c. Comparative description
d. Correlational
ANS: B
 Longitudinal design refers to data collection from the same subjects at different points in time.
A comparative descriptive design is used to describe variables and to examine differences in
variables in two or more groups that occur naturally in a setting that may have been formed
using gender, age, or socioeconomic status. Correlational studies seek to examine
relationships among variables without manipulation of a treatment by the researcher.
Cross-sectional designs involve data collection on variables at one point in time.

DIF: Cognitive level: Applying

7. A researcher wishes to conduct a correlational study to determine whether there is a

relationship between stress levels and relapse rates among patients who have chronic
conditions. To determine the existence of a relationship between these two variables, the
researcher will attempt to
a. manipulate the level of stress in study subjects.
b. obtain a large range of possible scores.
c. provide lengthy descriptions of subjects’ behaviors.
d. randomly assign subjects to study groups.
ANS: B
In correlational designs, a large range in the variable scores is necessary to determine the
existence of a relationship. Correlational studies do not involve manipulation of a variable.
Providing lengthy descriptions of subjects’ behaviors is a necessary part of the discussion of
the results, but it does not determine the existence of a relationship. Subjects in correlational
studies are not randomly assigned to study groups.

DIF: Cognitive level: Applying

8. If a researcher wishes to describe variables and to examine many relationships in a study,

which type of study design will the researcher employ?
a. Correlational
b. Descriptive
c. Descriptive correlational
d. Descriptive cross-sectional
ANS: C
A descriptive correlational design is used to describe variables and examine relationships
among these variables. Using this design facilitates the identification of many
interrelationships in a situation. Correlational studies seek to examine relationships among
variables without manipulation of a treatment by the researcher. A descriptive study is used to
examine variables as they occur naturally without manipulation of variables. Cross-sectional
designs examine a group of subjects simultaneously in various stages of development, illness
severity, or recovery to identify changes in a phenomenon across stages.

DIF: Cognitive level: Applying

9. A nurse researcher conducts a study to determine whether women who breastfeed their infants
experience better sleep in the first two postpartum months. This study will employ which type
of research design?
a. Correlational
b. Descriptive
c. Descriptive correlational
 d. Predictive correlational
ANS: D
A predictive correlational design is used to predict the value of one variable based on the
values obtained for another variable or variables. Correlational studies seek to examine
relationships among variables without manipulation of a treatment by the researcher. A
descriptive study is used to examine variables as they occur naturally without manipulation of
variables. A descriptive correlational design is used to describe variables and examine
relationships among these variables.

DIF: Cognitive level: Comprehension

10. A researcher theorizes a set of relationships among concepts used to describe why patients
with chronic illness are often depressed. To test the accuracy of these hypothesized
relationships, which type of study will be used?
a. Descriptive correlational
b. Grounded theory
c. Model testing
d. Predictive correlational
ANS: C
The model testing design requires all concepts relevant to the model be measured and the
relationships among these concepts examined. A descriptive correlational design is used to
describe variables and examine relationships among these variables. Grounded theory
research is designed to generate theory and to develop new concepts. A predictive
correlational design is used to predict the value of one variable based on the values obtained
for another variable or variables.

DIF: Cognitive level: Applying

11. A researcher conducts a study to examine possible contributors to glycemic control in a group
of subjects who have type 2 diabetes mellitus in a local community. A convenience sample of
patients includes patients from 28 to 65 years old who range in weight from normal to obese,
with time since diagnosis ranging from several months to several years. To determine
causality in this study, the researcher will
a. discuss outcomes in terms of the probability that education will improve glycemic
control.
b. increase the manipulation of the independent variable to allow greater control by
the researcher.
c. identify multicausal variables that may influence the outcome of glycemic control
measures.
d. limit the study to younger persons only to minimize the effects of extraneous
variables.
ANS: C
 Multicausality is the presence of multiple causes for an effect. In this study, patient age,
weight, and length of time of diagnosis may all influence the outcome and should be
addressed as factors that may alter the results. Probability addresses relative and not absolute
causality and may be used when given effects are not produced consistently. In this case,
increasing the manipulation of the independent variable does not alter the influence of
multiple causes. Limiting the study to patients of a certain age only controls for one
extraneous variable.

DIF: Cognitive level: Analyzing

12. Which statement is true about a cross-sectional design?

a. This design includes a time element that involves data collection on variables at
one point in time.
b. This design includes a time element that involves data collection on variables at
different points in time.
c. This design involves collecting data from the same study participants at multiple
points in time and might also be referred to as repeated measures.
d. This design looks at predictive relationships between variables.
ANS: A
A cross-sectional design involves data collection on variables at one point in time. Cross-
sectional designs examine a group of subjects simultaneously in various stages of
development, illness severity, or recovery to identify changes in a phenomenon across stages.
A longitudinal design refers to data collection from the same variables at different points in
time and is also referred to as repeated measures. A correlational study design looks at
predictive relationships between variables.

DIF: Cognitive level: Understanding

13. A study in which subjects are assigned by the researcher into experimental and control groups
increases
a. bias.
b. control.
c. manipulation
d. validity.
ANS: A
Bias occurs when the attitudes or motivations of the researcher cause a deviation from a true
measurement of the study variables. This may occur when researchers control assignment to
study groups. Control is used to manage manipulation of variables and to reduce extraneous
factors in the environment that might alter outcomes. Manipulation of independent variables is
used to evaluate changes in dependent variables. Researcher control over assignment into
groups does not increase a study’s validity.

DIF: Cognitive level: Understanding

14. In a quasi-experimental study examining the effects of nonpharmacologic treatments on

postoperative pain management, the researcher trains nursing staff so that all experimental
group subjects receive the same types of treatments. This is an example of
a. bias.
b. manipulation.
 c. reliability.
d. validity.
ANS: B
Manipulation is a form of control used in quasi-experimental and experimental studies and
may involve control of the intervention so that it is applied consistently. Bias refers to
interference by the researcher that influences the outcome of a study. Reliability and validity
are related to consistency and trustworthiness of measurement tools.

DIF: Cognitive level: Applying

15. A nurse researcher understands there are numerous concepts relevant to quantitative research
designs. What concept best describes the following example, “Patient diagnosis, age,
pre-surgical condition, and complications after surgery are interrelated causes of the length of
patients’ hospital stays”?
a. Probability
b. Multicausality
c. Causality
d. Bias
ANS: B
Multicausality is the presence of multiple causes for an effect. Studies developed from a
multicausal perspective will include more variables than those using a strict causal orientation.
Causality basically means that things have causes, and causes lead to effects. Bias means a
slant or deviation from the true or expected. Probability addresses relative rather than absolute
causality.

DIF: Cognitive level: Analyzing

16. A researcher conducts a quasi-experimental study to determine whether there is appropriate

weight gain among premature infants who are fed according to cue-based protocols. The
researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed
infants and notes a statistical difference in weight gain between infants fed according to
cue-based protocols and those fed according to standard protocols. The reviewer critiquing the
study notes that not all nurses completed the cue-based feeding module. This would affect
which type of validity?
a. Construct validity
b. External validity
c. Internal validity
d. Statistical conclusion validity
ANS: D
Statistical conclusion validity is concerned with whether the conclusions based on statistical
analyses are an accurate reflection of the real world. This can be threatened by anything
interfering with consistent implementation of a variable, including inadequate training of
individuals who implement the intervention. Construct validity is concerned with the fit
between conceptual and operational variables and requires adequate conceptual and
operational definitions. External validity is concerned with the extent to which findings can be
generalized beyond the study sample. Internal validity looks at the influence of extraneous
variables on study outcomes.
 DIF: Cognitive level: Analyzing

17. A researcher conducts a quasi-experimental study to determine whether there is improved

weight gain among premature infants who are fed according to cue-based protocols. The
researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed
infants and notes a statistical difference in weight gain between infants fed according to
cue-based protocols and those fed according to standard protocols. The reviewer notes that
components of cue-based feedings are not clearly identified. This is a threat to
a. construct validity.
b. external validity.
c. internal validity.
d. statistical conclusion validity.
ANS: A
Construct validity is concerned with the fit between conceptual and operational variables and
requires adequate conceptual and operational definitions. External validity is concerned with
the extent to which findings can be generalized beyond the study sample. Internal validity
looks at the influence of extraneous variables on study outcomes. Statistical conclusion
validity is concerned with whether the conclusions based on statistical analyses are an
accurate reflection of the real world.

DIF: Cognitive level: Analyzing

18. A researcher conducts a quasi-experimental study to determine whether there is improved

weight gain among premature infants who are fed according to cue-based protocols. The
researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed
infants and notes a statistical difference in weight gain between infants fed according to
cue-based protocols and those fed according to standard protocols. Which might be a threat to
internal validity in this study?
a. The concept of cue-based feeding is not well defined.
b. The study sample is homogeneous.
c. Some infants developed gastroenteritis.
d. Not all nurses received cue-based protocol education.
ANS: C
Internal validity looks at the influence of extraneous variables on study outcomes. Inadequate
definitions of constructs are threats to construct validity. External validity is concerned with
the extent to which findings can be generalized beyond the study sample. A study with a more
homogenous sample is less likely to have findings that can be generalized to other
populations. Statistical conclusion validity is concerned with whether the conclusions based
on statistical analyses are an accurate reflection of the real world. If not, all nurses received
cue-based education, the intervention implementation will be unreliable.

DIF: Cognitive level: Analyzing

19. A researcher conducts a quasi-experimental study to determine whether there is improved
weight gain among premature infants who are fed according to cue-based protocols. The
researcher trained neonatal intensive care nurses to apply cue-based feeding to orally fed
infants and notes a statistical difference in weight gain between infants fed according to
cue-based protocols and those fed according to standard protocols. The reviewer notes that
parents who gave consent to participate in the study were from a higher socioeconomic class
than the population. This is a threat to
a. construct validity.
b. external validity.
c. internal validity.
d. statistical conclusion validity.
ANS: B
External validity is concerned with the extent to which findings can be generalized beyond the
study sample. Construct validity is concerned with the fit between conceptual and operational
variables and requires adequate conceptual and operational definitions. Internal validity looks
at the influence of extraneous variables on study outcomes. Statistical conclusion validity is
concerned with whether the conclusions based on statistical analyses are an accurate reflection
of the real world.

DIF: Cognitive level: Analyzing

20. A researcher develops a 7-point Likert scale to evaluate feelings of well-being in patients who
are undergoing chemotherapy. The researcher administers this measure to other similar
patients in other medical centers. This is done to
a. decrease mono-operation bias.
b. improve the test-retest reliability.
c. increase interrater reliability.
d. strengthen the operational definition of constructs.
ANS: B
To improve the reliability of the measurement tool, it should be tested in various settings to
determine whether it gives consistent measures each time it is used. Mono-operation bias
occurs when only one measure is used to evaluate an outcome. Interrater reliability refers to
consistent results that occur when various people administer study measures. Evaluating the
consistency of a measurement tool does not affect the operational definition of constructs.

DIF: Cognitive level: Analyzing

21. In a research study, ambulatory clinic nurses teach children with asthma how to monitor peak
expiratory flow volumes and how to use metered-dose inhalers to determine whether asthma
control scores improve. The researcher discovers inconsistencies in how these measures were
taught and how well the children understood the concepts. This represents a lack of
a. control of extraneous variables.
b. internal validity.
c. intervention fidelity.
d. precision of measurement.
ANS: C
 Consistent implementation of the treatment is referred to as intervention fidelity. If the method
of administering a research intervention varies from one person to another, the chance of
identifying a true difference based on the independent variables decreases. To control for
extraneous variables, the researcher would identify characteristics of subjects or settings that
might influence outcomes. Internal validity looks at the influence of extraneous variables on
study outcomes. Precision of measurement refers to whether or not the tools yield the same
readings or findings from one test to another.

DIF: Cognitive level: Analyzing

22. A researcher wishes to conduct a study of a small number of subjects on a large hospital
intensive care unit. To minimize problems associated with extraneous variables in the study
setting, the researcher will
a. ensure double-blind data collection methods.
b. randomly assign subjects to treatment and control groups.
c. test the reliability of study measures.
d. train a small number of nurses to administer the intervention.
ANS: D
One way to reduce the effect of extraneous variables is to train a small number of staff to
administer the intervention to improve consistency. Double-blind data collection, random
assignment of subjects, and reliability of test measures are important to improve control and
reduce bias. Extraneous variables in complex settings can influence scores on the dependent
variable.

DIF: Cognitive level: Analyzing

23. A researcher reviews demographic characteristics of potential study subjects, such as age and
gender, to determine whether these characteristics may influence the outcome of the study.
This is done to help ensure
a. construct validity.
b. external validity.
c. internal validity.
d. statistical conclusion validity.
ANS: C
Internal validity looks at the influence of extraneous variables on study outcomes. Construct
validity is concerned with the fit between conceptual and operational variables and requires
adequate conceptual and operational definitions. External validity is concerned with the extent
to which findings can be generalized beyond the study sample. Statistical conclusion validity
is concerned with whether the conclusions based on statistical analyses are an accurate
reflection of the real world.

DIF: Cognitive level: Analyzing

24. An important measure to decrease threats to internal validity in an experimental study is to

a. apply the intervention consistently.
b. improve the precision of measurement methods.
c. increase the sample size.
d. randomly assign subjects to study groups.
 ANS: D
An important threat to internal validity is any concern about subject selection and assignment
to groups. Randomly assigning subjects to treatment and control groups helps to minimize this
threat. Consistent application of the intervention and improved precision of measurements
help minimize threats to statistical conclusion validity. Increasing sample size minimizes
threats to external validity.

DIF: Cognitive level: Analyzing

25. Which action will the researcher take to improve construct validity?
a. Allow data collectors to know which subjects are assigned to which groups.
b. Ensure that operational definitions reflect theoretical constructs.
c. Make sure that the researcher is involved in data collection.
d. Utilize only one measurement method to measure study variables.
ANS: B
Construct validity depends on adequate definition and measurement of constructs. The
conceptual definition should emerge from the concept analysis and the operational definition
should clearly reflect both. Allowing data collectors to know which subjects are assigned to
which groups and involving the researcher in data collection both increase the risk of bias.
Using only one measurement tool increases the risk of mono-operation bias.

DIF: Cognitive level: Analyzing

26. A researcher wishes to study the effects of effective sleep hygiene on sleep quality and
behavior among children diagnosed with attention deficit disorder. To minimize
mono-operation bias, the researcher will
a. accurately describe conceptual and operational definitions.
b. adequately discuss construct validity in the introduction.
c. evaluate multiple sleep hygiene techniques.
d. utilize a double-blind data collection methodology.
ANS: C
Mono-operation bias occurs when only one method of measurement is used to assess a
construct and can be minimized with the use of multiple measures. Construct validity is
improved with adequate description of conceptual and operational definitions. Use of
double-blind data collection methods helps to minimize bias.

DIF: Cognitive level: Analyzing

27. Multiple replications of an initial study conducted in different populations produce findings
that do not match those in the initial study. The initial study may lack which type of validity?
a. Construct validity
b. External validity
c. Internal validity
d. Statistical conclusion validity
ANS: B
 External validity is concerned with the extent to which findings can be generalized beyond the
study sample. Construct validity is concerned with the fit between conceptual and operational
variables and requires adequate conceptual and operational definitions. Internal validity looks
at the influence of extraneous variables on study outcomes. Statistical conclusion validity is
concerned with whether the conclusions based on statistical analyses are an accurate reflection
of the real world.

DIF: Cognitive level: Analyzing

28. To increase participation among potential subjects of a larger population, the researcher will
a. limit the time and effort required to participate in the study.
b. provide demographic information about those who refuse to participate.
c. provide instruments that are detailed to increase the amount of data collected.
d. offer potential subjects a financial incentive to participate in the study.
ANS: A
Limiting the investment demands on subjects helps to improve participation. Providing
demographic information about those who do not participate is an important part of the
discussion of limitations of a study but does not ensure generalization to a larger population.
Detailed instruments may be time consuming and may limit participation to a small sample
size. Offering financial incentives does not ensure a sample that is representative of the larger
population.

DIF: Cognitive level: Analyzing

29. To attribute causality of a posttest measure in an experimental study, the independent variable
will be
a. administered to control group subjects only.
b. administered to subjects selected by the researcher.
c. administered to treatment group subjects.
d. defined loosely to avoid bias.
ANS: C
To improve determinations of causality, the independent variable should be administered
consistently to all subjects in the treatment group. The independent variable is administered to
the treatment group and not the control group. Selection of subjects by the researcher
increases the likelihood of bias. The independent variable should be precisely defined.

DIF: Cognitive level: Applying

30. In a study to examine the effects of a newly modified anxiety-reducing nursing action on a
group of subjects who have cancer, the control group will receive
a. an alternative intervention.
b. no intervention.
c. the newly modified intervention.
d. the standard intervention.
ANS: D
 In many nursing studies, offering no intervention (when one exists) to subjects in the control
group is considered unethical. Subjects in this group generally receive the standard
intervention as a comparison to those in the treatment group. An alternative intervention
would invite comparison, but if it is new, it would also be experimental. Offering no
intervention is often unethical. Giving the newly modified intervention would not create a
difference between the treatment and the control groups.

DIF: Cognitive level: Analyzing

31. In a quasi-experimental study design, the group that receives standard care is usually referred
to as the
a. comparison group.
b. control group.
c. experimental group.
d. treatment group.
ANS: A
In a quasi-experimental study, the group that does not receive treatment is usually referred to
as the comparison group. Subjects not receiving treatment in an experimental group are
generally referred to as the control group. Groups that receive the intervention in either type
of study are referred to as experimental or treatment groups.

DIF: Cognitive level: Analyzing

32. In a quasi-experimental study using a convenience sample of subjects from a local high
school, the researcher asks potential subjects to volunteer for placement in either a “low
sugar” diet program or a “regular sugar” diet program. This technique for assigning
participation may compromise
a. construct validity.
b. external validity.
c. internal validity.
d. statistical conclusion validity.
ANS: C
Internal validity looks at the influence of extraneous variables on study outcomes. Construct
validity is concerned with the fit between conceptual and operational variables and requires
adequate conceptual and operational definitions. External validity is concerned with the extent
to which findings can be generalized beyond the study sample. Statistical conclusion validity
is concerned with whether the conclusions based on statistical analyses are an accurate
reflection of the real world.

DIF: Cognitive level: Analyzing

33. Which type of study is considered strongest for testing the effectiveness of an intervention?
a. Experimental
b. Pretest/posttest
c. Quasi-experimental
d. Randomized controlled trial
ANS: D
 Randomized controlled trials are noted to be the strongest methodology for testing the
effectiveness of a treatment due to the elements of the design that limit the potential for bias.
Experimental designs involve manipulation of independent variables, but without random
assignment of subjects to groups, which can weaken the study by increasing the potential for
bias. Pretest/posttest designs are a type of quasi-experimental study design that generally
doesn’t use random assignment of subjects. Quasi-experimental studies do not have complete
control over variables and usually do not use random assignment of subjects.

DIF: Cognitive level: Remembering

34. Which statement is true about a quantitative research design?

a. A research design is a blueprint for conducting a quantitative study that minimizes
control over factors that could interfere with the validity of the findings.
b. A research design is a blueprint for conducting a quantitative study that minimizes
control over factors that could interfere with the reliability of the findings.
c. A research design is a blueprint for conducting a quantitative study that maximizes
control over factors that could interfere with the validity of the findings.
d. A research design is a blueprint for conducting a quantitative study that maximizes
control over factors that could interfere with the reliability of the findings.
ANS: C
A research design is a blueprint for conducting a quantitative study that maximizes control
over factors that could interfere with the validity of the findings. All other statements are
incorrect.

DIF: Cognitive level: Remembering

35. When using Consolidated Standards for Reporting Trials (CONSORT) guidelines to critically
appraise a randomized controlled trial (RCT), the nurse will make sure that the study
a. is designed to definitively test a hypothesis.
b. is conducted in a laboratory to minimize setting bias.
c. uses subjects selected by the researcher for participation.
d. uses a descriptive or correlational design.
ANS: A
RCTs should be designed to be a definitive test of the hypothesis that the intervention caused
the defined dependent variables. RCTs should be conducted in a clinical setting and not a
laboratory. Subjects selected by the researcher may be biased. Descriptive or correlational
designs are not RCTs.

DIF: Cognitive level: Applying

MULTIPLE RESPONSE

1. Which of the following are true statements about randomized controlled trials (RCTs)? Select
all that apply.
a. The RCT design is noted to be the weakest methodology for testing the
effectiveness of an intervention.
b. In a RCT design, participants are randomized to the intervention and control
groups to reduce selection bias.
 c. Blinding or withholding of study information from data collectors, participants,
and their healthcare providers can enhance the potential for bias.
d. RCTs may be carried out in a single setting or in multiple geographic locations to
decrease sample size and obtain a more representative sample.
e. RCTs, when appropriately conducted, are considered the gold standard for
determining the effectiveness of healthcare interventions.
ANS: B, E
In a RCT design, participants are randomized to the intervention and control groups to reduce
selection bias. RCTs, when appropriately conducted, are considered the gold standard for
determining the effectiveness of healthcare interventions. An RCT design is noted to be the
strongest methodology for testing the effectiveness of an intervention. Blinding or
withholding of study information from data collectors, participants, and their healthcare
providers can reduce the potential for bias. RCTs may be carried out in a single setting or in
multiple geographic locations to increase sample size and obtain a more representative
sample.

DIF: Cognitive level: Analyzing (Analysis)

2. A nurse researcher understands that to critically appraise the RCTs reported in nursing
journals, specific guidelines are followed. To assess the quality of RCTs reports, which of the
following are accurate statements? Select all that apply.
a. The study has low internal validity.
b. Outcomes are measured consistently with quality measurement methods.
c. Study participants are drawn from a reference population through clearly defined
criteria.
d. The study is conducted in a laboratory setting.
e. The intervention is clearly described and consistently implemented.
f. The design meets the criteria of a nonexploratory study.
ANS: B, C, E
Dependent variables or outcomes are measured consistently with quality measurement
methods. Study participants are drawn from a reference population using clearly defined
criteria. Baseline values are comparable in all groups included in the study. Selected
participants are then randomly assigned to treatment and comparison groups. The intervention
is clearly described and consistently implemented to ensure interventions fidelity. The study
has high internal validity, conducted in a clinical setting, and the study design meets the
criteria of an experimental study.

DIF: Cognitive level: Analyzing (Analysis)

3. Which of the following are true statements about external validity? Select all that apply.
a. External validity is concerned with the fit between the conceptual and operational
definitions of variables and that the instrument measures what it is supposed to in
the study.
b. External validity is concerned with the extent to which study findings can be
generalized beyond the sample used in the study.
c. External validity is focused on determining if the study findings are accurate or are
the result of extraneous variables.
d. Threats to external validity include mono-operation bias and inadequate definitions
of constructs.
Test Bank for Understanding Nursing Research: Building an Evidence-Based Practice 7th Editio

e. Threats to external validity include interaction of selection and intervention, setting

and intervention, and/or history and intervention.
f. Threats to external validity include participation selection, participant attrition,
history, and maturation.
ANS: B, E
External validity is concerned with the extent to which study findings can be generalized
beyond the sample used in the study. Threats to external validity include interaction of
selection and intervention, setting and intervention, and/or history and intervention. Construct
validity is concerned with the fit between the conceptual and operational definitions of
variables and that the instrument measures what it is supposed to in the study. Internal validity
is focused on determining if the study findings are accurate or are the result of extraneous
variables. Threats to construct validity include mono-operation bias and inadequate definitions
of constructs. Threats to internal validity include participation selection, participant attrition,
history, and maturation.

DIF: Cognitive level: Analyzing (Analysis)

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