Chapter 9

Question 1

The research design for a quantitative study involves decisions with regard to all except:
A) which conceptual framework to use.
B) whether there will be an intervention.
C) what types of comparisons will be made.
D) how many times data will be collected.

Answer 1

A) which conceptual framework to use.

Question 2

A nurse researcher tested whether sucrose (vs. sterile water) had a beneficial effect on infant pain during immunizations. Neither those administering the intervention nor the parents of the infants knew which infants received the sucrose. This strategy is an example of:
A) randomization.
B) attrition.
C) crossing over.
D) blinding.

Answer 2

D) blinding.

Question 3

When researchers withhold information from the people collecting research data (e.g., information about who received an intervention and who did not), the researchers are taking steps to minimize which type of bias?
A)Selection bias
B)Attrition bias
C)Expectation bias
D)History bias

Answer 3

C)Expectation bias

Question 4

Which design decision is at issue when researchers decide what to use as a counterfactual?
A)Deciding on the type of comparison that will be made
B)Deciding where the study will take place
C)Deciding how confounding variables will be controlled
D)Deciding when and how often the data will be collected

Answer 4

A)Deciding on the type of comparison that will be made

Question 5

Which is a question that researchers may ask when deciding how to control confounding variables?
A)From whom should information about the design be withheld?
B)When will the research data be collected?
C)What factors, other than the independent variable, could affect the outcome?
D)Where and how often will data collection occur?

Answer 5

C)What factors, other than the independent variable, could affect the outcome?

Question 6

Which is a key criterion for making a causal inference about the relationship between two variables?
A)Lack of ambiguity about how outcomes will be measured
B)Lack of ambiguity about which variable occurred first
C)The ability to randomly assign study participants to groups
D)The ability to blind study participants and research staff

Answer 6

B)Lack of ambiguity about which variable occurred first

Question 7

The causes of health-related phenomena (e.g., a cancer diagnosis) are usually:
A)probabilistic.
B)deterministic.
C)prognostic.
D)counterfactual.

Answer 7

A)probabilistic.

Question 8

An important function of a research design in a quantitative study is to exert control over which variables?
A) Outcome variables
B) Mediating variables
C) Carryover variables
D) Confounding variables

Answer 8

D) Confounding variables

Question 9

A hypothetical condition embodying what would have happened to people if they were simultaneously exposed and not exposed to a cause is:
A) a cause.
B) an effect.
C) a confounder.
D) a counterfactual.

Answer 9

D) a counterfactual.

Question 10

There are three well-known criteria for establishing a causal relationship, attributed to John Stuart Mill. Which is one of those criteria?
A) A cause and effect must occur simultaneously.
B) A counterfactual must be known and controlled for in the research design.
C) The relationship between the cause and the effect cannot be explained as being caused by a third factor.
D) The relationship between the cause and the effect must be deterministic.

Answer 10

C) The relationship between the cause and the effect cannot be explained as being caused by a third factor.

Question 11

For which broad category of EBP research questions is causality not an issue?
A) Therapy
B) Meaning
C) Prognosis
D) Etiology/harm

Answer 11

B) Meaning

Question 12

Which is not a standard feature of a true experimental design?
A) An intervention
B) A placebo
C) Randomization
D) Control

Answer 12

B) A placebo

Question 13

In a true experimental design, what does the researcher manipulate?
A) The independent variable
B) The dependent variable
C) The confounding variable
D) The mediating variable

Answer 13

A) The independent variable

Question 14

he use of randomization for assigning participants to conditions eliminates:
A) systematic bias.
B) ethical problems.
C) need for a control group.
D) unnecessary manipulation.

Answer 14

A) systematic bias.

Question 15

Which statement is true?
A) Random assignment is accomplished with random sampling.
B) Grouping participants with similar features together is the best way to achieve random assignment.
C) Random assignment to different conditions is a signature of a true experiment.
D) Recruiting participants from different neighbourhoods results in random assignment.

Answer 15

C) Random assignment to different conditions is a signature of a true experiment.

Question 16

A pretest in a pretest–posttest design corresponds to:
A) an outcome measure.
B) a baseline measure.
C) a measure of attitudes toward the intervention.
D) a measure of the independent variable.

Answer 16

B) a baseline measure.

Question 17

Which statement is true?
A) A crossover design allows participants to choose the intervention they will receive.
B) A crossover design is useful for eliminating crossover effects.
C) A crossover design is not a true experimental design.
D) A crossover design achieves the highest possible equivalence among participants exposed to different conditions.

Answer 17

D) A crossover design achieves the highest possible equivalence among participants exposed to different conditions.

Question 18

A nurse researcher tested two different head-of-bed elevations for the prevention of ventilator-associated pneumonia. In this 2-day trial, patients were randomly assigned to receive either the 30-degree elevation or the 45-degree elevation on the first day, and the other elevation on the second day. What type of design was used?
A) Crossover
B) Posttest only
C) Delay of treatment
D) Time series

Answer 18

A) Crossover

Question 19

Which statement is true about RCTs?
A) The control condition in an experiment corresponds to the “I” in PICO-format questions.
B) The control group condition is a proxy for an ideal counterfactual.
C) Control groups never get the experimental intervention.
D) Experiments involving a pseudointervention use an attention control group.

Answer 19

B) The control group condition is a proxy for an ideal counterfactual.

Question 20

An RCT could use all of the following designs, except a:
A) crossover design.
B) nonequivalent control group design.
C) randomized posttest-only design.
D) randomized pretest–posttest design.

Answer 20

B) nonequivalent control group design.

Question 21

A researcher randomized nursing home residents to a fall prevention intervention or to “usual care.” After outcome data are collected, control group members were offered the chance to receive the intervention. This control group strategy is called:
A) a “usual care” control group.
B) an attention control group.
C) a wait-listed control group.
D) an alternative treatment control group.

Answer 21

C) a wait-listed control group.

Question 22

To test the effect of a Hatha yoga intervention on blood pressure, 100 prehypertensive adolescents were randomly assigned to either Hatha yoga classes or to an art class. This control group strategy is called:
A) a “usual care” control group.
B) an attention control group.
C) a wait-listed control group.
D) an alternative treatment control group.

Answer 22

B) an attention control group.

Question 23

Which is a major strength of true experimental designs?
A) They are less artificial than other designs.
B) They are undertaken with a strong theoretical underpinning.
C) They tend to be less costly than other designs.
D) They permit greater confidence in making causal inferences than other designs.

Answer 23

D) They permit greater confidence in making causal inferences than other designs.

Question 24

Which statement is true?
A) RCTs are in the middle of most evidence hierarchies for Therapy questions.
B) RCTs are more susceptible to confounding variables than quasi-experiments.
C) Many variables of interest to nurse researchers cannot be experimentally manipulated.
D) RCTs are the most often used design for studying the effect of cigarette smoking on lung cancer.

Answer 24

C) Many variables of interest to nurse researchers cannot be experimentally manipulated.

Question 25

Which is invariably a feature of quasi-experimental research?
A) A control group
B) An intervention
C) Matching
D) Randomization

Answer 25

B) An intervention

Question 26

Which statement is true?
A) A signature of quasi-experiments is that they involve randomization.
B) Quasi-experiments sometimes—but not always—involve an intervention.
C) A hallmark of quasi-experiments is that they involve a comparison group.
D) In a nonequivalent control group design, it cannot be assumed that the groups being compared are equivalent at the outset.

Answer 26

D) In a nonequivalent control group design, it cannot be assumed that the groups being compared are equivalent at the outset.

Question 27

A researcher initiated an innovative cigarette cessation intervention. Seventy participants received the intervention, and their cigarette smoking 3 months later was compared to smoking at baseline. What type of design is this?
A) A crossover design
B) A nonequivalent control group pretest–posttest design
C) A one-group pretest–posttest design
D) A time-series design

Answer 27

C) A one-group pretest–posttest design

Question 28

A team of researchers evaluated a protocol designed to reduce medication errors. Data on medication errors were obtained for each month in the 12 months preceding the intervention, and for each month in the 12 months following the intervention. What type of design is this?
A) A crossover design
B) A nonequivalent control group pretest–posttest design
C) A one-group pretest–posttest design
D) A time-series design

Answer 28

D) A time-series design

Question 29

Compared to true experiments, quasi-experiments are more susceptible to:
A) rival hypotheses about causality.
B) ethical transgressions.
C) feasibility problems.
D) recruitment difficulties.

Answer 29

A) rival hypotheses about causality.

Question 30

What is a central feature of nonexperimental (observational) studies?
A) Researchers do not manipulate the independent variable.
B) Researchers do not manipulate the dependent variable.
C) Data are collected through the observation of participants’ behaviours.
D) Their strength lies in their ability to elucidate cause-and-effect relationships.

Answer 30

A) Researchers do not manipulate the independent variable.

Question 31

A sample of both users and nonusers of electronic cigarettes was followed over a 10-year period to assess whether there were any long-term adverse effects. What type of design was this?
A) Time series
B) Case control
C) Prospective
D) Crossover

Answer 31

C) Prospective

Question 32

Women with and without lymphedema following breast cancer surgery were compared in terms of their presurgical body mass index (BMI). Which design did the researcher use?
A) Time-series
B) Case control
C) Prospective
D) Crossover

Answer 32

B) Case control

Question 33

A researcher collected cross-sectional data to estimate the percentage of community-dwelling older people who were at risk of malnutrition. What type of study is this?
A) A descriptive correlational study
B) A prospective study
C) A retrospective study
D) A prevalence study

Answer 33

D) A prevalence study

Question 34

A nurse researcher plans a study to compare the occurrence of anxiety disorders in military personnel deployed overseas with those who were never deployed overseas. What research design would the researcher use?
A) A crossover design
B) A time-series design
C) A nonequivalent control group design
D) A nonexperimental design

Answer 34

D) A nonexperimental design

Question 35

If a researcher studied the relationship between women’s age and their frequency of performing breast self-examination, how would the study be classified?
A) Descriptive correlational
B) Quasi-experimental
C) Longitudinal
D) Experimental

Answer 35

A) Descriptive correlational

Question 36

What is a major weakness of correlational studies?
A) They tend to be expensive.
B) They tend to be artificial.
C) They are vulnerable to self-selection bias.
D) They are impractical.

Answer 36

C) They are vulnerable to self-selection bias.

Question 37

Researchers collect data at a single point in time in which type of study?
A) Time-series studies
B) Cross-sectional studies
C) Longitudinal studies
D)Crossover studies

Answer 37

B) Cross-sectional studies

Question 38

A nurse researcher is studying the attitudes of high school students toward bullying at Metro High School during the past school year. What type of study is this?
A) A time-series study
B) A cross-sectional study
C) A longitudinal study
D) A follow-up study

Answer 38

B) A cross-sectional study

Question 39

In a study examining the quality of life of patients who had undergone coronary artery bypass surgery, the research team collected data 2 months after the surgery, and then 2 years later. What type of study is this?
A) Cross-sectional
B) Crossover
C) Follow-up
D) Retrospective

Answer 39

C) Follow-up

Question 40

Which is a major challenge specific to longitudinal designs?
A) Loss of research control
B) Deterioration of participants’ health
C) Inferential challenges
D) Attrition

Answer 40

D) Attrition

Question 41

How can researchers take steps to control the study context?
A) Using standardized scripts in communicating with participants
B) Using a prospective rather than retrospective design
C) Maximizing the external validity of the study
D) Using matching

Answer 41

A) Using standardized scripts in communicating with participants

Question 42

There are several alternative strategies for controlling confounding participant characteristics. Which method is the most effective?
A) Using a homogeneous sample
B) Statistically controlling confounders
C) Matching subjects on confounding variables
D) Randomizing participants to conditions

Answer 42

D) Randomizing participants to conditions

Question 43

Researchers do not have to know in advance which confounding variables need to be controlled for which control strategy?
A) Matching
B) Randomization
C) Statistical control
D) Homogeneity

Answer 43

B) Randomization

Question 44

Homogeneity is a principle that can be used to control extraneous variation from participant characteristics. What does homogeneity entail?
A) Randomly assigning participants to homogeneous groups
B) Not allowing important confounders to vary in the research sample
C) Making the treatment conditions as homogeneous as possible
D) Creating homogeneous groups of participants through matching

Answer 44

B) Not allowing important confounders to vary in the research sample

Question 45

In a retrospective case-control study of the relationship between having or not having a herniated disc and patients’ prior history of trauma in a sample of 200 men and women, the researcher would most likely use which method to control the gender distribution in the groups?
A) Having patients serve as their own controls
B) Randomizing patients to groups
C) Matching cases and controls on gender
D) Maintaining homogeneity of the sample

Answer 45

C) Matching cases and controls on gender

Question 46

A researcher used a two-group quasi-experimental (nonequivalent control group) design to test the effect of a Tai Chi intervention on quality of life in nursing home residents. The researchers used analysis of covariance to control residents’ age. What strategy for controlling participant characteristics did the researcher use?
A) Statistical control
B) Matching
C) Randomization
D) Homogeneity

Answer 46

A) Statistical control

Question 47

Four types of validity affect the rigor of a quantitative study. Which type concerns the validity of inferences that there is an empirical relationship between variables?
A) Statistical conclusion validity
B) Internal validity
C) Construct validity
D) External validity

Answer 47

A) Statistical conclusion validity

Question 48

There are four types of validity that affect the rigor of a quantitative study. Which type of validity does a researcher address in choosing to use a true experimental design?
A) Statistical conclusion validity
B) Internal validity
C) Construct validity
D) External validity

Answer 48

B) Internal validity

Question 49

Which can result in a threat to statistical conclusion validity?
A) Temporal ambiguity
B) Maturation
C) Small sample size
D) Selection bias

Answer 49

C) Small sample size

Question 50

A nurse researcher tested the effectiveness of a telephone intervention to support family caregivers of patients with Alzheimer’s disease. During the trial, the researcher undertook an assessment and found that staff were not following the established intervention procedures. The assessment focused on:
A) statistical power.
B) intervention fidelity.
C) risks for participant attrition.
D) maturation threats.

Answer 50

B) intervention fidelity.

Question 51

In their cross-sectional correlational study, researchers hypothesized that stress was a risk factor for depression among college students. The researchers found a correlation between stress and depression, consistent with the hypothesis. Which is a possible threat to the internal validity of this study?
A) Selection
B) Mortality
C) Maturation
D) Temporal ambiguity

Answer 51

D) Temporal ambiguity

Question 52

Using a one-group pretest–posttest design, nurse researchers studied the effect of quiet music on sleep efficiency in low-birth-weight infants. Which threat to internal validity would be especially salient in this study?
A) Selection
B) Mortality
C) Maturation
D) Temporal ambiguity

Answer 52

C) Maturation

Question 53

Nurse researchers randomly assigned 50 participants to a 3-month smoking cessation intervention and 50 to be in the control group. At the end of the study, there were 40 in the intervention group and 32 in the control group. Which threat to internal validity would be especially salient in this study?
A) Selection
B) Mortality
C) Maturation
D) Temporal ambiguity

Answer 53

B) Mortality

Question 54

A nurse researcher implemented a physical fitness program for nurses in one hospital and used nurses in another hospital as the control group. Which threat would be the most serious to internal validity in this study?
A) Selection
B) Mortality
C) Maturation
D) Temporal ambiguity

Answer 54

A) Selection

Question 55

Which threat to internal validity can emerge when external events co-occurring with the independent variable affect outcomes?
A) Maturation
B) Selection
C) Mortality
D) History

Answer 55

D) History

Question 56

Which is typically the most serious threat to the internal validity of RCTs?
A) Mortality
B) Selection
C) Maturation
D) History

Answer 56

A) Mortality

Question 57

Using homogeneity as a strategy for controlling confounding variables can reduce which type of validity?
A) Statistical conclusion validity
B) Internal validity
C) External validity
D) Construct validity

Answer 57

C) External validity

Question 58

Construct validity concerns inferences from the particular exemplars of a study to the higher order constructs that they are intended to represent. The absence of which strategy in an RCT could undermine construct validity?
A) Randomization
B) Statistical control
C) Matching
D) Blinding

Answer 58

D) Blinding