NUR 400 MIDTERM EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

NUR 400 MIDTERM EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 evidence based practice (EBP) - Answers · Evidence based practice: the integration of the best research evidence with clinical expertise and patients' needs and values · EBP is not a "one size fits all" approach to healthcare · EBP is not a cost-cutting practice or method for rationing healthcare services Florence Nightingale - Answers Early nursing theory ● Most people agree that research in nursing began with Florence Nightingale in the mid 19th century ● Nightingale's Environmental Theory ○ "What nursing has to do is to put the patient in the best condition for nature to act upon him" ○ Derived from observations about patient experience · Nightingale had discovered that the majority of deaths in the Crimea were due to poor sanitation rather than casualties in battle. She wanted to persuade the government of the need for better hygiene in hospitals · It was discovered that the Barrack Hospital was built on a sewer, meaning patients were drinking contaminated water. The hospital, along with other British army hospitals, was flushed out and ventilation improved. Consequently, the death rate began to fall. Levels of Evidence - Answers ● Meta-analysis of randomized controlled trials are at the pinnacle of traditional evidence hierarchies for therapy questions ● The essence of a meta-analysis is that findings from each study are used to compute a common index (an effect size) Effect sizes are averaged across studies, yielding information about the relationship Experimental - Answers ○ Researcher actively introduces intervention to address a question ○ Explicitly designed to test causal relationships ○ Clinical trial Non-experimental - Answers ○ Researcher observes, but does not intervene ○ Collect data without introducing treatments ○ Observational study Qualitative Studies - Answers ● Understanding people's perception of reality ● Data are based on observations, narratives, pictures, and text that can be summarized through themes, categories, or other units PICOT Question - Answers ● P: population of interest ● I: intervention or issue of interest ● C: comparison of interest ● O: outcome expected ● T: time needed for the intervention to achieve the outcome or the time in the course of the disease/ symptom that the intervention is applied Theory - Answers ● Two or more concepts and a set of propositions that form a logically interrelated system, providing a mechanism for deducing hypotheses ● Abstract generalization that explains how phenomena are related ● Model: representation of phenomena and their interrelationships (diagram) ● Framework: underpinning a study (overall rationale) Nursing Theories - Answers ● Usually described in three levels ○ Grand: attempts to explain large aspects of human experience (most abstract) ○ Middle-range: focuses on a specific aspect of human experience (i.e. stress, comfort, health promotion) ○ Practice: developed for use within a specific range of nursing situations (limited, least abstract) Quantitative - Answers ○ Understanding a reality that exists ○ Data are based on surveys, biological measures and other sources that can be quantified numerically ○ Types ■ Descriptive ■ Correlational ■ Quasi-experimental ■ Experimental Qualitative - Answers ○ Understanding people's perception of reality ○ Data are based on observations, narratives, pictures, and text that can be summarized through themes, categories, or other units ○ Types ■ Phenomenological ■ Grounded theory ■ Ethnographic ■ Historical research Basic - Answers ■ Extending information for the sake of knowledge ■ Discover a vaccine that you find in a lab ■ Finding out new information ■ Appropriate for discovering general principles for human behavior and biophysiologic processes Applied - Answers ■ Examines how principles can be used to solve problems in nursing practice ■ Discovering solutions to immediate problems ■ How can it be used in real life Pre-appraised - Answers ○ Combining other people's studies to come to a conclusion ○ Consensus recommendations ○ Evidence that has been selected from primary studies and evaluated for use by clinician ○ Authoritative group ■ Governmental bodies ■ Professional boards ■ National guideline clearinghouse (end this year) ○ Pro: usually easier to integrate into clinical practice ○ Con: worst case is biased opinion Primary studies - Answers ● Original study ● Published in journals and used in practice ● Not pre-appraised for quality and use in practice ● Pros ○ Direct from source ○ Newest knowledge ● Cons ○ Need technical knowledge ○ May not link clearly to practice Independent variable - Answers ○ Variable believed to affect the dependent variable ○ Predictor ○ "Cause" ○ Intervention must have comparison Dependent variable - Answers ○ The variable a research is interested in ○ Outcome ○ "Effect" Confounding - Answers ■ 3rd variable ■ Potential other cause ■ 3rd variable that influences both IV and DV ■ Correlation is not causation meta-analysis - Answers ● Meta-analysis: systematic review and analysis of quantitative studies ● Statistically pools results from previous studies into single quantitative analysis ○ Systematic review + math = meta-analysis ● Meta-analyses of RCTs are the pinnacle of traditional evidence hierarchies ● Allows for application of scientific criteria ○ Sample size, statistical significance, measurement, bias, effect size ○ Describe averages ○ Test relationships ● Summary of state of knowledge ● Not appropriate for broad questions or when findings are substantially inconsistent ● Replicable, quantifiable method ("greater objectivity") ● Combines results from many people ("greater power") Forest plots - Answers ■ Individual study results (squares) ■ Confidence intervals (line) ■ Average result (diamond) ■ Vertical line = NO difference/relationship meta-synthesis - Answers ● Meta-synthesis: systematic review and analysis of qualitative studies ● Qualitative meta-synthesis ● Intentional and coherent approach to analyzing data across qualitative studies ● Process that enables researchers to identify a specific research question and then search for, select, appraise, summarize, and combine qualitative evidence ● More than just a summary of qualitative findings; they involve the discovery of essential features of a body of findings and a transformation that yields new interpretations systematic review - Answers ● A narrowly focused synthesis of research findings ● Looks at studies of similar methodology ● Has the same standards of clarity, rigor, and replication as primary research studies ● Research question should be nearly identical across studies ○ This means that the independent and dependent variables and the study populations are sufficiently similar to merit interrogation ● Summary of a state of knowledge ● Pre-specified and transparent method ● Integrates research evidence about the research question ● Summary state of scientific literature ● Carefully developed ○ Sampling ○ Data collection ● Spelled out in advance in a protocol ○ Cornerstone for EBP ● Methods are very clear and can be replicated Clinical Practice Guidelines - Answers ● Guideline development typically involves the consensus of a group of researchers, experts, and clinicians ● In the United States, nursing and health care guidelines are maintained by the National Guideline Clearinghouse ● Pro: Usually easier to integrate into clinical practice ● Con: Worst case is biased opinion, May not be replicable ● Make recommendations for clinical practice Scientific Article Structure - Answers ● Abstract ○ Read this first ○ Brief overview of the study ○ Headings match sections ● Introduction (research problem & context) ○ Introduce problem ○ Describe significance ○ Context ○ Purpose of study ○ Research question (s) ● Method (strategies used to answer the research question) ○ Design/ setting ○ Participants ○ Procedures ○ Measures ○ Analysis plan ● Results (study findings) ○ Organized with research questions ○ Quantitative: statistical tests (p .05) ○ Qualitative: themes, meanings ○ Most tables/ figures ● Discussion (interpretation and implications of findings) ○ Text of summary of results ○ Integrate/compare results to past studies, or to results expected from theory ○ Limitations/strengths of study ○ Conclusions/implications Peer Review - Answers ● Evaluation of articles by other scientists in the field (peers or referees) ● Goal: ensure quality work ● Requires ○ Community of experts in a field ○ Impartial experts ● Blind review: anonymity (reviewer and/ or author) Randomized Control Trials (RCT) - Answers ● RCT is the gold standard for interventions because they meet the criteria for inferring causal relationships ● Involve an intervention, control, and randomization ● Testing Interventions ○ Manipulate the IV through specific procedures ● Control ○ Comparison group that is not given the intervention ● Randomization ○ Procedure to assign interventions vs control ○ Makes the groups more comparable ● Strict protocols for study ○ Inclusion ○ Follow up ○ Measurement ○ Reporting ○ Analysis Random assignment - Answers ■ Inferences about internal validity ■ Researchers assign participants to levels of IV Intervention vs control Random sample - Answers ■ Inferences about external validity ■ All members of the population have equal chance to be in sample The Belmont Report - Answers ● The Belmont Report articulated three primary ethical principles on which standards of ethical research conduct is based ○ Beneficence ■ Imposes a duty on researchers to minimize harm and maximize benefits ■ The right to freedom from harm and discomfort (physical, emotional, social, financial) ■ The right to protection from exploitation ○ Respect for Human Dignity ■ Right to self-determination (participants have the right to decide to take place in the study) ■ Right to full disclosure (the researcher has fully explained the study, the person's right to refuse participation, and the risks/benefits) ○ Justice ■ Includes participants' right to fair treatment and privacy Concealment - Answers ● A tactic involving the unobtrusive collection of research data without participant's knowledge or consent, used to obtain an accurate view of naturalistic behavior when the behavior would be distorted if the participants knew they were being observed ● "Covert data collection" ● Ethically problematic because they interfere with people's right to make truly informed decisions about personal costs and benefits of participation Institutional Review Board (IRB) - Answers ● A type of committee that applies research ethics by reviewing the methods proposed for research to ensure they are ethical ● External reviews and the protection of human rights ● Before undertaking a study, researchers must submit research plans to the IRB and undergo formal IRB training