NUR 388 MIDTERM EXAM | 2026/2027
60 Questions | Accurate Spring-Summer | Guaranteed Pass | 100% Verified
Instructions: Select the best answer for each question. Correct answers are indicated in bold cyan with
rationales.
Domain 1: Research Design & Methodology (Q1-Q6)
1. A nurse researcher is designing a study to examine the effect of a new wound care protocol on healing
rates in patients with pressure injuries. Which type of research design is most appropriate for establishing
cause-and-effect?
A. Descriptive cross-sectional survey B. Randomized controlled trial (RCT)
C. Phenomenological study D. Case report
Answer: B
Randomized controlled trials (RCTs) are considered the gold standard for establishing cause-and-effect relationships
because they control for confounding variables through randomization. The AACN Essentials emphasize the ability of
BSN-prepared nurses to appraise and apply evidence from RCTs to guide clinical decision-making.
2. In a quasi-experimental study examining the impact of hourly rounding on patient falls, the researcher
does not randomize participants. What is the primary limitation of this design?
A. It can only be used with qualitative data B. It is unable to establish causality as rigorously
as an RCT due to lack of randomization
C. It requires a sample size of fewer than 30 D. It cannot be conducted in a hospital setting
participants
Answer: B
Quasi-experimental designs lack randomization, which increases the risk of selection bias and confounding variables,
limiting the ability to make causal inferences. However, they are valuable in real-world clinical settings where
randomization may be impractical or unethical, as noted in QSEN EBP competencies.
3. Which sampling method ensures that every member of the target population has an equal chance of being
selected for a study?
A. Convenience sampling B. Purposive sampling
C. Simple random sampling D. Snowball sampling
Answer: C
Simple random sampling is a probability sampling technique where each member of the population has an equal and
independent chance of selection, minimizing selection bias. This aligns with the QSEN competency of integrating best
evidence with clinical expertise, as probability sampling strengthens the generalizability of research findings.
1
,4. A researcher conducts a grounded theory study to explore the lived experiences of nurses transitioning
from bedside care to management roles. Which qualitative methodology is being used?
A. Grounded theory B. Randomized controlled trial
C. Cohort study D. Cross-sectional survey
Answer: A
Grounded theory is a qualitative research methodology designed to generate theory from data through systematic
coding and constant comparison. It is particularly useful for exploring social processes and experiences, consistent
with AACN Essentials that emphasize understanding diverse patient and provider experiences in nursing research.
5. A nurse researcher finds that the measurement tool used in a study produces consistent results when
repeated under similar conditions. Which psychometric property is being demonstrated?
A. Validity B. Reliability
C. Bias D. Confounding
Answer: B
Reliability refers to the consistency and reproducibility of a measurement instrument over time and across conditions. A
reliable tool yields stable results upon repeated administration, which is essential for generating trustworthy evidence
in nursing research per the EBP framework outlined by Melnyk & Fineout-Overholt.
6. In a study examining the relationship between nurse staffing levels and hospital-acquired infections, the
researcher identifies that patient acuity may influence both variables. What is patient acuity in this context?
A. A dependent variable B. An extraneous variable (confounder)
C. A moderator variable D. A mediating variable
Answer: B
A confounding variable (extraneous variable) is one that is related to both the independent and dependent variables
and can distort the true relationship between them. Patient acuity could affect both staffing decisions and infection
rates, making it a confounder that must be controlled through study design or statistical analysis.
Domain 2: Literature Review & Critical Appraisal (Q7-Q12)
7. When conducting a systematic literature search for evidence on a clinical topic, which database is most
appropriate as a primary source for nursing literature?
A. Google Scholar B. CINAHL (Cumulative Index to Nursing and
Allied Health Literature)
C. Wikipedia D. WebMD
Answer: B
CINAHL is the most comprehensive database for nursing and allied health literature, indexing thousands of journals,
books, and dissertations. Using discipline-specific databases aligns with the AACN Essentials for identifying the best
available evidence to inform clinical practice decisions.
2
, 8. A nurse uses the Boolean operator 'AND' when searching PubMed. What effect does this have on the
search results?
A. It broadens the search by including synonyms B. It narrows the search by requiring all terms to
appear in results
C. It excludes all results containing the specified D. It sorts results by publication date
terms
Answer: B
The Boolean operator 'AND' narrows a literature search by requiring that all specified search terms appear in each
result. This strategy is essential for conducting focused evidence searches, a key QSEN competency that supports
effective evidence-based practice implementation.
9. The PRISMA framework is primarily used to guide which of the following activities?
A. Data collection in qualitative research B. Reporting of systematic reviews and meta-
analyses
C. Patient consent procedures D. Hospital quality improvement metrics
Answer: B
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) provides a standardized checklist for
transparent and complete reporting of systematic reviews. Understanding PRISMA supports the QSEN EBP
competency of critically appraising published research syntheses before applying findings to clinical practice.
10. A nurse is critically appraising a research article and notes that the study sample size was very small (n =
12) with wide confidence intervals. What is the most appropriate appraisal conclusion?
A. The study findings are robust and generalizable B. The small sample and wide confidence intervals
suggest limited statistical power and cautious
interpretation is warranted
C. The study should be immediately adopted into D. The study is invalid because qualitative methods
clinical practice were used
Answer: B
Small sample sizes lead to wide confidence intervals and reduced statistical power, increasing the risk of Type II errors
(failing to detect true effects). Critical appraisal skills, as emphasized in the AACN Essentials, require nurses to
evaluate sample adequacy before applying evidence to practice.
11. A meta-analysis differs from a systematic review in that a meta-analysis:
A. Does not follow a structured search protocol B. Uses statistical methods to combine and analyze
data from multiple studies
C. Only includes qualitative research D. Relies exclusively on expert opinion
Answer: B
A meta-analysis extends a systematic review by using statistical techniques to quantitatively synthesize data across
studies, providing a more precise estimate of effect. This represents the highest level of evidence in the Melnyk &
Fineout-Overholt hierarchy for answering therapy-focused clinical questions.
3
60 Questions | Accurate Spring-Summer | Guaranteed Pass | 100% Verified
Instructions: Select the best answer for each question. Correct answers are indicated in bold cyan with
rationales.
Domain 1: Research Design & Methodology (Q1-Q6)
1. A nurse researcher is designing a study to examine the effect of a new wound care protocol on healing
rates in patients with pressure injuries. Which type of research design is most appropriate for establishing
cause-and-effect?
A. Descriptive cross-sectional survey B. Randomized controlled trial (RCT)
C. Phenomenological study D. Case report
Answer: B
Randomized controlled trials (RCTs) are considered the gold standard for establishing cause-and-effect relationships
because they control for confounding variables through randomization. The AACN Essentials emphasize the ability of
BSN-prepared nurses to appraise and apply evidence from RCTs to guide clinical decision-making.
2. In a quasi-experimental study examining the impact of hourly rounding on patient falls, the researcher
does not randomize participants. What is the primary limitation of this design?
A. It can only be used with qualitative data B. It is unable to establish causality as rigorously
as an RCT due to lack of randomization
C. It requires a sample size of fewer than 30 D. It cannot be conducted in a hospital setting
participants
Answer: B
Quasi-experimental designs lack randomization, which increases the risk of selection bias and confounding variables,
limiting the ability to make causal inferences. However, they are valuable in real-world clinical settings where
randomization may be impractical or unethical, as noted in QSEN EBP competencies.
3. Which sampling method ensures that every member of the target population has an equal chance of being
selected for a study?
A. Convenience sampling B. Purposive sampling
C. Simple random sampling D. Snowball sampling
Answer: C
Simple random sampling is a probability sampling technique where each member of the population has an equal and
independent chance of selection, minimizing selection bias. This aligns with the QSEN competency of integrating best
evidence with clinical expertise, as probability sampling strengthens the generalizability of research findings.
1
,4. A researcher conducts a grounded theory study to explore the lived experiences of nurses transitioning
from bedside care to management roles. Which qualitative methodology is being used?
A. Grounded theory B. Randomized controlled trial
C. Cohort study D. Cross-sectional survey
Answer: A
Grounded theory is a qualitative research methodology designed to generate theory from data through systematic
coding and constant comparison. It is particularly useful for exploring social processes and experiences, consistent
with AACN Essentials that emphasize understanding diverse patient and provider experiences in nursing research.
5. A nurse researcher finds that the measurement tool used in a study produces consistent results when
repeated under similar conditions. Which psychometric property is being demonstrated?
A. Validity B. Reliability
C. Bias D. Confounding
Answer: B
Reliability refers to the consistency and reproducibility of a measurement instrument over time and across conditions. A
reliable tool yields stable results upon repeated administration, which is essential for generating trustworthy evidence
in nursing research per the EBP framework outlined by Melnyk & Fineout-Overholt.
6. In a study examining the relationship between nurse staffing levels and hospital-acquired infections, the
researcher identifies that patient acuity may influence both variables. What is patient acuity in this context?
A. A dependent variable B. An extraneous variable (confounder)
C. A moderator variable D. A mediating variable
Answer: B
A confounding variable (extraneous variable) is one that is related to both the independent and dependent variables
and can distort the true relationship between them. Patient acuity could affect both staffing decisions and infection
rates, making it a confounder that must be controlled through study design or statistical analysis.
Domain 2: Literature Review & Critical Appraisal (Q7-Q12)
7. When conducting a systematic literature search for evidence on a clinical topic, which database is most
appropriate as a primary source for nursing literature?
A. Google Scholar B. CINAHL (Cumulative Index to Nursing and
Allied Health Literature)
C. Wikipedia D. WebMD
Answer: B
CINAHL is the most comprehensive database for nursing and allied health literature, indexing thousands of journals,
books, and dissertations. Using discipline-specific databases aligns with the AACN Essentials for identifying the best
available evidence to inform clinical practice decisions.
2
, 8. A nurse uses the Boolean operator 'AND' when searching PubMed. What effect does this have on the
search results?
A. It broadens the search by including synonyms B. It narrows the search by requiring all terms to
appear in results
C. It excludes all results containing the specified D. It sorts results by publication date
terms
Answer: B
The Boolean operator 'AND' narrows a literature search by requiring that all specified search terms appear in each
result. This strategy is essential for conducting focused evidence searches, a key QSEN competency that supports
effective evidence-based practice implementation.
9. The PRISMA framework is primarily used to guide which of the following activities?
A. Data collection in qualitative research B. Reporting of systematic reviews and meta-
analyses
C. Patient consent procedures D. Hospital quality improvement metrics
Answer: B
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) provides a standardized checklist for
transparent and complete reporting of systematic reviews. Understanding PRISMA supports the QSEN EBP
competency of critically appraising published research syntheses before applying findings to clinical practice.
10. A nurse is critically appraising a research article and notes that the study sample size was very small (n =
12) with wide confidence intervals. What is the most appropriate appraisal conclusion?
A. The study findings are robust and generalizable B. The small sample and wide confidence intervals
suggest limited statistical power and cautious
interpretation is warranted
C. The study should be immediately adopted into D. The study is invalid because qualitative methods
clinical practice were used
Answer: B
Small sample sizes lead to wide confidence intervals and reduced statistical power, increasing the risk of Type II errors
(failing to detect true effects). Critical appraisal skills, as emphasized in the AACN Essentials, require nurses to
evaluate sample adequacy before applying evidence to practice.
11. A meta-analysis differs from a systematic review in that a meta-analysis:
A. Does not follow a structured search protocol B. Uses statistical methods to combine and analyze
data from multiple studies
C. Only includes qualitative research D. Relies exclusively on expert opinion
Answer: B
A meta-analysis extends a systematic review by using statistical techniques to quantitatively synthesize data across
studies, providing a more precise estimate of effect. This represents the highest level of evidence in the Melnyk &
Fineout-Overholt hierarchy for answering therapy-focused clinical questions.
3
