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NR 503 MIDTERM EXAM – QUESTION AND ANSWERS

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Midterm Exam Review NR503 1. The nurse practitioner is reviewing a recent study that utilizes analytic epidemiology by means of a cohort study design. The cohort study design informs the practitioner about which of the following: Outcomes that develop from an exposure 2. A group of providers have implemented population-based intervention and are now assessing the efficacy of the intervention. Which of the following would be an example of a population based outcome? Decreased mortality rate compared to previous year 3. Appraisal of research publications is critical as providers assess for relevance to population health. Which of the following items should be considered during the appraisal process? Select all that apply. Outcome measure, Transparency, Internal Validity 4. What is being compared in a cohort study design? The incidence of a disease between exposed and non-exposed individuals 5. Analytic epidemiology is best described as: Studies that investigate origins and casuals’ factors of health-related events 6. You are part of a research group investigating association between exposure and disease. Which study design is a best fit for this type of study: Case-Control Study 7. The provider is concerned about what appears to be an increase in the mortality rate for their community. Mortality is an example of which of the following: Vital statistic 8. An example of a tertiary prevention measure for chronic obstructive pulmonary disease is: Pulmonary Rehabilitation 9. Which of the following statements best describe efficacy? It is an estimate of the benefit of treatment under ideal conditions It is an estimate of the reduction of disease in treated groups 10. A study is conducted for a pharmaceutical agent that has shown promise for reducing heart disease among women. In order to more fully test the agent, an additional study is done restricting the participants to be randomized to those who have a history of hypertension. Which of the following advantages cannot be claimed by the researchers? The generalizability of the study is increased 11. What is the main advantage of the randomization of the 168 study participants to one of the two drug treatment groups? Reduces selection bias 12. After entry into the study, patients were first classified into three groups, those who had a previous AMI, those with a first AMI who were at high risk for other cardiovascular diseases such as congestive heart failure, and those with a first AMI who were at low risk for other cardiovascular diseases. Which term best describes the study design? Randomized clinical trial with stratified randomization 13. After assignment to treatment group, 77% of those in the placebo group were men, while 80% of those in the drug X group were men. Which statement is most likely to be true? Randomization was successful since the investigators did not alter the selection of participants in either group in order to ensure equal percentages of men 14. A preliminary analysis was conducted after 6 months and found that 87% of participants in the placebo group and 85% of those in the drug X group had taken more than 90% of their prescribed dosages. Which statement best describes this finding? 15. Which of the following statements best describes the reason for conducting the study as a double- blind trial? Double blinding ensures that potential biases regarding selection, follow-up, and analysis can be reduced A multicenter double-blind randomized study was carried out to compare the effect of drug X with that of a placebo in patients surviving acute myocardial infarction (AMI). Treatment with the drug started 7 days after infarction in 1,884 patients, 52% of all persons who were evaluated for entry in

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Midterm Exam Review
NR503
1. The nurse practitioner is reviewing a recent study that utilizes analytic epidemiology by means
of a cohort study design. The cohort study design informs the practitioner about which of the
following:
Outcomes that develop from an exposure
2. A group of providers have implemented population-based intervention and are now assessing
the efficacy of the intervention. Which of the following would be an example of a population
based outcome?
Decreased mortality rate compared to previous year
3. Appraisal of research publications is critical as providers assess for relevance to population
health. Which of the following items should be considered during the appraisal process? Select
all that apply.

Outcome measure, Transparency, Internal Validity

4. What is being compared in a cohort study design?
The incidence of a disease between exposed and non-exposed individuals
5. Analytic epidemiology is best described as:
Studies that investigate origins and casuals’ factors of health-related events
6. You are part of a research group investigating association between exposure and disease.
Which study design is a best fit for this type of study:
Case-Control Study
7. The provider is concerned about what appears to be an increase in the mortality rate for
their community. Mortality is an example of which of the following:
Vital statistic
8. An example of a tertiary prevention measure for chronic obstructive pulmonary disease
is: Pulmonary Rehabilitation
9. Which of the following statements best describe efficacy?
It is an estimate of the benefit of treatment under ideal conditions
It is an estimate of the reduction of disease in treated groups
10. A study is conducted for a pharmaceutical agent that has shown promise for reducing heart
disease among women. In order to more fully test the agent, an additional study is done
restricting the participants to be randomized to those who have a history of hypertension.
Which of the following advantages cannot be claimed by the researchers?

, The generalizability of the study is increased
11. What is the main advantage of the randomization of the 168 study participants to one of the
two drug treatment groups?
Reduces selection bias

12. After entry into the study, patients were first classified into three groups, those who had a
previous AMI, those with a first AMI who were at high risk for other cardiovascular diseases
such as congestive heart failure, and those with a first AMI who were at low risk for other
cardiovascular diseases. Which term best describes the study design?
Randomized clinical trial with stratified randomization
13. After assignment to treatment group, 77% of those in the placebo group were men, while 80%
of those in the drug X group were men. Which statement is most likely to be true?
Randomization was successful since the investigators did not alter the selection of participants in
either group in order to ensure equal percentages of men

14. A preliminary analysis was conducted after 6 months and found that 87% of participants in the
placebo group and 85% of those in the drug X group had taken more than 90% of their
prescribed dosages. Which statement best describes this finding?
The characteristics of patients who failed to comply with the treatment dosages should be
assessed as they may differ from those who complied


15. Which of the following statements best describes the reason for conducting the study as a
double- blind trial?
Double blinding ensures that potential biases regarding selection, follow-up, and analysis can be
reduced

A multicenter double-blind randomized study was carried out to compare the effect of drug X
with that of a placebo in patients surviving acute myocardial infarction (AMI). Treatment with
the drug started 7 days after infarction in 1,884 patients, 52% of all persons who were evaluated
for entry into the study. 945 participants were randomized to treatment with drug X while 939
were assigned to the placebo group. Patients were then followed for 12 months for reinfarction.
There were 152 deaths in the placebo group and 98 in the group receiving drug X.
The researchers conclude that treatment with drug X reduces mortality in patients who have had
an AMI. The researchers are:
Correct because the rate of death is decreased in the drug X group

16. The following data come from a study of approaches to smoking cessation. Smokers who want
to quit were randomized to one of four groups: control. .brochures and a monthly phone call
from
a counselor. Participants received mailed surveys at 8, 16, and 24 months after randomization.
The results after 2 years are in the table below. Which group had the least success in terms of
quitting smoking?
Group QS


17. The following data come from a study of approaches to smoking cessation. Smokers who want
to quit were randomized to one of four groups: control group C who received no intervention
assistance, quitting guide group Q who received brochures about how to quit smoking, quitting
guide and support group QS who received quitting brochures as well as social support brochures

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