NR 503 / NR503 MIDTERM ACTUAL EXAM REVIEW 2023 - QUESTIONS AND ANSWERS

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 - ANSOutcomes that develop from an exposure 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? - ANSDecreased mortality rate compared to previous year 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. - ANSOutcome measure, Transparency, Internal Validity What is being compared in a cohort study design? - ANSThe incidence of a disease between exposed and non-exposed individuals Analytic epidemiology is best described as: - ANSStudies that investigate origins and casuals' factors of health-related events 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: - ANSCase-Control Study 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: - ANSVital statistic An example of a tertiary prevention measure for chronic obstructive pulmonary disease is: - ANSPulmonary Rehabilitation Which of the following statements best describe efficacy? - ANSIt is an estimate of the benefit of treatment under ideal conditions It is an estimate of the reduction of disease in treated groups 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? - ANSThe generalizability of the study is increased What is the main advantage of the randomization of the 168 study participants to one of the two drug treatment groups? - ANSReduces selection bias 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? - ANSRandomized clinical trial with stratified randomization 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? - ANSRandomization was successful since the investigators did not alter the selection of participants in either group in order to ensure equal percentages of men 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? - ANSThe characteristics of patients who failed to comply with the treatment dosages should be assessed as they may differ from those who complied Which of the following statements best describes the reason for conducting the study as a double-blind trial? - ANSDouble blinding ensures that potential biases regarding selection, follow-up, and analysis can be reduced 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? - ANSGroup QS 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 listing benefits of smoking cessation, and telephone support group T who received the 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. What is the main purpose of randomization in this study? - ANSTo avoid assigning more persons who have tried and failed to quit in the past to the control group Test A has a sensitivity of 95% and a specificity of 90%. Test B has a sensitivity of 80% and a specificity of 98%. In a community of 10,000 people with 5% prevalence of the disease, Test A has always been given before Test B. What is the best reason for changing the order of the tests? - ANSThe total number of false positives found by both tests is decreased if Test B is given first This table represents the results of coronary magnetic resonance (CMR) angiography compared to x-ray angiography (the gold standard in diagnosis of coronary artery disease) in a high-risk population of patients scheduled to undergo x-ray angiography for suspected coronary artery disease.After reviewing the results of the test comparison, an epidemiologist decides that the specificity of the test is too low. Using the same CMR images, he raises the cutoff value for a positive test to increase the specificity. What is the likely effect on the sensitivity? - ANSSensitivity will decrease In comparing the mammography readings of two technicians who evaluated the same set of 600 mammograms for presence of breast cancer from a generally representative sample of women from the population - ANSOverall percent agreement calculated for both readers may conceal significant disagreements regarding positive tests A researcher is interested in the etiology of cervical cancer among women between 18 and 35 years of age. Her hypothesis concerns the influence of sexually transmitted diseases such as human papilloma virus (HPV) and subsequent development of cancer. What is the best study approach to address this hypothesis? - ANSCase-control study of women 18 to 35 years of age identified with cervical cancer in the hospital (cases) compared to women admitted for other diseases (control) Suppose that one third of all cervical cancer cases were smokers as were one third of all controls and smoking status is independent of HPV infection. Is smoking a potential confounder in this study? - ANSNo, the chance of being a smoker among women with cervical cancer is the same as that of being a smoker among women without cervical cancer ...