N 108 Hesi Nursing Research

Correct Answer A: To the extent that it is possible, informed consent is obtained from mentally disabled adult subjects in addition to a consent from their guardians.

Explanation:

Vulnerable populations, such as mentally disabled adults, require extra safeguards to protect their autonomy and rights in research. The correct answer reflects a heightened sensitivity because the researcher makes an effort to obtain assent (affirmative agreement) from the mentally disabled participants themselves, whenever possible, in addition to obtaining legally authorized consent from their guardians. This dual approach respects the dignity of the individual and complies with ethical standards.

Why the Other Options Are Incorrect:

B. The researcher has petitioned the Institutional Review Board for an exempted review due to negligible risks posed to the adult subjects.

Requesting an exempted review does not demonstrate sensitivity to vulnerable subjects, especially if the study involves individuals who are mentally disabled, prisoners, or otherwise at risk. Vulnerable populations typically require full review, not exemption.

C. The wife of a subject who is visually impaired will receive and sign the written informed consent document because her spouse cannot see it.

This violates ethical standards. The subject—not a proxy—must give informed consent unless legally unable. For visually impaired individuals, the consent process must be adapted (e.g., using verbal explanations, Braille, or witnessed consent), not handed off to someone else to sign.

D. Prisoners selected as subjects are asked to sign two separate informed consent documents to show that their participation was voluntary.

Requiring two consents is not a standard or recognized practice. Voluntary participation is ensured through appropriate education, assurance of no coercion, and independent review, not through redundant paperwork.

Correct Answer B: Ex-post-facto study

Explanation:

An ex-post-facto study is a non-experimental research design that investigates possible relationships between variables by examining existing conditions or events that have already occurred. In this case, the use of oral contraceptives and the breast self-exam practices are both existing behaviors or conditions. The researcher cannot manipulate the contraceptive methods, so the ex-post-facto approach allows analysis based on natural groupings. This design is best when studying cause-and-effect relationships where direct control of variables is not possible but where the researcher wants to explore how one variable may influence another.

Why the Other Options Are Incorrect:

A. Correlational study

A correlational study examines the strength and direction of a relationship between two variables but does not establish cause-and-effect. While it could be used here, it does not allow for comparison between predefined groups (oral contraceptive users vs. other users) as effectively as an ex-post-facto design.

C. Longitudinal study

A longitudinal study involves repeated observations of the same variables over time. While useful for tracking changes in behavior, it is not necessary here unless the goal is to observe how breast self-exam practices change over time, which is not stated in the research question.

D. Exploratory study

An exploratory study is used when little is known about a topic and the goal is to generate hypotheses rather than test them. Since this research question is already specific and comparative, an exploratory study would not be the most effective or structured design for answering it.

Correct Answer B: What discharge medication instruction can clients most often re-state at the first follow-up clinic visit?

Explanation:

This question directly relates to nursing practice because it evaluates client comprehension and recall of medication instructions — an essential component of nursing education and discharge planning. Assessing which parts of medication education clients remember most helps nurses improve communication techniques and enhance adherence to treatment plans, making it a relevant and actionable nursing research focus.

Why the Other Options Are Incorrect:

A. Which flavored syrups do clients choose most often for prescribed cough elixirs: strawberry or grape?

This option addresses patient preference, not adherence or education, and does not provide insight into improving nursing practice related to medication administration.

C. Why do clients have a tendency to forget to take their morning medications while they are on vacation?

While this may be useful, it is more behavioral and exploratory in nature and less directly focused on a measurable nursing intervention or education strategy.

D. Are clients who have pets more responsible about taking medications than those without pets?

This is an interesting sociobehavioral question but does not specifically relate to nursing roles in education or discharge planning for medication adherence.

Correct Answer C: How does massage therapy affect sepsis outcomes of preterm neonates hospitalized on a neonatal unit?

Explanation:

This clinical question is well-targeted for a literature search focused on the effectiveness of massage therapy in influencing sepsis outcomes. It clearly defines the population (preterm neonates), intervention (massage therapy), and outcome (sepsis), making it specific enough to locate relevant studies. It does not require a comparison group to assess impact, which makes it appropriate for a broad evidence search including observational and experimental research.

Why the Other Options Are Incorrect:

A. How does massage therapy compare to standard treatments in decreasing sepsis among preterm neonates on a neonatal unit?

This question adds a comparison component, which can be helpful, but it may unnecessarily narrow the search and exclude relevant studies that do not include a comparison group.

B. What interventions are most commonly used to decrease sepsis in preterm neonates who are hospitalized on a neonatal unit?

This question is too broad and does not focus on massage therapy specifically, which is the nurse’s area of interest.

D. Should massage therapy be included in the care of preterm neonates in a neonatal unit to prevent sepsis?

This is a decision-based question rather than a research-oriented one. It assumes consideration of implementation before evidence is reviewed, which is not ideal for initiating a literature search.

 Correct Answer B: Cumulative Index of Nursing and Allied Health Literature (CINAHL) reference.

Explanation:

CINAHL is a comprehensive and specialized nursing and allied health database that indexes scholarly, peer-reviewed articles, including those authored by nurses. It is specifically designed to retrieve information on nursing practices, interventions, and outcomes. For a topic like nurse-authored client education programs aimed at reducing STIs, CINAHL is the most reliable and focused source, offering a high volume of relevant, evidence-based studies that are searchable using key terms like “sexually transmitted infections,” “teenagers,” and “nurse-led education.”

Why the Other Options Are Incorrect:

A. Google Internet meta-search engine search by subject matter (STIs)

Google results are broad, unfiltered, and often include non-scholarly or commercially biased information. While it may provide general awareness, it is not a reliable source for scholarly nursing research or nurse-authored interventions.

C. American College of Obstetricians and Gynecologists Website for the public

This website offers public health education, but it is not focused on nursing research or nurse-authored client education programs. Its target audience is patients and providers in obstetrics and gynecology, not researchers or nursing students.

D. US Department of Health and Human Services epidemiology webpage

While this source may offer statistical data about STI rates, it does not focus on nursing interventions or education programs. It is useful for background or prevalence data but does not meet the specific requirement for nurse-authored education program information.

Correct Answer C: Cultural immersion experience

Explanation:

The independent variable is the factor that the researcher manipulates or introduces to observe its effect on the outcome. In this study, the cultural immersion experience is the intervention being tested to determine whether it influences the dependent variables—cultural sensitivity and cultural self-efficacy. It is the experimental condition applied to senior nursing students to measure its impact.

Why the Other Options Are Incorrect:

A. Cultural sensitivity

Cultural sensitivity is a dependent variable—it's one of the outcomes being measured to see if it changes as a result of the immersion experience.

B. Senior nursing students

The participants in the study (senior nursing students) are not variables—they are the sample population being studied. A population group is not considered an independent or dependent variable.

D. Cultural self-efficacy

Like cultural sensitivity, this is also a dependent variable. It is the second outcome the study is evaluating to determine the effect of the cultural immersion experience.

Correct Answer C: Journal of Obstetric, Gynecologic and Neonatal Nurses (JOGNN)

Explanation:

The Journal of Obstetric, Gynecologic and Neonatal Nurses (JOGNN) is the most appropriate and targeted publication for disseminating nursing research related to neonatal care, especially interventions in neonatal intensive care units (NICUs). JOGNN reaches an audience of maternal and neonatal nurses and healthcare professionals who are directly involved in the care of low birth weight infants and are most likely to implement and benefit from evidence-based practice changes based on the study's findings.

Why the Other Options Are Incorrect:

A. Journal of the American Medical Association (JAMA)

While JAMA is a prestigious, widely read medical journal, it is primarily physician-focused and covers a broad range of medical topics. It is not the ideal platform for nursing-specific neonatal research aimed at nursing practice changes.

B. Parents of Multiples (POMs) National Association Newsletter

This newsletter is intended for a lay audience—primarily parents—and is not a scientific or peer-reviewed journal. It is not suitable for disseminating research intended to influence clinical best practices.

D. Journal of Nursing Administration (JONA)

JONA focuses on issues related to nursing leadership and healthcare administration. While it supports nursing scholarship, it is not the best fit for clinical neonatal research intended to influence bedside practice.

Correct Answer A: The range of motion following joint replacement surgery for clients with PCA-delivered narcotics was compared to those receiving intermittent IM narcotics.

Explanation:

Option A describes an experimental or quasi-experimental design where the researcher assigns or observes different treatments (PCA-delivered narcotics vs. intermittent IM narcotics) and measures the effect on an outcome (range of motion). This involves manipulation of the independent variable (type of pain management) and observation of the dependent variable (range of motion), which fits the definition of a study design that allows for variable manipulation.

Why the Other Options Are Incorrect:

B.The researcher randomly selected 200 medical records to identify the frequency of discharges to skilled nursing facilities following total hip replacement surgery.

This is a retrospective descriptive or observational study. There is no manipulation of variables—just analysis of existing records.

C. Clients with fibromyalgia received logbooks to record the actions they took over a period of two weeks to alleviate their symptoms of fatigue.

This is a descriptive or observational study based on self-report. The researcher does not manipulate any variables.

D. Nurse managers were interviewed about their levels of job satisfaction for the purpose of identifying themes of autonomy in their roles.

This describes a qualitative study, specifically a phenomenological or thematic analysis, where the researcher seeks to understand experiences. There is no manipulation of variables.

Correct Answer D: Compare the location where the study was conducted with the location of the pediatric clinic

Explanation:

The most important first step is to assess the generalizability of the study findings by comparing the geographical, cultural, socioeconomic, and demographic characteristics of the study population with those of the local clinic. Differences in environmental factors, healthcare access, or cultural practices may affect the nutritional status of Hispanic children differently in the northeast compared to the southwest. Without this context, applying the study findings directly could be inappropriate or ineffective.

Why the Other Options Are Incorrect:

A. Replicate the study using white children from the pediatric clinic as subjects

This is inappropriate because the original study focused specifically on Hispanic children. Changing the ethnic group would not provide a valid replication and may introduce confounding variables that invalidate comparisons.

B. Propose initiating a policy of administering vitamin A twice annually to children ages 6 to 20 months

It is premature to propose a clinic-wide policy change without first confirming whether the findings are applicable to the nurse’s current population and setting. This action would require further evaluation and possibly additional research.

C. Determine how the nurse researcher measured the subjects' nutritional status

While this is a relevant question when assessing a study’s validity, it is not the most important initial action. Generalizability of the findings to the local context takes precedence before examining measurement tools.