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EBP-EAP study materials
EBP-EAP study resources

EBP-EAP practice questions

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Question 1Evidence-Based Practice Foundations

In evidence-based practice, which element is placed at the center of the decision-making triangle alongside best research evidence and clinical expertise?

  1. Institutional billing requirements
  2. Patient values and preferences Correct answer.
  3. Manufacturer marketing claims
  4. Insurance reimbursement policy

Explanation

The classic EBP triad combines the best available research evidence, the clinician's expertise, and the patient's values, preferences, and circumstances. Reimbursement and marketing considerations are not part of the defining triad and cannot substitute for patient preferences.

Question 2Evidence-Based Practice Foundations

A clinician asks a well-built clinical question about a therapy. Which component of the PICO format identifies the outcome of interest?

  1. C
  2. I
  3. O Correct answer.
  4. P

Explanation

PICO stands for Population/Patient, Intervention, Comparison, and Outcome. The final letter, O, designates the outcome the clinician wants to measure or predict, such as mortality or functional status.

Question 3Evidence-Based Practice Foundations

Which study design provides the strongest evidence for questions about the effectiveness of a therapeutic intervention when it is well conducted?

  1. Case series
  2. Systematic review of randomized trials Correct answer.
  3. Expert opinion
  4. Cross-sectional survey

Explanation

In the traditional evidence hierarchy for therapy questions, well-conducted systematic reviews and meta-analyses of randomized controlled trials sit at the top. They aggregate multiple trials and reduce the play of chance and selective reporting.

Question 4Evidence-Based Practice Foundations

What does the acronym GRADE refer to in evidence-based practice?

  1. A statistical test for heterogeneity
  2. A grading system for strength of evidence and recommendations Correct answer.
  3. A patient-reported outcome instrument
  4. A search strategy for grey literature

Explanation

GRADE (Grading of Recommendations Assessment, Development and Evaluation) is a framework for rating the certainty of evidence and the strength of recommendations. It separates judgments about evidence quality from judgments about recommendation strength.

Question 5Evidence-Based Practice Foundations

A study reports a relative risk of 1.0 for an intervention compared with control. How should this result be interpreted?

  1. The intervention halves the risk of the outcome
  2. There is no observed difference in risk between groups Correct answer.
  3. The intervention doubles the risk of the outcome
  4. The result cannot be interpreted without a p value

Explanation

A relative risk of 1.0 means the risk in the intervention group equals the risk in the control group, indicating no observed association. Confidence intervals are still needed to judge precision, but the point estimate itself denotes no difference.

Question 6Evidence-Based Practice Foundations

Which section of a primary research report typically describes the search strategy and eligibility criteria?

  1. Discussion
  2. Results
  3. Methods Correct answer.
  4. Introduction

Explanation

The Methods section documents how the study was conducted, including participant selection, eligibility criteria, and, for reviews, the search strategy. This allows readers to judge reproducibility and risk of bias.

Question 7Evidence-Based Practice Foundations

Which question type is best answered by a qualitative study design?

  1. The prevalence of diabetes in a county
  2. The sensitivity of a screening test
  3. Whether drug A lowers blood pressure more than drug B
  4. How patients experience the transition to home dialysis Correct answer.

Explanation

Qualitative designs explore meaning, experience, and process, making them suited to questions about how people live with or interpret health events. Questions of comparative effect, prevalence, and test accuracy call for quantitative designs.

Question 8Evidence-Based Practice Foundations

What is the primary purpose of a confidence interval around an effect estimate?

  1. To prove that the null hypothesis is true
  2. To indicate the range of values compatible with the observed data Correct answer.
  3. To replace the study's sample size calculation
  4. To remove the need for a control group

Explanation

A confidence interval expresses the precision of an estimate by giving a range of values consistent with the data at a stated confidence level. A wide interval signals imprecision, while a narrow one suggests a more precise estimate.

Question 9Evidence-Based Practice Foundations

A systematic review reports substantial statistical heterogeneity across pooled trials. Which action is most appropriate when applying the findings?

  1. Discard the review entirely as uninformative
  2. Ignore heterogeneity and apply the pooled estimate directly
  3. Explore possible sources of heterogeneity before generalizing Correct answer.
  4. Assume the largest trial is always correct

Explanation

Substantial heterogeneity means the trials may not share a single true effect, so reviewers and clinicians should examine subgroup, sensitivity, or meta-regression analyses to identify sources. Applying the pooled estimate without this exploration risks misleading conclusions.

Question 10Evidence-Based Practice Foundations

Which element most directly reduces the risk of selection bias in a randomized controlled trial?

  1. Reporting of adverse events
  2. Allocation concealment at randomization Correct answer.
  3. Blinding of outcome assessors
  4. Use of a placebo in the control arm

Explanation

Allocation concealment prevents recruiters from anticipating or manipulating assignment, which protects the randomization sequence and reduces selection bias. Blinding addresses detection bias, and placebos address performance bias, but neither substitutes for concealment.

Question 11Evidence-Based Practice Foundations

A clinician wants to find the highest-level evidence on a nursing intervention and has limited time. Which resource type is most efficient for this purpose?

  1. A single case report on one patient
  2. A raw search of primary studies in a general database
  3. A preappraised clinical practice guideline or evidence summary Correct answer.
  4. A textbook chapter from a decade ago

Explanation

Preappraised resources such as guidelines and evidence summaries synthesize and critically appraise the literature, saving the clinician time. Searching primary studies directly is appropriate when no preappraised source exists.

Question 12Evidence-Based Practice Foundations

Which description best characterizes a cohort study?

  1. Participants are grouped by exposure and followed forward for outcomes Correct answer.
  2. Participants are assessed once with no follow-up
  3. Participants are randomly assigned to interventions
  4. Participants are grouped by outcome and compared on past exposures

Explanation

A cohort study starts with exposure status and follows participants over time to observe incident outcomes, allowing calculation of incidence and relative risk. Grouping by outcome and looking backward describes a case-control design.

Question 13Evidence-Based Practice Foundations

In appraising a diagnostic accuracy study, which measure expresses the proportion of people with the disease who test positive?

  1. Specificity
  2. Sensitivity Correct answer.
  3. Likelihood ratio for a negative test
  4. Positive predictive value

Explanation

Sensitivity is the proportion of truly diseased individuals who test positive, reflecting the test's ability to detect disease. Specificity concerns the proportion of disease-free people who test negative.

Question 14Evidence-Based Practice Foundations

A study reports a number needed to treat of 20. What does this value mean?

  1. The treatment costs twenty units per patient
  2. Twenty patients experienced an adverse event
  3. Twenty percent of treated patients will experience a cure
  4. Twenty patients must be treated for one additional patient to benefit Correct answer.

Explanation

The number needed to treat is the reciprocal of the absolute risk reduction and represents how many patients must receive the intervention for one additional favorable outcome. A smaller value indicates a more effective intervention.

Question 15Evidence-Based Practice Foundations

Which practice most directly reduces publication bias in a systematic review?

  1. Including only studies with significant p values
  2. Searching trial registries and grey literature in addition to databases Correct answer.
  3. Restricting inclusion to English-language journals
  4. Relying solely on the reference lists of included articles

Explanation

Publication bias arises when studies with null or unfavorable results remain unpublished, so searching registries, conference abstracts, and grey literature improves the chance of capturing them. Restricting language or significance further increases selective inclusion.

Question 16Evidence-Based Practice Foundations

A nurse manager wants to implement a new fall-prevention protocol. Which step best reflects the 'assess' phase of the EBP process?

  1. Publishing a press release about the change
  2. Formulating an answerable question and gathering the best evidence Correct answer.
  3. Evaluating outcomes after implementation
  4. Routinely mandating the change without evidence review

Explanation

The assessment phase involves identifying the clinical problem, framing a focused question, and locating and appraising the relevant evidence. Implementation and outcome evaluation come later in the EBP cycle.

Question 17Evidence-Based Practice Foundations

Which statement correctly distinguishes internal from external validity?

  1. Internal validity concerns causal inference within the study; external validity concerns generalization Correct answer.
  2. Internal validity concerns generalization; external validity concerns causal inference
  3. Both concern only statistical significance
  4. Both concern only the sample size

Explanation

Internal validity asks whether the study's observed effect is truly causal for the studied sample, while external validity asks whether findings generalize to other populations and settings. A study can be strong in one and weak in the other.

Question 18Evidence-Based Practice Foundations

A clinician reads that an intervention reduced mortality with a relative risk of 0.80 and a 95% confidence interval of 0.65 to 0.98. What is the most defensible conclusion?

  1. The result is inconclusive because the interval excludes 1.0
  2. The intervention has no effect because the interval is wide
  3. The intervention increases mortality
  4. The intervention probably reduces mortality, with a statistically significant result Correct answer.

Explanation

A relative risk below 1.0 with a confidence interval that excludes 1.0 indicates a statistically significant reduction in mortality. The point estimate of 0.80 corresponds to a 20 percent relative reduction.

Question 19Evidence-Based Practice Foundations

What is the main purpose of blinding in a clinical trial?

  1. To reduce the influence of expectations and bias on results Correct answer.
  2. To guarantee external validity
  3. To increase the sample size
  4. To eliminate the need for informed consent

Explanation

Blinding conceals treatment assignment from participants, clinicians, or assessors so that expectations do not distort behavior or measurement. It addresses performance and detection bias rather than sample size or generalizability.

Question 20Evidence-Based Practice Foundations

Which scenario best illustrates the use of clinical expertise within the EBP triad?

  1. A clinician judges how a trial's findings apply to a patient with multiple comorbidities Correct answer.
  2. A researcher publishes a randomized trial
  3. A patient selects a treatment based on personal values
  4. A hospital adopts a policy based on a single expert's opinion

Explanation

Clinical expertise is the clinician's ability to integrate research evidence with the individual patient's circumstances, including comorbidity, risk, and preferences. It is distinct from patient values and from the research evidence itself.

Question 21Evidence-Based Practice Foundations

A meta-analysis pools trials with different follow-up durations and outcome definitions under a random-effects model. Which interpretation is most appropriate?

  1. The pooled estimate represents an average effect across heterogeneous studies and should be applied cautiously Correct answer.
  2. Differing outcome definitions do not affect interpretation
  3. The pooled estimate is valid only if all trials used fixed effects
  4. The random-effects model removes all heterogeneity

Explanation

A random-effects model assumes the true effect varies across studies and estimates an average effect, but it does not eliminate clinical or methodological heterogeneity. Clinicians should consider whether the pooled average applies to their population and setting.

Question 22Evidence-Based Practice Foundations

A study reports a statistically significant result with p = 0.04 but a very small effect size. Which interpretation is most defensible for clinical decision-making?

  1. The effect size should be ignored
  2. Statistical significance alone justifies changing practice
  3. The p value proves the intervention is effective for all patients
  4. The result may be statistically significant but clinically unimportant Correct answer.

Explanation

Statistical significance indicates that an effect is unlikely due to chance, not that it is large enough to matter clinically. Clinicians should weigh effect size, confidence intervals, and patient-relevant outcomes before changing practice.

Question 23Evidence-Based Practice Foundations

Which situation constitutes a violation of the ethical principle of equipoise in a randomized trial?

  1. Using a placebo when no proven treatment exists
  2. Stopping a trial early for clear benefit
  3. Obtaining informed consent before randomization
  4. Randomizing patients when substantial evidence already shows one treatment is superior Correct answer.

Explanation

Equipoise requires genuine uncertainty about which treatment is superior before randomizing participants. Randomizing when evidence already favors one arm exposes participants to a known inferior treatment and violates equipoise.

Question 24Evidence-Based Practice Foundations

A clinician wants to apply a trial's results to an older patient with renal impairment, but the trial excluded patients with renal impairment. Which appraisal issue is most relevant?

  1. Internal validity of the randomization
  2. Applicability and indirectness of the evidence Correct answer.
  3. Statistical power of the trial
  4. Risk of publication bias

Explanation

When a trial's population differs from the patient in important ways, the evidence is indirect for that patient, raising questions about applicability. This is a GRADE domain of indirectness rather than a flaw in the trial's internal validity.

Question 25Evidence-Based Practice Foundations

Which statement best explains why absolute risk measures are preferred over relative risk alone when communicating evidence to patients?

  1. Relative measures cannot be calculated from trials
  2. Absolute measures eliminate the need for confidence intervals
  3. Relative measures are always statistically invalid
  4. Absolute measures convey the baseline risk and actual size of benefit Correct answer.

Explanation

Relative risk can make small effects sound large when baseline risk is low, whereas absolute risk reduction and number needed to treat show the actual magnitude of benefit. Communicating both supports informed decision-making.

Question 26Evidence-Based Practice Foundations

In the evidence hierarchy used for therapy questions, which design provides the strongest single-study evidence when a systematic review is unavailable?

  1. Cross-sectional survey
  2. Randomized controlled trial Correct answer.
  3. Case-control study
  4. Prospective cohort study

Explanation

For questions of intervention effect, the randomized controlled trial sits above observational designs because randomization distributes known and unknown confounders between groups. Cohort, case-control, and cross-sectional designs lack this safeguard and are therefore more susceptible to bias when estimating treatment effects.

Question 27Evidence-Based Practice Foundations

Which component of the EBP triad refers to the preferences, values, and circumstances of the person receiving care?

  1. Institutional policy
  2. Best available research evidence
  3. Patient values and preferences Correct answer.
  4. Clinical expertise

Explanation

The EBP triad combines the best available research evidence, clinical expertise, and patient values and preferences. Patient values and preferences capture what matters to the individual, including goals, beliefs, culture, and personal circumstances, and they shape how evidence is applied in a specific encounter.

Question 28Evidence-Based Practice Foundations

A nurse formulates the question: 'In hospitalized adults, does a scheduled toileting program compared with usual care reduce the incidence of falls?' Which PICO element does 'incidence of falls' represent?

  1. Comparison
  2. Intervention
  3. Outcome Correct answer.
  4. Population

Explanation

In PICO, the O stands for outcome, which is the result or endpoint measured to judge whether the intervention works. The incidence of falls is the measured endpoint here, whereas the population is hospitalized adults, the intervention is scheduled toileting, and the comparison is usual care.

Question 29Evidence-Based Practice Foundations

Which study design is most appropriate for establishing the incidence of a condition and its natural history over time?

  1. Case series
  2. Cohort study Correct answer.
  3. Randomized controlled trial
  4. Meta-analysis

Explanation

A cohort study follows a defined group free of the outcome at baseline and measures new cases over time, which allows incidence and natural history to be described. Randomized trials assign an intervention rather than observe natural exposure, case series lack a comparison group, and meta-analyses synthesize existing studies rather than generate incidence data directly.

Question 30Evidence-Based Practice Foundations

A clinician needs a quick, pre-appraised summary that grades the strength of recommendations for a clinical topic. Which resource type is designed for this purpose?

  1. Primary randomized trial report
  2. Unpublished conference abstract
  3. Narrative textbook chapter
  4. Clinical practice guideline Correct answer.

Explanation

Clinical practice guidelines systematically review evidence and attach explicit grades to recommendations, which makes them a pre-appraised source for busy clinicians. A single trial report, a narrative textbook chapter, and an unpublished abstract do not provide systematically graded recommendations across a topic.

Question 31Evidence-Based Practice Foundations

Which measure describes the proportion of people without the disease who are correctly identified as disease-free by a test?

  1. Sensitivity
  2. Specificity Correct answer.
  3. Positive predictive value
  4. Prevalence

Explanation

Specificity is the proportion of truly non-diseased people whom the test classifies as negative, so it reflects how well a test rules out disease in those who do not have it. Sensitivity addresses diseased people, positive predictive value addresses the probability of disease given a positive result, and prevalence is the underlying frequency of disease.

Question 32Evidence-Based Practice Foundations

A trial reports an absolute risk reduction of 5 percent for a serious complication. How should this be interpreted?

  1. The result was not statistically significant
  2. The number needed to treat equals 5
  3. Five fewer events occurred per 100 people treated Correct answer.
  4. The intervention reduced risk by 5 percent relative to control

Explanation

Absolute risk reduction is the arithmetic difference in event rates between groups, so a 5 percent reduction means 5 fewer events per 100 people treated. This differs from relative risk reduction, which expresses the change as a proportion of the control rate, and the number needed to treat would be the reciprocal, or 20.

Question 33Evidence-Based Practice Foundations

Which feature most clearly distinguishes a systematic review from a traditional narrative review?

  1. It focuses only on randomized trials
  2. It reports results without pooling data
  3. It uses a prespecified, reproducible search and selection method Correct answer.
  4. It is written by a single author

Explanation

A systematic review follows an explicit, prespecified protocol for searching, selecting, and appraising studies, which makes the process reproducible and reduces reviewer bias. Narrative reviews typically lack such transparency, and pooling data through meta-analysis is an optional component rather than the defining feature.

Question 34Evidence-Based Practice Foundations

A clinician is deciding whether to apply trial results to a patient who differs from the trial population in age and comorbidity. Which concept is most directly at stake?

  1. Randomization concealment
  2. External validity Correct answer.
  3. Internal validity
  4. Statistical power

Explanation

External validity, or applicability, concerns whether results from the study sample generalize to other patients and settings. When a patient differs from the enrolled population in age or comorbidity, the clinician must judge whether the treatment effect is likely to hold in that person, which is a question of external rather than internal validity.

Question 35Evidence-Based Practice Foundations

Which statement best describes the role of a forest plot in a meta-analysis?

  1. It displays each study's effect estimate and the pooled estimate with confidence intervals Correct answer.
  2. It ranks studies by their risk of bias
  3. It tests whether publication bias is present
  4. It shows the sample size of each included study

Explanation

A forest plot graphs each included study's effect estimate and confidence interval alongside the pooled summary estimate, allowing visual assessment of consistency and weight. Risk-of-bias ranking, sample size, and publication bias assessment are handled by other tools or plots, such as a funnel plot.

Question 36Evidence-Based Practice Foundations

A team is deciding whether to adopt a new pressure injury prevention bundle. Which action best reflects the 'ask' phase of the evidence-based practice process?

  1. Searching several databases for relevant studies
  2. Appraising the methodological quality of retrieved studies
  3. Monitoring compliance after the change is implemented
  4. Converting a clinical uncertainty into a focused, answerable question Correct answer.

Explanation

The ask phase involves translating a clinical problem into a focused, structured question, often using PICO, that can then be answered with evidence. Searching databases, appraising studies, and monitoring implementation occur in later phases of the EBP process.

Question 37Evidence-Based Practice Foundations

Which level of evidence is typically assigned to a well-conducted systematic review of randomized controlled trials in a standard hierarchy?

  1. Level V
  2. Level I Correct answer.
  3. Level III
  4. Level VII

Explanation

In the common seven-level hierarchies, a systematic review or meta-analysis of randomized controlled trials is placed at Level I as the highest form of evidence for intervention questions. Lower levels are occupied by single trials, non-randomized studies, and expert opinion.

Question 38Evidence-Based Practice Foundations

A trial reports a large relative risk reduction, but the confidence interval is wide and crosses the line of no effect. Which conclusion is most defensible?

  1. The intervention is harmful because the interval is wide
  2. The result is inconclusive because the data are compatible with no benefit Correct answer.
  3. The sample size was adequate to detect the effect
  4. The intervention is proven effective

Explanation

When the confidence interval includes the null value, the data remain compatible with no true effect, so the finding is inconclusive despite a large point estimate. A wide interval also signals imprecision, which usually indicates limited sample size or few events rather than proof of benefit or harm.

Question 39Evidence-Based Practice Foundations

A systematic review pools trials that used different outcome scales and follow-up periods. Which approach best addresses the resulting heterogeneity?

  1. Reporting only the single largest trial's result
  2. Excluding all trials that used nonstandard scales
  3. Applying a random-effects model and exploring sources of heterogeneity Correct answer.
  4. Ignoring heterogeneity because the pooled estimate is significant

Explanation

A random-effects model allows for between-study variation in true effect and is appropriate when heterogeneity is expected. Investigators should also explore sources of heterogeneity through subgroup or sensitivity analyses rather than discarding studies or ignoring the variation, since heterogeneity affects how much confidence can be placed in a pooled estimate.

Question 40Evidence-Based Practice Foundations

A clinician applies a validated risk prediction model derived in a younger population to an older patient. Which consideration most affects whether the model's estimate is trustworthy for this patient?

  1. Whether the model has been validated in a similar population Correct answer.
  2. Whether the model was published in a high-impact journal
  3. Whether the model was derived using a randomized design
  4. Whether the model uses many predictor variables

Explanation

A prediction model's transportability depends on validation in populations resembling the patient being assessed, because case mix and predictor-outcome relationships can differ. Journal prestige, the number of predictors, and the derivation design do not by themselves establish that the model calibrates well in a different age group.

Question 41Clinical Question Formulation and Literature Search

A clinician wants to build a well-structured clinical question before searching for evidence about a therapy. Which framework is designed primarily for quantitative questions about the effect of an intervention?

  1. PICo (Population, Interest, Context)
  2. PICO (Population, Intervention, Comparison, Outcome) Correct answer.
  3. PEO (Population, Exposure, Outcome)
  4. SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research type)

Explanation

PICO structures therapy and other quantitative questions around a defined population, an intervention, an optional comparator, and measurable outcomes, which maps directly onto controlled study designs. The other frameworks target exposures, qualitative phenomena, or context and therefore lack the intervention-comparison-outcome structure PICO provides.

Question 42Clinical Question Formulation and Literature Search

In a PICO question, what element does the 'C' represent?

  1. The confidence interval of the expected effect
  2. The citation database to be searched
  3. The clinical setting where care is delivered
  4. The comparator or control group Correct answer.

Explanation

The 'C' in PICO stands for comparison, meaning the alternative intervention, placebo, or usual care against which the intervention of interest is contrasted. Without a comparator, the question cannot express a relative effect, so this element defines the contrast that the search and appraisal will target.

Question 43Clinical Question Formulation and Literature Search

A nurse asks: 'In hospitalized adults, does a nurse-led early ambulation protocol compared with usual care reduce the incidence of hospital-acquired pneumonia?' Which element is the outcome?

  1. Usual care
  2. Hospitalized adults
  3. Nurse-led early ambulation protocol
  4. Incidence of hospital-acquired pneumonia Correct answer.

Explanation

The outcome is the result measured to judge whether the intervention worked, which here is the incidence of hospital-acquired pneumonia. The population, the intervention, and the comparator are the other PICO elements and are not the endpoint being evaluated.

Question 44Clinical Question Formulation and Literature Search

When formulating a question about the accuracy of a screening test, which PICO element is replaced to reflect the reference standard?

  1. The comparator is removed entirely from the question
  2. The population is replaced by the study setting
  3. The outcome is replaced by the prevalence of the condition
  4. The intervention is replaced by the index test and the comparison by the reference standard Correct answer.

Explanation

Diagnostic accuracy questions restructure PICO so that the index test occupies the intervention slot and the reference standard occupies the comparison slot, with sensitivity and specificity as typical outcomes. This preserves the comparative logic needed to judge test performance.

Question 45Clinical Question Formulation and Literature Search

A team is framing a qualitative question about how patients experience waiting for a transplant. Which framework best fits this aim?

  1. PEO
  2. PICo (Population, Interest, Context)
  3. PICO
  4. SPIDER Correct answer.

Explanation

SPIDER was developed specifically for qualitative and mixed-methods evidence synthesis, capturing sample, phenomenon of interest, design, evaluation, and research type. This structure accommodates experiential questions where outcomes and comparators are not meaningful.

Question 46Clinical Question Formulation and Literature Search

Which question is best classified as a prognosis question?

  1. How do adults with type 2 diabetes describe their medication adherence?
  2. Is point-of-care HbA1c as accurate as laboratory HbA1c?
  3. In adults with newly diagnosed type 2 diabetes, what proportion develop peripheral neuropathy within five years? Correct answer.
  4. In adults with type 2 diabetes, does metformin compared with lifestyle alone lower HbA1c?

Explanation

Prognosis questions concern the likelihood of future outcomes over time in a defined population, which matches estimating the proportion developing neuropathy within five years. The other items address intervention effect, lived experience, and diagnostic accuracy respectively.

Question 47Clinical Question Formulation and Literature Search

A librarian suggests using a controlled vocabulary term alongside free-text keywords in a database search. What is the main purpose of combining both?

  1. To eliminate the need to apply any limits or filters
  2. To ensure the search returns a manageable number of results
  3. To guarantee that only randomized trials are retrieved
  4. To increase recall by capturing synonyms and newly coined terms not yet indexed Correct answer.

Explanation

Controlled vocabulary captures indexed concepts consistently, while free-text terms capture synonyms, spelling variants, and concepts not yet assigned index terms. Combining them improves sensitivity so relevant studies are not missed.

Question 48Clinical Question Formulation and Literature Search

Which Boolean operator should be used between synonyms for the same concept to broaden retrieval?

  1. NOT
  2. NEAR
  3. OR Correct answer.
  4. AND

Explanation

OR combines alternative terms for the same concept so that records containing any of them are retrieved, which broadens the search. AND narrows by requiring all concepts, while NOT excludes records and risks discarding relevant studies.

Question 49Clinical Question Formulation and Literature Search

A searcher writes the string: (nurse OR nursing) AND (burnout OR 'emotional exhaustion'). What does this strategy accomplish?

  1. It retrieves records where nurse appears within five words of burnout
  2. It retrieves only records containing all four terms
  3. It excludes records that mention emotional exhaustion
  4. It retrieves records containing either nurse term together with either burnout term Correct answer.

Explanation

OR groups synonyms within each concept, and AND requires at least one term from each group, so records must contain a nurse-related term plus a burnout-related term. This is the standard block-building approach for concept-based searching.

Question 50Clinical Question Formulation and Literature Search

What is the primary function of a methodological search filter (for example, a randomized controlled trial filter)?

  1. To restrict retrieval to studies using a specified design Correct answer.
  2. To rank results by journal impact factor
  3. To translate the search strategy between databases automatically
  4. To remove duplicate records across databases

Explanation

A methodological filter is a validated combination of terms and indexing that targets a particular study design, improving precision when a question calls for that design. It does not translate strategies, rank by impact, or deduplicate records.