Advanced Practice Nursing Master’s Comprehensive Exam


2011 APN Comprehensive Exam Packet

2011 Nursing Administration Comprehensive Exam Packet

Admin Comprehensive Examination Cover Sheet

Comprehensive Examination Cover Sheet

2012 FAQ

2010 FAQ

2009 FAQ

Frequently Asked Questions from 2012


I have prepared a "Payback" calculation together with a five year cash flow in an Excel file to help with my request/argument to the CFO for approval of the project of my choice.  Can I submit these two documents as appendices (on top of the 12-month Pro-forma and Breakeven Analysis required)?

The answer is no. You cannot include any other information/materials in the appendix except  what is specified in the instructions. You can however integrate this work into the exam/paper. Perhaps a table could work or describe the results of this work without actually showing the calculations but providing the rationale for your proposed project. 
One of the instructors has strongly encouraged us to use Microsoft Project for constructing a timeline for projects.  Can I submit a pdf file of the file from MS Project, not an Excel file?

The answer is yes. The phrase 'excel file' was used to be specific about what should be submitted but not meant to exclude other types of file such as MS project. This can be used.

When we upload the files to CCLE site, should all the documents in pdf format only?  (I understand that MS Word and pdf formats are appropriate for the turn-it-in site.)

Turnitin currently accepts the following file types for submission: MS Word (.doc), WordPerfect (.wpd), PostScript (.eps), Portable Document Format (.pdf), HTML (.htm), Rich Text (.rtf) and Plain Text (.txt). All files submitted to Turnitin must be text based. Papers which have been scanned must be sent through Optical Character Recognition (OCR) software before they can be submitted to Turnitin

Thank you for your response.   I guess I need to clarify my question.  I have already decided to choose dyspnea in minority inner-city children due to asthma.  But will it be okay to focus my intervention and therefore lit review on preventing asthma exacerbations in this populations.  or do i need to find an intervention that will directly prevent dyspnea rather than asthma exacerbations? 
Thank you!

Your paper needs to fully describe your thinking process leading up to the topic and population you identify as significant, which is part of the Comprehensive Exam. I cannot choose this for you. If you provide a strong rationale for choices, and you stay within the scope of your APN program and the symptom you chose, you can narrow your topic accordingly.

I have always written my TOE as appendices to my papers, the comps directions says appedicies are not permitted, am I correct to assume we should write our TOE as a table and follow APA guidelines by labeling each as Table # title (and then include full citation in the TOE)

Yes, follow APA with the exception that single spacing is permitted.

The directions says we can use tables and figures, but I wanted to make sure we could do that in addition to the TOE,  if we create a flow chart or algorithm as our intervention can we attach it as a figure?
Thank you in advance for your assistance!

Yes, figures and other (needed) tables are separate from the Table of Evidence.

I believe I have read all of the frequently asked questions listed, yet I do not remember a question regarding international studies. It seems that a majority of the studies that support my intervention are from different countries; mainly in Europe. I have spent days and used many different MESH terms conducting research; specifically looking for U.S. studies. I have found two studies from the United States, but in my opinion, are not up to the level of the European studies. Is it not recommended to have all of the studies outside of the U.S.? Is it okay to use at least half from the U.S.?

Your selection criteria for research studies should focus on the quality of the design and methodology and the relevance to the topic of your paper.

I was wondering if evaluation and treatment of fever in the Mediterranean population would be a good topic. All of the research is linking the treatment to "Familial Mediterranean Fever". Is this too specific? Should I switch the population to Arabic individuals? Thank you.

These are choices you have to make, based on available literature. Narrowing the topic is the most challenging part of the paper

If I am doing unintentional weight loss in the elderly, should my 7-10 articles focus on one assessment tool or one intervention? Or can I have a combinations of both, multiple assessment tools and multiple interventions? The literature review section is vague and I checked the 2010 responses and it is still vague in question number 13, can you please clarify ? Thanks

Depending on the results of your topic and literature review, you may choose a combination or keep a single focus. Each paper is original and individually guided by your analysis of the results.

In the table of evidence, there is not a designated column for "study purpose and design". Where should we add this information?

The Table of Evidence is not an abstract. The information you want to present can be incorporated either into an appropriate column or could be referenced in the text.

Do the 7-10 articles used in the table of evidence and for discussion have to be on ONE intervention ONLY? I am having trouble finding only one.

Depending on your topic and literature review, you would not necessarily have to focus on a single intervention.

 Can we use articles from 2005? We are in the beginning of 2011, and I am aware that we should use articles written in the past 5 years.
Select the most up-to-date, high quality articles you can find on your topic. There may be an occasional groundbreaking publication that you can identify as such.

Does this mean we cannot submit our paper to turn it in after April 8?
The deadline for submitting your exam is April 14, 2011 at 3 PM. During the window period (3/22-4/8), you can submit your paper in advance to turn it in to preview how the program would evaluate your work prior to submitting your final version. Please refer to Dr. Phillips' email dated 3/22/11.

I am having a difficult time with my intervention. Am I supposed to just choose one interventions for the table of evidence or can my research vary? I have multiple articles on nutritional supplements for weight gain and have also found ones for music therapy, environmental changes, and medications. Do I compare and contrast that data? Thank you
The Overview section of the Comprehensive Examination packet directs you to select one of three listed problems and focus your problem as it relates to a population appropriate for your program. In a later segment of the paper, you will propose an intervention related to your literature review and synthesis of your findings. Please re-read both the overview and the following directions which provide information on the weighting of each section of the paper and the evaluation criteria.
I would like to inquire about "narrowing the topic". The instructions ask students to "identify a specific problem related to one of the following general topics". Therefore, is it acceptable to choose a focus such as, "Dyspnea: evaluation and management of dyspnea in adult asthmatic patients". Another words, can I narrow the symptom to a pathological condition?
The purpose of the initial portion of the exam is to demonstrate your analytical thinking process of "narrowing the question." Your first step involves selection of a population relevant to your APN program. How specifically you further narrow your topic depends on your focus of inquiry. Several student questions from 2009 and 2010 address your question very specifically. See in particular an entry from 3/28/2009.

My question is on the section II and section IV. Is the literature review based on the symptom or the intervention? If the literature review is based on the intervention then is section IV a proposed intervention for that particular symptom and is that a separate review of the literature. In previous papers the literature review has been based on the intervention for a particular diagnosis and the conclusion of the paper was the discussion of the appropriateness of the intervention.
The Overview (p. 6 of Comprehensive Exam instructions) is a broader description of the purpose of this paper and should be helpful to you. The Areas To Be Addressed help you to understand the various sections of the paper and how they will be evaluated by the faculty reader. The literature review is based on the topic you have developed using the described process. The intervention is designed by you in order to address the identified problem. You would use appropriate citations from the literature, but not conduct a separate formal literature review.

Question: APN Question Re: Narrowing the topic. Is it acceptable to narrow the topic to a disease? For example dyspnea in elderly African Americans with COPD? I understand this paper is symptom focused and I plan to focus on the symptom rather than the disease in this population however I want to know if narrowing to a disease is incorrect. I feel like the topic dyspnea in elderly African Americans is too broad and may lead my paper in the wrong direction. I would like a direct answer as I do not want to fail because my narrowed topic has a specific disease in it. Question: A common cause of dyspnea in this population is asthma. Can my lit review be focused on the interventions to prevent asthma exacerbation through improved patient and parent education regarding asthma prevention, as dyspnea is a symptom of asthma exacerbations? I guess I am not sure if the interventions measuring asthma outcomes and improved asthma education is too much of a diagnosis related intervention vs focusing on how to improve dyspnea of minority children in general (i.e finding an intervention to increase use of rescue meds during dyspnea episodes)?
We have received many questions on narrowing the topic for the comp exam and we hope that this answer will ENCOURAGE EVERYONE to narrow the topic as you have for the papers that you have done previously in your course work. We can not approve or disapprove your topic or how you narrow your topic or the intervention that you choose for the comp. This is part of the exam process. If you start with your selected symptom and show the reader how and why you narrowed it the way you have in the population you selected based on your specialty area, then you are on the right track.

Question: We were taught that defining a population needs two identifiers (ex: African American women, Hispanic elderly, etc.) In the comps example the population is defined by one identifier: evaluation of fever in children, dyspnea in Latinos, weight loss in elderly. I don't know how to take this conflicting information. Is it OK to define my population as given in the comps example ("elderly", "Latinos" etc.)? Or should I follow what we were taught for the last 2 years and use 2 identifiers? Question: I'm very concerned about comps because I'm not sure how much I should be narrowing down my topic. If it is too specific will that be a problem? I'm having a hard time finding articles that address a broad topic such as, assessment and management of dyspnea, as had been suggested in our packet. Also, if I narrow it down, such as dyspnea in adolescents, should I then narrow it down to for example sickle cell disease causing the dyspnea, or should I always focus on dyspnea alone?

You can define your population as narrowly or as broadly as you deem appropriate given the clinical situation you are researching. Underlying causative factors may also relate to and define the problem. There is no standard number of characteristics to define your population.

When using weight loss as a problem, can my topic be about the problem of helping obese children lose weight? I can discuss the differential diagnosis of the frequent causes of obesity and wanted to do my intervention about gastric bypass. Or do i need to use weight loss as the symptom in pediatric patients and discuss differentials such as failture to thrive, and how to help them gain more weight as the intervention.
If this topic is selected, you must identify a specific problem related to weight loss (not obesity) in a given population.

Can someone proof-read your paper for simple grammar and punctuation errors or is this considered "Editorial Assistance"?
Proof-reading for grammatical errors, including punctuation, is a form of editorial assistance and it is not allowed. Spell-check and grammar-check available on most word processing software is allowed. When students agree to the honesty pledge that is implicit with this examination, they are stating that they received NO assistance from others of any kind in preparing the examination composition. 

Section III. Discussion and Application (22%) A. Using an evidence-based framework (or approach), present a synthesis of the research findings. For the evidence-based framework, would that be something like the Iowa model? Could you please clarify?
Please refer to the definitions of evidence-based framework provided in your initial research course. The essentials of evidence based practice are based on a systematic approach to answering clinical questions. Part of your research involves selecting appropriate theoretical and evidence based frameworks to select, analyze and synthesize research findings.

Will the Curriculum Committee allow students to review their reports in advance of the examination, knowing that students who can pay for this privilege will be able to obtain the plagiarism check for a fee from the TURN-IT-IN.COM company?
Students do not need to use WRITECHECK.COM because they will be allowed to submit their examination beginning on April 9, 2011, 5 days in advance of the first possible submission date, to TURN-IT-IN.COM. Generally, submitted drafts may be retrieved for plagiarism checking within 24 hours of submission. Thus, if you are electing to submit your paper in advance for a final check, you will still be held to the final submission date and time for TURN-IT-IN.COM, i.e., April 14 at 3 p.m.


Frequently Asked Questions from 2010

1. 3/6/10 APN Question #2 In regards to narrowing the topic when you ask, "describes specific identified need" can you please elaborate further? Are you asking for a population identified by age, ethnicity and gender or as how the symptom is presented in your area of specialty?

You should narrow your topic as you have done for previous assignments, taking into consideration the symptom that you have chosen for your exam and your specialty area. That can mean that you choose a population identified in any way that is relevant to your specialty. 

2. 4/10/10 APN Once reviewing the literature has been completed. If there is a gap in presence of EBP (meaning, the literature has admittedly stated a lack of EBP) in my identified patient populationand approach to care- may I continue to propose an intervention based on what is currently being used in practice while pointing out it is not technically EBP and may benefit into establishing EBP through my proposed intervention?

Please remember that evidenced-based practice refers to the use of the BEST evidence available–which may be research of various designs and quality–through expert opinion. That's why we rate the quality of the evidence. It is up to you to be sure you are using the best evidence available.

3. 4/10/10 APN When stating the limitations and implications of a specific study in the table, Do I need to reference the article within the table if I am writing the specific limitations mentioned by the researchers themselves?

You are referencing this if you have the complete article citation in your table and you distinguish between the authors' identification of the research limitations and your identification of the study limitations.

4. 4/6/10 APN Are we allow to create another table for other purposes besides the data-based articles? 

You may include other tables and must number them in the order that you refer to them in the paper.

5. 4/9/10 APN uestion on Section III 2 (integration and synthesis). Could you clarify this section? I'm just not understand the question. Are we supposed to show how we could apply our theoretical model/approach in real life based on our lit search findings/conclusions? Secion IV-APN intervention: Does this intervention have to be based solely on the findings/conclusion from our lit search (about drug management)? My intevention is mainly based on physician's inadquate knowledge of treating/diagnosing the symptom (hence, am going to talk about the need for education physician in diagnosing and treatment and how to evaluate outcomes).

For your first question you must synthesis your literature review across the evidence and yes you need to discuss how you apply these findings in practice. You need to pick an intervention supported by the evidence–please read page 7 of your comp package where it discusses the intervention.

5. 4/9/10 Are statistical tests and software considered measuring tools? In the table when entering information, sometimes it is difficult to reword information sometimes without changing the meaning. Since we are already citing authors in the table, do we need to have quotes and page numbers if we have some wording the same as in the article under different columns?
The table is a succint summary of the major components of the research articles that you are using. You do not need to include quotes on your table. Stastical tests are not measuring tools–a measure or a tool is a questionnaire or a biologic measure, ie BP that reflects changes in the outcome variable of interest. For example if the research proposes to improve depression–they must have a measure of depression in order to demonstrate that.

6. Admin 3/29/10 Can you clarify the comment on admin question from 3/23/10 about opening a new unit as a way to implement a new service/line. The comment states "think ahead to the financial aspects to see if this service enables you to address the financial criteria completely." If we develop revenue/ expenses (pro forma) with positive $ amount and BEA for occupancy, would not it be sufficient?

Yes that would be sufficient.

7. Admin Question 3/23/10 1) Can developing a new specialty unit be considered as option 4 a) (establishing a new service line) 2) Can we use some of the research articles that we used in the past papers , such as change paper for Winter 2010 quarter? 3) We have to utilize change theory and project management theory in the paper. Can it be the same theories/ frameworks that we used in our past work, or does it have to be something new?

1) Can developing a new specialty unit be considered as option 4 a) (establishing a new service line) Yes, the new specialty unit can be considered a new service/service line. Think ahead to the financial aspects to see if this service enables you to address the financial criteria completely. 
2) Can we use some of the research articles that we used in the past papers , such as change paper for Winter 2010 quarter? Yes.  
3) We have to utilize change theory and project management theory in the paper. Can it be the same theories/ frameworks that we used in our past work, or does it have to be something new? Yes the same theories/frameworks you used in past work can be used and no, it definitely does not have to be something new.

8. APN 1: Two questions about narrowing the topic are similar–the answer is meant to address both: All of our papers thus far for the Acute Care Specialty have been choosing a symptom followed by reasearching the literature for treatments regarding the top differential diagnosis for the symptom in relation to our chosen population. For the literature review of the exam, are we focusing on research related to our symptom in relation to a differential diagnosis? Example…cough in a Caucasian Male over the age of 65, top differential diagnosis would be PNA, CHF, or COPD. Then would we research literature in regards to treating the symptom within a certain disease? And if so, in what portion of the paper should we discuss differential diagnosis? Also can you give an example of a conceptual or theoretical perspective that we are supposed to discuss in the literature review portion of the exam?

You should proceeed as you have with your papers throughout the program when narrowing your topic. I would also suggest that you check the 2009 FAQ for further suggestions. Concerning theory or conceptual perspective consider the theories you studied in N200 and any specialty theoretical perspectives from your specialty area.

9. APN 3/25/10 After reviewing the 7-10 articles…are we choosing 2 out of the 7-10 to then talk about health care systems issues to influence this problem? Such as choosing two of the interventions talked about in the lit review and comparing them as far as cost, access to the intervention, scope of the APN practice compared to our population? 

Remember that in addition to the 7-10 research articles, you should use additional supporting articles for yout paper (See page 7 of your comp packet). Therefore, when discussing the health care systems issues you may use supporting literature or any relevant findings from your research articles. From the list of issues presented in the comp packet, or if you believe another issue to be important, you must address two of these issues that influence the problem that you have selected.

10. APN 3/25/10 I am struggling with my topic, but would like to write about cough in adult hypertensive individuals that are taking ACEI. In doing my literature search I have found that I want to narrow it by differences in ethnic groups.. Do I need to narrow down my patient population more? Am I on the right tract? 

You can narrow the topic for this exam in any way you can support with the literature that you are reviewing. You should consider your specialty area and then weigh what the literature shows–if it shows importance in considering ethnic background, or age or gender as influencing factors on the management of your problem then you would want to consider one or several of those issues. 

11. APN 3/25/10 On the COMPS packet, it is required that "Your paper may not be a duplication of a paper written during graduate school" I understand that and want to clarify something. I am planning to write my COMPS on Confusion: assessment and management of confusion and its underlying causes in the geriatric hospitalized patients. In N439C, I wrote my case report about a patient presenting with altered mental status and how we diagnosed her with septic versus hepatic encephalopathy. It was not a paper researching the symptom of confusion but I did write some about the relevance of confusion in the inpatient setting. My case report was titled " Why Do Elderly Present with Atypical Symptoms of Infection, Most Commonly Acute Change in Mental Status?" Am I okay with my topic selection for COMPS?

You may not use an entire paper that you have submitted for another class for the comp exam. As long as your work for the comp is original, you may choose any of the three topics listed.

12. APN 3/29/10 : In reading last years Q&A, I read that our literature review tables are not to include 1 table per article, that the lit review should be 1 table. In previous papers for the program i have used 1 table per article. Is this years comps the same as last in regard to using 1 table only? If so do we need to repeat the topic heading i.e. citation, study sample, procedures etc. after each article review. 

The table of evidence is one table—your aticle may take up one page, however, others may only be only a part of a page–you only need to put headings on the top of each page to assist faculty readers with evaluating the table.

13. APN 3/29/10 belong to the FNP specialty and want clarification for Section II part B of the rubric. It seems redundant to summarize the articles in the table and rewrite again in the paper the details of the findings. In addition, when the instructions asks for "fully describe in the text of the paper," does it mean to include inclusion, exclusion, study procedures, outcome measures, etc.? My inclusion/exclusion criteria are VERY long, so it's taking too much space in my paper. Please kindly clarify. Thanks. 

You should addresss the studies in your table in depth and will have to summarize the most relevant parts of the study in your text. Remember you are building a case for the problem you have selected and your approach to treatment given your specialty area.

14. APN 3/29/10. 1) If we are dual NP/CNS, are we required to do an intervention for both roles? 2) Since we are not required to do an APA style cover page, does are paper need a title on the first page of our paper? 3) Is "data-based" articles any original research? Does it have to be clinical trials comparing two types of interventions? 4) For our literature review, is it ok to discuss a couple articles on our chosen symptom, a couple on our narrowed topic, and then a few on the intervention that we plan to use in our APN intervention section? Is that what you're looking for?

1) The comp instructions on page 7 say to "design an APN intervention addressing the identified population in a specific population and delineate methods used to carry out the intervention". You may arrange this section for 1 intervention as an APN would approach it. I would suggest that you think about how you as a a person with experience in both roles might approach the problem–rather than think of 2 interventions.
2) No the title page that is provided in the packet is sufficient.
3) Yes–and no you don't need to review only clinical trials.
4) You need to set up the review as best addresses the problem you have choosen in the population you have narrowed it to taking into account your specialty area.

15. APN 3/29/10 For the tables and figures, I just want to clarify. 1) On the format instruction page, it says "Tables and figures must follow the sequence of the writing." Does it mean: a. The tables and figures are in the middle of the writing or b. The tables and figures are right after the paper, before the refrences or c. The tables and figures are right after the references. 2) Someone mentioned that we can use either APA 5th or 6th edition? If so, where do we indicate which edition I am going to use. Can I put in the cover sheet? 3) For the font, can I use 12 point for the writing and 11 point on the table? Or it has to be either 11 or 12 for the entired paper?
1) Tables should be formatted at the end of the paper–according to APA style. The statement refers to how you reference your tables in your text; for example the first table you reference should be table 1, the second 2, etc.  You shouldn't reference table 5 and then table 1.
2) You may use APA 5th or 6th edition and may put that on the title page.
3) You may use no smaller than 11pt Times new Roman font. If you need smaller font in tables that is up to you.

16. APN 3/29/10 Is it permitted to have repetition of a top author within the 7-10 articles? For example Smith, Jones & Lang 2005 than Smith, Jones & Williams et al. 2006? The articles are of different focus and not a continuation of one study. 

If the article supports your paper than you may use it.

17. APN 3/29/10 Question R/T referencing the lit table: As we have one table with multiple articles – When we are critically analyzing the articles within the paper we refer to it as (Table 1), correct? We do not need to cite the authors who wrote each article we are descibing? i.e. (Table 1) vs. (Smith, et al. 2010). Is this because our table needs to give enough info about the study that the reader should be able to read the paper, compare to the table and know exactly which study is being described? 

You should reference your table in your text, but if you are discussing results from individual studies you must cite the authors of the research as well. Remember if you don't cite the authors' work you are claiming that it is your ideas that you are discussing.

18. APN 4/10/10 Questions about research used in your tables: Can I use national survey for my research articles? Can I use books for references?
Any original research from scholarly journals that relates to yor identified problem can be used in your table. It is up to youto demonstrate the link between the research and your problem. Books can not be used for your table of evidence and in general are not good reference sources for evidenced-based information because the information is dated.

19. APN 4/3/10 s it permitted to decrese the margin size to .5 on the table pages only as to allow more room? 

Your paper should use 1 inch margins—according to APA format.

20. APN 4/3/10 am done with my paper but have second doubts about what I've actually written for section III and IV. Section IIIA-what do you mean by an evidence-based framework research synthesis? I attribute this to as the rules of conducting a "perfect" research study, therefore my approach was talking about all the pros and cons of the research study (hence, strength and weakness), i.e., small sample size, non-randomized, etc. Or do you mean using the grading criteria such as that one used by UpToDate and the NGC? (grades A, B, C, etc.,) Section II+III3- Section II states to "evaluate potential contribution to knowledge and nursing practice", whereas section III3 states "discuss significance for addressing this issue in specialty nursing practice," these two statements sound about the same to me. For example for section II could be increase knowledge on medication A to decrease confusion and section III3 would be importance of teaching healthcare providers on the utility of med A to decrease confusion, does this sound about right? These are not actual examples of my paper. Section IV-Does both the educational or clinical has to be patient-specific? Correct me if I am wrong, it needs to relate back to my symptom, right? Do interventions have to be based on our lit review? For example, let's say I chose headaches secondary to menstrual migraine in perimenopausal women and articles talks about medical management but somewhere along my paper i have backup research that states the problem of women being under-diagnosed with menstrual migraine, hence, the increase prevalence of headaches, so can i talk about an educational intervention targeting physicians in correctly diagnosing menstrual migraines which ultimately decreases the frequency of headache?
Section IIA: See previous questions on this topic. Section II: You need to describe the implications of your evalaution of the research for nursing and specifically for your specialty practice. Section IV: I don't know what you mean by this–It is an intervention that is based on your review of the research literature relted to the problem you have selected.

21.  1)APN 4/3/10 Do the articles that address the 2 healthcare issues need to be included in the table of evidence and summary/synthesis of findings? 2) APA format for tables does not include borders or gridlines…is this how you want it formatted? 3) You said to state what edition of the APA manuel we used…where do we indicate this?

1) The healthcare articles may or may not be in your table of evidence depending on whether your research articles include health care implications or not–please see othe question of date that also addresses this issue.–please read the instructions on page 7 of your comp packet that states that you may use additional literatrue to support your exam.
2) It is fine to use gridlines.
3 This has been answered in previous questions. Please read the FAQ page.

22. APN 4/3/10 In section II of instructions: Do the articles that address the 2 healthcare issues need to be included in the table of evidence and summary/synthesis of findings? 2) In section III of instructions: What do you mean by using an evidence based framework or approach? Do you mean specifically choosing a theoretical framework (e.g. Anderson)? I don't see how a theoretical framework would be used in the presentation of data synthesis.

Your table of evidence includes the research-based articles related to your identified health problem. The health services artilce smay be supporting literature and therefore may not be in your table of evidence. If some of your research literatrue suggests health policy or health service implications than it might be in your table. An evidence-based approach refers to how you rate the strength of the evidence that you have selected related to your problem.

23. APN/ ADMIN Question–3/23 just wanted to clarify… since we are given directions for a specific cover sheet, that replaces our APA cover page correct? or does it not? do we add the running head, page #, etc to that specified cover sheet? or do we place that specific cover sheet on top of our APA style cover page, then the paper?

The required cover sheet is all you need for the comp. Remember to follow APA style for the rest of the paper and put your ID number at the bottom of each page of your exam.

For questions about narrowing the topic for comp exam: 
For questions on narrowing the topic for your comp exam please use view the 2009 FAQs.

Last minute style Questions 4/14/10 1) Should I include the title page in 17 page limit? 2) Should I number the tables consecutively at the end of the paper? 3) Should I cite the page numbes of a supplement as the are reported, ie S12-16?
1) The title page is not counted in the 17 page limit for APN papers and 15 page limit for ADMIN papers.
2) Yes put page numbers on your table that run consecutively to your paper.
3) Yes cite the page numbers from a supplement as they appear, often this is S followed by a number which signifies that the article is in a special issue of the journal.

Frequently Asked Questions from 2009

3/26/09 ADMIN QUESTION: Is it appropriate to include the mission/vision/values of our organization? As well as location and population served? Is this information we should include, or is it not required?
Yes, include the mission/vision/values of your organization as well as location and population served.

3/26/09 ADMIN QUESTION: I understand we are to choose one descriptor from each of the bold options. Is it appropriate to add to this scenario? As far as # of codes or LOS? Can we make up additional information for our scenario?
Yes, add that information to the scenario.

3/26/09 ADMIN QUESTION: When writing my paper about the CHCC and its demographics is it okay that I'm making up my information about the patient population, ethnicity, income, poverty, etc. I was saying "According to the 2000 Census" or "based on demographic info from 2007," but not citing any real citations because, again, this information is fictitious.
Yes, correct.



3/26/09 QUESTION: According to the APA we need to put the table in the back of the references.. In the directions it says it must follow the direction of the paper… Please clarify
You should put your table and any figures at the end of the references and should refer to it in your text. The statement below refers to numbering your tables or figures consecutively as they are mentioned in the text of your paper; so Table 1 is mentioned first in your paper, Table 2 is mentioned second, etc. You may or may not have more than 1 table or figure–the only required table is your table of evidence. "Strict 17 page maximum (excluding references, tables and figures). Tables and figures must follow the sequence of the writing."  

3/26/09 QUESTION: For the lit review table – I am using about one page per article due to the number of columns necessary to provide all required information. Does this length sound acceptable?
There is no page limit for your table, you are required to provide the informaion requested as succintly as you can and further elaborate on the literature included in the table in the text of your paper.

3/26/09 QUESTION: Hi, am struggling with an appropriate focus for my comp exam. I would like to try Depression in Postmenopausal Women, with the intervention of physical exercise. Am I headed in the right direction? Should I choose an intervention that has a measurable outcome? Also, the link for questions that have been answered does not seem to be working, is there a trick to geting in?
Please see the other responses for narrowing your topic. You want to narrow it as you have for previous assignments in your classes. Your specialty area, the symptom and the research literature will help you to narrow it. Concerning the weblink it is: This is working because I am answering your question. Alternately you can also access through the SON webpage–Master's APN program (on the L-side of the page)and then APN exam questions. 

3/26/09 QUESTION: I have selected fatigue in African Americans with end stage renal disease. Do I have to include a gender as well?
The research literature concerning the symptom you have selected as you have specificed above, should help you determine whether it is important to narrow your topic by gender. 

3/26/09 QUESTION: In the problem and context section of the paper we are supposed to identify a specific problem r/t one of the following general topics: abdominal pain, depression or fatigue. Let's assume I have chosen abdominal pain as the symptom and PID as the specific problem. The instructions then go on to say to indicate the scope and significance of the PROBLEM in the identified population. Does this mean that you want us to address the scope and significance of the PROBLEM-PID in the population and include psychological and sociocultural dimension of PID or do you want us to address the scope and significance of the SYMPTOM- Abdominal Pain?
You need to focus on the chosen symptom.

3/26/09 QUESTION: So-in terms of narrowing things down, we need to find primary-source research based articles 7-10 that are targeted to one age and/or ethnic group? This is possible for the supporting articles but to find that many interventions that are within the past 5 years that pertain to only one group is that the expectation? Are we restricted to the last 5 years, it is not clear in the instructions.
There is not a time limit for your research articles, but we expect that they would be current. If there are classic articles that are older than 5 years they may be included.

3/28/09 ADMIN QUESTIONS: 1.Under section I.Financial portions, if our topic lends itself to a CBA, would it be appropriate to include that even though it is not listed? Otherwise we only have to do #1 and #3 2.Please review the item in section E on page 9 of the exam, what is meant by "maximize their satisfaction". I do not understand the meaning nor the structure of this sentence unless we picked the staffing ratio scenario right? 3.On page 9 of the exam, the word "initiative" is used often, is this word being used interchangeably or used to describe the program/service line that we are implementing? If not, what are you referring to when using this word? 4.Please explain and/or give an example as to what is meant by, "name of the problem you responded to", noted on page 4 of the exam. This is to be listed on the cover sheet, but no example is given as to how this should be done. Is the "problem" you are referring to the item we chose to write on in question #4 on page 8 of the exam.
ANSWER: 1.Correct, you only have to do #1 and #3 unless you picked the staffing ratio scenario. Yes, you can do a CBA although it is not required. 2."Incorporate a discussion of the multicultural backgrounds of the stakeholders and how you will maximize their strengths and satisfaction." Another way of saying this is: You want to implement this project successfully among stakeholders with multicultural backgrounds. How can you/will you plan to do that in order to optimally? 3."The organization has just completed a new strategic plan and you are responsible for the following initiative: (choose one): " Yes, it is used to mean the program/service line you chose from the selections in #4. 4.These instructions may have been developed for all and the term problem was used as a generic term. You are correct. The term problem refers to the initiative you chose from the selections in #4.



3/28/09 APN Question Further clarification needed. Within section II: lit review critical analysis component-this is where we would discuss the findings (7-10 articles), and discuss the strengths and weaknesses. However, in section III: discussion and application-this is where, using an evidence-based framework or approach to synthesize or make conclusions based upon the table and analysis, as presented in section II. Also, under section II: is this where we would present and discuss a theory but will be later tied into the literature findings in section III?
Yes–nice summary.



3/28/09 APN QUESTION: How do we focus on the chosen symptom without discussing a certain diagnosis that causes the symptom? Are we allowed to mention a specific diagnosis that is the cause of our chosen symptom or will this cause me to fail the exam? A direct answer would be greatly appreciated as I do not see any other questions/answers posted on this topic.
There are several ways to discuss a symptom without initially narrowing it down to a particular diagnosis. This is part of the task of this exam- "Narrowing the Topic". Which is why the exam suggests using things like choosing a population by age, gender, and/or SES is helpful, so that you can talk about the problem for that specific population. You must first make the links between symptom and population before you discuss a specific disease/diagnosis. 

3/28/09 APN QUESTION: Just a clarification-the intervention is one that we create or we choose one of the ones from our research findings to discuss in the final section?
However you choose to do it–you must have research evidence to support your intervention. 

3/28/09 APN QUESTION: Should the lit review focus on interventions for the problem chosen or can the lit review be more general and then one intervention can be discussed?
The purpose of the lit review is two-fold, 1. to show the reader that you understand the symptom, especially in your targeted population (which may include an age, racial/ethnic group, geographic setting, etc) and 2. to identify interventions that are associated with the problem especially as it effects your clinical setting (e.g. primary care or acute care) and your target populations. To that end, the lit review should somewhat tell a story, from problem to intervention.

3/3/09 APN QUESTION 1) If I am using an intervention that is currently still under research, how am supposed to include specificity and sensitivity? 2) Do we need to have a title page as well as the cover sheet? 3) Can we use 12pt font in New Times Roman or are we to only use 11pt font?
1)Any intervention that is being researched will include whether the intervention is effective or not–that's the purpose of the research. It may not always be reported as sensitivity and specificity–so you need to report whatever stats tests are reported in the literature. 2) You need to follow APA format which calls for a title page (this is not part of the total page count). 3) Font questions have been answered on this page–please check the list.

3/30/09 ADMIN QUESTION Just a clarification, the paper format calls for a 15 page maximum (excluding tables/figures); therefore, if a timeline table is embedded in the body of the paper, it is okay for the paper to total 16 pages (i.e., run over 15 pages in proportion to the size of the table)?
Tables need to be placed after the reference page in accordance with APA style guidelines.

3/30/09 ADMIN QUESTION On page 9 section I, portion 2, what is meant by the "staffing ratio selection" and does this only include the nursing staff (RN,LVN, CNA)? Also, please explain what is meant by "pre and post ratio"? Is this pre program, post program, I am clueless here?? I am unclear as to what you are looking for in this section, and can not find any examples from our financial class literature.
If you selected #4c below, then in this section, you need to complete #2 below; 2) for only the staffing ratio selection, incorporate a pre and post ratio variance analysis including volume, quantity, and price, and describe what the variances are related to; 4. CHCC is anxious to be better positioned in the future, to provide excellent care, and to be financially secure. The organization has just completed a new strategic plan and you are responsible for the following initiative: (choose one): a) Expand an inpatient or outpatient care unit of your choice; b) Establish a new service line (your choice) to increase revenue, or c) Develop a system of staffing to comply with the California ratios that is both cost and quality oriented. Explain whether the ratios have been a factor in financial efficiency Pre and post ratio refers to the cost of staffing before the ratios were enacted and the cost of staffing after the ratios were enacted. These ratios are the current law we have for staffing in CA. The ratios are for licensed staff, so RN or LVN.

3/31/09 APN QUESTION As an ACNP specialty, does the focus of the paper and intervention component have to involve the inpatient setting or can it involve outpatient setting instead.
Acute care takes place in all areas of the health-care continuum. Your intervention can take place in an outpatient setting, in response to an acute care problem.

4/10/09 APN QUESTION From the literature review I was able to narrow the possible interventions to 3 and then I choose 2-3 articles on each of three different interventions and put all 8 articles in the table. All the data based articles are on the same topic/symptom. Is that correct? Or should all the 7-10 articles be on the one intervention chosen for the paper?
You need to select your research articles based on the symptom/population/intervention that you choose. You can do this is in any way that supports your thinking in your paper.

4/10/09 APN QUESTION Can I use an article that takes data from a previously published prospective study and analyzes that data to form new conclusions
Without knowing the subject matter this sound like a secondary analysis and could be included in your evidence table.

4/10/09 APN QUESTION I am doing my paper on depression. I know I need to focus on the symptom of depression and not the diagnosis, but can I write a paragraph about distinguishing the symptoms of depression and knowing when the patient has clinical deprssion such as major depression, dysthamia, etc. Also can I write a paragraph about the differential diagnosis that need to be rule out in my population to be able to manage their symptoms of depression.
As long as you focus on depression as a symptom, you can discuss this in any way that supports your thinking in your paper. 

4/10/09 APN Question I do not want to miss the entire concept of the comp paper, so please be as specific as possible to the following questions if I am doing this paper incorrectly. My questions are as follows: 1. My topic is depression as a co-morbid condition to post MI Hispanics/Latinos with the intervention being combination therapy (psychotherapy + antidepressants). Is this topic and intervention done appropriate? 2.If there are already guidelines out regarding the use of combination therapy (psychotherapy + antidepressants) to manage depression, can I still use this as my research intervention for my topic in Hispanics with depression (even though it's already a proven fact and I would use this method for any other population)? 3. Would combination therapy (use of psychotherapy AND antidepressants) be considered ONE intervention or would it be two interventions?
We have received many questions on narrowing the topic for the comp exam and we hope that this answer will ENCOURAGE EVERYONE to narrow the topic as you have for the papers that you have done previously in your course work. We can not approve or disapprove your topic or how you narrow your topic or the intervention that you choose for the comp. This is part of the exam process. If you start with your selected symptom and show the reader how and why you narrowed it the way you have in the population you selected based on your specilaty area then you are on the right track.

4/10/09 APN Question I would like to know if you want our literature reviews to be based only on ONE intervention (i.e. exercise)or can our literature review be on multiple aspects of the topic (i.e. intervention, screening, and health perceptions? Basically, if my topic is post MI depression in Hispanics and my intervention is finding out the best screening tool to use for this population (i.e. PHQ) can my literature review be all articles related to PHQ screenings? Or should my literature reviews be based on different aspects of the topic (i.e. PHQ screenings, Hispanic perceptions to interventions, meds-SSRIs, activity/exercise, psychotherapy), and then summarizing which ONE intervention I would use as an APN? Or are both methods explained above correct?
you may do it in any way that supports the direction of your thinking in your paper. there is no one correct way to do this. Again it is related to the symptom/population/intervention and your APN specialty area.

4/10/09 APN QUESTION When I'm narrowing my topic (abdominal pain) I use the scope of the problem (prevalence in a particular population, effect on quality of life, burden of cost on society/sociocultural dimensions) to demonstrate the significance/scope of the problem. Section "C" under "II. Literature Review" asks to describe some of these issues ("health disparities, access, cost") again. Question: Do I analyze these issues again? It seems redundant since I'm using some of these issues to help describe the "Scope of Problem" and "Significance of Problem" and my "Literature Review: Critical Analysis" section focuses on a critique of articles regarding interventions for abdominal pain.
You need to thread the discussion of sociocultural/health care service issues throughout your comp as speicified in the instructions.

4/12/09 APN QUESTION Can a combination intervention be utilized (e.g. CBT referral with an adjunctive self-help manual)?
You need to support any intervention (combination or otherwise) you choose based on your symptom and the literature that you have reviewed. It is up to you to make the case for the selected intervention.

4/12/09 APN Question Can application of a screening questionnaire, such as the PHQ-9, be used as an intervention?
We can not approve or disapprove your intended intervention–you need to make the case for any intervention you choose based on the symptom, your population and your specialty area.



4/12/09 APN QUESTION Do we need to upload our table into The reason I ask is that my table is in a seperate file (since the view is landscape) so if I needed to upload it could we do it in two seperate uploads (one is the paper and one is our table)?
Yes, you need to upload the table as well as the text.

4/12/09 APN QUESTION I'm finished with my comps and am in the editing process. I have a few concerns about grammer. Is it considered editing assistance if I seek help from a source like the Graduate Writing Center just to review the few sentences I have questions about? I don't want to jeopardize any honesty issues about this paper but don't want to get marked off because I put an apostrophe or colon in the wrong place.
Thank you for this question. You should NOT take your exam paper to the writing center or for any formal editing unless you have requested and have been approved for editorial assistance. Unlike a paper that you may write for a class, this is a test, and as you mentioned, you need to pledge that it is your work. If you have grammar concerns you may consult the APA book–it does have suggestions for grammar when writing a scientific paper.

4/12/09 APN QUESTION Is it allowable for an intervention to be multilayered so long as it is one intervention? Specifically, what I'm asking is: is it legitimate to create a population specific program (so long as I can justify it with EB research) to be applied as an intervention in my population? My interventional program does not exist in the literature, but its component parts do.
It is up to you to make the case for any intervention that you select. You need to convince your reader that your ideas for an intervention, based in the research literature is what would make a good intervention for the symptom that you have selected.

4/12/09 APN QUESTION Regarding the theoretical approches section, can I use chronic care model as my guidence about the symptoms and management?
You may use any theoretical approach that supports your thinking in the paper. You should consider the symptom you select, your population of interest and you specialty area. You need to make the linkages in your paper.

4/12/09 QUESTION 1. when we write the self-addressed envelope, do we just use $0.42 stamp? 2. Do we need to use a "forever stamp" or can it be any $0.42 stamp? 3. Also, do we write our name on the envelope or use exam code #? 4. Do we place the self addressed envelope into the provided brown envelope along with our three comp papers?
You need to put a forever stamp on the envelope–to make sure that there is appropriate postage as it is expected to go up this spring and results won't be sent until all comps are graded. Yes, you need to put your name on the envelope and you can place it into the large evelope with your comp papers. They should be submitted to Adrienne Thompson in Academic Affairs 2-248. 

4/13/09 In regards to the tables, is it allowed to have margins at 0.5? I understand the text must be 1 inch. However, formatting wise the tables are easier to read/follow when they are all on one page. I understand there is no page limit to the tables, however as a courtesy to the reader I would rather have all information on one page per article, as it is simply easier to look at and follow.
You should follow APA style guidelines for this. Margins should be 1 inch. 

4/13/09 ADMIN QUESTION In this paper if we use a table for the SWOT and timeline, don't those go right after the paper and are labeled as "table," not appendix? And those do NOT count in the 15 page limit, correct? Then for the appendixes, this is only the proforma and break-even analysis (so there should be 2 appendixes). Do we need to include the other financial information that we used to get to the proforma and break even analysis like a table about payor contribution margin, weighted average contribution margin and our predicted volume?
If your paper had no tables, then only the proforma table and break-even analysis would go into the appendix. See APA for how to handle more than one item in an appendix and for placement of the appendix in the paper. For this paper, tables are to be included in an appendix. Yes, correct. Tables and the other items in the appendix do not count in the 15 page limit. Regarding other information that you need to include such as payor contribution margin, weighted averages, predicted volume: if you put this information into a table, it should go into the appendix. If you do not put it into a table, then discuss it in your paper as part of the narrative text. 

4/13/09 APN Question The following question is brought up because I feel that there is conflicting information posted on the FAQ website. Please refer to the quoted question and answer below especially the last question in blue. Please clarify whether conceptual/theoretical approaches used in Section II is the same as the evidence-based framework (or approach) in section III except used to address different purposes. For example, is it acceptable to introduce a theoretical approach such as the Shuler model in Section II and use it again to present a synthesis of the research findings in Section III? OR Is it asking to use the Shuler model in Section II but use an evidence-based framework such as the Stetler or IOWA model to integrate the findings in Section III? OR is either option acceptable?
You need to decide what works best for your paper given the symptom, your population, the literature you are using and the theoretical perspective or perspectives that you choose. 


Yes you need to turn it in to Adrienne Thompson in 2-248. Please check with her to make sure she will be available when you want to turn it in. Her email is and her telephone is 310-825-5884. 

4/14/09 APN QUESTION I am quite discouraged with my critical analysis of section II. It seems very redundant when comparing my table to the text. Should this be the case? When I enter similar information form the table into my paper, it takes up more length than planned. Should the table be more detailed than the text? It seems that the text should be a summary of the databased articles ONLY with a focus on #4) the evaluation of potential contribution to APN knowledge and #6) consideration of impact for health care issues.
Please see the instructions ofor the paper under section II: II. Literature Review: Critical Analysis (42%) A. Present theoretical approaches to the topic B. Critically analyze current relevant research Select 7-10 data-based research articles from your literature search. Summarize in a table and fully describe in the text of the paper C. Describe health care systems issues known to influence this problem such as access, cost, ethical, health disparities, and scope of APN practice. Select and discuss a minimum of two of your findings. The instructions say to summarize the articles in the table and "fully describe in the text". You need to decide which nd how much content from your table you want to emphasize in your paper. This is guided by your perspective on your symptom, your population and your area of specialty. 

4/14/09 QUESTION am having someone turn in my comps for me on friday. The guideliness on comps says that the only thing I need to do is sent a hand written note with my signature along with my paper. Is this correct?
Yes, you need a hand written note with your signature. Please don't forget to submit your paper to by the same deadline, 4/17 at 4:00pm. If ANYONE has not signed up for N596 with Dr. Mentes, please do so ASAP.

4/14/09 QUESTION Is the title page included in the 15 pages?
A title page is not counted as text for the paper, the 15-page limit refers to text.

We have had many questions about— please follow these suggestions: Submit your paper to the APN ADMIN Comp assignment–there is only one for all MS specialty and ADMIN students. Submit your paper as ONE file. will not accept multiple files. If you have submitted a partial file please email DR. Mentes at and ask that your file be deleted so that you can resubmit a complete comp file with your text and table.

4/16/09 ADMIN QUESTION I have a question about the grading criteria for the paper. Are we being graded on the success of our initiative we are designing and if the reader thinks the initiative will be successful?
The grading criteria are included in your comp packet.

4/16/09 ADMIN QUESTIONS 1- In question G what do you mean by "power bases"? Do you mean power styles? Power base means the base of an individual's power; the source(s) of power; the type of power. Question 2- Also in the body of the paper, if we are referring to the timeline as a table do we say see appendix "A" or see Timeline table. Since the table is part of the appendix how do you want us to identify it?
ANSWER 1: Refer to the theories/literature on power from your coursework. ANSWER 2: You can refer the reader to Table 1. in Appendix A as you want to specify that it is a table and the number of the table and where it is located.

4/16/09 APN PAGE LIMIT The page limit on the syllabus is 17 pages, but the answer on 4/14 was 15 pages, which one is the page limit?
For the APN Specialty comprehensive exams the page limit is 17 pages, the question about 15 pages is for the ADMIN exam.



4/16/09 APN QUESTION 1. It is my interpretation that the one chosen APN intervention, should be an intervention that can be implemented by the APN. If I were to choose CBT (cognitive behavioral therapy) as my primary intervention, this patient would have to be referred out. Therefore, is it okay if the chosen intervention requires the patient to be referred out as long as means to measure the outcome is provided. 2. Would it be safe to cut and paste the cover sheet from the comprehensive examination packet on pg 6 or do we have to create our own.
For your intervention question–you need to support which intervention that you choose. In terms of the cover sheet you can do it however you choose as long as the required information is included.



4/16/09 APN QUESTION I had a quick question about the conceptual model I am using in my paper. I was wondering if I could put the diagram (picture) of the model as a figure in the back of my paper in the figure section after my table. I talked about the model in my paper but a picture of the model says a thousand words and I would like the reader to understand what the model looks like because it's is a new model that the reader may not be aware of. I would reference it correctly as it is not my original work. Please let me know if this is acceptable to provide to strengthen my paper.
This is up to you. The guidelines allow for tables and figures formatted according to APA.

4/16/09 APN QUESTION It is my understanding that 2 of the copies we turn in will be destroyed. What will happen to the third copy? Will it be returned to us? When can we expect to recieve the results from this comp exam?
No the exam will not be returned to you, you will receive a written letter mailed to you in your self-addressed stamped envelop, after all of the comps have been read and graded. 



4/17/09 APN UPLOAD TABLE SUGGESTION I don't know if anyone else was having a problem putting the synthesis table together with the comps paper in 1 document to turn it in as 1 file to the I just figured out last night how to do this and figured I'd share since I was so excited upon the discovery. It's fairly easy. You can go to the end of your paper document which is in Portrait format, do a page break. Click on File, page format, choose page setup to be landscape and then look at the little box on the right bottom corner that asks "apply to" and change from whole document to from this point forward, accept/enter. Cut and paste the table into the document and you have successfully merged both documents into 1 file without compromising the beauty of your table or paper. Exciting.

4/2/09 Thank you for addressing my questions. I have check, read and reread the question page on the website. The only answers that I see that address my font questions are those that deal with formulating a table, title or reference page. My question is in reference to the body of the paper as a whole. I saw an answer that states to use APA guidelines, so is it safe to assume that I may use either times new roman or courier new in a 12 point font as specified in the APA book?? Thank you
The comp packet states that you should not use less than 11 point font in the text, so you can use 12 or 11 point font.

4/2/09 ADMIN QUESTION Can the Financial tables in the Appendix have horizontal and vertical lines?

4/2/09 APN QUESTION I have decided to write about abdominal pain in individuals with pancreatic cancer. I have done a literature search on different strategies to managing the abdominal pain associated with pancreatic cancer. In the first section of my paper I was planning on giving some general statistics about pancreatic cancer and how it is most common in the elderly population. I have found general statistics about how often abdominal pain occurs in patients with pancreatic cancer, but there is little information available as to specifics of the populations most susceptible to abdominal pain with pancreatic cancer. Am I on the right track or do I need to focus in more specifically on abdominal pain? Do I need to narrow down my patient population more?
Please see some of the other questions that address narrowing of your topic posted here. As long as you remember to stay focused on your symptom you are fine. You may narrow your population as you prefer and with what is available in your research literature–this includes specifying gender, age, ethnicity, etc. 



4/2/09 APN QUESTION I realize that this question has been posted several times on the website, but I'm still not sure I'm narrowing my topic correctly. Also, in the one paper we wrote to prepare for the comprehensive exam during Fall term, we made a differential diagnosis and it was more focused on the disease than a specific symptom. Here are my examples–are they okay? Abdominal pain as a symptom of constipation in school age children.- Intervention dietary/medication to facilitate stool passage and decrease pain Depression as a co-morbid condition in overweight adolescents. Intervention- exercise (to facilitate improved mood)
You have good examples–remember that the interventions need to be supported by your research articles.



4/2/09 APN Question If a research article analyzes data from ONE reputable national survey can it be used as one of our 7-10 primary research articles, or is it considered a meta-analysis?
For what you describe, this research article is not a meta-analysis, which is a synthesis of many studies. As long as the article reports the result of one study it is fine for your table. 


4/2/09 APN QUESTION In reading the answers to the posted questions there seems to be conflicting responses in terms of the table/lit review portion of comps. Are the articles in that section all supposed to be interventions for our problem or are they to be a combination of prevalence, assessment and interventions?
The articles can be in the areas you mention, as long as they are related to your selected symptom.  

4/2/09 APN QUESTION I just had a couple of questions about the table. First, would you like the table headings to be exactly as they are described in the instructions? i.e. – full citation for each article – study sample and selection criteria – study procedures – measurement tools – results – conclusions – limitations and threats to validity Second, for clarification, would the measurement tools be the scales used on the subjects, such as the Fatigue Impact Scale? Third, would you like us to indicate the statistical analysis used for the results (Student's t-test, etc.), or just the results themselves, with pertinent p-vales, etc.?
Yes, you need to use the headings indicated in the comp packet for your table. Yes, you are correct about measurement tools You need to briefly mention the results, you may cite the stats tests and p values. 

4/4/09 APN LIT REVIEW QUESTIONS 1.I would like to include as one of my data-based research articles an article that is a retrospective chart review. It is NOT a review of other studies, but is in itself it's own study. Is this OK to inclulde as one of my 7-10 articles? 2.I just wanted to clarify the lit review table. I understand that we are to refer to the table in the body of our paper. How are we to refer to the table? Meaning, do we label each citation or review within the table i.e Table I, Table II, etc. I know we are not to use any appendices so can we label each table? 3. Is a pilot study ok to use for my lit review as part of the 7-10 articles?
1.Any research article, regardless of methodology; ir clinical trial, qualitative or retrospective chart review is acceptable for your lit review as long as it reports the results of a single study. 2. The table of evidence is ONE table regardless of the number of articles or pages to the table. your articles are used as references in your paper and at the time youcite it you may refer to the Table. Or if you referring to the body of evidence that you have developed you may refer the reader to your table. 3. A pilot study is not the strongest evidence, but is a single study–so would use with caution.  

4/4/09 APN QUESTION When I'm narrowing my topic (abdominal pain) I use the scope of the problem (prevalence in a particular population, effect on quality of life, burden of cost on society/sociocultural dimensions) to demonstrate the significance/scope of the problem. Section "C" under "II. Literature Review" asks to describe some of these issues ("health disparities, access, cost") again. Question: Do I analyze these issues again? It seems redundant since I'm using some of these issues to help describe the "Scope of Problem" and "Significance of Problem" and my "Literature Review: Critical Analysis" section focuses on a critique of articles regarding interventions for abdominal pain.
You are directed to address cost of the problem in section one of your comp which relates to the cost of the problem to the health care system or to the patient. In the lit review, rememeber you may review interventions for the problem which may influence the cost of treating the problem or preventing it–which is looking at cost in a slightly different manner. Each problem will be different, so this is just an example of what you might find in your research. 


4/4/09 APN QUESTION With regards to choosing a population, if the symptom is common among both men and women, can your chosen population include both genders but within a specific ethnicity and age group? Or does the population have to be only one gender?
Whether you want to narrow your topic to a gender depends on the symptom you choose and the literature that you find about the symptom. 


4/4/09 APN STYLE QUESTIONS 1.Does the cover page get sent in to or is it only to accompany each of the 3 hard copies that are turned in? 2.OK to print reference table horizontally? 3. Ref table is listed alphabetically by author, correct 4. I have a question pertaining to the format for the tables. For previous papers, I have made one table with multiple rows and columns for my literature review and critique that included multiple articles. For the Comp exam, if I choose 7 articles to critique, may I generate 7 tables, utilizing one page per table (7 tables = 7 pages)?
1. Yes turn the cover page in wto 2. You may print the table horizontally. 3.Yes alphabetize the table according to author 4. Your table of evidence is one table, regardless of the number of pages or articles that you critique. 


4/4/09 APN QUESTION Question 1. For the intervention portion of the comp can I have a pharmaceutical intervention as well a physical intervention? Or either or? Question 2. For the table is their a specific format (i.e., a basic format of columns and rows or can it be more professional looking with highlighted areas?) besides the single spacing?
1. You are asked to present one intervention appropriate for your symptom–you need to support the one that you choose. 2.A standard table is sufficient for the comp. Please review the point distribution for the comp so you can see how we will evaluate the comp. 


4/409 APN QUESTION In regard to the methodology described under section I, the instructions imply it is only to describe the strategies used when finding the 7-10 primary articles for the literature review (and not other sources in our paper), is this correct? Also, I feel the discussion of methodology used would fit more appropriately in section II just before I begin the critical analysis of the articles. Am I able to include the methodology under section II or will points be deducted if it is not in section I?
It seems appropriate to use the methodology piece, which is your strategy for searching the literature as a bridge between section 1 and section 2. 


4/6/09 ADMIN QUESTION Would just like to clarify letter A, in regards to the exec summary: we are able to start the body of the paper on the same page as the exec summary?
Yes, see A. on your comp that says "Write a one-paragraph executive summary upon completion of your paper; place this summary at the beginning of the paper (this counts as part of the 15-page exam but you may continue on the same page)." 


4/6/09 ADMIN QUESTIONS 1).Referring to letter E, multicultural backgrounds of stakeholders, are you referring to cultures based on race, or are you referring to multicultural as far as culture of physicians, nurses, patients, etc? 2).under format on page 4, #3 states no other infomration or material can be submitted as an appendix. So a SWOT analysis or the timeline can not be part of the appendix?
1. We are referring to all of the groups you mentioned. 2.Your exam guidelines should say the following for admin/OEH admin: The financial portion (I. #1, 2, or 3) of your program plan can be included as an appendix. No other information or material can be submitted as an appendix. You can include the swot analysis and timeline in the 15 page paper or you can make a table of the swot analysis and timeline and include that in the appendix as tables and figures are allowed in the appendix. #3 means in addition to tables and figures, the financial portion can be included in the appendix but nothing more than the financials for I.#1,2,3. 


4/6/09 APN QUESTION 1.On section II I have completed my table, and have analyzed most of my articles in the body of the text. It just feels so redundant, as though I am just restating my table, not to mention its taking up a lot of space. Did I miss interpret the directions of where it states "summarize in the table and fully describe in the text"? 2. I am I supposed to be integrating the theoretical dissection in the analysis or can I refocus that to the synthesis of articles? For, example, I chose the Health Belief Model.. I tied it in prior to the analysis can I resume that after the analysis or do I have to incorporate it into the actual analysis?
1. The table is to be a brief summary of your articles, not a full analysis. The analysis of the indivudal articles should be in the text of the paper. 2. I'm having a hard time following your question, but it sounds like you are asking about he integration of theory in your analysis of single articles. It would be better to address this after you complete your analysis as you have suggetsed. 


4/6/09 APN QUESTION Are we supposed to only analyze the strengths and weakness of the articles in the text of the paper. I'm getting confused…
You review and analyze the literature just as you have had to do for the papers that you have written throughout the program, which includes the stregths and weaknesses of the research. 


4/6/09 APN QUESTION I am having trouble finding enough literature to fulfill the literature review requirements. I wanted to know if it is acceptable to include studies that test interventions against one another (i.e. ssri verses TCA verses placebo in treating depression). Although the studies are not solely focused on my intervention (ssri) the results do show their isolated efficacy on depression and furthermore compare their results to other interventions.
I would first make sure that your literature search is complete and that you are not missing literature on your topic. Second, you select the literature that best supports the points that you are making in your paper. It is your repsonsibility to link the literature you have selected to the text of the paper. 


4/6/09 APN QUESTIONS a descriptive study ok to use as one of 7-10 articles in the lit review? I was told that we can only use clinical trials, is this true? 2.Are cross-sectional studies allowed for the table? (it's a cross-sectional analysis of data from a longitudinal clinical trial)
For the literature included in your table PLEASE READ the instructions in your comp package page 7 which states: "select, summarize and critique 7-10 relevant primary source articles (data-based). In addition articles that are reviews, clinical practice guidelines, meta-analyses may not be counted among the 7-10 source articles but can however be used as references to support the discussion." Any article which reports a single study, REGARDLESS of design, is considered a data-based study. 


4/9/09 ADMIN QUESTION im even more confused about the appendix and what is allowed. For example: is it appropriate to say refer to Appendix B for a swot analysis? (and its in a table format, same thing with a timeline, Appendix C, etc)?? if i include a CBA can I also make that its own appendix?
Tables are allowed in the appendix and figures. So if you make the SWOT analysis into a table, it is allowed in the appendix. Same for the timeline. Same for a CBA. 


4/9/09 APN Question I have two questions: #1: I've read all previous answers (a few times), and am still unclear: When you say narrow the topic, do you mean start with a discussion on, say, depression in the general population, THEN link the problem of depression to my population? #2: In Section I, Part B: When discussing the population, "population" would be defined as: the persons AND the disease for which depression is a co-morbidity? In other words, if I'm writing about depression as a co-morbid condition in African Americans with sickle cell disease, then I am now addressing the group I underlined as a whole. Or do you mean talk about African Americans and depression THEN link it to sickle cell?
You should narrow your topic as you have for other papers that you have completed for this program. You should decide on your symptom—then the population—look at the literature and see how you can best build a case for any further linkages. It is up to you to how you do this. 


4/9/09 APN Question Section III asks to use an evidence-based framework (or approach). Is the approach referring to the same theoretical approaches used in section IIA? Or, is the evidence-based framework referring to the Stetler or IOWA model for a synthesis of the research findings?
An evidence-based approach refers to how you evaluate the quality of your research literature. 


4/9/09 APN QUESTION The current title of my paper is Abdominal Pain in the Elderly: Mangement of Intestinal Ischemia. I picked ischemia because of its prevalance in this population…am on on the right track?
Please review the section under narrowing your topic–you must focus on the chosen symptom in your chosen population (however you specify it). It is up to you to support the direction of your paper based on the literature that you select to specify the scope of the problem and should identify: (from your comp packet) 1) the population at risk, including sociocultural features of the population 2) the current status of the problem in that population, along with psychological and physiological aspects of the problem in that population. 3) current primary, secondary, or tertiary prevention efforts aimed at resolving the problem, including evidence-based practice guidelines. 


4/9/09 APN QUESTION Do we need to include an abstract?

APN UPDATED QUESTION 4/49/09 1. Are the articles in the table supposed to be in alphabetical order or in the order they are referred to in the text? 2. I understand we are supposed to have a title page in addition to the cover page. The exam instructions state to not have our name anywhere on the paper, so do we just use our exam code in leiu of our name for both the title page and cover page?
1. This is an UPDATED ANSWER. You MAY or MAY NOT alphabetize the articles in your evidence table. If listing the articles in a non-alphabetized order in your table helps to organize your paper, please do it that way. The most important issue is that the comp reader can link what you are saying about the research articles in your text to the appropriate article summary in your table. Please remember that your Evidence Table is ONE table, regardless of how many pages it is, Please DO NOT make each article a table. 2. Yes, do not put your name on the title page. Every page of your paper should have your exam code. 


QUESTION 1 For the intervention portion of the comp, do we have to choose the first-line recommended intervention, or can we choose an intervention that is being studied at this time, but has yet been "approved" or one that is not as common or popular. For example, for pain…could we choose guided imagery as our intervention even though probably a pharmaceutical agent would be the first-line intervention? QUESTION 2 May we use more than 7-10 references, or is this the MAXIMUM number we are allowed to use?
Question 1 Any intervention that can be found in the literature maybe used for the comp exam, as long as it is relevant to the symptom selected and the other points listed in section IV of the comp under evaluation criteria are covered. Question 2 The 7-10 articles is a minimum number–you may use more. 


QUESTION PLEASE SEE ADDITIONAL RESPONSE I was wondering if we were allowed to use articles from Up to for our table/references? There are wonderful articles but not from nursing journals.
UPDATED ANSWER: To clarify the first response to this question–peer reviewed research studies that report 1 study are required for the evidence table. Up-to-date provides synthesis of several research studies so this WOULD NOT be appropriate for the table. You should treat the Up-to-date literature as a review. As stated in the beginning comments of your comp packet, "articles that are reviews, clinical practice guidelines, meta-analyses may not be counted among the 7-10 source articles but can however be used as references to support the discussion." 


QUESTION Could you please define and give examples of "Study Procedures" and "Measurement Tools" for use in the table. Also, is it possible to use a smaller font in the table, for example Times New Roman 9?
For your Table of evidence, the heading entitled Study Procedures are those actions that relate to the conduct of the study, for example, how the data was collected. Measurement tools are those instruments (surveys, or biologic measures) that are used to measure variables in the study. For example using the Beck Inventory to measure depressive symptoms or using salivary osmolality to measure hydration status. You may single-space your table but should use 11-point font throughout. It is an art to summarize the essential points in your evidence table–we ask that you put sufficient but not excessive information in your table. 


QUESTION Earlier in the year my instructors were teaching us to really narrow our topics down when writing a comp like paper by choosing an age, race, sex and setting. The instructions for the comp do no specify the need for this specific narrowing of the topic. Is it needed or recommended?
You need to narrow your focus of the problem as specified in Section 1 "Problem and context" of the comp. Under 1B it advises you to: "Indicate the scope and significance of the problem in the identified population. Include psychological and sociocultural dimensions" which suggests that it is entirely appropriate to narrow your focus population based on ethnicity, age and/ or socioeconomic class. 



QUESTION I want to focus on depression; with my topic being assessment and managment of depression in adolescent teenagers in the pediatric primary care clinic, but a lot of the research is not just on the symptom of depression but the actual diagnosis. Is that okay? Its kinda the same thing. Depression as a symptom is just not necessarily specific enough to meet DSMIV diagnostic criteria, but as just a symptom it should still be addressed in a similar manner by a PCP.
Using depression alone without further narrowing the topic will not suffice for the comp. You need to provide context for the symptom of depression, by further defining the population, and addressing the related biopsychosocial issues involved in exploring the symptom of depression in adolescents. The following steps maybe helpful: 1) start with a general symptom and narrow it 2) Define the purpose of the paper and its limits 3)review the literature for a narrowed and specific concept 4)Select research literature based on the concept 5) Make it clinical–don't forget APN role. 


QUESTION I was wondering if we were allowed to use articles from Up to for our table/references? There are wonderful articles but not from nursing journals.
You may use peer reviewed research literature from any source for your table. 


QUESTION When formatting our reference table, can we use a font smaller than Times New Roman 11? If so, what is the smallest font size we can use. Also, according to APA style, when formatting a table, there are to be no lines between columns. Do you want us to include lines to divide each column?
The table may be single spaced and the font should be no smaller than 10-font Arial. You may use lines in the table. 3/10/09 


QUESTION: I have been searching for an intervention for depression in the geriatric population for 5 days. I have been unable to find 7 databased articles on a specific intervention in this population. I have used mesh terms and basic PubMed searches with age limits and have come up empty handed. Researching topics is one of my strengths. I am considering using fatigue, but have just written a paper on fatigue and hypersomnolence in an ALS patient. Can I use fatigue with a different diagnosis and intervention?
ANSWER: You may use any of the three symptoms that have been provided with the comp: depression, fatigue or abdominal pain. 


QUESTION: If we decided to use additional resources beyond our 7-10 primary data based articles such as reviews do they need to be included in the table?
You are only required to have 7-10 primary databased articles for your table, but you may use additional sources, like reviews, to document points in your paper. They must be listed in your reference list. 


QUESTION: Hi-I have three questions about comps. First-someone asked previously about depression as a symptom and they were told that this was not narrow enough to use for the comprehensive exam yet it was one of the symptoms given to us. I guess what I am asking is are you saying that the symptom is too broad or that the target group that was mentioned as the subject was? Secondly, is age an appropriate population or does it have to be specific to a cultural group? Finally, in regards to the table since it is not included in the page count, should it not have page numbers or do we just subtract the number of pages of the table from our total number?
In terms of narrowing the topic, please narrow the topic as you have for your assignments throughout the program–and use the guidelines through out the comprehensive exam. You need to narrow the topic to inform your literature search in terms of age and culture. Remember that faculty from your specialty will be reading your comp. Finally you need to paginate your paper throughout. The faculty readers are aware that the page limit pertains to the text of the exam. 


QUESTION: I am trying to narrow my subject, but I want to make sure that I'm not narrowing it down too much. I have chosen abdominal pain. If we choose abdominal pain can we narrow it down to a quadrant within a specific population? Or are we supposed to only narrow it down to a population for that particular symptom? For instance, RUQ pain in women of childbearing age. Is that appropriate or must we do all quadrants? Any info would be greatly appreciated. Thank you in advance.
You need to narrow your topic as you have for other assignments during your master's studies. Remember that the faculty in your specialty area will be reading your comp exam. 


QUESTION: I am wondering how you see the distinction between depression as a symptom and depression as a disorder in term of comps? Most interventions that I have come across in the literature describe interventions for depression but do not specify whether they are for depression as a symptom or a disorder.
You need to look at depression from your clinical specialty, which in many instances is as an accompanying symptom to other disorders. Please see the example given in the comp packet. 


QUESTION: My literature review is a review of different types of interventions used to treat depression in postpartum African American women to determine which is most effective. Would it be appropriate to then focus on just one of these interventions for section IV, perhaps the one that seems to be the "best"?
In your comp packet under section IV page 10 it asks you to present one APN intervention–you need to decide which one based on your review of research. 


QUESTION: On page 9 of the comp under Lit review A. Present theoretical approaches to the topic. I am not sure what you mean is it referring to models?
ANSWER: Theoretical approaches refer to the theory or theories you use to guide your thinking about the symptom and its management that you are researching for this paper. Theories include NP practice (Schuler or Anderson), approaches to patient care; ie. Orem self care theory, health belief model, change theory or levels of prevention. This list is not inclusive but is meant to give some examples. 


QUESTION: Please help to clarify before I get much further on this paper! We pick a topic and narrow it down to age, gender, etc. We research based on this narrowed topic and those articles are the ones that we put in the table. The intervention is for the symptom, but can we use a cause of the symptom, i.e. PID causing abd pain, to house the intervention?
Please read the other responses to the issue of narrowing your topic posted on this answer page. You need to narrow your topic, just as you have for other papers that you have completed in this program. How you narrow your topic will be determned by your specialty area, your topic and what you find in the literature. 


QUESTION: When making our chart for the literature critique we had previously been taught to include in the table, the citation, author, summary, provenance, objectivity, persuasiveness and value. In reading the instructions for the comprehensive exam it doesn't mention provenance or objectivity. Should we include them in our table?
ANSWER: The table for the comps should include the following items: full citation for the article, study sample and selection, study procedure, mesurement tools, results, conclusions, limitations and threats to validity. Your question specifically asks if provenance and objectivity should be included in the table–the answer is no–use the criteria in your comp packet. However, the elements that you were taught are important and can be considered under the discussion and application section of your comp.


When/where/to whom is the comp due?
April 17th, by 4:00pm to Adrienne Thompson, 2-248 Factor Bldg.