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Professionally designed to give realistic questions with correct answers. Most of the questions are in a multiple choice format. These are the same questions that you are most likely to face on the exam. You can rest assured that these questions cover all of the key concepts in the book.
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Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
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International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
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Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
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Stewardship is the act of taking good care of something.
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WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
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According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Test Bank for Critical Care Nursing Diagnosis and Management 9th Edition by Linda D. Urden, Kathleen M. Stacy Complete Chapter 1 - 41 100 % Verified.docx
1. lOMoAR cPSD|12504245
TEST BANK For Critical Care Nursing: Diagnosis and Management,
8th edition & 9th
Edition (Urden), Chapter 1 - 41 | 100 % Verified
Chapter 01: Critical Care Nursing Practice
Urden: Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. During World War II, what type of wards were developed to care for critically injured
patients?
a. Intensive care
b. Triage
c. Shock
d. Postoperative
ANS: C
During World War II, shock wards were established to care for critically injured patients.
Triage wards establish the order in which a patient is seen or treated upon arrival to a hospital.
Postoperative wards were developed in 1900 and later evolved into intensive care units.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 1
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
2. What type of practitioner has a broad depth of specialty knowledge and expertise and manages
complex clinical and system issues?
a. Registered nurses
b. Advanced practice nurses
c. Clinical nurse leaders
d. Intensivists
ANS: B
Advanced practice nurses (APNs) have a broad depth of knowledge and expertise in their
specialty area and manage complex clinical and systems issues. Intensivists are medical
practitioners who manage the critical ill patient. Registered nurses (RNs) are generally direct
care providers. Clinical nurse leaders (CNLs) generally do not manage system issues.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 2
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
3. What type of practitioner is instrumental in ensuring care that is evidence based and that
safety programs are in place?
a. Clinical nurse specialist
b. Advanced practice nurse
3. Clinical nurse specialists (CNSs) serve in specialty roles that use their clinical, teaching,
research, leadership, and consultative abilities. They are instrumental in ensuring that care is
evidence based and that safety programs are in place. Advanced practice nurses (APNs) have
a broad depth of knowledge and expertise in their specialty area and manage complex clinical
and systems issues. Registered nurses are generally direct care providers. Nurse practitioners
(NPs) manage direct clinical care of groups of patients.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 2
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
4. Which professional organization administers critical care certification exams for registered
nurses?
a. State Board of Registered Nurses
b. National Association of Clinical Nurse Specialist
c. Society of Critical Care Medicine
d. American Association of Critical-Care Nurses
ANS: D
American Association of Critical-Care Nurses (AACN) administers certification exams for
registered nurses. The State Board of Registered Nurses (SBON) does not administer
certification exams. National Association of Clinical Nurse Specialists (NACNS) does not
administer certification exams. Society of Critical Care Medicine (SCCM) does not
administer nursing certification exams for registered nurses.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 3
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
5. Emphasis is on human integrity and stresses the theory that the body, mind, and spirit are
interdependent and inseparable. This statement describes which methodology of care?
a. Holistic care
b. Individualized care
c. Cultural care
d. Interdisciplinary care
ANS: A
Holistic care focuses on human integrity and stresses that the body, mind, and spirit are
interdependent and inseparable. Individualized care recognizes the uniqueness of each
patient’s preferences, condition, and physiologic and psychosocial status. Cultural diversity in
health care is not a new topic, but it is gaining emphasis and importance as the world becomes
more accessible to all as the result of increasing technologies and interfaces with places and
peoples. Interdisciplinary care is care among a variety of health care professionals with the
patient’s health as the common goal.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 4
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
6. The American Association of Critical-Care Nurses (AACN) has developed short directives
that can be used as quick references for clinical use that are known as
4. a. Critical Care Protocol.
b. Practice Policies.
c. Evidence-Based Research.
d. Practice Alerts.
ANS: D
The American Association of Critical-Care Nurses (AACN) has promulgated several
evidence-based practice summaries in the form of “Practice Alerts.” Evidence-based nursing
practice considers the best research evidence on the care topic along with clinical expertise of
the nurse and patient preferences. Critical care protocol and practice policies are established
by individual institutions.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 3
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
7. What type of therapy is an option to conventional treatment?
a. Alternative
b. Holistic
c. Complementary
d. Individualized
ANS: A
The term alternative denotes that a specific therapy is an option or alternative to what is
considered conventional treatment of a condition or state. The term complementary was
proposed to describe therapies that can be used to complement or support conventional
treatments. Holistic care focuses on human integrity and stresses that the body, mind, and
spirit are interdependent and inseparable. Individualized care recognizes the uniqueness of
each patient’s preferences, condition, and physiologic and psychosocial status.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 4
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
8. Prayer, guided imagery, and massage are all examples of what type of treatment?
a. Alternative therapy
b. Holistic care
c. Complementary care
d. Individualized care
ANS: C
The term complementary was proposed to describe therapies that can be used to complement
or support conventional treatments. Spirituality, prayer, guided imagery, massage, and
animal-assisted therapy are all examples of complementary care. The term alternative denotes
that a specific therapy is an option or alternative to what is considered conventional treatment
of a condition or state. Holistic care focuses on human integrity and stresses that the body,
mind, and spirit are interdependent and inseparable. Individualized care recognizes the
uniqueness of each patient’s preferences, condition, and physiologic and psychosocial status.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 4
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
5. 9. What is the systematic decision-making model used by nurses termed?
a. Nursing diagnosis
b. Nursing interventions
c. Nursing evaluations
d. Nursing process
ANS: D
The nursing process is a systematic decision-making model that is cyclic, not linear. An
essential and distinguishing feature of any nursing diagnosis is that it describes a health
condition. Nursing interventions constitute the treatment approach to an identified health
alteration. Evaluation of attainment of the expected patient outcomes occurs formally at
intervals designated in the outcome criteria.
PTS: 1 DIF: Cognitive Level: Understanding REF: n/a
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
10. What is a health condition primarily resolved by nursing interventions or therapies called?
a. Nursing diagnosis
b. Nursing interventions
c. Nursing outcomes
d. Nursing process
ANS: A
An essential and distinguishing feature of any nursing diagnosis is that it describes a health
condition. Nursing interventions constitute the treatment approach to an identified health
alteration. Evaluation of attainment of the expected patient outcomes occurs formally at
intervals designated in the outcome criteria. The nursing process is a systematic
decision-making model that is cyclic, not linear.
PTS: 1 DIF: Cognitive Level: Remembering REF: n/a
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
11. Designing therapeutic activities that move a patient from one state of health to another is an
example of which of the following?
a. Nursing diagnosis
b. Nursing interventions
c. Nursing outcomes
d. Nursing process
ANS: B
Nursing interventions constitute the treatment approach to an identified health alteration. An
essential and distinguishing feature of any nursing diagnosis is that it describes a health
condition. Evaluation of attainment of the expected patient outcomes occurs formally at
intervals designated in the outcome criteria. The nursing process is a systematic
decision-making model that is cyclic, not linear.
PTS: 1 DIF: Cognitive Level: Remembering REF: n/a
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
6. 12. A patient was admitted to a rural critical care unit in Montana. Critical care nurses are
assisting with monitoring and care of the patient from the closest major city. What is this type
of practice termed?
a. Tele-nursing
b. Tele-ICU
c. Tele-informatics
d. Tele-hospital
ANS: B
Tele-ICU is a form of telemedicine. Telemedicine was initially used in outpatient areas,
remote rural geographic locations, and areas where there was a dearth of medical providers.
Currently, there are tele-ICUs in areas where there are limited resources onsite. However,
experts (critical care nurses, intensivists) are located in a central distant site.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 5
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
13. Which core competency for interprofessional practice can be described as working with
individuals of other professions to maintain a climate of mutual respect and shared values?
a. Interprofessional teamwork and team-based care
b. Values and ethics for interprofessional practice
c. Interprofessional communication
d. Roles and responsibilities for collaborative practice
ANS: B
Values and ethics for interprofessional practice mean working with individuals of other
professions to maintain a climate of mutual respect and shared values. Roles and
responsibilities for collaborative practice include using knowledge of one’s own role and the
roles of other professions to appropriately assess and address the health care needs of the
patients and populations served. Interprofessional communication includes communicating
with patients, families, communities, and other health professionals in a responsive and
responsible manner that supports a team approach to maintaining health and treatment of
disease. Interprofessional teamwork and team-based care means applying
relationship-building values and principles of team dynamics to perform effectively in
different team roles to plan and deliver patient population-centered care that is safe, timely,
efficient, effective, and equitable.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 5|Box 1-5
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
14. What is the stepwise decision-making flowchart for a specific care process named?
a. Algorithm
b. Practice guideline
c. Protocol
d. Order set
ANS: A
7. An algorithm is a stepwise decision-making flowchart for a specific care process or processes.
A practice guideline is usually created by an expert panel and developed by a professional
organization. Protocols are more directive and rigid than guidelines, and providers are not
supposed to vary from a protocol. An order set consists of preprinted provider orders that are
used to expedite the order process after a standard has been validated through analytic review
of practice and research.
PTS: 1 DIF: Cognitive Level: Understanding REF: p. 6
OBJ: Nursing Process Step: Intervention TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
15. Which nursing intervention continues to be one of the most error-prone for critical care
nurses?
a. Inappropriate care
b. Intimidating and disruptive clinician behavior
c. Injury to patients by falls
d. Medication administration
ANS: D
Medication administration continues to be one of the most error-prone nursing interventions
for critical care nurses. Intimidating and disruptive clinician behaviors can lead to errors and
preventable adverse patient outcomes. Patient safety has been described as an ethical
imperative and one that is inherent in health care professionals’ actions and interpersonal
processes; examples include inappropriate care and injury to patients by falls.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 7
OBJ: Nursing Process Step: Assessment TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
16. A practitioner and nurse are performing a dressing change on an unresponsive patient in room
14. The practitioner asks the nurse for an update on the patient in room 13. Which action
should the nurse take next?
a. Give the update to the practitioner.
b. Refuse to give the update because of Health Insurance Portability and
Accountability Act (HIPAA) requirements.
c. Give the update because the is patient’s unconscious.
d. Refuse to give the update because of Occupational Safety and Health
Administration (OSHA) requirements.
ANS: B
Most specific to critical care clinicians is the privacy and confidentiality related to protection
of health care data. This has implications when interacting with family members and others
and the often very close work environments, tight working spaces, and emergency situations.
A patient’s unconscious state is not a reason for another patient’s care to be discussed in his or
her presence. Research shows hearing is the last sense to deteriorate. Occupational Safety and
Health Administration (OSHA) has to do with safety in the workplace, not privacy and
confidentiality.
PTS: 1 DIF: Cognitive Level: Applying REF: p. 8
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
8. MULTIPLE RESPONSE
1. What considerations are taken into account in evidence-based nursing practice? (Select all that
apply.)
a. Clinical expertise of the nurse
b. Availability of staff and facility equipment
c. Research evidence on the topic
d. Patient knowledge of the disease
e. Patient preference regarding care
ANS: A, C, E
Evidence-based nursing practice considers the best research evidence on the care topic along
with clinical expertise of the nurse and patient preferences. For instance, when determining
the frequency of vital sign measurement, the nurse would use available research and nursing
judgment (stability, complexity, predictability, vulnerability, and resilience of the patient).
Availability of staff and facility equipment and the patient’s knowledge of the disease do not
factor into evidence-based nursing practices.
PTS: 1 DIF: Cognitive Level: Remembering REF: p. 3
OBJ: Nursing Process Step: Assessment TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
2. The concept of diversity encompasses what thoughts and actions? (Select all that apply.)
a. Sensitivity to ethnic differences
b. Openness to different lifestyles
c. Openness to different values
d. Reticence to different beliefs
e. Lack of concern regarding different opinions
ANS: A, B, C
Diversity includes not only ethnic sensitivity but also sensitivity to openness to difference
lifestyles, opinions, values, and beliefs. Reticence and lack of concern are not part of the
concept of diversity.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 4
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
3. According to American Association of Critical-Care Nurses, what are the responsibilities of a
critical care nurse? (Select all that apply.)
a. Respecting the values, beliefs, and rights of the patient
b. Intervening when the best interest of the patient is in question
c. Helping the patient obtain necessary care
d. Making decisions for the patient and patient’s family
e. Monitoring and safeguarding the quality of care the patient receives
f. Acting as a gatekeeper for the patient, the patient’s family, and other health care
professionals
ANS: A, B, C, E
9. American Association of Critical-Care Nurses (AACN) critical care nurse role responsibilities
include respecting the values, beliefs, and rights of the patient; intervening when the best
interest of the patient is in question; helping the patient obtain necessary care; and monitoring
and safeguarding the quality of care the patient receives. The nurse is not to make decisions
for the patient or the patient’s family but should support their decisions. The nurse should act
as a liaison, not a gatekeeper, for the patient and the patient’s family and other health care
professionals.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 2|Box 1-1
OBJ: Nursing Process Step: N/A TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
4. According to Kupperschmidt, what factors are needed to become a skilled communicator?
(Select all that apply.)
a. Becoming candid
b. Becoming reflective
c. Setting goals
d. Surveying the team
e. Becoming aware of self-deception
ANS: A, B, E
Kupperschmidt and colleagues posed a five-factor model for becoming a skilled
communicator: becoming aware of self-deception, becoming authentic, becoming candid,
becoming mindful, and becoming reflective, all of which lead to being a skilled
communicator. The HWE model was offered by Blake, who suggested five steps: rallying the
team, surveying the team, establishing work groups, setting goals and developing action steps,
and celebrating successes along the way.
PTS: 1 DIF: Cognitive Level: Evaluating REF: p. 9
OBJ: Nursing Process Step: General TOP: Critical Care Nursing Practice
MSC: NCLEX: Safe and Effective Care Environment
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