Research Design, Biostatistics, and Literature Evaluation

An epidemiologic study seeks to determine the

impact of adverse drug events in the intensive care

unit (ICU) on patient outcomes, which have an esti-

mated incidence of 52%. Which would be the best

approach to conducting this study?

tinuous variables to determine the difference in

outcomes.

for proportions to determine the difference in

outcomes.

analysis to determine the difference between

cohorts.

proportions to determine the difference in

outcomes.

A case-control study is conducted to deter-

mine whether proton pump inhibitor (PPI) use is

associated with an increased risk of developing

Clostridioides difficile infection (CDI). The final

analysis shows the odds ratio (OR) for CDI with PPI

exposure to be 1.3 (95% confidence interval [CI],

0.8–1.5). Which best describes the results?

130%.

risk of CDI.

A systematic review evaluated the effect of albu-

min for fluid resuscitation. A meta-analysis that

evaluated the effect of albumin use compared

with normal saline on 28-day mortality reported a

combined OR of 0.45 (95% CI, 0.3–0.75) for the

treatment of hypovolemic shock caused by trauma.

For the treatment of septic shock, albumin com-

pared with normal saline resulted in a combined OR

of 1.1 (95% CI, 0.98–1.21) when evaluating 28-day

mortality. Which best represents the findings of the

review?

did not affect survival in the treatment of

septic shock.

did not affect survival in the treatment of

septic shock.

ment of hypovolemic shock caused by trauma

but improved survival in the treatment of

septic shock.

of hypovolemic shock caused by trauma or

septic shock.

A critical care pharmacist is faced with an acute

drug shortage in which no furosemide is available

for immediate use in patient care. During patient

care rounds in the ICU, the decision is made to

implement a fluid-conservative strategy for a patient

with acute respiratory distress syndrome (ARDS).

The critical care pharmacist procures an allotment

of bumetanide. Which statement best describes the

course of action for this patient?

medical literature and experiential knowledge

to develop a titration scheme using bumetanide

to achieve a central venous pressure of less than

4 mm Hg.

research trial design and experiential knowl-

edge to develop a titration scheme using

bumetanide to achieve a central venous pres-

sure of less than 4 mm Hg.

vince the nephrologist to treat this patient with

hemodialysis to achieve a goal central venous

pressure of less than 4 mm Hg.

research ethics to obtain informed consent

from the patient’s surrogate for treatment with

bumetanide.