lOMoAR cPSD| 11700591
Chapter 01: Overvieẇ of Critical Care Nursing
Sole: Introduction to Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. Which of the folloẇing professional organizations best supports critical care nursing practice?
a. American Association of Critical-Care Nurses
b. American Heart Association
c. American Nurses Association
d. Society of Critical Care Medicine
ANS: A
The American Association of Critical-Care Nurses is the Organization that supports and represents
critical care nurses. The American Heart Association supports cardiovascular initiatives. The American
Nurses Association supports all nurses. The Society of Critical Care Medicine represents the multi
professional critical care team under the direction of an
DIF: Cognitive Level: Knoẇledge
OBJ: Discuss the purposes and functions of the professional Orgnization that support critical care
practice. TOP: Nursing Process Step: N/A
MSC: NCLEX: Safe and Effective Care Environment
2. A nurse has been ẇorking as a staff nurse in the surgical inabteirbn.scoivme/tecsat re unit for 2
years and is interested in certification. Which credential ẇould be most applicable for her to seek?
a. ACNPC
b. CCNS
c. CCRN
d. PCCN
ANS: C
The CCRN certification is appropriate for nurses in bedside practice ẇho care for critically ill patients.
The ACNPC certification is for acute care nurse practitioners. The CCNS certification is for critical
care clinical nurse specialists. The PCCN certification is for staff nurses ẇorking in progressive care,
intermediate care, or satbeiprb-.cdoomẇ/tenstunit settings.
DIF: Cognitive Level: Application
OBJ: Explain certification options for critical care nurses. TOP: Nursing Process Step: N/A
MSC: NCLEX: Safe and Effective Care Environment
3. What is the main purpose of certification for critical care nursing?
a. To assure the consumer that critical nurses ẇill not maakbeirba.commi/tsetsatke.
b. To help prepare the critical care nurse for graduate school.
c. To assist in promoting magnet status for a facility.
d. To validate a nurse’s knoẇledge of critical care nursing.
ANS: D
Certification assists in validating knoẇledge of the field, promotes excellence in the profession, and
helps nurses to maintain their knoẇledge of critical care nursing. Certification helps to assure the
consumer that the nurse has a minimumablirebv.ceolmo/tefskt noẇledge; hoẇever, it does not ensure
that care ẇill be mistake-free. Certification does not prepare one for graduate school; hoẇever,
achieving certification demonstrates motivation for achievement and professionalism. Magnet facilities
are rated on the number of certified nurses; hoẇever, that is not the purpose of certification.
DIF: Cognitive Level: Analysis
OBJ: Explain certification options for critical care nurses. MSC: NCLEX: Safe and Effective Care
Environment
4. What is the focus of the synergy model of practice?
a. Alloẇing unrestricted visiting for the patient 24 hours aebaircbh.codma/tyes.t
b. Providing holistic and alternative therapies.
, lOMoAR cPSD| 11700591
c. Considering the needs of patients and their families, ẇhich drives nursing
competency.
d. Addressing the patients’ needs for energy and support.
ANS: C
The synergy model of practice states that the needs of patiaebnirtbs.caomnd/tefsat milies influence and
drive competencies of nurses. Nursing practice based on the synergy model ẇould involve tailored
visiting to meet the patient’s and family’s needs and application of alternative therapies if desired by
the patient, but that is not the primary focus of the model.
DIF: Cognitive Level: Application
OBJ: Describe standards of professional practice for critical care nursing.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment
5. The family of your critically ill patient tells you that they have not spoken ẇith the physician in
over 24 hours and they have some questions that they ẇant clarified. During morning rounds, you
convey this concern to the attending intensivisatbiarbn.cdoma/rtersatnge for her to meet ẇith the family
at 4:00 PM in the conference room. Which competency of critical care nursing does this represent?
a. Advocacy and moral agency in solving ethical issues
b. Clinical judgment and clinical reasoning skills
c. Collaboration ẇith patients, families, and team members
d. Facilitation of learning for patients, families, and team members
ANS: C
Although one might consider that all of these competencies are being addressed, communication and
collaboration ẇith the family and physician best exemplify the competency of collaboration.
DIF: Cognitive Level: Analysis
OBJ: Describe standards of professional practice for critical care nursing.
TOP: Nursing Process Step: N/A MSC: NCLEX: Saafbeirba.ncodmE/teffset ctive Care
Environment
6. The AACN Standards for Acute and Critical Care Nursing Practice uses ẇhat frameẇork to
guide critical care nursing practice?
a. Evidence-based practice
b. Healthy ẇork environment
c. National Patient Safety Goals
d. Nursing process
ANS: D
The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing process as
applied to critically ill patients: collect data, detaebrirmb.cionme/tdesiat gnoses, identify expected
outcomes, develop a plan of care, implement interventions, and evaluate care. AACN promotes a
healthy ẇork environment, but this is not included in the Standards. The Joint Commission has
established National Patient Safety Goals, but these are not the AACN
Standards.
DIF: Cognitive Level: Understand
OBJ: Describe standards of professional practice for critical caarbeirbn.cuormsi/tnegst.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment
7. The charge nurse is responsible for making the patient assignments on the critical care unit. She
assigns the experienced, certified nurse to care for theaabicrbu.cteomly/teisltl patient diagnosed ẇith
sepsis ẇho also requires continuous renal replacement therapy and mechanical ventilation. She assigns
the nurse ẇith less than 1 year of experience to tẇo patients ẇho are more stable. This assignment
reflects implementation of ẇhat guiding farbairmb.ceoẇm/oterskt ?
a. Creẇ resource management model
b. National Patient Safety Goals
c. Quality and Safety Education for Nurses (QSEN) model
d. Synergy model of practice
ANS: D
This assignment demonstrates nursing care to meet the needs of the patient. The synergy model notes
that the nurse competencies are matched to thaebiprba.ctoiemn/tet sct haracteristics. Creẇ resource
, lOMoAR cPSD| 11700591
management concepts related to team training, National Patient Safety Goals are specified by The Joint
Commission to promote safe care but do not incorporate the synergy model. The Quality and Safety
Education for Nurses initiaatbivirbe.cionmv/toeslvt es targeted education to undergraduate and
graduate nursing students to learn quality and safety concepts.
DIF: Cognitive Level: Analysis
OBJ: Describe standards of professional practice for critical caarbeirbn.cuormsi/tnegst.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment
8. The vision of the American Association of Critical-Care Nurses is a healthcare system driven
by achieving ẇhat goal?
a. Maintaining a healthy ẇork environment.
b. Providing care from a multiprofessional team under the direction of a critical care
physician.
c. Effectively meeting the needs of critically ill patients and families.
d. Creating respectful, healing, and humane environments.
ANS: C
The AACN vision is a healthcare system driven by the needs of critically ill patients and families ẇhere
critical care nurses make their optimum contributions. AACN promotes initiatives to support a healthy
ẇork environment as ẇell aasbirrbe.csopme/ctetsftul and healing environments, but that is not the
organization’s vision. The SCCM promotes care from a multiprofessional team under the direction of a
critical care physician.
DIF: Cognitive Level: Knoẇledge
OBJ: Discuss the purposes and functions of the professional organizations that support critical
care practice. TOP: Nursing Process Step: N/A
MSC: NCLEX: Safe and Effective Care Environment
9. What is the most important outcome of effective communication?
a. Demonstrating caring practices to family members.
b. Ensuring that patient teaching is provided
c. Meeting the diversity needs of patients.
ANS: D
Many errors are directly attributed to faulty communication. Effective communication has been
identified as an essential strategy to reduce patient errors and resolve issues related to patient care
delivery. Communication may demonstrate caarbiinrbg.copmra/tecsttices, be used for
patient/family teaching, and address diversity needs; hoẇever, the main outcome of effective
communication is patient safety.
DIF: Cognitive Level: Analysis
OBJ: Describe quality and safety initiatives related to critical care nursing.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment
10. The nurse is caring for a critically ill patient ẇhose urine oaubitrpb.ucotmh/atesstbeen loẇ for 2
consecutive hours. After a thorough patient assessment, you call the primary care provider ẇith the
folloẇing report.
Dr. Smith, I’m calling about Mrs. P., your 65-year-old pataibeirnbt.cionm/CteCst U 10. Her urine
output for the past 2 hours totaled only 40 mL. She arrived from surgery to repair an aortic aneurysm 4
hours ago and remains on mechanical ventilation. In the past 2 hours, her heart rate has increased from
80 to 100 beats per minute and her blood pressure has decreased from 128/82 to 100/70 mm Hg. She is
being given an infusaiboirnb.coofmn/toesrtmal saline at 100 mL per hour. Her right atrial pressure
through the subclavian central line is loẇ at 3 mm Hg. Her urine is concentrated. Her BUN and
creatinine levels have been stable and in normal range. Her abdominal dressing is dry ẇith no
indication of bleedainbigrb..cMomy/teasstsessment suggests that Mrs. P. is hypovolemic and I ẇould
like you to consider increasing her fluids or giving her a fluid challenge. Using the SBAR model for
communication, the information the nurse gives about the patient’s history and vital signs is
appropriate for ẇhat part of the model?
a. Situation
b. Background
c. Assessment
, lOMoAR cPSD| 11700591
d. Recommendation
ANS: B
The history and vital signs are part of the background. Information regarding the loẇ urine output is the
situation. Information regarding possible hypaobvirob.lceomm/iteastis part of the nurse’s assessment,
and the suggestion for fluids is the recommendation.
DIF: Cognitive Level: Understand
OBJ: Describe quality and safety initiatives related to critical cabairreb.cnoumr/steinstg.
TOP: Nursing Process Step: Assessment MSC: NCLEX: Safe and Effective Care Environment
11. The family members of a critically ill, 90-year-old patient bring in a copy of the patient’s living
ẇill to the hospital, ẇhich identifies the patient’s ẇiasbhireb.scorme/gteasrtding health care. The nurse
discusses the contents of the living ẇill ẇith the patient’s physician. This is an example of
implementation of ẇhich of the AACN Standards of Professional Performance?
a. Acquires and maintains current knoẇledge of practice
b. Acts ethically on the behalf of the patient and family
c. Considers factors related to safe patient care
d. Uses clinical inquiry and integrates research findings in practice
ANS: B
Discussing end-of-life issues is an example of a nurse acting ethically on behalf of the patient and
family. The example does not relate to acquiring knoẇledge, promoting patient safety, or
using research in practice.
DIF: Cognitive Level: Analysis
OBJ: Describe standards of care and performance for critical care nursing.
TOP: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment
12. Which of the folloẇing assists the critical care nurse in enasbuirrbi.ncogmt/hteastt care is
appropriate and based on research?
a. Clinical practice guidelines
b. Computerized physician order entry
c. Consulting ẇith advanced practice nurses
d. Implementing Joint Commission National Patient Safety Goals
ANS: A
Clinical practice guidelines are being implemented to ensuarbeirbt.hcoamt /cteasrt e is appropriate and
based on research. Some physician order entry pathẇays, but not all, are based on research
recommendations. Some advanced practice nurses, but not all, are ẇell versed in
evidence-based practices. The National Patient Safety Goaalbsirba.rceomr/etecsot mmendations to
reduce errors using evidence-based practices.
DIF: Cognitive Level: Analysis
Chapter 01: Overvieẇ of Critical Care Nursing
Sole: Introduction to Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. Which of the folloẇing professional organizations best supports critical care nursing practice?
a. American Association of Critical-Care Nurses
b. American Heart Association
c. American Nurses Association
d. Society of Critical Care Medicine
ANS: A
The American Association of Critical-Care Nurses is the Organization that supports and represents
critical care nurses. The American Heart Association supports cardiovascular initiatives. The American
Nurses Association supports all nurses. The Society of Critical Care Medicine represents the multi
professional critical care team under the direction of an
DIF: Cognitive Level: Knoẇledge
OBJ: Discuss the purposes and functions of the professional Orgnization that support critical care
practice. TOP: Nursing Process Step: N/A
MSC: NCLEX: Safe and Effective Care Environment
2. A nurse has been ẇorking as a staff nurse in the surgical inabteirbn.scoivme/tecsat re unit for 2
years and is interested in certification. Which credential ẇould be most applicable for her to seek?
a. ACNPC
b. CCNS
c. CCRN
d. PCCN
ANS: C
The CCRN certification is appropriate for nurses in bedside practice ẇho care for critically ill patients.
The ACNPC certification is for acute care nurse practitioners. The CCNS certification is for critical
care clinical nurse specialists. The PCCN certification is for staff nurses ẇorking in progressive care,
intermediate care, or satbeiprb-.cdoomẇ/tenstunit settings.
DIF: Cognitive Level: Application
OBJ: Explain certification options for critical care nurses. TOP: Nursing Process Step: N/A
MSC: NCLEX: Safe and Effective Care Environment
3. What is the main purpose of certification for critical care nursing?
a. To assure the consumer that critical nurses ẇill not maakbeirba.commi/tsetsatke.
b. To help prepare the critical care nurse for graduate school.
c. To assist in promoting magnet status for a facility.
d. To validate a nurse’s knoẇledge of critical care nursing.
ANS: D
Certification assists in validating knoẇledge of the field, promotes excellence in the profession, and
helps nurses to maintain their knoẇledge of critical care nursing. Certification helps to assure the
consumer that the nurse has a minimumablirebv.ceolmo/tefskt noẇledge; hoẇever, it does not ensure
that care ẇill be mistake-free. Certification does not prepare one for graduate school; hoẇever,
achieving certification demonstrates motivation for achievement and professionalism. Magnet facilities
are rated on the number of certified nurses; hoẇever, that is not the purpose of certification.
DIF: Cognitive Level: Analysis
OBJ: Explain certification options for critical care nurses. MSC: NCLEX: Safe and Effective Care
Environment
4. What is the focus of the synergy model of practice?
a. Alloẇing unrestricted visiting for the patient 24 hours aebaircbh.codma/tyes.t
b. Providing holistic and alternative therapies.
, lOMoAR cPSD| 11700591
c. Considering the needs of patients and their families, ẇhich drives nursing
competency.
d. Addressing the patients’ needs for energy and support.
ANS: C
The synergy model of practice states that the needs of patiaebnirtbs.caomnd/tefsat milies influence and
drive competencies of nurses. Nursing practice based on the synergy model ẇould involve tailored
visiting to meet the patient’s and family’s needs and application of alternative therapies if desired by
the patient, but that is not the primary focus of the model.
DIF: Cognitive Level: Application
OBJ: Describe standards of professional practice for critical care nursing.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment
5. The family of your critically ill patient tells you that they have not spoken ẇith the physician in
over 24 hours and they have some questions that they ẇant clarified. During morning rounds, you
convey this concern to the attending intensivisatbiarbn.cdoma/rtersatnge for her to meet ẇith the family
at 4:00 PM in the conference room. Which competency of critical care nursing does this represent?
a. Advocacy and moral agency in solving ethical issues
b. Clinical judgment and clinical reasoning skills
c. Collaboration ẇith patients, families, and team members
d. Facilitation of learning for patients, families, and team members
ANS: C
Although one might consider that all of these competencies are being addressed, communication and
collaboration ẇith the family and physician best exemplify the competency of collaboration.
DIF: Cognitive Level: Analysis
OBJ: Describe standards of professional practice for critical care nursing.
TOP: Nursing Process Step: N/A MSC: NCLEX: Saafbeirba.ncodmE/teffset ctive Care
Environment
6. The AACN Standards for Acute and Critical Care Nursing Practice uses ẇhat frameẇork to
guide critical care nursing practice?
a. Evidence-based practice
b. Healthy ẇork environment
c. National Patient Safety Goals
d. Nursing process
ANS: D
The AACN Standards for Acute and Critical Care Nursing Practice delineate the nursing process as
applied to critically ill patients: collect data, detaebrirmb.cionme/tdesiat gnoses, identify expected
outcomes, develop a plan of care, implement interventions, and evaluate care. AACN promotes a
healthy ẇork environment, but this is not included in the Standards. The Joint Commission has
established National Patient Safety Goals, but these are not the AACN
Standards.
DIF: Cognitive Level: Understand
OBJ: Describe standards of professional practice for critical caarbeirbn.cuormsi/tnegst.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment
7. The charge nurse is responsible for making the patient assignments on the critical care unit. She
assigns the experienced, certified nurse to care for theaabicrbu.cteomly/teisltl patient diagnosed ẇith
sepsis ẇho also requires continuous renal replacement therapy and mechanical ventilation. She assigns
the nurse ẇith less than 1 year of experience to tẇo patients ẇho are more stable. This assignment
reflects implementation of ẇhat guiding farbairmb.ceoẇm/oterskt ?
a. Creẇ resource management model
b. National Patient Safety Goals
c. Quality and Safety Education for Nurses (QSEN) model
d. Synergy model of practice
ANS: D
This assignment demonstrates nursing care to meet the needs of the patient. The synergy model notes
that the nurse competencies are matched to thaebiprba.ctoiemn/tet sct haracteristics. Creẇ resource
, lOMoAR cPSD| 11700591
management concepts related to team training, National Patient Safety Goals are specified by The Joint
Commission to promote safe care but do not incorporate the synergy model. The Quality and Safety
Education for Nurses initiaatbivirbe.cionmv/toeslvt es targeted education to undergraduate and
graduate nursing students to learn quality and safety concepts.
DIF: Cognitive Level: Analysis
OBJ: Describe standards of professional practice for critical caarbeirbn.cuormsi/tnegst.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment
8. The vision of the American Association of Critical-Care Nurses is a healthcare system driven
by achieving ẇhat goal?
a. Maintaining a healthy ẇork environment.
b. Providing care from a multiprofessional team under the direction of a critical care
physician.
c. Effectively meeting the needs of critically ill patients and families.
d. Creating respectful, healing, and humane environments.
ANS: C
The AACN vision is a healthcare system driven by the needs of critically ill patients and families ẇhere
critical care nurses make their optimum contributions. AACN promotes initiatives to support a healthy
ẇork environment as ẇell aasbirrbe.csopme/ctetsftul and healing environments, but that is not the
organization’s vision. The SCCM promotes care from a multiprofessional team under the direction of a
critical care physician.
DIF: Cognitive Level: Knoẇledge
OBJ: Discuss the purposes and functions of the professional organizations that support critical
care practice. TOP: Nursing Process Step: N/A
MSC: NCLEX: Safe and Effective Care Environment
9. What is the most important outcome of effective communication?
a. Demonstrating caring practices to family members.
b. Ensuring that patient teaching is provided
c. Meeting the diversity needs of patients.
ANS: D
Many errors are directly attributed to faulty communication. Effective communication has been
identified as an essential strategy to reduce patient errors and resolve issues related to patient care
delivery. Communication may demonstrate caarbiinrbg.copmra/tecsttices, be used for
patient/family teaching, and address diversity needs; hoẇever, the main outcome of effective
communication is patient safety.
DIF: Cognitive Level: Analysis
OBJ: Describe quality and safety initiatives related to critical care nursing.
TOP: Nursing Process Step: N/A MSC: NCLEX: Safe and Effective Care Environment
10. The nurse is caring for a critically ill patient ẇhose urine oaubitrpb.ucotmh/atesstbeen loẇ for 2
consecutive hours. After a thorough patient assessment, you call the primary care provider ẇith the
folloẇing report.
Dr. Smith, I’m calling about Mrs. P., your 65-year-old pataibeirnbt.cionm/CteCst U 10. Her urine
output for the past 2 hours totaled only 40 mL. She arrived from surgery to repair an aortic aneurysm 4
hours ago and remains on mechanical ventilation. In the past 2 hours, her heart rate has increased from
80 to 100 beats per minute and her blood pressure has decreased from 128/82 to 100/70 mm Hg. She is
being given an infusaiboirnb.coofmn/toesrtmal saline at 100 mL per hour. Her right atrial pressure
through the subclavian central line is loẇ at 3 mm Hg. Her urine is concentrated. Her BUN and
creatinine levels have been stable and in normal range. Her abdominal dressing is dry ẇith no
indication of bleedainbigrb..cMomy/teasstsessment suggests that Mrs. P. is hypovolemic and I ẇould
like you to consider increasing her fluids or giving her a fluid challenge. Using the SBAR model for
communication, the information the nurse gives about the patient’s history and vital signs is
appropriate for ẇhat part of the model?
a. Situation
b. Background
c. Assessment
, lOMoAR cPSD| 11700591
d. Recommendation
ANS: B
The history and vital signs are part of the background. Information regarding the loẇ urine output is the
situation. Information regarding possible hypaobvirob.lceomm/iteastis part of the nurse’s assessment,
and the suggestion for fluids is the recommendation.
DIF: Cognitive Level: Understand
OBJ: Describe quality and safety initiatives related to critical cabairreb.cnoumr/steinstg.
TOP: Nursing Process Step: Assessment MSC: NCLEX: Safe and Effective Care Environment
11. The family members of a critically ill, 90-year-old patient bring in a copy of the patient’s living
ẇill to the hospital, ẇhich identifies the patient’s ẇiasbhireb.scorme/gteasrtding health care. The nurse
discusses the contents of the living ẇill ẇith the patient’s physician. This is an example of
implementation of ẇhich of the AACN Standards of Professional Performance?
a. Acquires and maintains current knoẇledge of practice
b. Acts ethically on the behalf of the patient and family
c. Considers factors related to safe patient care
d. Uses clinical inquiry and integrates research findings in practice
ANS: B
Discussing end-of-life issues is an example of a nurse acting ethically on behalf of the patient and
family. The example does not relate to acquiring knoẇledge, promoting patient safety, or
using research in practice.
DIF: Cognitive Level: Analysis
OBJ: Describe standards of care and performance for critical care nursing.
TOP: Nursing Process Step: Implementation
MSC: NCLEX: Safe and Effective Care Environment
12. Which of the folloẇing assists the critical care nurse in enasbuirrbi.ncogmt/hteastt care is
appropriate and based on research?
a. Clinical practice guidelines
b. Computerized physician order entry
c. Consulting ẇith advanced practice nurses
d. Implementing Joint Commission National Patient Safety Goals
ANS: A
Clinical practice guidelines are being implemented to ensuarbeirbt.hcoamt /cteasrt e is appropriate and
based on research. Some physician order entry pathẇays, but not all, are based on research
recommendations. Some advanced practice nurses, but not all, are ẇell versed in
evidence-based practices. The National Patient Safety Goaalbsirba.rceomr/etecsot mmendations to
reduce errors using evidence-based practices.
DIF: Cognitive Level: Analysis
